Northwestern Memorial Hospital and affiliated doctor groups are discussing a major restructuring to help its doctors and facilities better prepare for the health overhaul law and put the academic medical center in the nation’s top tier, according to sources and a document obtained by the Tribune.

Called “Northwestern Medicine,” the new structure being pursued is being designed to be more nimble when it comes to contracting with health insurance companies who pay the hospital and doctors as well as making business decisions when it comes to recruiting physicians or obtaining grant money, these sources said.

Under the present model, Northwestern Memorial Hospital and the largest doctor group, the Northwestern Medical Faculty Foundation, are separate entities. Making decisions often involves multiple approvals through layers of bureaucracy, sources close to the hospital and doctors’ group say.

In the future, insurance companies are demanding a more coordinated approach that includes better data on patient outcomes and ways to show their patient care performs at a higher level than rivals. Insurers, in turn, act as an evaluator of such performance for consumers and employers who buy their products and network of services.

Neither Northwestern Memorial or doctor groups involved in the talks would provide specifics but confirmed talks were ongoing.

“As a premier academic medical center, Northwestern Medicine’s planning process will ensure that each of our missions – education, research, clinical care and community service is advanced as we consider and develop various approaches that better integrate clinical care,” Northwestern Memorial Hospital and a representative of the medical school and faculty foundation said in a statement to the Tribune. “Any changes in our model for the provision of clinical services will be driven by our commitment to provide highest quality care and an ideal patient experience.”

One scenario outlined in a document obtained by the Tribune has the hospital and doctor group reporting to the same leadership, which is not the case now. Neither Northwestern Memorial chief executive officer Dean Harrison nor any physicians were named as possible top executives of Northwestern Medicine.

In addition, executives are not ruling out merging various corporations that result in the faculty foundation being part of the same corporation as the hospital.

The idea of putting the entities under the same umbrella is one that already exists at academic medical centers across the country as well as Chicago. Often, the dean of the medical school or the top doctor is also the chief executive of the hospital or at least seen as a peer in the hospital leadership structure.

One of the most recent meetings in the “Northwestern Medicine” project was held on Sept. 15. It included representatives from Northwestern Memorial, the Northwestern Medical Faculty Foundation, Northwestern University and the Northwestern University Feinberg School of Medicine. All would be involved in any new structure for the health care enterprise, sources say.

bjapsen@tribune.com