Seven health systems in Pennsylvania and New Jersey created a mega-alliance last month to prepare for value-based reimbursement, improve patient care, and lower the cost of doing business.
Hospital and health system leaders know the reimbursement transformation is coming—even if it hasn't reached them yet. Many organizations are beginning to develop population health management strategies to prepare for value-based reimbursement.
In the most recent HealthLeaders Media Intelligence Report, "Population Health Management: Steps to Risk Sharing and Data Analytics," 46% of survey respondents say they are fully committed to improving the overall health of a defined population, and another 27% say they have an experimental or pilot program under way.
Going it alone may not be the best course of action, according to the report, which shows that 63% of respondents say they are either examining or have established with partnerships with other providers to address risk sharing and improve the health of defined populations.
One system that has recently partnered with other providers to bolster its population health management efforts is Reading (PA) Health System, which last month joined with six other systems that encompass 25 hospitals in New Jersey and eastern Pennsylvania to form AllSpire Health Partners.
The other charter members of this mega-alliance are Atlantic Health System, Morristown, NJ; Hackensack (NJ) University Health Network; Lancaster (PA) General Health; Meridian Health, Neptune, NJ; Wellspan Health, York, PA; and Lehigh Valley Health Network, Allentown, PA.
Clint Matthews, president and CEO of the 735 licensed–bed Reading Health, says he expects participation in AllSpire will allow his organization to improve patient care across the continuum of care settings while reducing the cost of doing business, particularly with regard to supply chain purchasing.
"We foresee population health management as an area we can better manage through AllSpire because we will have a larger universe and be able to share best practices and manage down the overall cost of the infrastructure," Matthews says. "I anticipate that AllSpire will be very helpful as we are dealing with population health management for the purposes of risk stratification."
Richard W. Jones, CPA, Reading Health's senior vice president, CFO, and treasurer, says that because six of the seven AllSpire members use Epic for their electronic health records and other technologies, the group has "a natural ability to share, to establish protocols, and to learn best practices from each other."
"We believe AllSpire offers opportunities to leverage purchasing power and to leverage our ability to utilize information systems in a way that will provide economic benefits … and best practices in how to use health information for the benefit of our patients. That is a big opportunity in and of itself," Jones says.
A quarter of respondents to HealthLeaders' Intelligence Report said their employee base was the preferred place to start population health management. Reading Health will initially do the same.
"The first thing we are going to do is look at the population of our own employees and use them really as a laboratory to hone our skills at managing populations, by engaging primary care physicians more directly and incentivizing patients to participate in their own care," Jones says, noting that employees will receive an inducement to complete a health risk assessment, although it will not be mandatory.
Along with achieving employee buy-in for its new population health management strategy, Reading Health is also seeking to educate its physicians to encourage engagement.
"We have a clinically integrated network of employed and independent physicians in order to help facilitate population health management," Matthews says. "We are finding that as they become more informed, they are coming on board with the idea and seeing their role as they move forward with evidence-based medicine, data collections, and analytics."
"Over the past year, we've spent quite a bit of effort working with physicians to educate them about what clinical integration is and how it enables us to facilitate population health management," Jones adds. "They are understanding it more, and they see how the industry is moving in this direction."
In addition to improving patient outcomes and the quality of care, Jones also sees population health management as a crucial component to handling a payer environment that is slowly but surely evolving into one based on value rather than volume.
"What we are expecting to see is more third-party payers wanting to move from payments made on an episodic basis to reimbursements that are value-based. We believe the advantage AllSpire offers us is that, as we get into more of those types of relationships, we can leverage the knowledge we are gaining from clinical best practices and the best use of information systems so we can engage a population to be more accountable for their own healthcare. That will provide tremendous benefits," Jones says.
Provider involvement in population health management strategies will also be important as patient volume moves from the inpatient to the outpatient setting, he says.
"We expect to see less utilization in acute care settings, and we have to be prepared to measure that, monitor that, and incentivize behaviors, and at the same time be able to reduce operating costs," Jones says. "We are really looking to this and see a great deal of potential in AllSpire. We think that these types of affiliations will become more commonplace as reimbursement structures change."