Ken­tucky hospi­tal col­lab­o­ra­tive eyes chal­lenge of pop­u­la­tion health

Modern Healthcare - - PROVIDERS - By Dave Barkholz

Hav­ing or­ches­trated mil­lions of dol­lars in sav­ings in the sup­ply chain, a group of 10 hos­pi­tals in Ken­tucky is now turn­ing their at­ten­tion to a larger chal­lenge: man­ag­ing pop­u­la­tion health.

“This thing is go­ing to work,” said Michael Karpf, Univer­sity of Ken­tucky ex­ec­u­tive vice pres­i­dent for health af­fairs and one of the driv­ing forces be­hind the Ken­tucky Health Col­lab­o­ra­tive.

Years in the mak­ing, the col­lab­o­ra­tive came about as Karpf and oth­ers saw the com­ing re­im­burse­ment shift from tra­di­tional fee-for-ser­vice to value-based care that puts hos­pi­tals and physi­cians at risk for the cost and qual­ity of care.

To get the mem­ber hos­pi­tals used to work­ing to­gether, they jointly de­cided to start with some group pur­chas­ing ini­tia­tives over the past year that would gen­er­ate sav­ings be­yond the larger group pur­chas­ing or­ga­ni­za­tions that the mem­bers be­long to, in­clud­ing Premier, Karpf said.

By carv­ing out pros­thetic pur­chases and some med­i­cal-sur­gi­cal items, the hos­pi­tals have saved about $2 mil­lion so far, with an­other $2 mil­lion to $3 mil­lion in sav­ings ex­pected this year.

The sav­ings over time are ex­pected to pay for the $10 mil­lion that the mem­ber hos­pi­tals have pledged to cap­i­tal­ize the col­lab­o­ra­tive over three years, Karpf said. But an­other rea­son for start­ing with pur­chas­ing was to give the col­lab­o­ra­tive’s CEOs a chance to work to­gether, he said.

“We wanted to see this jell,” Karpf said. Other hos­pi­tals mak­ing up the col­lab­o­ra­tive in­clude Nor­ton Health­care in Louisville, St. El­iz­a­beth Health­care in Edge­wood, the Med­i­cal Cen­ter in Bowl­ing Green and Owens­boro (Ky.) Health.

The CEOs next month are ex­pected to give some di­rec­tion on how far and how fast the mem­bers want to in­te­grate clin­i­cally through in­for­ma­tion tech­nol­ogy ties, he said, adding that the process is still in the early stages.

The idea would be to help fa­cil­i­tate ear­lier in­ter­ven­tion on high-risk pa­tients with chronic con­di­tions. That’s es­pe­cially im­por­tant to the state.

Nor­ton has been ex­plor­ing ini­tia­tives in­volv­ing pop­u­la­tion health, but hasn’t com­mit­ted to any yet. “The goal around any of these would be to en­sure that in­di­vid­ual hos­pi­tals and the col­lab­o­ra­tive as a whole have a co­or­di­nated, in­te­grated sys­tem to take care of pa­tient needs in a new world of col­lec­tive con­tracts,” said Stephen A. Wil­liams, pres­i­dent emer­i­tus of Nor­ton Health­care.

Ken­tucky, for ex­am­ple, has the fifth-high­est adult obe­sity rate in the na­tion, ac­cord­ing to a Septem­ber study by the Trust for Amer- ica’s Health and the Robert Wood John­son Foun­da­tion.

Hos­pi­tals in other states have formed col­lab­o­ra­tives to tackle sim­i­lar is­sues. Two years ago, Mary­land formed the Ad­vanced Health Col­lab­o­ra­tive to share best prac­tices and ex­plore op­por­tu­ni­ties to re­duce costs by in­vest­ing in care-man­age­ment in­fra­struc­ture.

The col­lab­o­ra­tive was in part a re­sponse to Mary­land’s all-payer model, in which hos­pi­tals re­ceive a pre­de­ter­mined re­im­burse­ment for care based on the size of the pop­u­la­tions they serve.

The Univer­sity of Ken­tucky Med­i­cal Cen­ter in Lex­ing­ton, part of UK Health­Care, is one of 10 hos­pi­tals in the col­lab­o­ra­tive.

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