Intermountain reorganizes its regions to form a 'model for tomorrow'

Looking to get ahead of any changes roiling the industry, Intermountain Healthcare is reorganizing its management structure, CEO Marc Harrison said Thursday at Modern Healthcare's Leadership Symposium in Arizona.

The Salt Lake City-based integrated health system is replacing its geographically defined administrative regions with a systemwide structure made up of community care and specialty care divisions.

The community care group will focus on keeping people well through preventative services like health screenings as well as primary care including regular outpatient treatments for managing chronic diseases, the company said. The latter aims to deliver the proper care at the right time through specialist and hospital inpatient settings.

The goal is to get aligned internally so that decisions are made more strategically and the health system can adapt quickly and communicate better with patients to deliver more efficient and effective care, Harrison said. There will be greater stewardship over quality and safety as the organization aims to establish consistency across the system, he said.

Harrison pointed to the provider Iora Health in Boston as a company that helps build successful primary care models.

"What would I do if Iora Health came to Salt Lake City and took us apart? I'd much rather we disrupt ourselves," Harrison said at the symposium.

The community and specialty divisions will have their own leadership teams made up of chief medical, nursing and operating officers who will report to Harrison's leadership team. A chief consumer officer will also take on traditional marketing roles and drive digital strategy as well as leverage big data and artificial intelligence to pursue things like precision medicine, Harrison said.

The hope is that this will streamline decision-making and remove some of the competition between practices and hospitals, he said. Some administrative jobs would disappear, while others would be put into new roles, said Harrison. He did not specifiy how many jobs would be impacted.

As health systems move beyond initial strategies to reduce costs and improve care like shuffling supplier agreements or shifting more care to ambulatory facilities, some organizations like Intermountain are embarking on the more complex task of restructuring management and revamping corporate culture.

As patients pay for a larger share of their care, more competitors contend for certain markets and services, and the demand for better access and quality mounts, more providers are realizing they need to reorganize around the patient, said Brian Fuller, national partner of consulting at Advisory Board. The most difficult transformation starts at the human level, he said.

"There is a realization that organizations need to change how they fundamentally think and behave," Fuller said. "They are rewiring the circuitry of these organizations."

Providers are increasingly relying on executives with backgrounds in strategy and operational integration—sometimes outside of the industry—to lead these changes.

Intermountain, which has 22 hospitals, 1,400 employed primary-care and secondary-care doctors at more than 185 clinics and an insurance plan, recently tapped Kevan Mabbutt as its senior vice president and chief consumer officer to help develop a more customer-centric mentality and culture. Mabbutt has helped brands like Disney, Discovery Channel and the BBC boost their customer experience.

"There is no U.S. healthcare system. It falls to providers to now get organized to more effectively deliver efficient care," said Dr. Mike Schatzlein, of-counsel at consulting firm Jarrard and former senior executive at Ascension Health. "You need the ability to deliver comprehensive care to a population in a regional area or multiple regions. How you organize to get that is still being experimented with."

On Jan. 1, Intermountain will launch an entirely virtual hospital that will cost a fraction of a traditional hospital build, Harrison said. It will provide tele-stroke, tele-behavioral health and tele-trauma, among other services co-located in a "bunker" in Salt Lake City, he said.

The system plans to add virtual pediatric and adult acute care services in 2019.

The goal is to keep people at home, or as close to home as possible, Harrison said.

"We want to be a model for tomorrow," he said.

An​ edited​ version​ of​ this​ story​ can​ also​ be​ found​ in​ Modern​ Healthcare's​ Oct.​ 23​ print​ edition.