To expand a program which promises cost savings to employers, Cleveland Clinic is creating a network of organizations "[known to] function with high quality for patients having standard cardiac operations." Its latest deal puts it in the New York market.
Toby Cosgrove, MD |
Cleveland Clinic is extending its East Coast presence through another affiliation for cardiac services. This time, it is partnering with North-Shore-Long Island Jewish Health System.
The arrangement between the providers, characterized as "exclusive," was announced Tuesday by Michael Dowling, NS-LIJ's President and CEO and the Cleveland Clinic's President and CEO, Toby Cosgrove, MD.
Dowling says he's delighted with the arrangement because it will merge two high quality heart programs to become even better. But he acknowledges it may not result in a significantly higher volume of patients, at least not any time soon.
A Cleveland Clinic program that enables employees of large, self-insured companies such as Lowe's, Walmart, and Boeing to travel to Cleveland for high quality heart care hasn't seen many patients take them up on that offer.
In the four years since the program launched, "What has become apparent to us is the [low volume of] participation," says Bruce Lytle, MD, chairman of Cleveland Clinic's Sydell and Arnold Miller Family Heart & Vascular Institute.
"People aren't worried about getting the procedure here once they leave home," he says. "But they are worried enough about it before they leave so that we think it may have limited participation."
Lytle says that no more than 75 to 100 employees of those three large companies have made the trek to Cleveland each year, a number he acknowledges is low.
The rest have chosen local hospitals, even though patients may have a financial disincentive to do so given the somewhat higher share of out-of-pocket costs for local care.
Michael Dowling President and CEO, NS-LIJ Health System |
The Cleveland heart center is partnering with New York's NS-LIJ in part so that New York-area employees of Walmart and Lowe's can get care equal to the high quality heart care provided at Cleveland without having to travel to Ohio. Boeing has no employees living in the area.
Lytle says that Cleveland Clinic is creating "a network of places that we know function with high quality for patients having standard cardiac operations." Starting this week, elective angioplasties, valve repairs, coronary artery bypass procedures, and other heart operations will be available at NS-LIJ to any of those employees who need it.
"Even if I only get one patient, this gives us—our clinicians, nurses, and quality people—an opportunity to work together with the Cleveland Clinic," says Dowling.
"We have the quality that's synergistic with the quality metrics of the Cleveland Clinic," he says, noting that NS-LIJ is listed by the New York State Department of Health as having the best outcomes in the state in mortality measures for coronary artery bypass graft, valve replacement, and angioplasty procedures.
Lytle and Dowling couldn't say how many employees they expect will come seek treatment at NS- LIJ who might have gone to other hospitals or to Cleveland for heart care. But Dowling says it doesn't really matter because the agreement has benefits "from a marketing point of view. The issue is much larger than the number of patients we will get."
For example, NS-LIJ, which has 17 hospitals, also operates an insurance company. It covers 11,000 lives and expects to have 30,000 in the next few months, mostly through small employers or individuals covered by the new health insurance exchanges.
The agreement with NS-LIJ is similar to Cleveland Clinic's agreement with MedStar Health of Washington, D.C. and Maryland, where patients who work for Boeing, Walmart, and Lowe's can go to MedStar hospitals for heart care.
Lytle says that for employers, there are big cost savings through avoided adverse outcomes, and "avoiding surgery that may not be necessary." For employees there can be a break on their share of payment, as long as they are approved for surgery in advance and healthy enough to travel.
Under the contract with Lowe's for example, all medical deductibles and co-insurance are covered, as are costs for a companion, plus concierge services to make necessary arrangements for employees of more than 1,700 home improvement stores across the country.
Lytle says Cleveland Clinic "is in negotiations with many other employers" to participate in its "direct-to-employer program" also called the "Program for Advanced Medical Care."
According to a spokeswoman, the goal is to have a total of 15 organizations in the network by the end of 2015.