“Affiliation” continues to be more than a buzzword in Orange County’s hospital world.
The latest affiliation happened this month when St. Joseph Hoag Health and Children’s Hospital of Orange County said they were creating an accountable care organization. CHOC and St. Joseph Hoag Health are going to share in the financial and medical responsibilities of managing and providing care to patients. The institutions said the affiliation’s goals include improving quality, enhancing patients’ experience, and creating “efficiencies through collectively attending to patients’ needs and avoiding unnecessary treatments.”
The accountable care organization includes eight hospitals and nine medical groups and affiliated doctor networks. CHOC is remaining independent and will continue to care for children outside of the St. Joseph Hoag Health network.
Other combinations have come together in recent months.
• Fountain Valley-based MemorialCare Health System and UC Irvine Health said in October that they would team up to open clinics and other outpatient centers for delivering primary healthcare to newly insured patients via healthcare reform.
MemorialCare’s efforts even go past its Orange County core. The nonprofit said roughly a month ago that its Miller Children’s Hospital in Long Beach would work with Torrance Memorial Medical Center, an unrelated facility, to expand pediatric care.
And St. Joseph Hoag Health kicked off the affiliation surge in 2012 when its member hospital systems, St. Joseph Health System and Hoag Memorial Hospital Presbyterian, announced plans to create an integrated regional delivery network.
Affiliations are seen as key for hospitals to remain competitive with employers and health plans, which prefer a variety of options for their members. They are often designed to create efficiencies through collaboration and to squeeze costs out of the health system. The Business Journal’s Vita Reed asked several Orange County hospital executives to discuss what they hope to accomplish by affiliating. Edited excerpts of their answers follow.
Dr. Richard Afable
Chief Executive
St. Joseph Hoag Health
To meet the goals of improved quality and reduced costs in today’s changing healthcare environment, health systems must be creative and flexible in their strategies. As part of our transformation to value-based care, we will pay particular attention to strategies for the big task of population health management, one of the main goals of healthcare reform.
The work involves preventive health initiatives, better coordination of care at all points of access, and managing those with chronic conditions so that they experience fewer hospitalizations.
One hospital, or even one health system, cannot manage this type of broad, communitywide effort alone. It requires close relationships with physicians, greater expansion into preventative and outpatient care, and even innovative virtual connections with our patients.
Our latest accountable care organization partnership with CHOC is a good example of coming together to become better at population health management and doing more for the community. This collaborative, comprehensive approach across generations will prove efficient and effective.
Together, we will have a common goal of reducing cost, improving outcomes, increasing access and enhancing patient experiences. Care will be more coordinated with less chance of duplication and more opportunity for all to benefit from our collective good work.
On the financial side, our experience in other ACO relationships has shown reductions in cost of 10% to 15% or more. We believe that this is the type of partnering which brings value to the market and demonstrates what like-minded, visionary organizations can accomplish together.
Dr. Nick Anas
Pediatrician in Chief
Children’s Hospital of Orange County
For 50 years, CHOC Children’s has been guided by a vision to be the leading destination for children’s health by providing exceptional and innovative care. That’s a big job and one that we have always achieved through partnerships with other healthcare and community-focused organizations.
It certainly takes a community to provide outstanding healthcare services for our children. In recent years, however, as healthcare has become more complex, we have also found it important to formalize these relationships, ensuring that there is even more seamless coordination.
Our most recent accountable care organization with St. Joseph Hoag Health is an example of the type of arrangement we feel is important for the future. By joining in the organization, we share in the management and financial responsibility of ensuring excellent pediatric care is delivered in the right setting and in the most efficient and effective manner.
That’s good news for everyone as we keep costs down. It’s especially good news for patients and families as we help them navigate the often-confusing process of attaining care, particularly when a family is facing a serious health situation.
We also work together to find solutions outside of the acute-care setting, helping children with chronic conditions, such as asthma or diabetes, manage their health and live the active lives they deserve. As we see it, the very big job of giving our children the best in healthcare will yield better results when many caring, expert clinicians and staff agree to work together.
