Vanderbilt, University of Tennessee health systems form statewide 'value-based' network
A new partnership between doctors and facilities affiliated with University of Tennessee Medical Center and Vanderbilt University Medical Center aims to improve the quality of health care and reduce costs across the state.
University Health Network and Vanderbilt Health Affiliated Network announced Wednesday that they are joining to create a value-based health alliance that will ultimately provide statewide coverage.
It will include both teaching hospitals, as well as 87 practices and more than 1,000 providers in University Health Network, plus the 13 health systems, 67 hospitals, more than 350 practices and more than 5,000 providers in the Vanderbilt Health Affiliated Network. Health systems in the network span the state, from West Tennessee Healthcare to Mountain States Health Alliance in the Tri-Cities.
That also means UT Medical Center and University Health providers will be in-network for people covered by insurance plans accepted by Vanderbilt Health Affiliated Network.
But its primary benefit, officials from both said, is that it sets up even more providers to collaborate with a goal of helping patients — especially those with chronic health issues — achieve better long-term health at a lesser cost.
The network will be a “value-based” model of delivering health care, meaning that what hospitals, doctors and other providers get paid is based on the health outcomes of their patients.
Broadening that network means more collaboration among providers — leading, hopefully, to less duplication of costly tests and other services, since providers will be working together; better success managing chronic illnesses before they require more costly treatment or intervention; and more efficiently directing patients to primary care or preventive care, rather than having them end up in expensive emergency departments or hospital rooms in a crisis.
“Already within our clinically integrated network here, we have chronic disease programs focusing specifically on congestive heart failure, chronic obstructive pulmonary disease and diabetes,” three serious, costly chronic health issues whose rates in Tennessee exceed the national average, said primary-care physician Dr. Amy Barger Stevens, board chair of University Health Network. Patients who receive direction on managing or treating their health issues “know it’s been affirmed and supported by their physician, versus their insurer.”
Stevens said the network is already seeing a decrease in cost and expects to see less use of the ER and fewer re-admissions to hospitals among patients in the network. She expects an increase in patients’ investment in their own health care — already a trend — as well.
“I think they’re going to feel more like participants on the journey, rather than the classically paternalistic approach to health care,” she said.
While decreasing costs is a goal of the network, it’s not the primary goal, said University Health Systems President and CEO Joe Landsman, who said the network should result in cost savings and better care for all patients — those covered by commercial insurance, individual policies, TennCare/Medicaid and Medicare, as well as uninsured or self-paying patients.
“What we are trying to do is transform our delivery system, to create a better value option for those who choose to use our services,” Landsman said.
Combining clinically integrated systems has grown in popularity in recent years, but it’s commonly limited to a single metropolitan area or a single health care system, said Dr. C. Wright Pinson, deputy CEO and chief health system officer for Vanderbilt University Medical Center and chairman of the board for Vanderbilt Health Affiliated Network. What’s most unusual about this partnership is that it combines two different companies and seeks to cover the entire state, he said. That may mean using telehealth services to cover some rural areas, he said.
“This represents something that’s new, that we believe is better,” Pinson said. “It’s an effort to deal with what everybody popularly calls ‘the health care crisis.’ This group of people who have come together … have said we’re not just going to sit on our hands and listen to people complain about all the issues. We are trying to be proactive and put something on the table that could potentially be a building block for something better.”
Landsman and Pinson said serious discussions between the two organizations began about a year and a half ago. For now, the collaboration won’t result in new base contracts; providers will keep their current contracts, with the value-based payment layered on top of that.
Source: Knoxville News Sentinel, by Kristi Nelson
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Published September 28, 2018