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March 21, 2017

Ascension's CEO on replacing the ACA, clinical variation—and more

Daily Briefing

    Speaking at the J.P. Morgan Healthcare Conference in January, Ascension CEO Anthony Tersigni told Modern Healthcare that Ascension wants to be a "resource" for Republicans as they work to repeal and replace the Affordable Care Act (ACA)—but that the system believes in universal insurance coverage, Modern Healthcare reports.

    Ascension is the country's largest not-for-profit health system, with 141 hospitals in 24 states and the District of Columbia, as well as more than 2,500 care sites. Tersigni told Modern Healthcare's Dave Barkholz that the system's large footprint means it can offer a market-wide perspective on the health care debate.

    Hospitals and repeal and replace

    Tersigni's comments in January predate the House GOP's unveiling of the American Health Care Act earlier this month, but they offer general insights about how hospitals and health systems are thinking about the current health care debate, Barkholz writes.

    Tersigni told Barkholz that hospitals and health systems have been very "proactive" in sharing their opinions about health care reform. "It's been no different than when the [ACA] was being talked about," he said, adding that Ascension had been in contact with President Trump's transition team and Republican leadership since late last year.  

    Tesigni also said he understands that repeal and replace is moving forward and wants Ascension to be part of the conversation. "I'd like people to view Ascension in this health care debate—as a resource," he told Barkholz. "If somebody has a policy idea, we can let them know what the implications of that policy idea are for taking care of patients," he added.

    Tersigni added that it was premature to say how repealing and replacing the ACA would affect Ascension. For now, he said he is focused on advocating for what is important to the system. "Our slogan is we want 100 percent access, 100 percent coverage for every man, woman, and child in this country," he said, adding that access to mental health care was of particular importance because it was the top concern among its primary care physicians.

    Tersigni also called on Trump to form a task force that would examine how federal programs can help providers address the social determinants of health. "When we look at a patient who presents in a hospital setting, many times their health is related to something other than health care," he explained.

    The role of M&A

    Tersigni also spoke with Barkholz about how Ascension views mergers and acquisitions (M&A). He said the system saw M&A as "strategic" and appropriate when Ascension felt it could make facilities more efficient—rather than being driven by finances. Frequently, Ascension uses M&A to build out its care network, better serve patients, and enable population health, he said.

    At times, Tersigni said Ascension could further those goals by divesting itself from facilities and partnering with regional providers. That's what Ascension did in Tucson, Arizona, he said, where the system partnered with Dignity Health and Tenet to take charge of three hospitals in the area because they had more well-established care networks.

    Top priorities

    More broadly, Tersigni listed some of his top priorities for Ascension, including a continued shift toward fee-for-value, with a focus on partnering with the "risk side." He said, "I don't want to replace Aetna or Anthem. My intent is to partner so that we can, in fact, take care of defined populations."

    Other key priorities for the system, according to Tersigni, are enhancing behavioral and mental health and lowering costs. That, along with reducing care variation, is a key part of Ascension's strategy to appeal to large national employers. "The minute you move into that area, you can't have variance in quality, cost, or outcomes," he said, adding that the system's physicians are taking the lead on developing evidence-based protocols (Modern Healthcare, 3/18).

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