Mercy Health, the largest provider in Ohio, has managed a high level of change over the last few years—transforming from a federation of hospitals to an integrated, regional system. The system has moved into population health management by setting up an ACO, clinically integrated (CI) network, and a population health services organization (PHSO).
I sat down with Chief Clinical Officer, Brent Asplin, MD, MPH, who oversees Mercy Health’s physician network and clinical imperatives. Read on to learn about how they’ve embraced new payment models, why physician engagement needs to happen locally, and what’s next on the horizon for Mercy Health.
Q: Dr. Asplin, you’ve overseen Mercy Health along its transition to value-based care. So far, what’s been one of your biggest takeaways as Chief Clinical Officer?
Brent Asplin: It’s a great question, and we’ve learned a lot in the last few years. But above all, I’ve seen just how critical it is for Mercy Health to change its business incentives and the way we pay for health care. Today we are still reimbursed predominantly by fee-for-service payments, and accelerating the transition to value-based payment models will probably be the most important driver of success in our care transformation.
As we’ve embraced new payment models—shared savings, global risk, commercial partnerships—each has brought us closer to an infrastructure based on accountable care. This includes the right governance structures, physician engagement, care coordination, and chronic disease management programs. All of these elements create more value for Mercy Health, and of course for our patients.
I’ve also learned that being able to manage the health and wellness of our own associates is an important first step in preparing to manage broader populations. Our employee benefit plans and clinically integrated (CI) network have improved care transitions and high-risk care management, lowered year-over-year costs, and instilled payer confidence in our network.
Q: Since Mercy Health serves a handful of markets across Ohio and Kentucky, how has operational scale played a role in your population health strategy?
Asplin: I can’t stress enough how important this piece is. We recognized that to become a statewide care delivery system, with a strong CI network, we had to find an efficient way to support each market—and coordinate care between providers. Not to mention, we wanted to avoid duplication of costly population health management functions.
In many ways, our PHSO has become the answer to that challenge. It gives members shared access to technology, care model standards, and joint contracting—and enables our caregivers to improve community health and reduce clinical variation.
Also, we placed chief network integration officers in each local CI market that meet monthly with the central PHSO leadership. Along with both employed and independent market medical directors, they review financial and quality metrics and set upcoming goals. It’s been a tremendous way to build momentum, improve performance in our markets, and connect central and local efforts.
Q: Can you talk more about that balance between central oversight and local activity?
Asplin: Even though the PHSO provides much-needed, centralized support—at the end of the day, you can’t just dial in from a system level and expect physician engagement. If Mercy Health is going to be successful in a value-based care environment, we need the local physicians to lead our care transformation efforts.
I’m proud to say that the 1,500 providers we have as partners in our medical group, plus our clinically integrated independent partners, are at the frontlines of every strategy we execute and help distinguish Mercy Health in the markets we serve.
Just take the hospital efficiency improvement program (HEIP) as an example. Our physicians in the CI network are leading inpatient initiatives to reduce variation and cost, and improve quality—with incentives for achieving performance targets. The central system has visibility into these local initiatives, but the program is truly a local, peer-driven effort.
Q: I’m curious to know how things have changed from the patient’s perspective. How are these initiatives impacting the experience of Mercy Health patients?
Asplin: The traditional fee-for-service framework can be overwhelming to patients, often a pain to access, with disincentives for providers to support them between appointments.
Through our CI network and PHSO, we’re trying to take the complexity out of the patient experience—and hand back simplicity when it comes to access, navigation, and physician interaction. Also, by setting up incentives for providers to keep patients in-network, we now have better visibility into the care they receive across interactions. That’s helping us deliver higher quality to patients, and provide intervention and appropriate follow-up care as needed.
Q: As Mercy Health continues to grow and manage more lives, what’s next for the health system?
Asplin: I see technology, the backbone of any population health strategy, as an area of increased focus for us in the coming years. We’ve already invested in building an integrated EHR and data aggregation tools throughout all of our markets, and have both clinical and utilization data available for use.
The challenge though has been to get those data—especially utilization information—into the hands of care teams across the continuum at the point it can be used for intervention. It’s been particularly complex with the myriad of EHR platforms our members use—but we’re now working to make these data available and actionable throughout all platforms in the network for better-informed patient care. A key step in this process has been engaging physicians in our network to streamline the number of EHRs in use so we can better support clinical integration.
Another goal in the coming years will be the expansion of the PHSO—not only for the communities we serve, but also for providers outside the network. As the infrastructure continues to demonstrate value for us, we’d love to offer the same services to other subscribers who would benefit from cost-effective access to population health capabilities.
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