Independent providers have not historically worked together to solve their challenges, but six Ohio-based health systems are joining forces to share resources, lower costs, and reduce variations in care—all while continuing to operate as independent systems.
As healthcare provider organizations look for more effective ways to contain costs and improve quality, some are finding strength in numbers.
Six Ohio-based health systems are joining forces to form the Midwest Health Collaborative to exchange best practices, share resources, lower costs, develop population health innovations, and reduce variations in care—all while continuing to operate as independent systems.
Comprised of Aultman, Cleveland Clinic, OhioHealth, Premier Health, ProMedica, and TriHealth, the collaborative consists of 40 hospitals and hundreds of care sites throughout the state.
"There is a lot of mutual respect among the systems, and we don't believe we have to have a merger model to take advantage of best practices and everything each system is doing separately. We are all committed to remaining independent but focusing on a bigger vision," says Karen Strauss, chief marketing, strategic planning, and communications officer for ProMedica, a Toledo-based system with 2,268 licensed beds and fiscal year 2014 budgeted revenue of $2.6 billion.
Learning from Each Other
Independent hospitals and health systems have not historically worked together to solve their challenges, but that is beginning to change in the face of health reform, says ProMedica's president and chief executive officer Randy Oostra.
"One of the things that has happened since the [Patient Protection and] Affordable Care Act and that concerns everyone in healthcare is there is this need to be more efficient and more effective. Some of the cost pressures that everybody is facing have created a lot more dialogue in the healthcare community," he says.
"When we look at the core systems [in the collaborative], it is all about serving local communities, and at its essence, we all want to make sure we have the right structure in place to serve our communities when the day is over. We want to make sure we are positioned well for the future so we are starting to look at what we can work on, and some of the immediate things that make sense are standardizing care, sharing best practices, and investing in population health."
Oostra says that by working collectively through the Midwest Health Collaborative, the health systems can avoid the expensive doubling of efforts that occurs when going it alone.
"We cannot afford healthcare as it is in this country, and we cannot afford to all be duplicating the same efforts. We have all been calling the same consultants, doing the same work around standardizing care protocols, having doctors sitting in conference rooms looking at the same information, and investing in the same kinds of IT and data analytics infrastructures," he says.
"Through a series of discussions amongst systems, we got a group together, and it morphed into the six of us like-minded, community-based, mission-focused systems. We very quickly found common ground in all wanting to do better as an industry and believing there has to be a more rational way of doing things… We can't afford all the duplication of efforts that is happening across the country, and we all have an obligation to do better."
Seeing Encouraging Signs
The business plan for the collaborative is still being finalized to "create a global structure and get the systems aligned," Oostra says, noting that he is already heartened by what is happening between the organizations.
"We are working together to produce higher-quality, better-coordinated access across our communities so we can all be more efficient and effective, and it is really inspiring to all of us. We have just been extremely pleased by the comradery and the collaboration. Sometimes people think of healthcare as a hyper-competitive industry, and we've been very encouraged by the discussions, the tone, and the attitude everyone has toward this collaboration. People are trying to collectively move the needle and not just work in isolation."
Strauss adds that the connections being made between peers within the organizations are already beginning to have an impact as they all work to improve care and lower costs.
"While this collaborative started with the presidents and CEOs of the organizations, it quickly developed into some cross functional relationships. The advocacy groups are getting together, the HR and training groups are getting together, the population health teams within each organization are getting together. Once you start developing these contacts, it goes beyond the CEO level, and that is where you start to see some real value. Inside each organization is where the rubber meets the road and where we can make some real advancements and improvements," she says.
"We think we can enhance care and take cost out at the same time. It's a dual focus for us, and that is where standardizing care and finding the best, most efficient pathways and protocols is key. We are learning from each other and reducing costs."
Using Data to Focus on Population Health
By harnessing their collective patient data and analytics capabilities, MHC members will be able to make improvements in their population health management skills, Strauss says.
The collaborative will begin with its own employees. With more than 100,000 employees among them, MHC members are placing an emphasis on sharing best practices in employee health programs through plan benefit design analysis and wellness programs.
"By taking healthcare costs for employees and looking at that, we can figure out which pieces and parts work so that we are all analyzing data on a real practical basis in terms of preventing utilization, helping with readmissions, looking at interventions like care navigation and the things we can do to work with populations that keep showing up in the ER. If we are looking at the data and sharing it with each other more broadly, we can intercede earlier," Strauss says.
Finding Economies of Scale
In addition to establishing better population health protocols, MHC will benefit its members through collective supply chain and payer contract bargaining power, Oostra says.
"We are in the process right now of working through some ideas of how we want to work together in the supply chain world, and we have some ideas around some things we want to do for statewide [supply chain and payer] contracting. We are still in the early, formative stages, but everything we've talked about so far has been very promising," he says.
Expanding the Collaborative
Oostra says the long-term plan for the collaborative is to expand it beyond Ohio in order to have as wide a reach as possible.
"It's not called the Ohio Health Collaborative. It's called the Midwest Health Collaborative. The idea is to talk to others who might want to be part of it once we get things rolling and try to broaden the footprint."
"These six are the founding members, but that doesn't preclude us from involving and reaching out to others as well," Strauss adds. "If we can come together and provide some real value for the communities and for the patients we serve, then we can take some of these ideas and spread them to others. This is the core and the start, but it is by no means the vision for the end."