At Medecision, we understand the importance of healthcare partnerships and collaboration. When we work together, we can improve healthcare for everyone.
Even before the pandemic, the healthcare industry was undergoing sweeping changes. Like most industries, the pandemic revealed more vulnerabilities in the healthcare ecosystem and made it clear that strong partnerships may be more important than ever.
Partnerships between healthcare providers and insurers, as well as among nonprofits, community organizations and others—private and public—are increasingly important in a time of limited resources and increasing needs. As the healthcare system goes through “tectonic changes,” healthcare payers and providers have opportunities to shape the ecosystem in which they operate, rather than simply reacting to it, according to EY.
When various partners come together to make healthcare better and more accessible, they often focus on accomplishing one or more shared goals. Most often, those goals include cutting costs, improving care and increasing overall population health. Here’s a look at how various stakeholders are joining forces to meet these goals together.
Serving Local Employers and Employees
In the tri-county region of Portland, Ore., employers provide health coverage for almost 1 million residents. However, “employers in our region continue to grapple with the rising cost associated with providing comprehensive health benefits to their workforce,” said Ken Provencher, president and CEO of PacificSource Health Plans in a statement.
In an effort to rein in costs for employers provide high-quality care, PacificSource joined with two Portland hospital systems, Legacy Health and the Oregon Health & Science University (OHSU) Health System, to introduce new health plan offerings in January 2020. The two systems bring a total of 10 Portland-area hospitals, along with clinic and care locations across the metro area, and more than 5,200 providers, to participate in the provider network that anchors this collaboration.
By working together, this group of regional partners are able to offer highly competitive health benefit plans to help employers in their area provide comprehensive benefits to employees in a cost-effective way.
Other healthcare providers are working together in different ways to simplify employers’ ability to offer health benefits to their employees. For example, Chicago-based CommonSpirit Health, which owns 137 hospitals in 21 states, is partnering with Everside Health (formerly Paladina Health) to make it easy for employers to provide cost-effective, direct primary care for their employees. Everside Health is a boutique healthcare company that owns 340 employer-sponsored health centers across the United States.
Through the partnership, CommonSpirit and Everside offer membership-based primary care services at clinics in Las Vegas, with plans to expand to other regions served by CommonSpirit. Participating employers pay a fee for each employee for primary care services. As a result, their employees are able to access primary care without paying any copays or other out-of-pocket costs.
By making it easy for employers to provide affordable, convenient care for their employees and employees’ dependents, CommonSpirit and Everside aim to improve access, health and wellness. The clinics focus on prevention and chronic care management, which can help employers avoid the higher costs of untreated or unmanaged illnesses.
“To keep our communities healthier, we need to increase access to care models focused on prevention and primary care access,” Rich Roth, senior vice president of strategic innovation at CommonSpirit, said in a statement. “Working in partnership with [Everside] Health, CommonSpirit will support employers by developing direct-to-primary care options focused on access, affordability, health and wellness.”
Refocusing on Value
In addition to cutting costs, healthcare partnerships can also improve healthcare outcomes. And in Maryland, that’s what CareFirst BlueCross BlueShield and MedStar Health aim to do. The nonprofit health insurer and the nonprofit health system joined forces in 2020 to create a value-based care partnership. Their goals are to improve affordability, accessibility, quality and patient experience for their communities.
Rather than focusing on a traditional payment approach based on patient volume, the partnership focuses on positive patient outcomes, with an emphasis on preventive care. Over the next seven years, CareFirst and MedStar project a savings of $400 million.
A management team with leaders from both organizations will guide the partnership in its cost-saving objectives such as improving patient experience, increasing care coordination and enhanced technology integration.
“As two not-for-profit healthcare companies spanning the same region and serving the same people, we have a shared responsibility to ensure members and employers are getting maximum value for their healthcare dollar,” CareFirst President and CEO Brian Pieninck said in a statement.
Reaching Underserved Communities
The coronavirus pandemic uncovered widespread health disparities across our populations, and increasingly, healthcare partnerships are focused on eradicating those disparities and providing better, more equitable care for all. One example of a health partnership focused on reaching the underserved communities is in Detroit, where representatives from Michigan State University and Henry Ford Health System signed a letter of intent to work together to improve patient access to care, healthcare affordability and disparities in health outcomes.
Through this partnership, the two organizations aim to perform better research in an effort to improve patient care, and to boost the health of the populations in the Detroit area. Both the health system and the university will engage in shared research focused on health equity, health disparities, the social determinants of health, primary care and other important topics.