Four of Iowa’s premier health care organizations have announced they are creating a health care alliance in Iowa and contiguous areas. The announcement was made in a statewide press conference, held today, June 28, in several cities simultaneously.

The new alliance, to be called University of Iowa Health Alliance (UIHA), will include over 50 hospitals and more than 160 clinics. The members of the alliance will work together to advance the high quality of health care services, to improve the health status of patients and communities, and to achieve efficiencies that will help member organizations reduce the rising cost of care for their patients.

UIHA will create a platform for sharing expertise, selected support services, and information technologies needed to succeed in the emerging “accountable care” systems and payment programs. Working together in UIHA, members will strive to increase the value of services provided, improve clinical integration between the members, provide more streamlined and coordinated care to patients, and ultimately improve the health of people in Iowa and other regions served.

The four entities involved are:

• Mercy Health Network (MHN), a statewide system comprised of 11 owned and 30 contract-affiliated hospitals, and 142 physician clinics with 625 physicians. MHN is based in Des Moines and includes the Mercy Medical Centers in Des Moines, Sioux City, Mason City, Dubuque, and Clinton. It also includes owned community hospitals in Centerville, Dyersville, New Hampton, Primghar, West Des Moines, and Oakland, Neb.

• Genesis Health System (GHS), a system of four owned medical centers in Davenport, DeWitt, and Silvis, Ill., two affiliated hospitals, and numerous outpatient centers including urgent care clinics and ambulatory surgery centers. Genesis Health Group has more than 160 physicians. Genesis is based in Davenport and serves a 10-county region of eastern Iowa and western Illinois.

• Mercy-Cedar Rapids (MercyCare Service Corporation), a health care system serving the Eastern Iowa Corridor that includes Mercy Medical Center, the Hall-Perrine Cancer Center, Mercy Health Plaza, multiple outpatient centers, and a network of 13 family practice clinics. The clinics are served by more than 70 physicians, physician assistants, and nurse practitioners. Three urgent care facilities and four specialty clinics are also part of the system.

• University of Iowa Health Care (UI Health Care), based in Iowa City. UI Health Care is the state’s only comprehensive academic medical center. It includes University of Iowa Hospitals and Clinics, the University of Iowa Roy J. and Lucille A. Carver College of Medicine, and University of Iowa Physicians, the state’s largest multi-specialty physician group practice with 1,432 physicians, residents, and fellows. UI Health Care also employs 7,482 non-physician staff, and serves as a resource to the state through its research, medical education, patient care, and numerous other initiatives.

'Best of both worlds' approach

Members describe the arrangement as the “best of both worlds,” allowing each organization to maintain its legacy and independence, while promoting clinical integration and care coordination. It does not involve a merger of assets or changes in ownership or control.

The structure is designed to sustain and honor the members’ local missions and governance authorities, while supporting participation in a larger effort to lead needed changes in the health care system. The alliance also is designed to encourage additional health care providers in Iowa and contiguous states to join and participate in these important initiatives.

Examples of specific UIHA efforts will include:

• Strengthening primary care to ensure Iowans have access to a “medical home,” through which they can receive preventive services and improved coordination of care across settings and levels of clinical services and specialties.

• Assisting members in developing performance metrics and comparative reporting to support improvement efforts, i.e. using comparative data to identify and share best practices and reduce the variations in care, which will improve quality and lower costs.

• Developing programs to determine and address the health status of communities served.

• Developing educational programs for health care providers, patients, and consumers.

• Developing techniques and systems for improving patients’ engagement in managing their health.

• Sharing the high costs of the information systems and experts needed to analyze clinical data and convert it into information that can be used by physicians and others to improve care and better manage populations of patients with chronic diseases.

• Sharing expertise and operational costs associated with development of “accountable care” initiatives, enabling the members to evaluate and participate in new payment programs offered by governmental and commercial insurance programs.

• Collaborating in research initiatives.

Real value for patients and communities

“We believe by working together we can achieve the necessary expertise and size—the skill and scale—to be successful into the future and to bring real value to our patients and communities,” says Dave Vellinga, president and CEO of MHN.

Doug Cropper, president and CEO of GHS, agrees. “Lowering costs and improving quality requires organizations to work together to share best practices, reduce variation, streamline care and, most importantly, improve the health status of populations of patients," he says. "We are excited to have so many of Iowa’s hospitals and clinics committed to real improvement in their organizations and their communities.”

Tim Charles, Mercy-Cedar Rapids president and CEO, notes, “We also want to provide the opportunity for other independent health care providers to associate with or use the accountable care infrastructure and services of UIHA. The beauty of this alliance is that each participant can maintain its independence while enjoying all the benefits of the larger network’s capabilities and cost savings. The changes occurring in health care delivery and financing are daunting, and we all look forward to working together to create success in the future environment.”

Jean Robillard, vice president for medical affairs at the UI, says the alliance is a natural extension of the collaboration recently announced with Mercy-Cedar Rapids.

“As I noted at that time, we share a commitment to providing access to high-quality health care with a focus on building healthier communities," he explains. "This collaboration is an outstanding opportunity to extend UI Health Care’s mission to serve all Iowans.”

The executives say UIHA will strive not only to provide value, but to create person-centered care in a better coordinated system.

“We want to engage patients in new ways to help them maintain their health, thereby reducing their need for higher levels of health care services,” says David Swieskowski, senior accountable care executive at Mercy Medical Center-Des Moines. “Each member organization brings successes to the larger group—successes in improving quality, in streamlining care, and in proactively working with patients to improve and maintain their health. Working together to reduce the variation and streamline care will benefit everyone—the patient, the payer, and the community.”

Builds on successful models and relationships

Mercy Health Network was established in the mid 1990s as a similar model of both owned and contracted health care organizations working collaboratively in Iowa. Executives from all four of the organizations forming UIHA note they have longstanding relationships and a history of working together on selected projects.

“The formation of UIHA is a significant step forward because it formalizes our relationships and creates an infrastructure to achieve real improvement and cost savings,” says Cropper. “However, in many ways it’s just the next logical step in the collegial relationships between our organizations that we all value.”

The organizations have been working together in various configurations for more than a year to analyze the changing health care environment, determine the best strategies and structures for responding to future demands, and identify the specific services which can and should be shared to create better value for their patients and communities.

“We are very pleased and committed to working together to assure continued access to excellent health care for Iowans, as well as the shared expansion of our research and education missions into more communities. This is truly a very forward-thinking, exciting, and innovative way to address the many changes in our health care environment,” adds Robillard.

“We have approached this alliance in a very thoughtful way to ensure we’re moving in the right direction and at the right pace,” says Charles. “We genuinely believe we are creating a ‘best of both worlds’ alliance that will bring real benefits to the founding members, to many other independent providers and organizations wishing to join with us, and to the people of Iowa we serve every day.”