Skyrocketing cost and the need for high quality care has created the need for change in the healthcare industry. There is a dedicated and passionate group of healthcare professionals and physicians in Columbus working diligently to transform an ailing healthcare system into one that is affordable, accountable and sustainable. That group, led by Jim Zacharias, Executive Director of MyHealth Network and MyHealth Alliance, LLC, believes clinical integration is the answer to healthcare reform and society’s demands for improvements in the quality and efficiency of healthcare. 

In this interview Zacharias explains more about clinical integration and the role MyHealth Alliance is playing in bringing this concept to Columbus. 

What is MyHealth Alliance? What is clinical integration?  

We are a network made up of independent physicians, the hospitals of the Columbus Regional Health system, and several other healthcare facilities. What makes the Alliance a ‘clinically integrated’ network is the way in which our doctors and facilities share information and work together as a coordinated team of healthcare providers. We use cutting-edge information technology to develop new insights into the health of our population of patients and then we use those insights to ensure that our patients are always getting healthcare of the highest quality and efficiency.  

How is MyHealth Alliance governed? How is that different from other health care networks/programs?

MyHealth is purposefully set up with governance shared equally between our independent physicians and the physicians and administrative leadership of the Columbus Regional Healthcare System.  I’ve learned that most successful networks have influential physicians intimately involved in the development and operations and they are essential in achieving meaningful change.      

What is driving the move to clinical integration?

Simply stated, the unsustainable cost of healthcare is driving the change.   Did you know that 10,000 people a DAY are becoming Medicare eligible?  Not only are there more people becoming eligible, but also people are living longer.  Historically we have paid for our healthcare using a model called fee-for-service. At the end of the day it is ultimately the consumer that is driving this transformation. The consumer can be the insurance companies, employers and individuals who now foot the bill for healthcare.    

Why are doctors joining integrated networks?

Doctors are focused on taking care of their patients and can be overwhelmed with the business side of managing their practice. Many are fiercely independent and prefer a smaller practice. They also expect to be reimbursed fairly for their work. In the new era of value-based reimbursement, physicians are paid for the quality and efficiency of their work; good patient outcomes and lower costs become more important than the number of patients seen or tests ordered. But, it is time consuming and expensive for small, independent practices to track quality and efficiency in this way. By being part of a clinically integrated network, these independent doctors are able to participate fully in value-based payment programs without sacrificing their independence. 

Physicians are also joining networks like ours in order to take advantage of the sophisticated information technology (IT), technology that they couldn’t otherwise afford.  

What is the advantage to the patient?

There are several reasons for patients to be excited about this new kind of network. It will improve access to providers, allow providers to have a more patient-centered focus and create a decrease of errors and waste. There will also be a reduction in healthcare premiums as care becomes better coordinated and interventions take place BEFORE people need to be hospitalized.