It’s easy to think that the best way to manage patients is to own all of the sites they visit.
If money were no object, and if every care provider in your market wants to be part of a large system, that might be the case. But the reality is it’s impossible to own it all. No one has enough capital to buy everything. Additionally, many potential partners may want to remain independent.
Instead, systems evaluate selective partnerships and affiliations. In our research on high-performing population health managers, we see three attributes of the networks they build:
- They are highly selective about who they collaborate with
- They over-invest in building cultural compatibility with the partners they’ve selected
- They proactively manage performance within the partner network, holding partners accountable to the same standards they have for themselves
Limit referrals to highest-performers
The key to selectivity is transparency in what you are looking for along with a clearly defined mutual value proposition. The Michigan Pioneer ACO recently narrowed their number of home care partners from 47 down to 8. The team collected data and conducted interviews to evaluate interest, quality performance, cost performance, technology capabilities and capacity.
Takeaway here: anyone can talk about collaboration. You’re looking for those willing to make a true commitment. You also need an ability to assess where they stand on helping you achieve the outcomes you need.
Build leadership, staff connections
The second big issue in effective network development is cultural alignment. Once you’ve chosen your partners, you need to ensure that you’re building a unified culture and promoting a seamless patient experience. It starts with leadership. Billings Clinic gathers both CEOs and board members of partner facilities at meetings several times a year for education and best-practice sharing.
And their efforts extend all the way down to the level of front-line staff, who come to the Billings main campus for a two-week orientation session.
Align incentives to reward high performance
Lastly, you need to ensure that you’re holding your partners to the same standards that you have for yourself.
At Maine Medical Center’s PHO, they’re including non-owned ancillary providers in their shared savings contract. They’re working with providers in four areas: home health, lab, SNF, and behavioral health. And they’ve worked with each one to identify a shared performance dashboard, with financial upside for the partners if shared savings targets are achieved by the ACO.
If you have been rigorously selective about who you include and built cultural compatibility, the incentives dovetail nicely but don’t drive the partnership. And I would argue the converse is true as well. Getting the incentives aligned without doing the other things we’ve outlined here is no guarantee of success.