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Richard A. Sheff, MD, CMSL, is chairman and executive director with The Greeley Company, a division of HCPro, Inc., in Marblehead, MA. He brings more than 25 years of healthcare management and leadership experience to his work with physicians, hospitals, and healthcare systems across the country. With his distinctive combination of medical, healthcare, and management acumen, he develops tailored solutions to the unique needs of physicians and hospitals. He consults, authors, and presents on a wide range of healthcare management and leadership issues, including governance, physician-hospital alignment, medical staff leadership development, ED call, peer review, hospital performance improvement, disruptive physician management, conflict resolution, physician employment and contracting, health care systems, service line management, hospitalist program optimization, patient safety and error reduction, credentialing, strategic planning, regulatory compliance, and helping physicians rediscover the joy of medicine.

Managing ED call during maternity and paternity leave

A hospital I recently visited has been struggling over ED call, an experience many hospitals share. A gastroenterologist had gone out early for maternity leave due to pregnancy complications, triggering a debate over whether the remaining gastroenterologists would pick up her previously scheduled call slots or simply leave them uncovered.  One of the remaining gastroenterologists had made arrangements before her maternity leave several years previously to do extra call to “pay back” her colleagues for the call she would not take during her maternity leave. This gastroenterologist happened to be responsible for making up the call schedule and had assumed that the physician who is currently on maternity leave would do the same. However, no one discussed this with her. In fact, she had no intention of paying back any call missed during her maternity leave, and the medical staff had not adopted a policy on the matter. The result:  conflict, incriminations, and the risk of uncovered call slots.

Read the rest of this article at hcpro.com.

CMS issues first clarification of accountable care organizations

Last week, CMS offered the first glimpse into what accountable care organizations (ACOs) will look like in the form of a document with preliminary questions and answers about ACOs. Though much still remains to be worked out, CMS is now telling us that ACOs will be required to assume responsibility for a minimum of 5,000 Medicare beneficiaries and will receive financial rewards for improving quality and reducing costs for those beneficiaries.

The biggest new information in the CMS document is that ACOs will not be allowed to restrict the access of Medicare beneficiaries to physicians, hospitals, or any other providers. In other words, ACOs will not be allowed to utilize gate keeper or restricted network strategies. The most likely reason CMS has made this determination is that a scared and angry citizenry is already afraid that healthcare reform will limit their access to providers and benefits, so CMS is going on public record saying that ACOs, a major element in the recently passed healthcare reform bill, will not be able to do so.