By BETSY TAYLOR
Ascension Health and CHE Trinity Health have formed a clinically integrated network of health care providers in Michigan to support a population health management approach to health care and to service "value-based" health plan products, including insurance that will be sold through public and private health insurance marketplaces.
The systems are not merging assets. Through a new company announced May 7 called Together Health Network, they established nearly statewide service coverage, an important advantage in working with employers and other payers to develop health insurance products. An estimated 75 percent of Michigan residents will be within 20 minutes of a Together Health Network provider, said Rick O'Connell, executive vice president of CHE Trinity Health and president of Trinity Health Division. System leadership said this estimate is based on currently owned assets and employed providers. The network is recruiting additional providers, including physicians. It will negotiate contracts for network provider participants, system leaders said.
The network will provide access points for patients across Michigan. The systems said they're focused not on episodic care, but on a coordinated continuum of services. The network includes 27 hospitals and hundreds of ambulatory centers and physician offices, as well as skilled nursing, long-term care and senior living, home health and hospice and durable medical equipment.
Patricia Maryland, president of health care operations and chief operating officer of Ascension Health, said, "We're going to use this as an opportunity to think outside of the box. It's about innovation. It's about looking at ways that we can help improve clinical outcomes, create the most cost-effective delivery systems that we can provide." Leaders will explore a variety of contracts with payers, including those that allow for shared savings or bundled payments to promote accountability for the quality, cost and overall care provided to a patient population.
Ascension Health and CHE Trinity Health each will maintain 50 percent financial equity in the network, which will be a for-profit company, and contribute half of the capital and operating funds needed. Maryland said it's too early to say how much the systems will invest in the network, or even where in Michigan the network's headquarters will be located. Maryland and O'Connell said the network will have a physician chief executive, possibly with an interim executive appointed first, and a 15-member physician-majority board. O'Connell said the board will include physician representatives from throughout the geographic areas covered by the network.
Together Health Network will not be a Catholic company, but the sponsors of the parent health systems have retained reserved powers to prevent the network from actions that do not comply with the Ethical and Religious Directives for Catholic Health Care Services, Maryland said.
The new network is an outgrowth of the systems' commitment to Catholic health care, system leadership said. O'Connell said a population health approach can help the network reach more people and help meet their health needs in their communities. The network will allow providers to coordinate care, have access to best practices and refer to specialists throughout much of the state. System leadership said the network will focus on person-centered care in its physician and patient relationships.
Maryland, who resides in Detroit, drew from her own life to explain how care coordination benefits patients. Her mother died of complications from diabetes more than a decade ago. During her mother's long illness, Maryland saw firsthand how health care providers, in general, often provide "islands of care," taking care of one illness or condition without communicating with a patient's other doctors. Navigating a health care system can be difficult, particularly for someone with multiple chronic illnesses, she noted. She said the work of the new network will include improved communication between patient and providers, and between multiple providers, on care coordination.
Both employed physicians and independent physicians can participate in the network, which system leaders estimate will grow to over 5,000 independent and employed physicians.
O'Connell said the health systems developed the clinically integrated network to be able to care for members of various health plans. So, for instance, Blue Cross Blue Shield has multiple plans. "We would hope they'd choose our network to provide coverage for those plans. With Medicare Advantage products, federal products, we hope to build collectively to support an offering on a Medicare managed care basis. Our intention is not to be an insurance company, but to be the provider solution for those various products," he said.
Livonia, Mich.-based CHE Trinity Health has 13 hospitals in Michigan, with six hospitals in the Saint Joseph Mercy Health System and seven Mercy Health hospitals. St. Louis-based Ascension Health's ministry in Michigan includes 14 hospitals through Borgess Health in Kalamazoo, Genesys Health System in Grand Blanc, St. John Providence Health System in Warren, St. Joseph Health System in Tawas City, and St. Mary's of Michigan in Saginaw. Together, the systems employ about 60,000 people in Michigan.
"We complemented each other. We were pretty much in different markets with the exception of southeast Michigan, the Detroit area, where we have overlap," O'Connell said.
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