Leadership at Mercy Health knew that if they wanted the system to be an integrated “network of choice” across Ohio, they had to aggressively prepare to be capable of accepting accountability for the total cost and quality of care for defined populations.
The health system had already established a Medicare Accountable Care Organization (ACO) to participate in the Medicare Shared Savings Program (MSSP). Although this provided a good starting point to engaging physician leaders in care transformation, the system needed to explore other opportunities to create a high degree of interdependence and cooperation among physicians to control costs and measurably improve health across their regional markets.
So Mercy Health set out to build a stronger provider network, and advance its care model and IT resources—in order to successfully take on more risk. And we’re helping them get there.
Align physicians to build consistency
Getting physicians organized and enfranchised around outcomes-driven, more coordinated care is fundamental to establishing a patient-centered continuum of care with reduced costs and improved quality. As the fourth largest employer in Ohio, Mercy Health has 23 hospitals in seven markets including Kentucky, with more than 6,500 employed and affiliated physicians—and they needed to start delivering consistent results with shared accountability for performance.
We worked with Mercy Health to recruit more than 2,000 physicians and build a clinically integrated network (CIN) with employed and affiliated physician-led governance at a local level in each market and an overarching corporate infrastructure.
Build upon the CIN to drive cost and efficiency gains
Once the physicians were aligned in the CIN, Mercy Health turned its attention to inpatient clinical variability, the largest single source of both provider and payer costs. We often find that health systems struggle to realize the same outcome improvements in the hospital setting as they do in the ambulatory setting from the CIN. Therefore, we are helping to implement a “hospital efficiency improvement program” (HEIP) to financially align the hospital and the CIN towards the same clinical goals.
Through this program, we collaborated with Mercy Health to identify both universal and market-specific clinical initiatives to better serve high-opportunity population segments. And because we’ve set up a value-based incentive structure, physicians are fully engaged—and they are already starting to lead the effort.
In addition, the HEIP opens up new communication channels and opportunities for collaboration between market-based physicians and health system leadership. Physicians will now relay information on priority clinical initiatives to give leadership new visibility into each market’s needs. That way, Mercy Health leaders can apply this knowledge to the decisions that drive the system’s overall direction.
Provide scalable, coordinated services for providers
To efficiently manage all of Mercy Health’s population health programs, we are currently working with leadership to build a “population health services organization” (PHSO)—a centralized support function that allows the system to integrate value-based care resources and capabilities, promoting coordination and economies of scale.
Eventually, other entities outside the Mercy Health network will be able to purchase the PHSO’s shared services, and receive support while pursuing a variety of value-based payment arrangements.
See the power of a PHSO
$58 million in savings projected over three years and improved clinical outcomes
“At Mercy Health, we’re committed. It’s a big investment, but we believe if you’re really going to transform, you need to make that investment. It will no doubt be worth it.”
Brent Asplin MD, MPH
Chief Clinical Officer,
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