“Usually when you do something like this we get negative feedback from lots of different places, including the medical staff, but we’ve received none,” says Stacey.
Yet another method to build scale is on display in North Texas, where the Arlington-based, 24-hospital Texas Health Resources is joining forces with four-hospital Methodist Health System of Dallas. Putting a label on the agreement is difficult. It’s not a merger, an acquisition, or even a joint operating agreement, but the two geographically separate systems believe they can work together to form an accountable care organization of some kind in the Metroplex—Dallas, Fort Worth, Arlington— and the surrounding communities.
Doug Hawthorne, THR’s CEO, is not ready to provide specifics of the accountable care structure of the partnership, but he says neither organization finds the federal Medicare ACO framework attractive at this point, and local payers haven’t yet expressed much interest in building out commercial ACO options.
“We’ve created what we call a cooperative agreement,” he says. “They’re an excellent partner with us because they fill a geography we don’t have, so we don’t really compete.”
They do have complementary parts, especially for coordinating care and driving clinical protocols. For instance, early in 2011, THR did purchase one of the area’s largest physician associations, 280-physician MedicalEdge Healthcare Group. Hawthorne says Methodist’s deep involvement in home care and a well-developed clinically integrated service line structure was an obvious advantage in filling in gaps in knowledge that THR has as well.
“As we talk to other partners about filling out some of this continuum that neither of us has, we have a chance to visit together about something that might have significantly more benefit than what we might do individually,” he says.
Cutting down on variation also is a big target of the agreement.