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Some big providers launch nonprofit generic-drug company


Intermountain Healthcare’s headquarters in Salt Lake City.

FierceHealthcare reports:

“Some of the largest providers in the U.S. have officially joined forces to launch a nonprofit generic drug company.

Civica Rx was formally established Thursday after it first announced in January. The idea, which was spearheaded by Intermountain Healthcare, drew plenty of interest from hospitals and health systems; more than 120 healthcare organizations—including one-third of U.S. hospitals—have signed on.

The company’s initial governance will include seven health systems, each of which will contribute a member to the board: Intermountain, Catholic Health Initiatives, Mayo Clinic, Trinity Health, SSM Health, HCA Healthcare and Providence St. Joseph Health.”

To read the article, please hit this link.

Fed-up hospitals plan to enter drug business themselves



Fed up with astronomical drug prices, some of America’s largest hospital systems plan to enter the drug business themselves. Many patients would cheer them on.

“This is a shot across the bow of the bad guys,”  Marc Harrison,  M.D., the chief executive of Intermountain Healthcare, the nonprofit Salt Lake City hospital group that is spearheading the effort, told The New York Times. “We are not going to lay down. We are going to go ahead and try and fix it.”

The newspaper reported that “while Intermountain executives would not name the drugs they intend to make, hospitals have long experienced shortages of drugs like morphine or encountered sudden price increases for old, off-patent products like the heart medicine Nitropress. Hospitals have also come under criticism for overcharging for their services, including for some drugs.

“Several major hospital systems, including Ascension, a Catholic system that is the nation’s largest nonprofit hospital group, plan to form a new nonprofit company, that will provide a number of generic drugs to the hospitals. The Department of Veterans Affairs is also expressing interest in participating.

“In all, about 300 hospitals are now included in the group. Other hospitals are expected to join.”

To read more, please hit this link.



Intermountain is centralizing administrative structure

Salt Lake City.

Intermountain Healthcare will change an administrative structure that had been based on  geographic administrative regions to one more tightly controlled from the system’s Salt Lake City headquarters.

FierceHealthcare reported that nonprofit system’s new structure will operate under the direction of the system’s central executive leadership team. The system says that the new structure will make it easier  for the  organization’s caregivers and leaders  to provide faster and more direct care at its 22 hospitals and 180 clinics. We’d guess that it’s also aimed at saving a lot of money.

“The new alignment will create more value for those Intermountain serves, including the underserved to whom charity care is provided in times of need,” the system announced.

The system had been  organized around central, north, south and southwest regions. It’s unclear how many positions will be eliminated under the new structure.

The system’s senior executives told other employees  that the new structure would let the system  provide more affordable, efficient care regardless of how people are insured and how they pay for care.

To read more, please hit this link.



Intermountain Healthcare puts more money into Redox for EHR work


MedCity News reports:

Redox Engine, the Madison, Wis., health IT startup that’s helping healthcare facilities overcome interoperability challenges has received $1 million in follow-on investment from Intermountain Healthcare Innovation Fund.  The funding is part of Redox’s Series B round.

“Redox will work with Intermountain in the Salt Lake City-based health system’s push to adopt digital health solutions that fit into their electronic health records. The company will also support applications Intermountain has developed, such as the Rehab Outcomes Management System, as part of Redox’s API {application programming interface} platform.”

Healthbox has previously run an accelerator for healthcare startups called Healthbox Studio but with the management change last year, Healthbox repositioned itself as a venture capital investment manager with an innovation platform that functions as a consultant to and collaborator with healthcare partners.

To read more, please hit this link.

‘Care Management Plus’ for people with chronic conditions


Healthy-looking Salt Lake City, Intermountain Healthcare’s headquarters.

Care Management Plus is a health-care delivery model designed for older adults with multiple chronic conditions used at Intermountain Healthcare, an integrated care-delivery system serving patients in Utah and Idaho.

