Hartford Healthcare has formed a new physician organization that will attempt to redefine the way its doctors provide care, with the goal of creating a more integrated system that reduces health care costs and improves quality.
The group, called Integrated Care Partners, will be run by physicians employed or affiliated with Hartford Healthcare and represents a key part of the organization’s strategy to better manage providers throughout its network.
It’s also a signal that Hartford Healthcare physicians will take a more active role in shaping clinical strategy, which will likely include the adoption of new payment models with insurers and more aggressive and standardized quality metrics.
The formation of Integrated Care Partners, which will be overseen by a 15-member board that includes nine active doctors, comes just months after Hartford Healthcare consolidated its various physician practices into a single organization called Hartford Healthcare Medical Group, which now includes doctors from all of the network’s affiliated hospitals.
The consolidation and alignment efforts, officials say, is all part of meeting the demands of a rapidly changing health care environment.
“We’ve taken an aggressive stance that this is where we need to go,” said James Cardon, Hartford Healthcare’s executive vice president and chief clinical integration officer.
Clinical integration is a major buzzword in the health care industry and it’s what payers and providers are all trying to achieve. The aim is to create a system that keeps patients healthy by providing them with the right care, at the right time and place, and at the lowest cost.
But the notion is easier to discuss than actually achieve. Many experts blame exorbitant U.S. health care costs on the lack of care coordination and divergent incentives between providers and insurers.
Cardon, who is an Integrated Care Partners board member, said the group doesn’t actually employ physicians but it will serve as a facilitating body within Hartford Healthcare to align physicians, hospitals and insurers. That includes trying to break down silos that exist among private and ambulatory care doctors and other providers within the community.
Some key issues the group will tackle include defining performance objectives, quality standards and evidence-based medicine protocols and realigning incentives and contracts with insurers, Cardon said.
Hartford Healthcare needs to establish benchmarks for quality care based on proven techniques and strategies that have shown to produce the best outcome for patients at the lowest price, Cardon explained. They also need to incentivize providers to abide by those metrics so they can reduce variation among physicians.
One focus area will be reducing costly readmission rates. Hartford Healthcare affiliate the Hospital of Central Connecticut, for example, has a new program that cut in half readmission rates for heart failure patients, and now the organization is weighing how to implement the program at all of its hospitals.
“The key is setting expectations for performance based on what we agree is the best, most cost effective way to do things,” Cardon said.
Integrated Care Partners will also need to figure out how to better manage patient populations, to keep people, especially individuals with chronic illnesses, more healthy and out of the emergency department.
About 70 percent of health care costs come from people with one or more chronic illness, like diabetes, asthma or cancer, Cardon explained. The only way to bend the cost curve is to better manage those patients’ care.
That could involve Hartford Healthcare hiring care coordinators to track patients throughout the health care system to ensure patients are current with treatments, appointments, and medications.
Technology will also play a major role as Hartford Healthcare undergoes a major $200 million-plus IT conversion in the coming years that will focus in part on data analytics to allow physicians to identify and track chronically ill patients.
Aligning incentives between providers and insurers can be especially challenging, but must be addressed, Cardon said, adding that their goal is to move away from a fee-for-service model, which reimburses doctors based on the quantity rather than quality of care they provide.
Hospitals and insurers around Connecticut are experimenting with performance-based contracts, but the practice isn’t widespread, Cardon said.
“Moving away from fee-for-service is the goal but we don’t know when it will happen,” Cardon said. “It’s not going away overnight.”
Kent Stahl, a Hartford HealthCare vice president and medical director and CEO of Hartford Healthcare Medical Group, said many of the challenges Integrated Care Partners will tackle are about fundamentally changing the way the system operates.
“We are a great rescue system, but not a great health care system,” Stahl said. “There aren’t great incentives in place to prevent illnesses, like helping someone lose weight or change a bad lifestyle habit. This moves us down the path of addressing the things we all see are broken in the health care system.”
