Partners without mergers: Seven Wisconsin health care organizations join forces
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The Affordable Care Act has inspired a wave of mergers and consolidations in the health care industry. Hospitals are merging with insurers, other hospitals, and entire health systems, and smaller health systems are merging with larger health systems. And then there are the “OWAs” — other weird arrangements — as St. Mary’s Hospital President Frank Byrne has described them.
The seven Wisconsin organizations that have formed a new collaborative health network would certainly not characterize their partnership as weird. For several reasons, they chose not to merge or consolidate, as other organizations have done in response to certain provisions of the ACA, but whether they merge, consolidate, or simply partner, the law is incentivizing health care organizations to improve care, better manage large patient populations, and control costs.
To the cynics, the consolidation wave is nothing but a ploy to grab market share and maintain pricing power, but in announcing their new partnership, the participating organizations said they expect to create a new model for the nation when it comes to more effective and affordable care delivery. UW Health in Madison, the umbrella organization that includes UW Hospital and Clinics, joined the statewide partnership along with the following health care systems: Aspirus System, Wausau; Aurora Health Care, Milwaukee; Bellin Health, Green Bay; Gundersen Health System, La Crosse; and ThedaCare, Appleton. More recently, Waukesha’s ProHealth Care joined the network, which is still open to other prospective partners.
ThedaCare’s Greg Devine is president and CEO of the partnership, which still lacks a formal name. He said the organizations pursued a partnership rather than a merger because of the strong sense of community and culture embedded in each organization — some have served their respective communities for more than 100 years — and because they preferred to balance that community history with the opportunity to collaborate on a broader scale.
As health care evolves, the organizations hope to implement the fruits of collaboration — including the sharing of clinical and financial best practices — more quickly than if they had continued to work independently. “One of the opportunities that we think is going to result from this relationship is what you might call a ‘learning collaborative,’” Devine said.
Jeff Thompson, CEO of Gundersen Health System and chairman of the partnership’s board of directors, characterized the participating organizations as high performing compared to health care organizations in other states, but not high performing compared to the ideal. He believes the partnership, which he called a “system of systems,” will serve as a model for the nation on how to more quickly improve quality and lower costs. “We don’t need the encumbrances of mergers of organizations or assets to more quickly agree that this or that practice is what we need to do for the well-being of the communities we serve,” he stated.
Most news coverage of the ACA is centered on changes to insurance, insurance markets, and public exchanges; meanwhile, the law’s impact on the business of health care is buried. But the opportunity to incent or reward health care organizations for doing the right thing, rather than doing more things, is a fundamental principle of the law.
Devine said that in forming the Wisconsin partnership, participating organizations are not responding to the ACA but simply continuing a decade-old quest to improve clinical quality and control costs in the process. All of them participate in the Wisconsin Collaborative for Health Care Quality, a quality-reporting system that measures performance in various aspects of ambulatory and hospital care.
“By coming together and becoming clinically integrated, we will more carefully compare our performance on quality and safety measures than we have in the past,” noted Dean Gruner, president and CEO of ThedaCare. “In that regard, it’s like taking our work in the WCHQ and trying to put that on a turbocharger.
“The point is we’re going to be looking at our performance relative to each of the other organizations. There will be more scrutiny, and that starts with transparency and understanding your performance. But then you can learn from each other and improve your work.”