As you re-examine your physician alignment strategy, one viable option may be a co-management arrangement – an organized and formal mechanism to actively engage a group of physicians to achieve greater operational efficiencies and improved patient care outcomes. These arrangements, also called clinical co-management and medical co-management agreements, typically focus on one clinical service line, such as women’s care, orthopedic/rehabilitative surgery, or cardiac services.

Our multi-disciplinary team of experts, including service line and physician leaders, have helped hospitals establish medical co-management structures with physicians and affiliated physician groups for a variety of service lines. With our deep experience in physician-hospital relationships and operational and clinical expertise, we understand what works, what doesn’t, and why. We are also experienced in implementing co-management and establishing required operational functions, such as reporting, compensation management, and payer contracting, as well as in preparing fairness opinions to assure that the arrangements comply with regulatory guidelines.


  • Determine physician interest and capabilities in co-management
  • Design organizational structure and each party’s scope of responsibilities
  • Develop participation criteria and performance metrics
  • Recommend compensation, incentives, and payment models and develop terms and documents
  • Analyze financial impact analysis on the service line and participating physicians
  • Provide education/facilitation on the benefits of the new agreement to the organization, patients, and staff
  • Implement the co-management arrangement and onboard physicians
  • Prepare fairness opinions on the proposed agreement
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