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Rival Systems Realize They Gain From Collaboration

Cheryl Clark, for HealthLeaders Media, March 10, 2010

Lately, healthcare leaders at rival organizations seem increasingly likely to pick up the phone, call each other, and ask if they'd like to meet for a drink.

But these aren't social calls. These folks are trying to find opportunities to improve care.

Last week, for example, I wrote about CEOs from four small rural hospitals in Central West Texas that dropped their town rivalries to collaborate on the purchase of a single electronic medical record system that would bridge their hospitals, and eventually their clinics and physicians, with their patients' health histories.

This week, members of two California health information technology groups, which used to fiercely wrangle, will join hands to form Cal eConnect; as one entity they will provide leadership and oversight so that California health providers get every penny of the $3 billion in stimulus funds available for meaningful use. That's the biggest pot of HIT change of any state in the country. Cal eConnect will get $38.8 million in federal funds routed through the state to make it all happen.

There's more. I recently heard that two major hospitals in Nebraska, which normally vie for patients—the Methodist Health System and the Nebraska Medical Center—agreed to a special project that would improve patient care through the creation of a unified accountable care organization (ACO).

The idea is that by having their physicians and surgeons, nurses and other providers track patients from the hospital to the physician's office to the home, each system will drastically reduce avoidable hospital readmissions and improve patient compliance.

I spoke last week with Ken Klaasmeyer, vice president for MHS' Methodist Health Partners, and Rita Potter, director of managed care for the Nebraska Medical Center, who told me their hospitals are the only competing systems in the U.S. attempting to share information for an ACO model.

Combined, the two organizations have 50% of the healthcare market of the greater Omaha region, so it stands to reason that they would share patients and that both would stand to gain by tracking care better.

Klaasmeyer and Potter explained that their joint effort would encourage a variety of providers at both facilities to better manage their patients' care through educational classes, appointment reminders, follow-up visits, well-being phone checks and many other strategies.

Health system personnel can make sure patients fill their prescriptions, schedule and keep their appointments, and anticipate any adverse reactions they may have to their regimens.

"Patients who come to the hospital with certain chronic diseases—for starters diabetes, hypertension or congestive heart failure—will be tracked," Klaasmeyer says.

"We want to know, 'how do we encourage the patient to become complaint?' That's the $64,000 question. Maybe it's a phone call, or having the doctor make a house call; nothing is off the table," he says.

Potter and Klaasmeyer note that the process and reimbursement of these services is all new for both facilities. Nevertheless, the facilities expect that the amount of money spent establishing this program will be recaptured when chronic care patients aren't readmitted—care which the federal government is increasingly reluctant to reimburse.

Interestingly, chronic care has become such an issue that the leaders of the ACO are looking into an effort to have hospital officials meet with employers in the greater Omaha area to encourage them, possibly even with financial incentives, to promote healthy living among their workforces.

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