Strategic provider partnerships deliver best value in pursuit of population health
The prevailing model for academic medical centers is to own and expand a primary-care network. There is, however, another model—one focused on geography and community need.
We believe the future of academic medicine lies in strategic partnerships, where university medical centers affiliate with primary-care physicians and local specialty groups, complementing these relationships with tertiary and quaternary expertise drawn from the academic institution.
In our view, this approach is both visionary and pragmatic. Los Angeles may be a unique market, but there are lessons that can be applied in other communities. And if we take a step back, we can see where this discussion fits.
Value-based healthcare is premised on the value equation: quality and service/cost. The goal is to provide high quality and efficient care for each patient. Population health programs take a broader view by exploring and understanding discrete patient populations, and providing the educational tools and patient care to prevent disease, promote better health and prolong life. As an example, at Keck Medicine of USC, we have a stroke awareness program that uses detailed local demographic information to identify at-risk neighborhoods and educate residents about the dangers of smoking or being overweight, and so on.
Pursuing population health management is typically idiosyncratic; institutions are developing their own approaches and lack a real template. Many organizations say they have a strategy and have assumed increased risk, deploying programs aimed at defined populations. But we know from recent surveys that too many healthcare executives, while promising to pursue population health initiatives, haven’t actually started the process.
To achieve the objectives of population health, value-based care needs to be interwoven with population health programs. It’s essential to focus on the population while simultaneously delivering value-based care to individual patients (i.e., deliver care individually and focus on a population’s needs). Hospitals and healthcare providers are adopting value-based operational models. While some choose to own their primary-care networks, our institution chose to affiliate with strategically situated primary-care and local specialty groups to broaden our footprint. The strategy is to work with community providers to improve care locally while offering the complex care an academic medical center can deliver.
Our population health management strategy runs counter to what most academic medical centers are doing— that is, to try to manage care through owning primary-care and specialty physician groups—which ignores community physicians and their longstanding referral relationships. Los Angeles’ broad geography and our deep expertise in treating critically ill patients prompted us to go in another direction. Because quality primary care is being provided locally, we have departed strategically from the conventional model. Better to partner with primary-care doctors and complement local medical specialty groups—and thereby enable our organizational strengths to shine through.
To that end, we set up unique partnerships to support the area’s diverse healthcare communities while bringing the most complex cases back to our hospitals. We want to offer a high level of expertise while bringing care closer to patients on the assumption that if our surgeons can do cases in hospitals in the community, that’s what makes the most sense for the patient.
In practice, this means that for our multiple partners dispersed across Southern California, specialty care is now available. At Torrance Memorial Hospital, for example, our institution has effectively become the facility’s cardiac surgery program. Ditto for other specialty programs around the region. As these partnerships demonstrate, our population health goal is to add our expertise to the value equation.
As we grow our population health management strategy, we plan to take on risk for a specific portion of the patient population. That will mean taking capitation for high-end care and then focusing on reducing our costs, improving our quality, and making sure that we’re accessible for people when they need us.
We believe that’s a formula for both good business and exceptionally good medical care.
Tom Jackiewicz is CEO of Keck Medicine of USC in Los Angeles.