March 20—Hospital leaders say they no longer are “trying to do a little bit of everything.” Instead, they aim to specialize in some activities while finding outside partners that perform better in other areas.
“There are few health systems in the country that have the luxury of doing everything,” Sam Glick, a partner at Oliver Wyman, said this week at a Washington, D.C., discussion about hospital care coordination. “Increasingly, they have to separate their mission from their decision” about which services to provide.
New healthcare partnerships include Henry Ford Health System’s 2018 direct-to-employer contract with General Motors to deliver both healthcare management and wellness services to salaried GM employees and their families throughout southeastern Michigan. The manufacturer approached the health system for help with improving the value, access, quality, and cost management of its employees’ health care.
“It’s all about, ‘How do we really work together and share costs, share pain, share savings, and hopefully share outcomes of a healthier employee population?’” said Wright Lassiter III, president and CEO of the health system.
Elliot Joseph, CEO of Hartford Healthcare, said “partnerships are critical” amid multiplying competitors. In one such partnership, Hartford joined with GE Healthcare on an analytics initiative that optimized utilization and staffing at the system’s seven hospitals.
“It has had a profound positive impact on everybody,” Joseph said. “We could never do that before, not only for lack of the technical capability but just as an organization we couldn’t function that way.”
A more traditional partnership with the Center for Medicare & Medicaid Innovation (CMMI) produced a $10 million grant that Wilmington, Del.-based Christiana Care used to develop a predictive analytics system called Christiana Care Link.
Janice Nevin, MD, president and CEO of Christiana, said the engine has been able to “identify who is at risk right now” for steep health declines due to untreated depression or even severe loneliness. Any such alert prompts a multidisciplinary clinical team to reach out to patients.
“It’s all about that relationship; it’s all about that convenience,” Nevin said.
The health system also has come to realize that its ambitious plans to forge close relationships across the community will require more support—and funding—from local organizations.
Hospitals and health systems should consider which services or activities outside partners may be better positioned to provide, then plan such conversations in preparation for getting approached by market partners, Glick said.
The push to partner with outside groups comes as hospitals face increasing pressure from nontraditional competitors.
Henry Ford is most focused on disruptors looking to separate ambulatory care from hospitals, Lassiter said.
One step Henry Ford is taking in response, Lassiter said, “is thinking about, ‘How do we reimagine access to our system through primary care?”
That requires changing from a model in which employed physicians refer care to the inpatient environment. The new approach seeks to reduce brick-and-mortar expenses while increasing access to the system through technology and virtual care
“We’re also looking at how we expand our network beyond those physicians who are employed and tightly organized around our hospitals to folks in the communities where our patients need the care,” Lassiter said.
Bolstered data management capabilities aim to allow patients’ care to be comprehensively and longitudinally managed even in a looser network.
Hartford Healthcare is eyeing vertically integrated companies that have large amounts of “talent, capability, and capital” and that come from less regulated sectors such as information technology, according to Joseph.
“At the same time, we’re not thinking of this as a defensive thing. We’re thinking about being on the offensive,” Joseph said.
Consumer Relationships Are Paramount
Joseph described merger-and-acquisition efforts with various types of providers as “table stakes” necessary to achieve the system’s goal of providing the best-personalized and best-coordinated care.
“We knew that we were competing with much more agile organizations than we had traditionally been competing with, so we had a very tight, deeply integrated, and innovating operating model,” Joseph said.
As part of that effort, the health system sought to offer consumers one registration experience, one health record, one standard of excellence, one financial statement, and a single, cohesive relationship.
“The battle in our market is over the relationship; everyone wants that relationship” with the healthcare consumer, Joseph said.
Among new competitors, the emphasis on the consumer relationship is illustrated in CVS Health’s stated goal to use its acquisition of Aetna to become health care’s new front door, said Ken Kaufman, managing director of Kaufman Hall.
“They are trying to get in between the traditional caregiver and the patient, with the general approach being that if you get in between there then you’ll take away more of the care and then more of the revenue will actually flow” to the disruptor, Kaufman said.