But primary care is still critical, and care is going to have to be coordinated in a very different way—that is, it will have to actually be coordinated.
"Your primary care home would be the coordinator for all that care," says Garza. "That's why we entered into the Pioneer ACO so we could begin to learn about that coordination of care. Under that legal scheme, you can do shared savings and a bunch of other products in the structure of the ACO."
The Pioneer ACO, he envisions, could be the vehicle to do that connection without ownership.
"That's the tuition we wanted to pay," he says.
Further, Seton is developing its community care collaborative network of more than 500 physicians, where it takes risk. As well, its owned community care clinics and possible contractual relationships with federally qualified health centers should be fruitful in getting into population health management.
"We're also doing this through the health plan, a Medicaid HMO risk product, and our own associates, some 22,000 of whom are part of the health plan, so all of those are elements."
Of course, Seton's is only one approach. Three others are profiled in the cover story, but yours will be unique—as long as you develop and execute it.
One thing is clear: Now is no time for standing still.