The Clinic has provided quality-improvement consulting services for several years, a program that serves as a revenue stream for the health system.
It has branded cardiovascular affiliations with 14 hospitals. In those cases, the Clinic conducts detailed consultative assessments and ensures that the facility meets specific clinical quality thresholds before taking on a hospital as a Cleveland Clinic-branded affiliate.
The Rochester, Minn.-based Mayo Clinic has been working aggressively to expand a network of clinically affiliated hospitals. Mayo President and CEO Dr. John Noseworthy recently said the system plans to add another 10 organizations this year to the 14 already on board.
“As healthcare is changing, a healthcare system like ours has to be able to understand the nuances of practicing medicine in a much farther geographical area than we have functioned in the past, particularly on a day-to-day basis,” said Dr. Bruce Lytle, chairman of the Cleveland Clinic's Heart and Vascular Institute. “We have always functioned nationally and internationally in cardiovascular disease. In the future, it's going to be very important for us to continue to be able to do that.”
With CHS, the Clinic will evaluate the cardiovascular programs at two CHS hospitals, as well as the cardiovascular data and information systems at another five hospitals, said Dr. Joseph Cacchione, chairman of operations and strategy for cardiovascular medicine at the Clinic.
The goal is provide the information CHS needs to develop quality-improvement initiatives at a systemwide level for its own facilities. “We're not necessarily doing performance improvement with them,” Cacchione said.
With the quality alliance, in particular, CHS will work with the Clinic to establish clinical integration programs for the 17,000 physicians on the medical staffs of its 135 affiliated hospitals. Approximately 2,500 of those doctors are employed. The data that is collected, analyzed and compared can be used to support predictive modeling and population health management initiatives.
“If we can do this and do it in an effective way, it should be a helpful model in terms of delivery systems across the country,” Smith said.
The alliance may also serve as a marketing tool for CHS-affiliated hospitals and boost referrals for the Clinic. And, as health systems continue to evolve, the Clinic's role as a provider of specialized care may become a greater part of what it does.
Lytle said it's likely there will be a limit in the scope of complex care that a 300- or 400-bed hospital in a medium-sized city can provide, in part because of the costs associated with infrastructure and physician talent.
“Part of our future is going to be able to offer efficient medical care in conjunction with those organizations so that their patients stay their patients and at that time when they need very, somewhat unusual, and specialized care that they come to the Cleveland Clinic,” he said. “You're not going to be able to duplicate academic medical centers in every city in the country.”