As the saying goes – ‘if you’ve seen one accountable care organization (ACO), you’ve seen one accountable care organization.’ But while every ACO in our state is “homegrown” in its particular population and faces its own challenges as well as advantages, some transcendent lessons can be gleaned from each unique situation. Triad HealthCare Network (THN), based in Greensboro, for example, may be considered distinctive because of its relationship with the local hospital and employed physician network at Cone Health.
“Cone was masterful in their approach,” said Steve Neorr, vice president and executive director of THN. “Cone fully let physicians lead and drive this.”
The relationship between doctors and the hospital network, however, wasn’t always so trusting. Starting back in 2010, the real work began to create this successful partnership, which has proved itself through successful care management initiatives and shared savings through the Medicare Shared Savings Plan. THN was, in fact, the only ACO in North Carolina to exceed the threshold to achieve shared savings for the latest financial report from the Center for Medicare and Medicaid Services (CMS) in February 2014.
At first, though, it was just a group of three doctors who realized that health care as they currently were delivering it was not sustainable as to cost, access and quality. They believed that developing a local network based in the Piedmont-Triad area to serve patients and promote cost-efficient, high-quality health care across the broad provider community was key to the future of health care.
“Physicians have always been about quality and doing the right thing for their patients. That was an easy sell. The hard sell was we were telling them that now we were going to measure it,” said Thomas C. Wall, MD, the executive medical director at THN and one of the three doctors with the original vision for their community. “There also was a lack of trust between the hospital and doctors. It required a lot of relationship building.”
Wall and his colleagues set to work and initially chose 20 doctors, respected clinicians and leaders in the community who were willing to cross the old boundaries and open a dialogue with the hospital and other doctors. Three administrators from Cone also sat on the committee born out of dissatisfaction with the health care system status quo. Everyone agreed to check their egos at the door and have respectful, honest discussion, Wall said. Over hours of intense conversation, THN was born.
“It’s really a team effort,” Neorr said. “Having a hospital partner like Cone really made a difference for us. They have led the way in launching initiatives to keep people healthy and out of the hospital which is rather progressive for hospital systems. We believe strongly that Cone’s efforts combined with the efforts of THN Care Management to remove barriers to care and coordinate social services will equate to cost savings.”