I hate numbers.
There, I said it. I hate them. There was a reason I double-majored in English and political science. I'd do just about anything to avoid percentages, fractions, square roots. If it has a number in it, I want to avoid it. Just ask my kids. I break out in a cold sweat when they pull out their homework and there's nothing but fractions on both sides of the sheet of paper. Fractions? Really? They are in first grade! What happens next year, advanced trigonometry? They are far too young to see their daddy quiver like that in a corner.
Despite my best efforts though, I've spent 20-plus years in the trade press, much of that time reporting on budgets, finances and the like. Still, every May I get the shakes in anticipation of heading to the Big Apple for a health care investment conference.
Truth be told, the Non-Profit Health Care Investor Conference isn't that bad. The meeting, jointly sponsored by the AHA, Healthcare Financial Management Association and Citi, is a unique gathering. It brings together senior executives from 30 of the nation's top-performing health systems and analysts from credit rating agencies and investment houses. It's an invite-only affair with a list of marquee organizations: Ascension, Advocate, Geisinger, Trinity, and so on. Each health system team gets 30 minutes to present its strategic and financial plans to the analysts and then another 30 minutes for Q&A.
Thankfully, for my number-challenged mind, the presentations have taken an interesting turn over the past couple of years. While finances are still highly relevant and eat up a good chunk of talk time, there's a greater emphasis now on strategy. This year, a number of executives talked about their plans for growth — either regionally or nationally — while others discussed the need to focus more on ambulatory services and population health. Nearly all spent a considerable amount of time addressing clinical integration.
Dignity Health, formerly Catholic Healthcare West, for instance, is embarking on an effort to build so-called clinical integration networks. "We've adopted clinical integration as our central physician strategy," Marvin O'Quinn, Dignity's chief operating officer and senior executive vice president, told me. "It began at our hospital in San Bernardino as a way of helping us be competitive with some of the larger systems."
The message is pretty simple: Ask nonemployed physicians if they'd be willing to work on an initiative to improve care both in their offices and at the hospital and give them a voice in Dignity's strategy in the region. Between January and May, 425 physicians signed on; O'Quinn expects 600 by year's end with an ultimate goal of 4,500. He said the health system soon will be looking for the Federal Trade Commission's blessing to allow the networks and health system to contract together and to negotiate with insurers.
"There's emotional alignment in the networks. Physicians feel it is really their company," O'Quinn said when asked to compare the network approach with employment. While Dignity puts up the capital to fund the networks, the physicians are in charge. "They grow the network. It is physician-led," he said.
And that was the common theme across all of the presentations: True physician alignment is key to survival.
— Let me know what you think. You can reach me at email@example.com.