CHP and Mount Carmel are among partners
By JULIE MINDA
Two Catholic health systems are among the four nonprofit Ohio organizations that have joined together to form Health Innovations Ohio, a statewide provider network that plans to improve health care delivery by better coordinating the way care is provided, according to the organization's head.
Jim Reber, Health Innovations Ohio president and chief executive, said the organization's goal is to design a new model of care for Ohioans integrating the care provided by the four partners. Prior to assuming leadership of Health Innovations Ohio, Reber was president and chief executive of Catholic Health Partners' St. Rita's Health Partners Region and president and chief executive of St. Rita's Medical Center of Lima, Ohio.
CHP of Cincinnati; Mount Carmel Health System, a Catholic provider based in Columbus, Ohio, that is part of CHE Trinity Health; Summa Health System of Akron, Ohio; and University Hospitals in Cleveland began their partnership in Health Innovations Ohio in 2012 and launched it publicly in September 2013.
The partner organizations did not merge assets, according to Reber. Each will make an annual investment of $100,000 into Health Innovations Ohio, and they will share expenses.
The chief executive of each partner holds a seat on Health Innovations Ohio's board. The board includes Michael Connelly, president and chief executive of the CHP parent system; Claus von Zychlin, president and chief executive of Mount Carmel; Thomas Strauss, president and chief executive of Summa; and Thomas F. Zenty III, chief executive of University Hospitals. Health Innovations Ohio has one employee besides Reber, an assistant. Teams of the partner organizations' leaders and clinicians are doing the bulk of the implementation work, with Reber and the chief executives steering the efforts.
Through Health Innovations Ohio, the partner organizations will share best practices, implement population health approaches that use proven interventions to improve health outcomes in large groups of people, and work to reduce costs and improve efficiency in health care delivery, said Reber. He said the partners are avoiding antitrust concerns because, while they are sharing information about improving quality and services, they are not discussing specific pricing, they are not influencing revenue and they are not contracting jointly with any vendors. Also, the primary markets of the four organizations do not overlap, although some of their secondary service areas do.
Health Innovations Ohio has three initial areas of focus: expanding insurance products for seniors through Medicare Advantage, improving how care is coordinated for patients insured through Medicaid and applying population health approaches to the employees of the four partner organizations and those employees' dependents.
Medicare Advantage plans are offered to seniors by private companies through contracts with Medicare. The plans cover both Part A and Part B Medicare as well as drug benefits. To expand the availability of Medicare Advantage in Ohio, Health Innovations Ohio is making the insurance products of two of its partners available through its two other partners. As of January, Mount Carmel's MediGold plan and Summa Health System's SummaCare plan are available through CHP and University Hospitals' markets as well. Mount Carmel and Summa Health both have licenses to sell Medicare Advantage; CHP and University Hospitals will offer co-branded insurance products from Mount Carmel and SummaCare.
The four are exchanging information about how best to manage the care of their Medicare Advantage patients. They are focused on quality outcomes and cost management, Reber said.
The four organizations plan to participate in pay-for-performance and shared-savings contracts with Medicaid managed care contractors — one of the contracts is nearly in place, according to Reber, and another is under discussion. To work together on these contracts, Reber said, the four will share information on how to deliver care more effectively, and improve care coordination while cutting costs. They will collaborate on quality initiatives but negotiate financial arrangements separately, according to Reber. One shared-savings contract likely will aim to reduce Medicaid recipients' nonemergency use of emergency department care.
The four also will help each other determine which wellness approaches work best to improve employee health and reduce costs associated with employee illness. Reber said partners likely will use incentives to encourage employees to exercise more, eat healthier and better manage their chronic illnesses. "We will share best practices, and each member will design and implement their own programs," he said.
This should help to improve care and reduce costs, he said. The work happening in the three focus areas could build the foundation to improve the health of other populations in addition to the Medicare Advantage, Medicaid and employee populations, Reber said.
Health Innovations Ohio's partner systems
Catholic Health Partners of Cincinnati
- Operates 24 hospitals and 15 long-term care facilities in Ohio and Kentucky.
- Has 33,132 employees and 5,593 affiliated physicians.
- Plans to acquire Kaiser Permanente Ohio's health plan and to continue its group practice and care delivery in northeast Ohio.
- Plans to partner with Summa Health System, including a CHP minority investment in the system.
- The system's Mercy Health of Cincinnati is exploring a strategic affiliation with the 60-bed, private, not-for-profit McCullough-Hyde Memorial Hospital of Oxford, Ohio.
Mount Carmel Health System, Columbus, Ohio
- Includes four central Ohio hospitals.
- Has more than 8,000 employees and 1,500 physicians. One hundred and twenty of those physicians are part of Mount Carmel's medical group.
- Has affiliated with UnitedHealthcare to form an accountable care organization.
- Is affiliating with Ohio State University Wexner Medical Center.
Summa Health System of Akron, Ohio
- Has eight owned or affiliated hospitals.
- Has about 10,000 employees and more than 2,000 physicians. Three hundred of the physicians are employed by Summa's physician group.
University Hospitals in Cleveland
- Includes University Hospitals Case Medical Center, a 1,032-bed tertiary academic medical center, and network of affiliated hospitals and outpatient centers.
- Has about 18,500 employees and more than 5,500 physicians, if physicians with joint venture hospitals are included. More than 3,000 of those physicians are employed by University Hospitals.
- Has added Parma Community General Hospital of Parma, Ohio, and EMH Healthcare in Elyria, Ohio, to the University Hospitals system. Plans to add Robinson Memorial Hospital of Ravenna, Ohio.
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