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88 THOUGHT LEADERSHIP Innovative care models are new catalysts to transforming healthcare By Anthony R. Tersigni, EdD, President and CEO, Ascension T o keep our communities healthy, the health- care industry continues to drive toward a value-based system that provides care when, where and how it is needed. When you also con- sider technological advances and consumers who are more engaged than ever in their healthcare decisions, it has become increasingly clear that the industry must reimagine care delivery beyond the traditional definitions of health and healthcare. As the healthcare environment continues to rapidly evolve with increasing challenges and opportuni- ties, providers across the country are called to reach new levels of performance while ensuring the pres- ence of a strong and sustainable care delivery model for the future. While we adapt to address the health of entire communities through innovative ap- proaches, consumers are driving dynamic changes to ensure convenience, accessibility and affordabili- ty. It's no longer just about delivering quality health outcomes at an affordable cost — consumers are also demanding an exceptional experience to go along with it; one that makes care more integrated, accessible, seamless and convenient. In recent years, a growing number of healthcare providers have been working to better connect all aspects of care with the hope of improving health outcomes for the communities they serve. Key to the approach have been public and private efforts to address head-on the social influences on health — the conditions in which people are born, live, work, worship and play. Numerous studies correlate poor health outcomes with low-income neighborhoods, where financial and emotional pressures due to low-wage work, poor housing, food insecurity and neighborhood violence take a toll. Education and literacy, transportation, access to healthy food op- tions, cultural norms, social traditions, and family characteristics are social and environmental factors that work together to shape health outcomes. is shi in focus has catalyzed alignment among nontraditional partners that enables healthcare organizations to take a more holistic approach to patients' health and wellness and implement strategies that recognize and address socioeco- nomic influences as well. In the value-based care era, healthcare leaders are also asking providers to better coordinate with their peers across the care continuum and collaborate with diverse health and social teams. We must design models that incentivize providers, individuals and communities to work together to maintain health rather than overemphasize treat- ment only when an individual is sick. To do this, Ascension has set a bold goal of eliminating pre- ventable disparities in health outcomes by 2022. One of our many approaches has involved examin- ing some of the poorest ZIP codes in Detroit where we have a strong medical presence. We want to fully understand the factors that contribute to the cycle of poverty and establish community partner- ships that can, together, break this cycle. In other communities we serve, we have designed mixed- use environments that combine various healthcare and wellness services into one convenient, central location. e structures of these community-based care models depend on the needs of the people who will seek care there and how they wish to access that care, which, following the advent of the ACA and the Community Health Needs Assessment, impor- tantly acknowledges that many and varied factors affect a person's health. As consumers seek greater integration of their healthcare services, providers are compelled to better understand a person's full picture of health. Ridesharing services help ensure patients can make their doctor's appointments and follow-up care. Neighborhood hospitals, sometimes called micro-hospitals, are bringing services closer to pa- tients' homes. Virtual care is providing patients an increased level of connection to disease manage- ment and remote monitoring services. To reimag- ine care, health organizations across the country are also looking to partner with church groups, schools and food banks to spread the word about services offered, highlighting these important relationships that need to be made and strengthened. As we move away from traditional care models and look toward innovative options in the future, the goal remains the same: to improve the overall health of the communities we are privileged to serve. rough this model transformation, priority opportunities for future differentiation and devel- oping innovative solutions for new customers and new markets are on the horizon. Addressing the so- cial influences remains paramount to making this vision a reality. n 5 strategies that will define mergers of the future By Howard Kern, President and CEO, Sentara Healthcare M ergers are the defining character- istic of the contemporary health- care landscape, but the mergers of today bear little resemblance to ones in decades past. Providers previously utilized mergers to reap the benefits that come with increased size. ese "1+1=3" mergers leveraged the scale gained by combining two hospitals or systems for three primary objectives. Econ- omies of scale enabled the newly formed entities to achieve lowered administrative and other fixed costs, improved IT efficien- cy and increased buying power for supply chain management. As more health systems have pursued mergers as a strategy, healthcare policy experts, government leaders and regula- tors have looked more critically at many completed and proposed deals. ey have raised questions as to why some of these mergers are not delivering or even propos- ing documentable value, even at the "1+1 =3" level. Oen, the "1+1=3" merger is a reaction of hospitals and health systems to large- scale consolidation among health insurers. Mergers done for reactionary reasons have limited staying power and will not provide sustainable value for the health system partners. I believe innovative health systems are cur- rently working to implement a new kind of merger in order to be strategically focused and successful in today's highly competi- tive marketplace. We will refer to these advanced mergers as "1+1=5" because of the extensive value they leverage for five core strategic and op- erational areas. 1. Economies of scale. e initial val- ue offered in these mergers is the econo- mies of scale characteristic of "1+1=3" mergers. Two systems that are smart about forming a multi-market integrated deliv- ery network will always appreciate savings