The shift from volume- to value-based payment and care delivery has driven healthcare providers to reshape their approach to care operations, such as by investing in technology to improve patient care and eliminate waste.
“If reimbursement is now tied to population health measures along with the ability to use and make available electronic health records and to measure quality, you now need a new fixed infrastructure and group that you have to put in place just to be able to measure those things and keep them on the right side of the ledger,” says Howard Forman, MD (pictured at right), professor of Radiology, Economics, Public Health, and Management at Yale.
Although instances of clinical integration have demonstrated strengthened ability to manage patient health across the care continuum, there are concerns.
Mergers and acquisitions may decrease competition, for example, while looser affiliations are not guaranteed to achieve aligned incentives.
In an instance of increased financial alignment, Denver-based academic medical center University of Colorado and Fort Collins, Colo.-based community health system Poudre Valley formed University of Colorado Health through a joint-operating agreement in 2012.
University of Colorado Health aims to increase quality of care for an expanded patient population while the two consolidating entities retain control of their assets.
J.-based Atlanti Care in 2015, patient feedback has informed efforts to improve the patient experience across the care continuum.
For instance, to strengthen care delivery through a population health management focus, Denver-based kidney care provider, medical group, and management company Da Vita Health Care Partners acquired Everett, Wash.-based physician group The Everett Clinic last year.In 2011, Rochester, Minn.-based Mayo Clinic launched Mayo Clinic Care Network, partnering with member organizations following a thorough evaluation process to lend its brand and expertise through telehealth.This contractual relationship provides members with access to clinically based services, including telehealth consultations with Mayo Clinic specialists for patient care; care tools; and for member staff, consultations with Mayo Clinic experts in areas such as patient care, finance, and human resources.With national healthcare expenditures increasing from 12.5 percent of GDP in 1990 to nearly 18 percent today, healthcare organizations are aiming to bend the cost curve.“If you’re going to figure out a way to slow down the increase of healthcare cost, you’ve got to figure out a way to get certain efficiencies and economies of scale,” notes Harry Kraemer, executive partner with Madison Dearborn Partners and clinical professor of strategy at Northwestern University's Kellogg School of Management.
“Ultimately, healthcare consolidation will be judged by listening to our patients and learning how best to care for their needs,” Dominic Moffa, executive vice president and chief strategy officer, Geisinger, states in an email.