Riverside Health System, UVA Health Form Strategic Alliance

A joint steering committee will identify projects and track the progress of projects.

Riverside Health System and UVA Health have formed a strategic alliance to generate benefits in complex care, medical education, care coordination, and clinical research, the Virginia-based health systems announced last week.

The top executives at the health systems say the organizations are joining forces from positions of mutual strength, including strong financial standing. The agreement provides UVA Health with a 5% ownership stake of Riverside.

"The question that often comes up is, how is an alliance like this superior to a straight up merger? This alliance allows us to focus on our communities and our unique missions in a way that gives strength to both health systems, but that does not require a merger. We feel it is the best of both worlds—we gain the strengths of each institution while allowing us to focus on the needs of our local populations," says Michael Dacey, MD, Riverside's president and CEO.

The overall goal of the alliance is to improve the quality of care for nearly 2 million people in Eastern Virginia, he says. "The types of resources that are being committed fall into a number of categories. Certainly, there are some financial resources, but it's not about the money because both health systems are doing well financially. It is more about the expertise and the coordination of care."

A primary goal of the alliance is to keep complex care local, says K. Craig Kent, MD, CEO of UVA Health and executive vice president for health affairs at University of Virginia. "We believe all care should be delivered locally. With this alliance, 95% of care should be able to be provided locally. There will be rare instances when someone has to leave Eastern Virginia for something incredibly complex, but the idea is to partner with Riverside to provide as much complex care locally as possible. That is one of the underlying concepts of the alliance."

An example of collaboration on complex care and care coordination in the alliance is transplant medicine, Dacey says. "Riverside is not going to do organ transplantation, but UVA Health is one of the best transplant centers in the world. If we can help coordinate patient care and get patients into the transplant process earlier, that will help save lives, and all of the pre- and post-transplant care can be done locally."

As part of the alliance, UVA Health will have a transplant coordinator for Eastern Virginia, Kent says.

"In terms of solid organ transplantation, 90% of the work involved for patients is the pre-operative evaluation and the post-operative care. All of that can be performed extraordinarily well in Eastern Virginia by Riverside. The other 10% of the care can be provided by UVA Health. Patients that need transplantation are complex patients and care coordination is critically important. Part of our alliance is making sure that we have our teams working together closely, so patients can be cared for in the best possible way," he says.

Boosting clinical research is an important element of the alliance, Dacey says. "One of the things that we both have a joint interest in is research, particularly clinical trials. Riverside has a large number of patients. We have about 1.2 million ambulatory visits annually. A lot of those people would benefit from access to clinical trials, and the opportunity to work with UVA Health on clinical trials is one of the things we were attracted to."

Medical education is another key component of the alliance, Dacey says. "At Riverside right now, we have our own residencies in family medicine, emergency medicine, and obstetrics. We hope to grow both the number of residencies such as adding internal medicine next year and the opportunities for the residents to work with the resources at UVA Health, whether it be developing research projects or sharing faculty back and forth. We hope to grow those areas of medical education, particularly at the residency level."

Bolstering residencies is part of Riverside's strategy to address physician workforce shortages, he says. "There is a huge shortage of doctors coming, probably a shortage of 80,000 to 100,000 doctors nationally in the next 10 years. The problem is not necessarily medical schools, it is the ability to train at the post-graduate level. By growing residencies above what we have right now, we hope to help address that problem. Where a resident trains is the most important determining factor for where they end up practicing medicine. So, we feel growing residencies in Virginia will help with the physician workforce in Virginia, and UVA Health can clearly assist us in that effort."

Riverside and UVA Health are ideal partners, Dacey says. "We both share the same mission and values, which is to do what is best for our patients. We are both committed to providing the right care, at the right place, at the right time. So, it was a cultural fit. In addition, our medical staffs already collaborate in several areas in terms of specialty referrals back-and-forth. So, we already had pre-existing clinical relationships. Plus, there is the world-class reputation of UVA Health combined with the substantial patient base of Riverside, which was an additional attraction from Riverside's standpoint."

UVA Health and Riverside will each retain their governance and administrative structures, but there will be a formal mechanism to manage the alliance, he says. "We will have a joint steering committee, where members from UVA Health and members from Riverside will jointly identify projects and track the progress of projects, whether that is in clinical areas, educational areas, or clinical research areas."

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