Transforming a hospital system into a fully-functioning ACO is a huge project, and one which requires a big commitment. It’s hardly surprising that going through the process would change how its leaders think about their business. But the following is the first case I’ve heard of in which a hospital system made a major break with its peers over its ACO status.
Apparently, for-profit Steward Health Care System has just resigned from the Massachusetts Hospital Association, bringing its 10 hospitals (and 11 percent of the MHA’s revenues) with it. Steward, which was created by the acquisition of six-hospital Caritas Christi Health Care Chain a year ago by VCs, has since picked up four hospitals and done a host of doctor deals.
Not surprisingly, Steward seems to have bruised some competitors’ feelings along the path to ACO-hood, which probably has something to do with its MHA departure, but Steward isn’t copping to that of course.
At this point in its evolution, Steward’s leaders say, the MHA’s positions on politics don’t represent its needs anymore. Particularly when it comes to health reform, Steward’s leaders feel it now has a different take than other members of the MHA, which has to advocate for shared positions across almost 100 hospitals with varied approaches.
As for me, I’m not sure what those differences are; in fact, I’d think that a “real” ACO would be an inspiration for, and partner to, other hospitals on the path to health reform. In fact, this raises some questions as to how the growing ACO trend will affect hospital relationships this year:
* Are IDNs that work hard at building a true ACO going to upset their peers so much that it will create a drag on their business overall?
* Most healthcare business models have some detractors and some fans, but is this one of the few that can actually divide the industry?
* Are ACOs a direction every IDN can take, or are there resource constraints (such as the size of a local market or number of unaffiliated doctors) that will prevent some from building one? Will the coming rush create ACO “haves” and “have nots”?
What do you think, folks? Have you seen anything happening in your markets that might answer these questions?