Five Maryland-based health systems announced Monday that they will form a non-ownership alliance to strengthen their performance under the state's global budget reimbursement system.
Members of the Advanced Health Collaborative will share best practices and explore opportunities to reduce costs by investing in care-management infrastructure, the group said. The state's new all-payer model, in which hospitals receive a predetermined reimbursement for care based on the size of the populations they serve, is a driving force for the collaboration.
“What we're doing … is investing in care-management infrastructure,” said Robb Cohen, CEO of the new collaborative. “It gives everyone access to lower costs and best practices.”
Hospitals and health systems in several states have formed similar collaboratives in recent years hoping to achieve the benefits of sharing best practices and some level of integration without giving up their independence. Last month, for example, the Cleveland Clinic and five other Ohio providers announced they had formed an alliance.
The Maryland alliance of relatively small systems could offer its members a chance to play on a level field with the three big, multihospital health systems in Maryland: MedStar Health, Johns Hopkins Medicine and the University of Maryland Medical System.
There are only a few independent hospitals left in the state that aren't members of the alliance, including Greater Baltimore Medical Center and Atlantic General Hospital in Berlin, Md. By uniting smaller systems to collaborate on population health for a large portion of the state, the AHC could offer patients and payers a competitive “fourth alternative” to Hopkins, MedStar and the University of Maryland, said Charlotte Kohler, CEO of Woodstock, Md.-based Kohler Healthcare Consulting.
“I think that they'll be successful from the standpoint that there are times in which the big hospital systems sort of get in their own way,” Kohler said. “These people are coming together collaboratively and they all have their own best interests at heart.”
The systems involved in AHC have 10 hospitals. They include Adventist HealthCare, LifeBridge Health, Mercy Health Services, Peninsula Regional Health System and Trivergent Health Alliance, which encompasses Frederick Regional Health System, Meritus Health and Western Maryland Health System.
Though the collaboration is in the early stages, Cohen said many of its joint projects will include care-management infrastructure designed to reduce patient hospitalization. Included may be investments in updated IT infrastructure and telemedicine, multidisciplinary patient-centric care teams, palliative care, medication therapy management and primary-care office retooling.
Agreements such as this provide hospitals an alternative to dealing with the financial complexities and lack of autonomy that comes with a merger while still taking advantage of reduced costs and idea-sharing.
“It's really a forum, more for dialogue and knowledge sharing to occur in a way that is legally permitted,” said Janice Anderson, an attorney specializing in healthcare and transactional law at Kansas City-based law firm Polsinelli.
The big three Maryland systems are capable of each offering the kind of continuum of care the AHC is offering, Kohler said, but they might have difficulty covering as much geographic area. “With the push from the (state government) to figure out ways to pull costs out of the system, what they're doing is figuring out ways to say all of our heads are better than one, while staying independent,” Kohler said.
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