Barry Arbuckle
President, Chief Executive
MemorialCare Health System
At MemorialCare Health System, we truly value our partnerships with leading, high-quality hospitals, health systems, physician groups, colleges and universities, outpatient centers, health plans and other forward-thinking organizations—which help us more optimally serve our communities.
Our goal is to create new, innovative models of care that improve the health and well-being of communities by leveraging the strengths of each participating organization. These partnerships are rooted in a shared focus on providing superior quality and exceptional service with affordable locations easily accessible to patients and families.
MemorialCare’s partnerships are transforming healthcare in local communities. An affiliation agreement with UC Irvine Healthcare, for example, creates new state-of-the-art primary care health centers that relieve shortages of primary care physicians and improve access to care. Collaborative activities with colleges and universities greatly increase the numbers of much-needed, highly trained physicians, nurses and other clinicians. Joint ventures with physician groups and well-regarded ambulatory organizations resulted in two dozen ambulatory surgery centers, imaging facilities, and urgent care centers throughout the region.
Unique relationships with health plans broaden the continuum of care for those facing chronic illnesses. Joint efforts among our emergency departments, urgent care centers, and physician practices ensure ongoing healthcare provided in the right location with the right physician at an affordable cost.
An affiliation between our Miller Children’s Hospital Long Beach and Torrance Memorial is one of many opportunities for community hospitals to improve pediatric services so children can stay in their community with local access to highly specialized pediatric physicians.
A strategic partnership with Cedars-Sinai that provides a valuable gateway for entrepreneurs to refine and accelerate product development results in easier access to the latest healthcare advances. These represent just a few examples of how partnerships make a difference in the health of our communities.
Partnerships also serve to deepen physician relationships, expand outpatient offerings, create efficiencies by managing costs, further the continuum of care, and strengthen MemorialCare Health System’s position as a comprehensive, integrated delivery system that offers access to more than 200 care locations, including six top hospitals, with many more partnerships in the works.
These efforts are fueled by our promise to provide the most convenient healthcare options in locations where Southern Californians live and work. Cultural, operational, clinical, and information technology integration, as well as economic alignment of all partners, ensures MemorialCare delivers the highest value in healthcare.
Terry Belmont
Chief Executive
UC Irvine Healthcare
We have entered into a number of formal affiliations in recent years with the intent of creating an integrated healthcare network that extends UC Irvine Health’s world-class care across the region. As Orange County’s only university hospital, we are embracing the goal of high-value healthcare as intended by the Affordable Care Act.
UC Irvine Health continues to serve our traditional role as the tertiary-quaternary care provider of choice for community hospitals, physicians and their patients. Last year, more than 1,100 patients were transferred from community hospitals for treatment of complex conditions, and our busy trauma and burn centers are essential to the county’s emergency medical services network. We are also working with our partners in leading the effort in managing the health of our community, which requires us to offer our preventative and primary care programs throughout the community.
Extending UC Irvine Health’s clinical footprint across Orange County and the region is a key goal for us and in many cases will be achieved through partnering with existing hospitals and physician groups.
These partnerships are also an important part of our academic mission. Hundreds of community physicians help teach our medical residents as volunteer members of UC Irvine’s faculty.
As Orange County’s only National Cancer Institute-designated comprehensive cancer center, one of only 41 in the nation, we view these partnerships as a means to increase the number of patients who have access to the groundbreaking research and clinical trials that are offered through UC Irvine Health’s cancer center.
Last year, we took a major step toward expanding UC Irvine Health into the community by entering into an affiliation with MemorialCare Health System. Our goal is to create an innovative, high-quality, and cost-effective primary care network that will serve as the backbone for keeping people in our community healthy and coordinating their care when they do need additional tests or treatment.
The UC Irvine Health affiliation with CHOC Children’s is in its fifth year and remains committed to a pediatrics center that integrates high-quality, comprehensive patient care; leading-edge research; and excellent teaching programs to train the next generation of pediatric specialists. Children across the region are benefiting from our clinical and academic collaboration.
We will continue to evaluate formal partnerships with health systems and healthcare providers who share our goal of delivering high-quality and cost-effective care to the Orange County community.
