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Home    News Releases    CoxHealth News: October 2012    Four leading not-for-profit health systems announce formal relationship    BJC Collaborative Q & A
BJC Collaborative Q & A

Why these four organizations?
BJC, Cox, Memorial and Saint Luke’s are the leading and largest not-for-profit health systems in their respective regions. The territories they serve are adjacent, largely within the contiguous states of Illinois, Missouri and Kansas, but do not overlap. Each system brings a strong commitment to its unique mission and its local community, and all four systems are highly regarded for clinical quality, patient service, and responsible financial stewardship.

All four systems have boards of trustees that are proactively anticipating the changes to come in American health care. We recognize that medical science and technology is advancing rapidly, making it more and more difficult for smaller health care organizations to keep pace. We anticipate that new payment models, such as accountable care organizations or specialty care bundles or other innovative approaches, will require higher levels of care coordination, sizable investments in information systems, and greater assumption of financial risk. All hospitals will be challenged in the years ahead to improve their outcomes and quality, while reducing the cost of medical care.

These four systems have a history of creating larger clinical platforms that involve bringing previously independent hospitals together for the benefit of their respective communities. Together, these systems can achieve scale, a diverse and comprehensive offering of health care programs and services, and a focus on the population health in Southern Illinois, Missouri and Eastern Kansas that few other system groupings could replicate.

Is this the first step towards merger?
The four systems have not discussed merger. The new Collaborative signals a commitment to working together – under a structure that allows each member to maintain its unique identity, to preserve its independence, to serve the health care needs of their local communities - while at the same time, deriving both the quality-of-care and financial benefits that come from being part of a larger collaborative enterprise, enabling the four systems to share services, costs and best practices.

Will there be leadership changes?
No. Each system will continue to operate independently, with local governance and local leadership teams as presently constituted. Initially, the Collaborative will not have employees or a physical location. The CEO of each system and a representative of each system’s board will serve as the voting members of the board of directors of the Collaborative. The work of the Collaborative will be conducted through “operating committees.” Members of each system’s leadership team will be called upon to serve on these committees, bringing to the effort their unique expertise in areas of shared endeavor.

How will health system employees be affected by this collaborative?
Initially, the work of the Collaborative will be transparent to patients, families and the people who take care of them. The early years will be devoted to capturing opportunities to reduce or share costs in areas such as supplies, energy management, contracted services, equipment purchasing and maintenance, and information technology hardware and infrastructure. We will convene leadership roundtables to share best practices in areas such as regulatory compliance and employee lifelong learning and professional development. We will work together to find new approaches to improving patient care and service and making our hospitals even safer places to receive medical care.

How will physicians be affected?
Physicians from among the medical staffs at the four health systems who want to collaborate in the development of clinical programs and services will be encouraged to do so, and will be supported by the Collaborative. Importantly, the granting of medical staff credentials continues to be under the purview of each hospital’s board of trustees.

Exactly how will this collaboration lead to better patient care? Reduced costs?
Each of the four health systems has achieved superior quality scores in a number of clinical service areas. Comparing different approaches and measuring patient-specific outcomes will help us determine what works best and for whom. While BJC may have coined the phrase, each system is equally committed to “Making Medicine Better.”

The four systems already have a proven track record of working together as members of VHA, Inc. VHA, and its group purchasing organization, Novation, have already afforded these four systems numerous cost reduction opportunities. The idea is to expand the list of what we can purchase together, what we can develop together, and what we can implement together to realize even greater economies of scale and improvements in service.

Are you creating a new, combined purchasing organization?
No. All four systems are presently members of VHA, and three of the four (excluding BJC) are owners of Mid-America Service Solutions, Inc. However, to the extent that the four systems can adopt standards for certain products, supplies, and equipment – and coordinate the timing of these purchases – there may well be additional opportunity for savings. Examples of opportunities to be explored could be food purchases or data center back-up services. We are already working on a list.

What does this mean for BJC’s relationship with the Washington University School of Medicine?
Each of the four systems involved have affiliations with Schools of Medicine: BJC with Washington University, CoxHealth with the University of Missouri-Columbia, Memorial Health System with Southern Illinois University, and Saint Luke’s with the University of Missouri-Kansas City. Our shared commitment to academic medicine and to education in the health professions is one of the key reasons we have selected one another as partners in this Collaborative. The Collaborative does not change any of these medical school affiliations.

What does this mean for CoxHealth’s relationship with the University of Missouri-Columbia?
Same answer as above.

What does this mean for Memorial Health System’s relationship with Southern Illinois University School of Medicine?
Same answer as above.

What does this mean for Saint Luke’s Health System’s relationship with the University of Missouri-Kansas City?
Same answer as above.

Will you have one EMR platform?
Not for a very long time. Each of the four health systems has already made a sizable investment in different software applications that in the aggregate, make up an electronic medical record and allow each of the systems to qualify as a meaningful user of health information technology as defined by the federal government. However, over time, it is quite possible that as we need to replace existing hardware configurations, or upgrade communications systems and data centers, or replace technology platforms, we may migrate to common solutions for mutual benefit.

Will telemedicine be a part of this collaborative?
It is too early to identify which clinical programs and services have the greatest potential to benefit from our Collaborative. We will consult with clinicians at each of our respective systems, identify gaps in knowledge or service offerings, and then we will explore how best to meet each other’s needs.

Can others join the Collaborative?
Initially, we plan to spend our time working among these four health systems. In time, if we are successful together, others may benefit from what we have established.

Does this mean CoxHealth will not be partnering with any other health systems in the future?
CoxHealth will continue to have business relationships with other organizations. However, we are committed to working through this Collaborative in the priority areas we have identified to reduce costs, share best practices and improve quality.

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