Alliances: Pathways to an ACO
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He says an overriding positive for the two hospital boards was that they were assured that DLP wasn’t interested in driving all possible procedures to the main campus in Durham.
“When we talk to local trustees and physicians about this, it’s a compelling story about the value proposition for the hospital,” Fulkerson says. “Our first interest is in developing locally and making sure the kind of services that should be performed in Henderson or Roxboro are.”
The partnership isn’t necessarily limited to Duke’s traditional sphere of influence. LifePoint’s more than 50 other hospitals in 17 states will also benefit, he says. Besides, the future of the partnership most likely extends beyond North Carolina.
“We are pursuing other joint ventures in targeted regions,” Carpenter says. “Having said that, I am so excited about our partnership with Duke and what it brings to clinical program development and support for quality outcomes. We’ve not had extensive discussions yet, but Duke has a sphere of influence that is well beyond Durham and North Carolina.”
The relationship between Poudre Valley Health System and the University of Colorado Hospital could be categorized as permanent. What’s interesting is that the systems are building a new health system through a joint operating agreement. Although for now, they are operating under a letter of intent, the combination of the two geographically separate (by 50 miles) systems is aimed at presenting the combined organization to a much larger patient base. Its strength will come from combining a community-based system with an academic medical center to better coordinate care, says Poudre Valley CEO Rulon Stacey. Key to the deal is that both systems come to it from a position of strength, he says.
“We didn’t feel driven to do anything—we’ve had three bond rating upgrades in three years, and a Baldrige award for ourselves, but there’s an argument that organizations that affiliate in this way will better be able to meet the criteria under healthcare reform,” says Stacey.
Though the move won’t be a merger per se—as governmental entities, neither is statutorily authorized to merge its assets—they will combine organizational structures and issue one combined income statement. In other words, it’s a merger of operations, management styles, and mission, if not of assets.
The new system is undergoing a full review on the services that each partner offers that will complement the other. Stacey says, for example, that the University of Colorado Hospital offers transplant services that are unavailable anywhere else in the state and that Poudre Valley will contribute its system-owned medical group that has more than 20 clinics in three states.
“We’ll work to expand that,” he says, adding that branding is still to be determined.
“There are no sacred cows. We’re going to do our due diligence and whatever makes the most sense for patients and resonates with them is what we’ll do,” he says. “The governance issue is also under review. ”
Clinical leadership must also be addressed.
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