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Private Sector ACO Models Rooted in Rugged Individualism

Philip Betbeze, for HealthLeaders Media, September 13, 2011
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Further, the contract calls for Methodist to have built out an ACO model for Cat employees, their families, and retirees by September 2013, using its network of ambulatory and home care sites, in addition to the acute care provided at the hospital itself.

Like other affiliates of IHS, Methodist will retain its local board, as the system operates under a decentralized model that emphasizes local control.

Focusing inward

Other systems are working on efficiencies from the inside out—not only to improve their quality of care, but also to reduce or eliminate the need for expensive new construction and overhead. For instance, St. Luke’s Episcopal Hospital, the flagship of the health system of the same name in Houston, seemed as though it was operating at capacity, even though statistics showed otherwise.

Margaret Van Bree, DrPH, who took the reins nearly two years ago as CEO, explains: “We benchmark our performance against other hospitals, and we have a higher case mix index than many in the country. But still, our length of stay was longer than it should be.”

That meant that the hospital was busier and less efficient than it should be. Van Bree is a firm believer that efficiency and quality in healthcare are directly related.

“People were operating at this feverish pace,” she says. “It wasn’t like we were running at 95% occupancy, yet people still had to use heroic efforts every day to keep up.”

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