Issue link: https://beckershealthcare.uberflip.com/i/1047089
31 Executive Briefing Clinical integration for a competitive edge The competitive advantages of consolidation have motivated many hospitals and health system leaders to expand their organization's footprint in recent years. However, traditional economies of scale are not the sole motivating factors behind mergers and acquisitions: Evolving payment models have driven providers to turn a critical eye to their care coordination efforts. When care coordination is lacking, organizational leaders often seek partners to supplement these capabilities. In a marketplace where consumers and payers place a premium on quality, systems that do not value clinical integration put their bottom lines in jeopardy. Ms. Anctil leads Premier's clinical transformation team and emphasized that providers dedicated to clinical integration must ensure their efforts are not splintered across the organization. To truly leverage the competitive advantages of care management, especially when it comes to mergers and acquisitions, leaders must not only consider the care management infrastructure of their partners, but actively work to break down barriers that impede these processes. "Organizations must avoid building siloed care management programs and drive alignment. I think the real opportunity for success is centered around integrating the organizational structures, workflows and technology solutions to optimize the investment," Ms. Anctil said. "This creates the optimal patient experience and enhances return on investment, especially in mergers." Where the rubber meets the road — Cultural alignment and physician buy-in It's no secret that clinical integration can yield substantial benefits for hospitals and health systems. However, there is a vast gulf between understanding the complexity of mergers and acquisitions and executing them in a way that improves clinical integration. To truly support care coordination, leaders must perform thorough examinations of their potential partners and select those with complementary assets. Beyond the actual mechanisms of clinical integration, several cultural considerations can determine whether organizations are able to achieve clinical integration post-merger. "Successful organizations are evaluating the culture and values of the acquisition to determine if they have an aligned vision," Steve Valentine, Vice President at Premier, said. "You always want to think about your organizational philosophies should always drive the criteria for potential partners to avoid conflict down the line. If the values, cultures and organizational philosophies are different, it could mean conflict down the line." While it's often difficult to discern the cultural compatibility of an organization eager to present itself as an attractive partner, Premier offers services to help leaders decide whether clinical and administrative staff is up to the difficult task of merging and integrating care along the continuum. "We run a data-driven process to identify potential partners. We then screen those organizations, narrow the list down to a handful of strong choices, and participate in and facilitate site visits to closely review the terms of the transactions, the cultural fit, and what needs to be done to effectively consummate the merger or affiliation," Mr. Valentine said. Ms. Anctil's team interviews administrative and clinical leaders to evaluate how their teams operate and asks scenario-based questions to assess how they respond to different situations. One of the biggest challenges organizations face when trying to achieve clinical integration is generating buy-in among physicians. "It is sometime difficult to get physicians on board with models that would be driven by care coordinators, removing them from the center of the decision-making process," Mr. Valentine said. However, Premier helps health systems align physicians with a clinical integration mission by working directly with physician leaders. Ms. Anctil collaborates closely with physician leaders to show them the efficacy of care coordination so they can act as influencers and convince skeptical colleagues to get on board. "The rubber meets the road when you can bring together an internal champion and a physician that understand the goals and are willing to get their coworkers on the bandwagon," Ms. Anctil said. "Just recently, a physician we worked with told me how much she valued her care manager because the more coordinated process helped her more effectively transition patients and avoid the risk of readmission, while boosting her revenue. It proves how clinical integration truly adds value when aligned to financial goals." Turn potential into production Both Mr. Valentine and Ms. Anctil emphasized clinical integration does not bear immediate results. Organizations that dedicate resources to these efforts will have to wait before they begin to reap the rewards. Many organizations have the capabilities in place to coordinate care effectively but do not have the patience or expertise to properly utilize them. Premier's team of experienced clinical and administrative experts, backed by its robust physician and claims analytics, can help health systems improve clinical integration, especially when it comes to mergers and acquisitions, to optimize the patient experience and their own bottom line. n Premier Inc. is a leading healthcare improvement company, uniting an alliance of approximately 4,000 U.S. hospitals and health systems and approximately 165,000 other providers and organizations to transform healthcare. With integrated data and analytics, collaboratives, supply chain solutions, and consulting and other services, Premier enables better care and outcomes at a lower cost. Premier plays a critical role in the rapidly evolving healthcare industry, collaborating with members to co-develop long-term innovations that reinvent and improve the way care is delivered to patients nationwide. Headquartered in Charlotte, N.C., Premier is passionate about transforming American healthcare.