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St. Vincent and Community to dissolve partnership

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A highly touted partnership between St. Vincent Health, Community Health Network and suburban Indianapolis hospitals is coming to an end—just 18 months after it began.

The Accountable Care Consortium was envisioned as a vehicle through which the hospitals would eventually funnel all of their roughly $2.5 billion in annual contracts with health insurers and employers.

Those contracts would have been based on the ability of St. Vincent, Community and the suburban hospitals to keep patients healthy and in need of less care, especially expensive hospitalizations and surgeries. The concept is known in health care circles as “population health management.”

Simpkin Simpkin

In exchange for the savings created by population health management, insurers and employers would have steered their patients away from competing hospitals, boosting overall traffic at St. Vincent, Community and the suburban hospitals.

Indiana University Health and Franciscan Alliance—the two other major hospitals systems operating in Indianapolis—have similar efforts underway, although none has gained much traction.

The Accountable Care Consortium made progress toward being able to track patients and keep them healthy. It hired a president, Liz Simpkin, in early 2013 and built up a staff of eight.

The consortium signed up 12 employers as customers—half of which were among the hospitals that formed the consortium. Those hospitals included the 22 operated by St. Vincent, eight operated by Community and six that are part of the Suburban Health Organization.

Carmichael Carmichael

But the hospitals found that changes in the marketplace were happening at a faster pace than they anticipated—making it difficult to coordinate responses fast enough.

“This thing’s moving at a clip that we need to work on things ourselves rather than working on everything as one,” said Bryan Mills, CEO of Community Health, mentioning such changes as the launch of the Obamacare insurance exchanges and pressures from employers and the government to reduce health care spending.

“There’s so much going on and it’s very difficult for one organization to make all the changes that we need to make, and trying to do all that in concert, it’s very challenging,” said Julie Carmichael, chief strategy officer of St. Vincent Health.

accountable-care-factbox.gifMany local health care executives predicted the Accountable Care Consortium would dissolve after the participants took different approaches toward the new breed of health plans offered in the Obamacare exchanges.

Community and Suburban Health joined a “narrow network” plan created by Indianapolis-based Anthem Blue Cross and Blue Shield. But St. Vincent rejected the Anthem plan, choosing instead to participate in an Obamacare plan operated by MDwise Inc., a health plan co-owned by St. Vincent’s archrival IU Health.

But because the decisions about the Obamacare exchange, also called the marketplace, had to be made before the consortium was fully operational, the hospitals treated the two things separately.

“We were each in a position where we needed to make an independent decision when it came to the marketplace,” Carmichael said.

The participants in the Accountable Care Consortium expect population health to become a basic feature of future contracts between hospital systems and health insurance plans. But they also acknowledged there is more work to be done before that future becomes a reality.

“There was a lot of interest in it—and a lot of education that remains to be done with employers, and between payers and their customers too,” said Simpkin, the president of the consortium.•

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  1. These liberals are out of control. They want to drive our economy into the ground and double and triple our electric bills. Sierra Club, stay out of Indy!

  2. These activist liberal judges have gotten out of control. Thankfully we have a sensible supreme court that overturns their absurd rulings!

  3. Maybe they shouldn't be throwing money at the IRL or whatever they call it now. Probably should save that money for actual operations.

  4. For you central Indiana folks that don't know what a good pizza is, Aurelio's will take care of that. There are some good pizza places in central Indiana but nothing like this!!!

  5. I am troubled with this whole string of comments as I am not sure anyone pointed out that many of the "high paying" positions have been eliminated identified by asterisks as of fiscal year 2012. That indicates to me that the hospitals are making responsible yet difficult decisions and eliminating heavy paying positions. To make this more problematic, we have created a society of "entitlement" where individuals believe they should receive free services at no cost to them. I have yet to get a house repair done at no cost nor have I taken my car that is out of warranty for repair for free repair expecting the government to pay for it even though it is the second largest investment one makes in their life besides purchasing a home. Yet, we continue to hear verbal and aggressive abuse from the consumer who expects free services and have to reward them as a result of HCAHPS surveys which we have no influence over as it is 3rd party required by CMS. Peel the onion and get to the root of the problem...you will find that society has created the problem and our current political landscape and not the people who were fortunate to lead healthcare in the right direction before becoming distorted. As a side note, I had a friend sit in an ED in Canada for nearly two days prior to being evaluated and then finally...3 months later got a CT of the head. You pay for what you get...

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