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Shared-Risk Strategies

John Commins, for HealthLeaders Media, April 15, 2013
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Ronald A. Paulus, MD
President and CEO
Mission Health,
Asheville, N.C.

We are focusing strategically on the building-block components that an accountable entity would need to be successful and thrive under that revamped reimbursement paradigm.

First, we're establishing a comprehensive primary care network because we see that as the front door and the overall clinical managers of the population and their focus on population health.

Part two of the strategy is to ensure we have appropriate specialist alignment so we can support that work. We have been pursuing a mixed model that includes traditional physician employment and also professional service arrangements and other nonemployment-based agreements where we can have aligned incentives from both the clinical and patient experience standpoints.

The third thing we are focused on is developing core care management capabilities and ensuring our care management skills and focus extend beyond the walls of the hospital and into the ambulatory care arena.

Fourth, we're focusing on building data analytics and warehousing capabilities. That would include predictive modeling to understand our population and get our arms around managing it.

Last but not least, we're ensuring we have clinical data exchange and consumer engagement capabilities and focus. I don't see it as flipping a switch. We see this as a continuum where over the next three to five years we are going from where we are today to a full-fledged capability. It is something we are working on every day, every month, every quarter.

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