Hospital merger expected to accelerate reform efforts

Ashley Thurow

Intermountain Healthcare and SCL Health finalized a merger of the two hospital systems.  SCL Health, a system that includes St. Mary’s Medical Center in Grand Junction, will take on the Intermountain name and branding.

We’re excited at Monument Health to partner with Intermountain. Our organizations share similar goals of expanding the adoption of value-based care and payment reform. Intermountain Healthcare is known nationwide as a leader in value-based care with about half of its revenues derived from full-risk, value-based arrangements. Compared with a nationwide average of about 10 percent, Intermountain is well ahead of the curve in embracing alternative payment models. The presence of Intermountain in the Grand Valley will reinforce the work we’re doing at Monument Health and accelerate our efforts to expand health care reform.

How will payment reform and the presence of the Intermountain system change patient experiences in our market? Change won’t occur overnight, but patients can expect to see more integrated care as time goes on.  

One of the more noticeable ways this can happen is by expanding telehealth services. Marc Harrison, chief executive officer of Intermountain Healthcare, often touts a clicks and mortar approach to delivering care through digital innovation. Telehealth is important to improving health care access, particularly in rural communities like those in Western Colorado. Enhanced telehealth services mean patients won’t have to leave the Grand Valley to access specialty care because experts can be brought here via telehealth to partner with local physicians.  Driving four hours to Denver or Salt Lake is not only an inconvenience, but can disrupt the coordination of patient care during those handoffs. Telehealth solves for many of those tough situations to keep care closer to home.

Another change patients are likely to see is more emphasis on primary care services. Value-based care and payment reform seek to move care back into such lower-cost settings such as doctors’ offices. At Monument Health, we believe close relationships with primary care providers  offer the most powerful way to address the ballooning costs and disjointed patient experience within the health care system. Here in the Grand Valley, we’re fortunate to have high-performing, patient-centered primary care practices. But we still face a shortage of primary care doctors. The shortage becomes even more pronounced outside Mesa County.

Bryan Johnson, president of St. Mary’s Medical Center, asserts access to primary care constitutes a key tenet of value-based care. Patients must be connected to convenient and accessible primary care for the model to work. Intermountain recognizes this and often co-locates such services as behavioral health counselors and physical therapists with primary care doctors’ offices so patients can get all the care they need in one place.

Reducing costs goes hand in hand with a higher emphasis on primary care. Alternative payment models boost reimbursement for primary care physicians while simultaneously reducing payment to hospitals. The theory is patients should use lower-cost services more often to make expensive hospital visits less often. Monument Health has proven this concept for local employer groups as well as the Medicare and Medicaid populations we support.  

Reducing hospital use affects the price of health insurance. As insurance premiums are held in check, patients and employers across the Grand Valley gain more predictability in their health care expenses. Monument Health and Rocky Mountain Health Plans recently reported monthly premiums for our products sold on the Connect for Health Colorado insurance exchange are now cheaper than similar products in Denver. This progress was achieved by our value-based care approach and focus on driving patients to primary care settings.  We anticipate this momentum will continue with Intermountain Healthcare as a willing participant in our primary care-first approach.

Kim Bimestefer, executive director of the Colorado Department of Health Care Policy and Financing, alluded to Intermountain’s aggressive approach to value-based care in a newspaper interview: “If they bring that skill set to the Western Slope … it might actually bring overall health care costs down.”  

At Monument Health, we look forward to deepening our relationship with Intermountain Healthcare. Our network has never been more important, and we’re excited to see health care providers embrace value-based care.