Cardiovascular network provides benefits beyond patient referrals

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 - Quality_Measures

ATLANTA—If the alliance between his health system in Texas and the Cleveland Clinic didn’t bring a single new patient through their doors, it would still be a victory, said Michael Mack, MD. “We’ve already received enough value that we view this as a success.”

Mack, chair of the cardiovascular governance council and director of cardiovascular surgery at Baylor Scott & White Health based in Dallas and director of cardiovascular research at the Heart Hospital Baylor Plano, spoke about adjustments in healthcare under the Affordable Care Act on June 10 at the MedAxiom Cardiovascular Service Line Symposium in Atlanta.

“The Affordable Care Act will have the biggest impact on healthcare since Lyndon Johnson signed the Medicare Act in 1964,” he said. “I don’t think that is an overstatement by any means. In many ways it may surpass the impact of the institution of Medicare in the United States.”

Mack listed areas of focus at Baylor Scott & White and its two heart hospitals: quality, service, research and business. Among their initiatives is the affiliation in December of 2014 with the Cleveland Clinic’s Cardiovascular Specialty Network, which then included North Shore LIJ Health System in New York and the MedStar Heart Institute in Washington, D.C. Through the deal, Baylor Scott & White became Cleveland Clinic’s exclusive provider for Texas and Oklahoma referrals.

Baylor did not join the alliance simply to build its brand nationally, he said. The network emphasized shared protocols to reduce variation in practice and improve outcomes. The program relies on full transparency in peer review of outcomes.

“It is to create employer-direct contracting bundled payment through a national network that has a predictable price, a predictable outcome and predictable service," he said. Those employers include giants such as Walmart and Lowe’s. “It is to deliver Cleveland Clinic quality and outcomes on a regional and national basis.”

The program has potential to grow to include payers such as insurance companies, accountable care organizations and health exchanges, he proposed. They now are poised to roll out the program internationally, too.

The network is designed to allow patients whose employers use Cleveland Clinic’s services to receive high-quality regional care rather than have to travel, he said. But the greatest benefit to Baylor Scott & White has not been in its ability to draw patients beyond its established footprint.

“If we never saw a patient from the employer-direct contracting network, the affiliation would still be worth it,” Mack said. “As good as we thought we were, the Cleveland Clinic is just a little bit better.”