Carolinas HealthCare System and Novant Health, two longtime competitors in Charlotte, N.C., are setting aside any differences and collaborating in an effort to improve health in the city's underserved communities.

"Over the past decade, if you look at Charlotte and the surrounding area, the city has grown and flourished significantly," says Eugene Woods, president and CEO of Carolinas HealthCare. "But that prosperity has been a bit uneven."

For example, Woods says, six ZIP codes in the Charlotte area have two to three times the rate of emergency department utilization than more prosperous areas of the city, as well as significantly higher rates of obesity and heart disease.

Carl Armato, president and CEO of Novant, says the collaboration grew from conversations he and Woods had about the needs of poor communities. "How do we ensure that the remarkable health care that we provide is reaching everyone?"

The collaboration, announced in November, is in the planning stage. The inputs include data from the American Community Survey of the U.S. Census Bureau on factors such as minority health and food deserts.

Armato says the two systems envision a one-year plan to address how to narrow health care gaps through such means as advanced primary care clinics and greater utilization of mobile health units.

Woods says Carolinas HealthCare and Novant are already aware of patients who utilize the EDs of both systems. "Part of the opportunity is: How do we make sure we're coordinating care, so that when they come to the emergency room, we have a comprehensive picture of their needs?"

Armato says the two systems are focusing on issues such as access to care, behavioral health, immunizations for all children, disease prevention and chronic disease management — "ensuring that people are accessing health care in the right place, at the right time and at the right price," he says.

In addition, the collaboration will include a three-year plan that will delve into social determinants like nutritious food; places to play and exercise; access to affordable and safe housing; and access to a stronger education system, Armato says.

Woods and Armato agree that it's crucial for competing health systems to collaborate to be able to make an impact on such issues.

"I recently chaired the American Hospital Association's Committee on Research, and we did work on the next generation of community health and what it would look like," Woods says. "In that document we make the point that it's really incumbent, even on nonprofits that compete, to figure out ways to work together, because patients from these vulnerable communities end up in all of our facilities."

Armato says he believes "the future of health care is going to involve a lot more integration and collaboration among competitors. We've duplicated too many efforts. I think this is going to produce hundreds of millions of dollars that could be redeployed into meeting the unmet health care needs of communities."

"We did this on a handshake," Woods adds. "That's rare these days, but we intend to live by that handshake. And I think that over the coming years, the community will see that in action."