Kaiser Permanente and Providence Southern California are working together on a $750 million hospital to replace the aging Providence St. Mary Medical Center in Apple Valley, Calif., according to the Daily Press.
Under the partnership, 65-year-old Providence St. Mary will be closed and replaced with a 260-bed hospital in Victorville, Calif., the organizations said June 3. The hospital will be a full-service acute care facility and may include a medical office building and other ambulatory services. Providence would operate the hospital.
Providence St. Mary’s is closing because it doesn’t meet California’s new seismic requirements slated to take effect in 2030, according to the Daily Press. It would cost about the same to retrofit the hospital as it would to build a new one, hospital leaders told the newspaper.
Erik Wexler, Providence’s president of operations and strategy–South, outlined to the Daily Press what the Renton, Wash.-based health system’s affiliation with Oakland, Calif.-based Kaiser will look like.
“Health care delivery has become very complex, and Providence has found that affiliations truly benefit the communities we serve, particularly areas with significant rates of serious health risks,” he told the newspaper. He added that the partnership with Kaiser will allow the hospital to offer “more high-end acuity level types of care.”
The new hospital, which requires regulatory review and approval, is expected to open in 2026.
Nearly a year after the first confirmed case of COVID-19 in the U.S., some of the nation’s largest health systems made a case for the need to accelerate toward value-based arrangements and potentially acquiring or partnering with health plans to become an integrated system.
Amid new records for deaths and cases from the novel coronavirus, executives gathered virtually for J.P. Morgan’s 39th annual healthcare conference, which typically draws prominent healthcare leaders to San Francisco at the start of each year.
The pandemic has been a heavily discussed topic during the digital gathering. One theme has been health systems either acknowledging they are on the hunt for health insurer acquisitions and partnerships or advocating for such arrangements as result of the challenges.
Anu Singh, managing director and the leader of the mergers, acquisitions and partnerships practice at consultancy Kaufman Hall, said it’s a natural migration for health systems, though it does come with some risk.
“If you want to move into the realm of being a population health manager, and take greater responsibility for your patient bases, you’re going to have to be thinking about maintaining their health,” Singh said. “And that’s typically something that, at least traditionally and historically, has been driven a little bit more by the health plan.”
For Utah’s Intermountain Healthcare, the lessons of the pandemic are clear: The industry needs to move away from a system that rewards volume. Intermountain is a fully integrated system that manages both providers and an insurance unit.
“It is becoming increasingly apparent that systems that are well integrated, especially systems that understand how to take risks, have prospered in the face of the terrible burden, caring for people in the midst of the first pandemic in 100 years,” Intermountain CEO Marc Harrison said Monday.
From his vantage point, Harrison said it has been interesting to watch the consternation around telehealth visits.
“Lots of folks who are really still caught in the volume-based system are actively switching patients back from tele- or distance to in-person visits so they can maximize revenue,” he said. “I understand that. But that’s a really great example of poorly aligned incentives.”
Intermountain has managed to stay in the black as many other systems have struggled financially as a result of the pandemic driving down patient volumes. It reported net income of $167 million through the first nine months of 2020, compared with $919 million the year prior.
Another integrated system, Baylor Scott and White Health, the largest nonprofit system in Texas, said such diversification has helped buoy its finances as hospital and clinic operations bottomed out in the spring due to the virus.
Baylor Scott and White illustrated this point by showing how operating income for its clinical segment took a nosedive in the spring while operating income for its health plan remained relatively steady.
The theme of integrated health systems also seemed to be on the minds of investors. CommonSpirit Health executives were asked during their presentation if buying or creating a health plan was on their radar as the system has a sizable footprint of 140 hospitals across the country.
“I think this is a interesting question, one that of course we’ve discussed many times strategically,” CFO Daniel Morissette said, noting the system does have a number of regional plans. “At this time, we have no plan of having a national CommonSpirit branded plan.” However, Morissette said the system would consider a partnership opportunity.
On the other hand, Midwest-based Advocate Aurora Health said it is actively on the hunt for a potential insurer deal as part of its long-term strategy.
“We do believe that having health plan capability, not necessarily having our own, but partnering for health plan capability, is going to be critical to our success, and we are taking steps to do that,” CEO Jim Skogsbergh said during the virtual conference.
Kaufman Hall said in its latest report that it expects more payer-provider partnerships as a result of the pandemic. “Limitations on fee-for-service payment structures exposed by the pandemic may increase the number of payer-provider partnerships around new payment and care delivery models,” according to the report.
Singh of Kaufman Hall said it’s not surprising that some may lean more toward a partnership due to the risks of starting a new venture, especially an insurance unit that can have “catastrophic loss”. Systems with less experience of moving toward implementing value-based initiatives may be more vulnerable to such risk.
It’s why he thinks partnerships may be a good fit, at least at first. Payers and providers can work together to improve the health of certain populations and then share in the cost savings.
The role of hospital and health system CFO has changed in recent years. CFOs are now change agents within their organizations and are deeply embedded in the day-to-day operations of the business.
Speaking on a panel called “The Evolving Role of the CFO” at the Becker’s Hospital Review 8th Annual CEO + CFO Roundtable in November, a panel of health system CFOs and finance leaders from across the country discussed how the finance chief role has changed and expanded.
The five panelists were:
Jeanette Wojtalewicz, senior vice president of Omaha, Neb.-based CHI Health
Nicholas Mendyka, vice president of system finance operations at Minneapolis-based Allina Health
Doug Welday, CFO of Evanston, Ill.-based NorthShore University HealthSystem
Kris Zimmer, CFO of St. Louis-based SSM Health
Mike Browning, CFO of Columbus-based OhioHealth
Here are three takeaways from the discussion:
1. CFOs are strategic leaders. The panelists noted that younger CFOs — those in their early 30s — come to the role with a fresh viewpoint. They are strategic and drive performance across the organization. Though CFOs who have been in the role for a decade or two may have a more traditional viewpoint, they’re adapting to the role of the modern CFO and embracing their more strategic position.
2. CFOs need different skills than in the past. The CFO role has expanded beyond traditional finance and accounting, and the skills CFOs need have changed too. When recruiting new members to their teams, the CFOs on the panel said they look for candidates with natural curiosity, data visualization skills and natural leadership abilities.
3. Clinician-finance partnerships are important. New payment models link quality of care to reimbursement, making it vital for CFOs and their teams to develop an understanding of the clinical side of the business. This has caused some health system CFOs to change their approach to training. The panelists said they try to help their teams develop an understanding of each department and learn how clinical and finance are connected.