Health systems have experienced big challenges in the last year, with cyberattacks affecting thousands of hospitals, rising expenses, workforce shortages and fractured relationships with payers.
With more changes on the horizon, including possible Medicaid cuts and rapidly evolving artificial intelligence, C-suite executives are increasingly describing healthcare as a “team sport.”
Eduardo Conrado, president of St. Louis-based Ascension, said overcoming significant roadblocks in the last 12 months reminded him “no one does it alone.”
“Faced with unprecedented challenges this past year, our associates came together with credible collaboration to serve our patients and communities. We also recognized that, while we know a lot, we don’t know everything, and could not work in isolation,” he said. “Experts like our partners, industry peers, government leaders and more formed a network of insight and support.”
Many hospitals and systems are forging partnerships with payers to develop new programs or targeted initiatives for more population-based care. The alliance is especially critical among patients with chronic diseases and those who need expensive care. Health systems are also developing and growing their own health plans to manage risk and integrate care delivery.
“The biggest lesson I learned is the need to have alignment with payers and healthcare delivery systems, removing silos to have seamless flow of information to assist various functions of care coordination, gap closures for various quality metrics,” said Ria Paul, MD, clinical associate professor at Stanford University School of Medicine and chief medical officer of Santa Clara Family Health Plan in San Jose.
Taking on the health plan is a big change for many provider organizations that have traditionally focused more on care delivery.
“It is a culture change for the payer and the delivery side to function in a tandem manner,” said Dr. Paul. “The process of working towards a common goal is imperative. Payers can also support the activities on the healthcare delivery side. Change happens at the speed of trust, optimistic of strong collaborative partnerships between payers and delivery systems in the near future.”
The ability to trust other stakeholders in the healthcare ecosystem, including former competitors and adversaries, is critical for survival Thinning post-pandemic margins and challenging economic conditions are forcing health systems to get creative and identify collaborative solutions for serving their communities.
“In traditional business practices, we see risks and threats when it comes to competition,” Mayank Shah, MD, vice president and chief medical officer of Advocate Condell Medical Center. “Sometimes, we feel empowered and opportune when our competitive partners are struggling. We feel that it can be a formula for organic growth and capture of market share. However, in healthcare the dynamics are complex. Healthcare delivery systems today are not just catering to healthcare needs, but to community wellness.”
The shift to population health and value-based care expands the hospital’s accountabilities far beyond the sick patients housed inside their four walls. Hospitals are increasingly finding they can best meet their mission of service through mutually beneficial partnerships. Especially as hospital closures are on the rise and service cuts are becoming more common among community hospitals, academic centers and regional systems are seeing increased volumes and capacity.
“When one system is struggling, the other systems will have to bear the burden of meeting not only healthcare needs, but the community needs,” said Dr. Shah. “We need to put aside our competitive differences and come up with ideas of collaboration and partnership. Supporting each other is the best way to keep the market healthy for all players. Just as team work is important for our operational teams, this team work is profoundly important for our health industry and community.”
