Becker's Hospital Review

38 POPULATION HEALTH 38 CEO/STRATEGY With 8k more physicians than Kaiser, Optum is 'scaring the crap out of hospitals' By Morgan Haefner S ince its acquisition of 250 Las Vegas-area physicians in 2008, UnitedHealth Group has steadily expanded its physician work- force to shield itself from competitors and hospitals, according to a Bloomberg report. To date, the health insurance giant's physician arm, OptumCare, em- ploys or is affiliated with about 30,000 physicians. If OptumCare com- pletes its acquisition of Davita Medical Group, the insurer will tack on another 17,000 physicians to its ranks — making it one of the largest physician employers in America. Hospitals are gobbling up physicians, too. An Avalere Health study found that by mid-2016, hospitals employed 42 percent of U.S. phy- sicians. Nashville, Tenn.-based HCA Healthcare has roughly 37,000 physicians, Bloomberg reported. Still, Optum outpaces Oakland, Ca- lif.-based Kaiser Permanente's roughly 22,000 physicians by 8,000. "is is obviously scaring the crap out of hospitals in many markets," Chas Roades, CEO at consulting firm Gist Healthcare, told the pub- lication. By controlling a greater number of physicians, Optum is not only buffering itself from competitors, but attempting to steer patients toward lower-priced care outside of the hospital. In some cases, Bloomberg notes, UnitedHealth is directing members toward its acquired physicians. For example, UnitedHealth lists New West Physicians, a Denver-area group of 120 physicians that the insur- er purchased last year, as a favored narrow-network plan for commer- cial members. Some members can see the physicians for 20 percent to 30 percent less in out-of-pocket expenses compared to physicians outside the network. Andrew Hayek, a leader in UnitedHealth's care delivery operation, told Bloomberg the company has "been slowly, steadily, methodically aligning and partnering with phenomenal medical groups who choose to join us." In the future, OptumCare hopes to expand its 30-market operation to 75 markets, including the nation's most populous states: California, Texas, Florida and New York. Whether it's hospital- or insurer-employed physicians, Ken Marlow, an attorney with Waller Lansden Dortch & Davis, told the publica- tion, "e smartest participants in the system are the ones who are going to be able to provide quality care at the lowest cost setting. Whoever gets there first, and whoever is able to do that, I think will be the winner." n Colorado hospital terminates CFO days after ousting 2 execs, CEO By Alyssa Rege C ortez, Colo.-based Southwest Health System ousted CFO An- gela Kobel April 13, 10 days after terminating three members of its executive leadership team, the health system's board of directors announced April 16, according to The Journal. Paul Deshayes, chairman of the Southwest Health System board of directors — one of the institution's two boards — said, "In the absence of a CEO, it became apparent that Ms. Kobel was no longer able to fulfill the responsibilities of the position," according to a news release obtained by The Journal. Ms. Kobel's termination comes after the health system's CEO, CNO and chief ambulatory services officer were fired in April. At the time, officials cited a "change in leadership direction" as the reason for the executives' departure. However, Mr. Deshayes told KSJD Radio April 9 the executives, and Ms. Kobel, were fired as a result of the institution's ongoing financial issues. Southwest Health System hired Community Hospital Consulting, the consulting arm of Plano, Texas-based Community Hospital Corp., to analyze the health system's fiscal issues. While CMC provided the health system's boards with recommendations to improve its finan- cial position, Ms. Kobel's termination was not among those recom- mendations, according to The Journal. CHC announced April 16 officials hired Anthony G. Sudduth as inter- im CEO for Southwest Health System, effective immediately. n Express Scripts to lay off 456 employees: 3 things to know By Ayla Ellison S t. Louis-based Express Scripts, the nation's largest pharmacy benefits manager, will lay off 456 workers when it closes its pharmacy site in Columbus, Ohio, later this year, accord- ing to a Worker Adjustment and Retraining No- tification Act notice filed April 10. Here are three things to know. 1. The layoffs will begin around June 10. Phar- macists, support staff and other workers will be affected by the layoffs, according to the WARN notice. 2. Express Scripts told The Columbus Dispatch the work performed at the Columbus facility will be done at other sites across the country. 3. Express Scripts is closing the facility about a month after health insurer Cigna announced plans to acquire Express Scripts in a $67 billion deal. Express Scripts said the decision to close the facility in Columbus is not related to the company's deal with Cigna, according to The Columbus Dispatch. n

• Cover