Alliances: Pathways to an ACO

Philip Betbeze, for HealthLeaders Media , October 27, 2011
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He says an overriding positive for the two hospital boards was that they were assured that DLP wasn’t interested in driving all possible procedures to the main campus in Durham.

“When we talk to local trustees and physicians about this, it’s a compelling story about the value proposition for the hospital,” Fulkerson says. “Our first interest is in developing locally and making sure the kind of services that should be performed in Henderson or Roxboro are.”

The partnership isn’t necessarily limited to Duke’s traditional sphere of influence. LifePoint’s more than 50 other hospitals in 17 states will also benefit, he says. Besides, the future of the partnership most likely extends beyond North Carolina.

“We are pursuing other joint ventures in targeted regions,” Carpenter says. “Having said that, I am so excited about our partnership with Duke and what it brings to clinical program development and support for quality outcomes. We’ve not had extensive discussions yet, but Duke has a sphere of influence that is well beyond Durham and North Carolina.”

Poudre Valley Health System and University of Colorado Hospital
Building a bigger system

The relationship between Poudre Valley Health System and the University of Colorado Hospital could be categorized as permanent. What’s interesting is that the systems are building a new health system through a joint operating agreement. Although for now, they are operating under a letter of intent, the combination of the two geographically separate (by 50 miles) systems is aimed at presenting the combined organization to a much larger patient base. Its strength will come from combining a community-based system with an academic medical center to better coordinate care, says Poudre Valley CEO Rulon Stacey. Key to the deal is that both systems come to it from a position of strength, he says.

“We didn’t feel driven to do anything—we’ve had three bond rating upgrades in three years, and a Baldrige award for ourselves, but there’s an argument that organizations that affiliate in this way will better be able to meet the criteria under healthcare reform,” says Stacey.

Though the move won’t be a merger per se—as governmental entities, neither is statutorily authorized to merge its assets—they will combine organizational structures and issue one combined income statement. In other words, it’s a merger of operations, management styles, and mission, if not of assets.

The new system is undergoing a full review on the services that each partner offers that will complement the other. Stacey says, for example, that the University of Colorado Hospital offers transplant services that are unavailable anywhere else in the state and that Poudre Valley will contribute its system-owned medical group that has more than 20 clinics in three states.

“We’ll work to expand that,” he says, adding that branding is still to be determined.

“There are no sacred cows. We’re going to do our due diligence and whatever makes the most sense for patients and resonates with them is what we’ll do,” he says. “The governance issue is also under review. ”

Clinical leadership must also be addressed.

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1 comments on "Alliances: Pathways to an ACO"

Jennifer N (10/27/2011 at 1:03 PM)
These new partnerships are a great step to a more collaborative heath care system in our country. Once the mergers are set in stone and squared away, the establishment of ACOs will benefit each health care system and will be easier to institute thanks to the partnerships. With more resources housed under one roof, collaboration is much more beneficial to patients. I think there is a lot to keep in mind though, in order to have an effective ACO. The health care systems must be on the same page to deliver the best care. A great article by OptumInsight outlines a few key things to keep in mind while establishing their ACO models that all health care systems should take into consideration, especially those that are going through any kind of merger. Here is the link:




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