Trinity, Ascension create physician-led network across Michigan

July 1, 2015

By NANCY FRAZIER O'BRIEN

WASHINGTON, D.C. — New approaches based on long-standing values are fueling a year-old, physician-led collaboration between Ascension Health and Trinity Health in Michigan.

Leaders of the Together Health Network and the two health systems addressed an Innovation Forum at the Catholic Health Assembly here June 8 to describe the joint venture that aims to bring low-cost, high-quality health care to up to 160,000 Michiganders not previously served by the two systems.

Richard O'Connell, outgoing chairman of the Together Health Network and executive vice president of the east group of Trinity Health in Livonia, Mich., said the collaboration with St. Louis' Ascension Health was a natural fit because the missions and values of the two systems are "very much aligned."

But when discussions of the collaboration began in late 2012, Trinity and Ascension agreed from the outset that they would offer something "different from what others could provide" and that there would be no merger of assets of the two systems, he said.

O'Connell said the time was ripe for such a joint venture in 2012 because one in five residents of the state would be changing insurance in the next five years — either by becoming eligible for Medicare, obtaining insurance for the first time through a state exchange under the Affordable Care Act or qualifying for Medicaid as the program expanded.

Together Health Network is made up of nine different clinically integrated physician networks that cover most of the state, he said.

Dr. Scott Eathorne, chief executive of Together Health, said some physicians initially were "skeptical at best" about the new concept but most were eventually persuaded by the idea of "two sponsors with national reputations for health population management."

The network was deliberately created as a "thin-layer organization," he said, and physicians hold nine seats on Together Health's 15-member board. Four seats are held by the sponsoring systems and two go to community members.

Gwen MacKenzie, a board member of Together Health, and senior vice president of Ascension Health and market leader for Ascension Health-Michigan, said the network launched on Jan. 1 a Medicare Advantage product along with Michigan's Blue Care Network from Blue Cross Blue Shield of Michigan that has gained 29 percent of new Medicare Advantage participants in the state.

She said 75 percent of the Michigan population lives within a 20-minute drive of a Together Health location. Although some gaps remain, the network is being "very surgical, very tactical about filling those gaps," she said.

MacKenzie said she considers it a "courageous move for two competitors" to become sponsors of an organization that they then "turn over to be led by physicians.

"The capital needed to fund this and propel it forward was not insignificant," she said. "But we want to be sure to remain true to that thin-layer organization and to be sure we offer value-added health care."

She said physicians are not currently required to use particular tools offered by the network but are required to meet certain outcomes established by Together Health.

During a question-and-answer period, O'Connell said some issues remain to be resolved, such as how to share risks and savings across different geographical regions of the state and how to standardize information technology and reduce IT expenses. The latter, he said, is "not a question of if, but when and how."

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