Risky business for providers: Population-based planning in provider risk-bearing arrangements

Provider organizations that want to bear patient risk need to be informed by their local markets and the attending health care concerns that come with that market. That’s why our third action that leads to bearing risk is population-based planning.

Mayo Clinic is transforming its care coordination model based on local needs. The Rochester, Minn.-based organization, one of the most respected health care providers in the U.S., bears full risk for the primary care of about 150,000 patients. Having a premier research facility under its umbrella, Mayo developed a care coordination program with its academic medical center-based primary care physicians. However, population health programs that are tuned to an academic setting may not fit into a satellite clinic setting.Miles Snowden, MD, MPH, CEBS Chief Medical Officer, OptumHealth

Mayo sees an opportunity to translate the care coordination concepts that work in an academic setting to more regional and local settings, said Kari Bunkers, MD, a family medicine physician in Mayo’s Owatonna, Minn., facility.

“We are trying to be more un-academic and provide service on the regional and community levels that streamlines the layers of infrastructure [a large practice] has so we can make it more affordable,” Dr. Bunkers said.

Hartford HealthCare is customizing its integrated care program for each of its facilities. The Hartford, Conn.-based organization has established an integrated care program that has the objective of seamless transitions from one care setting to another. Hartford’s leaders asked which hospitals demonstrate the most target-rich potential for quick progress, said James Cardon, executive vice president and chief clinical integration officer for Hartford HealthCare.

“There are certain hospitals that are going to benefit more from really focusing on, say, length-of-stay issues, and there are others that won’t benefit as much,” Cardon said. “We are going to pick and choose and be thoughtful about this and do this well.”


“Risky Business” previous posts:


Miles Snowden, MD

One thought on “Risky business for providers: Population-based planning in provider risk-bearing arrangements

  1. Pingback: Risky business for providers: Planning for financial realities and capacity downturns | Healthcare Exchange

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