A Commonwealth Fund report on the program says  that the idea is not only to improve quality, including coordination, of care but also to cut costs and support primary-care providers who treat these high-cost patients.

It is based on the Chronic Care Model, which list six essential elements for high-quality chronic-disease care: the community, the health system, self-management support, delivery-system design, decision support, and clinical information systems.

“Care Management Plus embeds care managers in clinics to help high-risk patients with multiple needs, ‘’ reports the Commonwealth Fund, and it uses specialized Web applications to provide clinical teams with care-management tools.

The program’s Integrated Care Coordination Information System (ICCIS)  application “sits on top of” a patient’s electronic health record and is adaptable for use with several EHR systems.

The Commonwealth Fund article says that ICCIS lets practices:

  • “Track patient encounters and record activities
  • “Create “tickler,” or reminder, lists
  • “Perform assessments for depression and functional status .
  • “See, at a glance, in a ‘Patient Worksheet,’ a patient’s chronic conditions, medications, pertinent lab results, and receipt of preventive care, as well as their goals and the results of assessments of depression and functional status, and
  • “Generate clinic summary and quality performance reports.’’

To read the whole report, please hit this link.



Patient complaints: Geisinger lets it hang out


Putting it in the complaint box.

CMS star ratings  for hospitals are related to patient satisfaction with care experiences based on data from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) measures. The survey covers such things as   how well nurses and physicians communicated with patients, responsiveness of hospital staff to patient needs,  the cleanliness and noise level of hospital environments  and how well patients were prepared for life after they left  the hospital.

Opponents of  CMS star ratings  complain that they oversimplify complex data, conveying  misleading information that can hurt reputations and reflect unfairly on certain hospitals.

However, Healthcare Dive reports that the move toward value-based care and transparency has led some healthcare organizations – such as Intermountain Healthcare and Geisinger Health System – to publish what patients think of them, for better or worse.

“Patient stories have a greater impact on clinicians more than metrics like HCAHPS,” Dr. Greg Burke, chief patient experience officer at Geisinger, told the publication  after a  recent panel discussion.

Geisinger has gotten a lot of publicity because of its unorthodox implementation of its “ProvenExperience money-back guarantee.”   Dr. Burke said that Geisinger posts on its Web site about 97-98 percent of the comments it receives from patients on the system’s clinicians.

He explains why and how the system does this. Please hit this link to read the full article.


8 systems that have successfully moved into value-based care


Dan Beckham, writing in Hospitals &  Health Networks, looks at eight systems that have followed consistent strategies to create value-based systems.

The systems are:

  1. Advocate Health Care:  Mr. Beckham cites how it turned its physician-hospital organizations “into a super-PHO, becoming the national benchmark for clinically integrated networks.”
  2. Banner Health: “Banner centralized leadership and governance, and standardized care and management processes.”
  3. Baylor Scott & White Health: “Scott & White brought its highly integrated multi-specialty group practice model and its health plan to the merger, while Baylor brought a robust network of hospitals, surgery centers and entrepreneurial partnerships.”
  4. Cleveland Clinic: ”A pioneer in transparency related to demonstrated value and bundled contracts, Cleveland Clinic has combined one of America’s premier multi-specialty group practices with community hospitals and independent physicians to produce a powerful economic engine.”
  5. Geisinger Health System: “It is internationally recognized for innovating at the interface between health insurance, inpatient care, outpatient care and physician practice. Few organizations have positioned themselves as purposefully as Geisinger for the transition from volume- to value-based payment.”
  6. Intermountain Healthcare: “The late W. Edwards Deming, a quality icon, was a central inspiration for Intermountain’s relentless battle to drive out variation. While many health systems treated total quality management and its variants as a passing fad, Intermountain dug in and made it a way of life. The presence of Intermountain contributes greatly to Utah’s position as one of America’s healthiest places to live.”
  7. Mayo Clinic: “Its strength flows, to a great extent, from the team-based multispecialty group practice model that has been central to its operations since its founding, along with its unwavering focus on putting patient interests first. The ‘Mayo way’ is well-engineered and nonnegotiable. No organization has deeper, better-connected data.”
  8. Sentara Healthcare: “When other systems experimented with ownership of health plans, then exited in the face of losses, Sentara persevered. When physician employment became too big a financial burden for others, Sentara doubled down. Because it persisted when others folded, it was able to put more than two decades of experience into its intellectual bank vault. It learned to meld a managed care enterprise, a hospital enterprise,  and a physician enterprise into a formidable integrated delivery system.”
    To read all of Mr. Beckham’s piece, please hit this link.

