Sometime during 2015, we'll begin to put together a group of leaders to assess the environment again and begin to formulate the next 10-year strategy. Clearly those plans are directional and vision-focused, but if you don't have your eye on the focal point, it's too easy to get distracted or waylaid.
We're really looking at opportunities to fully deploy our population health strategy. We're redesigning care backwards from the outcomes we want. The advantage there is it really allows us to pursue upfront the highest quality- and evidence-based outcomes and the workflows we use to get to those outcomes are safe and reliable almost to the point that we would be comfortable warranting some things from a bundled care point of view.
That said, there's still a lot of variation in performance out there in facilities and practices. We have to understand that variation and coalesce around outcomes.
HealthLeaders: You mentioned that employers want to channel their business to healthcare organizations that can help them not only manage the cost but the quality of care. Given that payers are still trying to make that value proposition too, how has the competitive playing field changed for Texas Health?
Berdan: One of the things we've tried to do is lead in terms of quality. Back in spring, we published online a quality and safety report. That is designed to offer a transparent view of the organization's clinical outcomes. Many organizations themselves have not been as transparent with their quality and safety outcomes. So we stepped out this spring.
Whether we're performing great or not, it's on there, and we have demonstrated that we have a covenant with employers and the public so that they can see how we're doing. One of the bigger benefits is really internal. It motivates our leaders to make sure if there's a gap, they close it. We've not seen any of our competitors follow our lead.
It's scary in some ways. We had an awful lot of folks who were concerned about doing it, but since we've gone public, we've seen people reinvigorate their attention to the process and the outcomes. When asked, local employers felt it was appropriate. That said, I'm not sure employers and payers are yet using the data themselves, but they respect that we've done it.
HealthLeaders: In the medium- to long-term, is Texas Health's main competitive threat from other hospitals and health systems, or are there other entities that concern you more?
Berdan: I don't think there necessarily is a main competitor. The North Texas market is very interesting. We still have a huge number of uninsured. The ACA hasn't fixed that because Texas hasn't expanded Medicaid.
This is a vibrant and growing region but it's aging at the same time. That means a lot of people want to be in this market. We've retained our share in inpatient and grown it in outpatient, but there are a lot of potentially disruptive players in this marketplace.