Published in Health Care
Mayer Mayer

New statewide clinical care network looks to grow, share best practices

BY Sunday, February 07, 2016 11:23pm

The six independent health systems behind a new clinical care network across Michigan want to bring on more partners.

The founding members that are working to integrate their clinical operations are already talking to other health systems in the state about joining and extending the yet-to-be-named organization’s reach even further, both geographically and clinically.

“It is certainly something we are working at diligently,” said Dr. William Mayer, the recently named CEO of the clinically integrated network that includes members from Southwest Michigan, Lansing, Jackson and Midland.

“There are relationships that already exist among our members with other significant health care players across the state, and we are interested in building partnerships with others,” Mayer said. “We think it’s essential to be able to offer the kind of comprehensive, value-driven health care that we want to provide. We don’t deliver, as member organizations, all of the care that’s necessary to create a healthier Michigan at an affordable cost. We know that we have to create and be able to deliver a continuum of care and coordinated care across the health care continuum to make that happen.”

On Dec. 18, Mayer became CEO of the clinically integrated network, which should have name by mid-year. He most recently served as senior vice president for managed care and community health at Bronson Healthcare Group in Kalamazoo, where he’s held a variety of positions over the last decade.

The care network consists of Bronson Healthcare Group, Lakeland Health in St. Joseph, MidMichigan Health in Midland, Covenant HealthCare in Saginaw, Sparrow Health System in Lansing and Allegiance Health in Jackson.

Allegiance Health System is presently in the process of affiliating with Detroit-based Henry Ford Health System.


DRIVING OUTCOMES

Still in the formative stages, the new network wants to reach statewide and has no limit on the size it wants to become or the size of any new member health systems that may join in the future, Mayer said.

“We will be looking for organizations that share our passion for achieving a healthy Michigan at an affordable cost and who are committed to clinical integration and collaboration to make it happen,” he said.

In coming together, the six health systems want to accelerate improvements in cost and quality by adopting and sharing common standards in an era of accountable care.

The partners plan to integrate their own care networks and have their medical staffs collaborate to share best practices. The notion is that they are better working collectively, rather than on their own, to share risks, improve health, prevent illnesses and address the issues that drive up the cost of care.

“One of the key opportunity areas is for us to both learn from one another and teach one another,” Mayer said. “What we’re talking about is transforming health care in a way that will improve the health of a population of patients and at an affordable cost, and we recognize that to make that happen, we have to transform the way we do business.”


SHARING RISK

Key to that transformation is accommodating the flow of real-time data and health analytics “that can drive better value in health care at the point of decision making” for patient care. Developing the infrastructure and capability for that is expensive and necessitates partnerships to share the cost, Mayer said.

Partnerships through a clinically integrated network also enable members to share the risk of population health and accountable care. As changes in the industry base insurance payments to health systems more on how well they care for their patient populations rather than on the volume of procedures they perform, that creates significant risk that care providers need to spread.

“We are in an environment where we know that the payers of health care are looking to push risk for the cost of care and the quality of care onto providers. We know that, in order to be able to accept that risk and share in that kind of risk, we need scale,” Mayer said. “It takes a lot of people to have the kind of predictable insurance risk that is financially sustaining. By collaborating we can achieve that kind of scale.”

The venture by the six health systems is similar to the Together Health integrated care network formed in 2014 by Ascension Health Michigan, the parent corporation of Borgess Health in Kalamazoo, and Trinity Health, which owns Mercy Health Saint Mary’s in Grand Rapids and Mercy Health Muskegon.


SEEKING STABILITY

The promise of clinically integrated networks comes from how well they gather and analyze data on the health status and needs of the population and then tailor services accordingly to become more efficient and cut waste, said Anthony Colarossi, a health care consulting partner at Plante Moran PLLC.

The model “still needs to prove itself over time,” said Colarossi, and the success hinges on managing the risk that health systems are now assuming and the health of the population they serve.

The biggest issue is analytics and getting enough information and sharing it among a larger group of doctors “to say, ‘OK, what is the best way for us to address these issues within the population?’” Colarossi said.

Over time, a network’s effectiveness is reflected in clinical outcomes, improved health, the cost of care, and the cost of insurance coverage for employers and individuals within the market it serves.

“My theory 10 years from now is the proof in the pudding is the total cost of insurance stabilizing in a community,” he said. “That’s really what the selling point is going to be long term.”

Clinically integrated networks began emerging late last decade and in some ways are reminiscent of the physician-hospital organizations of years ago that came together to negotiate and manage contracts with health insurers, Colarossi said.

Some networks have been successful and some have not. Networks that failed often were brought down by the competitive nature of the personalities involved and “by protectionism — ‘this is mine, mine, mine’ — as opposed to ‘how do we work together,’” Colarossi said.


HISTORY OF COLLABORATION

The founding partners behind the new unnamed network in Michigan have going for them a history of collaboration. For three decades, the six organizations have been partners in a shared pool for medical liability coverage and reducing risk.

That partnership fostered a culture of collaboration and provided a foundation for their new venture together, Mayer said.

“That has led to a spirit of trust, transparency and collaboration that has been highly successful. We recognize what’s been built and the track record, and we see that as really being fundamental to who we have around the table as our founding members,” Mayer said. “That history of trust that’s been built over these 30 years is really a great foundation to be able to work from.”

In time, the network wants to work on contracting directly with health plans for new products, sharing risk and “creating a more sustainable approach to health care financing and incentives,” Mayer said. It also wants to share real-time data for patients receiving care outside of member health systems, he added.

“There are a variety of elements to a partnership that can and need to be considered,” Mayer said. “It’s a great opportunity to innovate.”

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