3 systems to share data for precision medicine


At the precision-medicine revolution rolls on:

Salt Lake City-based Intermountain Healthcare, Stanford (Calif.) Cancer Institute, Renton, Wash.-based Providence Health & Services and precision- medicine firm Syapse, in Palo Alto, Calif.,  have created the Oncology Precision Network.

This will let them share clinical, molecular and treatment data through an advanced software platform to help find breakthroughs in cancer care by leveraging previously untapped cancer data while preserving privacy and security.

The OPN will link aggregated data between these three big health systems, to provide clinicians with previously unavailable information.

“By aggregating all of our real patient experiences, we will rapidly expand our ability to learn how to choose the best targeted treatments for our cancer patients based on the molecular profile of their tumor and our informatics based research,” Jim Ford, M.D., associate professor of Medicine and Genetics at Stanford and director of Clinical Cancer Genomics at the Stanford Cancer Institute, told Becker’s Hospital Review.


2015 results of 4 big systems


Herewith 2015 financial results of four big systems:

1. Chicago-based Presence Health had an operating loss of about $186 million on $2.5 billion in revenue, a huge widening from the 2014  operating loss of $12.7 million on nearly $2.6 billion in revenue.

2. Intermountain Healthcare had revenue of $6.1 billion in 2015, up 9.6 percent from a year earlier. But the Salt Lake City-based system’s operating income of $228.5 million was down  24.1 percent from $301.4 million a year earlier.

Rochester, Minn.-based Mayo Clinic‘s revenue rose 5.7 percent to $10.3 billion. But operating income fell 36.9 percent to $526 million.

4. Cleveland Clinic had  revenue of $7.2 billion, up 7 percent from 2014. The hospital network recorded operating income of $481 million, up 3 percent.

Intermountain’s innovative cost-cutting


Salt Lake City.

Hospitals around America are watching nonprofit Intermountain Healthcare, a Salt Lake City-based hospital system, as it tries, in the words of The New York Times, ”something virtually unheard-of: promising to sharply cut costs rather than pass them on.

“Its new health plan, SelectHealth Share, is guaranteeing to hold yearly rate increases to one-third to one-half less than what many employers across the country typically face,” The Times reported.

“To help keep the rate increases roughly in line with a rise in consumer prices, Intermountain, which operates 22 hospitals and employs 1,400 doctors, says it will produce savings of $2 billion over the next five years.

“Health systems and insurers are closely watching Intermountain’s rollout. It has established itself as a leading health system by tracking and analyzing costs and the quality of patient care, allowing it to improve treatments and reduce unnecessary expenses.”

Intermountain’s plan is “the first innovative thing we’ve seen in a long time,”  Dave Jackson, managing partner for FirstWest Benefit Solutions, in Orem, Utah, told The Times. “Share has got everybody at the table — everybody’s got accountability and got things to do.”

“Some systems might be more likely to reduce services or shrink their money-losing operations if they tried to guarantee a long-term lock on price increases,” The Times reported.

“But a few are heading in a similar direction to Intermountain’s, experimenting with ways that avoid the traditional piecemeal approach of fee-for-service care. The idea of locking in rate increases — Intermountain’s Share program sets the increase at approximately 4 percent — is particularly attractive to employers because coverage then becomes a predictable expense.”

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