Tighter affiliation strategies such as a merger with

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close to home. Tighter affiliation strategies, such as a merger with a larger system, typically provide greater support for operational and IT needs. STAND-ALONE HOSPITALS Stand-alone hospitals in competitive markets probably are aware of acquisition and affiliation activity drivers that involve issues of size and scale. Some degree of affiliation activity likely will be necessary for these hospitals to remain competitive. The primary question is the extent to which stand-alone hospitals want to remain independent. The collaborative partnership models that are emerging in markets around the country, as described in this report, are among the affiliation options that offer opportunities to achieve the benefits of greater size and scale without yielding organizational inde- pendence. Whether a stand-alone hospital wishes to remain independent or join a larger system, considerations such as the hospital’s market position, financial strength, and physician relationships will have a significant effect on its options. HealthPartners’ ability to utilize data analytics to achieve Triple Aim goals has been demonstrated by tools the system has developed to reduce total cost of care within its own care delivery network and, as a health plan, with other providers across the state. In 2007, for example, HealthPartners developed a point-of-order decision support tool that could be embedded in EHR systems and offered the tool for use to all healthcare systems in the state (part of a multi-payer initiative to reduce the use and cost of high-tech diagnostic imaging). The decision support tool collects information submitted by a clinician during the ordering process and, based on indications from the patient assessment, feeds back a utility score for imaging ranging from 1 (low) to 9 (high). The clinician can still order imaging when the utility score is low, but the tool vendor but have been on different instances of that system. An immediate emphasis is on getting all entities on the same instance of the EHR, as well as on the same financial management system. The combination of HealthPartners and Park Nicollet has the potential to be a “game changer” because the combined entity is able to compete across the entire Twin Cities metropolitan area and has access to clinical data on a combined patient population of approximately 1 million. Among other factors working in its favor: It brings together key specialty focuses, with the ability to develop deeper subspecialization across the larger patient base. And it creates a system that is relatively light on hospital beds, with an emphasis instead on primary and specialty care services in clinics and ambulatory settings.
10 hfma.org Some combinations can comprise both horizontal and vertical components. An example is HealthPartners, which had both a health plan and care delivery components—i.e., hospitals and clinics—before its 2013 combination with Park Nicollet, which was composed of a multispecialty clinic and a hospital. For HealthPartners, the combination was

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