Two of Ohio's largest health systems, OhioHealth Corp. and Cleveland Clinic, are among six forming a statewide cost-control and quality improvement collaborative to get "ahead of the curve" as insurers demand better health outcomes for lower prices.
Members also are studying whether and how to create a statewide super-network to negotiate with those insurers.
"Somewhere up ahead – I cant tell you exactly when – the pressure and the demand by those paying for care are (to seek) more predictable price and predictability on outcomes," Mike Bernstein, OhioHealth senior vice president and chief strategy officer, told me. "We absolutely need to be prepared."
The first initiatives center on using data analytics across all six systems to find the best procedures and most cost-effective supplies – in particular, using data to appeal to doctors' scientific sensibilities over opinions on what devices and tools work best.
Some members are joining Explorys Inc., a big data spinoff of Cleveland Clinic, that analyzes how different supplies influence outcomes – one surgical kit over another in a knee replacement, for example. Some also are joining Excelerate Strategic Health Sourcing, a 2-year-old group purchasing cooperative of Cleveland Clinic and VHA Inc., an Irving, Texas-based consultant to nonprofit health systems.
"We as health care providers are expected to deliver the best value for patients; I would say the manufacturers of health-care products are expected to do the same," Bernstein said.
The release announcing the coalition says members actively are studying creating a "statewide provider network." For now, Bernstein said, activities will focus on evaluating and sharing best practices and launching community initiatives on public health and chronic disease management.
"Where that leads in terms of how we take that to the market, we don't know," he said.
With a collective 100,000 employees, members pledge to examine their own health benefits and workplace wellness programs.
"All of us are doing different things in different ways," he said. "It's a great opportunity to find how we can find the best of the best of that so we're ahead of the curve on value-based health care."
Systems that don't compete in the same geographic market are more often forming such collaborations to stay independent as they brace for the one-two punch of fewer inpatient stays and lower reimbursement rates.
Columbus-based Mount Carmel Health System is part of a similar statewide collaborative with systems in major markets that are rivals to those in the Midwest group, such as University Hospitals in Cleveland and Cincinnati's Mercy Health (the former Catholic Health Partners). Mercy, Ohio's largest system, also is in a nationwide purchasing and cost-control collaborative, publicly traded Premier Inc. (NASDAQ:PINC).
Founded in 2009 as an innovation spinoff from Cleveland Clinic, Explorys provides the healthcare industry a secure, cloud-based analytics platform that leverages big data for clinical integration, predictive analytics, and business intelligence. Its platform enables the country’s leading provider organizations to more effectively leverage their data to improve care quality, patient satisfaction, and deliver value-based care. The Explorys solution supports Population Health Management and Accountable Care models while applying the power of massively-parallel data processing to save lives and make healthcare affordable. Since its inception, the Explorys platform has been adopted by 23 major integrated healthcare systems with 315 billion data elements, 50 million unique cared-for-lives, 360 hospitals, and 317,000 providers who collectively deliver $69B in care annually.