« Posts

Moving from a Community Hospital to a True Health System

Community hospitals are facing a new era of health care where shrinking margins are not the only concern. They will be responsible for managing the health of the community, as opposed to just episodic treatment. In order to meet this need, the community hospital must be able to provide, or engage a partner to provide, the full continuum of health care services. “Systemness”is a term increasingly used to describe this future state  of complex healthcare delivery systems — delivering patient-focused, seamless and high-quality care across the many parts of the system to maximize value for customers.

In the case of smaller community hospitals, evolving from a traditional medical center into a true “system” is easier said than done.  In fact, an increasing number of hospitals are removing the “Medical Center” from their title, and substituting “System,” with little other change.  A name change is obviously not enough to effectively compete in the new era; the establishment of a system involves much more.

A true, high-functioning integrated delivery system (IDS) will have the following components:

  • Scale for market relevance
  • Appropriate service mix and continuum
  • Appropriate number of access points
  • Right-sized and distributed physician network
  • Engaged physician leadership
  • Medical practice models ensuring common vision and goal alignment
  • Team approach to care
  • Effective electronic network
  • Disciplined financial management
  • Effective care models with population health management capabilities
  • System-level structures, incentives, and coordination to support integration
  • System-driven organization, governance, and leadership

While larger, multi-hospital systems may be better positioned in their distribution of access points, access to quality medical and surgical specialists, and electronic network, community hospitals do have options for developing the care continuum to build a community system.  Some effective ways to attain the IDS components include:

Integration: An acute focus on integration of existing sites and services is a key driver for success.

Partnerships: Developing relationships with outside organizations is a very effective way to complete the care continuum. For example:

Relationships with community-based organizations to coordinate  population health management efforts

Partnerships with tertiary and specialty care providers for increased subspecialty coverage and clinical pathways for select service lines and   conditions

Joint Ventures: Creating new lines of business in cooperation with physician groups to increase revenue and alignment, or agreements with experts in specialty center development (e.g., imaging, urgent care, senior/residential, skilled nursing) will increase patient access and further complete the care continuum.