Organizations are working on a multitude of initiatives to prepare for greater contractual risk for population management, while also moving toward value-based care initiatives. In this new era of accountable healthcare, a new role, the chief integration officer, is beginning to take shape to link hospitals and providers in the care continuum.
The chief integration officer, which is going by many titles, such as the VP of population health, VP of integration, chief accountable care officer, and VP of the continuum of care, is beginning to formulate the organizational design for population health management, juggling an overwhelming number of projects in a short time frame without many dedicated team members, says Amanda Berra, practice manager, research and insights, at The Advisory Board Company, who identified this role in a recent research brief. [Click here to see an infographic further exemplifying the position.]
“I think the thing that is driving it is the growing industry commitment to a future in which providers are going to handle a lot more population-level risk,” says Berra. “Between the passage of the ACA [Accountable Care Act] , the emergence of a lot of commercial ACO contracts, the number of new Medicare programs for ACO and ACO-related demonstration projects, you definitely sense a momentum in the industry.”
Berra says she started seeing this position emerge a year ago, and it now is beginning to proliferate as hospitals are integrating and aligning with physicians to build care management platforms that allow for risk segmentation, the ability to reach out proactively to high-risk patients, avoid preventable readmissions, and focus on chronic care management. Berra says she has been finding this chief integration officer in organizations that are committed to change.
“The more clear-cut that ambition is to become a capable population manager at a health system, the more those health systems have taken early steps,” she says.
New Role, New Responsibilities
Ellis “Mac” Knight, M.D., senior vice president of physician and clinical integration at Palmetto Health (Columbia, S.C.), and executive medical director of Palmetto Health Quality Collaborative (PHQC), has been in his integrator role for a year now. He is an internist by training, and 10 years ago transitioned to the administrative side of medicine, after getting a business degree. He’s worked in a variety of roles: vice president of medical affairs at Palmetto Health Richland, senior vice president of ambulatory services for the health system, and now the head of the PHQC.
Knight’s clinical integration responsibilities fall into several buckets, which include overseeing the affiliation of the 1,100-member hospital medical staff; creating mechanisms for physician alignment; facilitating the creation of an accountable care organization (ACO); and negotiating for group contracting with payers.
It’s very important that each step along the way that we facilitate integration and wire and connect these physicians together, both with each other and with the hospital system,” says Knight. “Part of our strategy with the employed physician network is that we have everyone up on the same EHR.”
The health system currently has an inpatient EHR provided by the Kansas City, Mo.-based Cerner, and is currently implementing Cerner on the ambulatory side to provide connectivity. Through the PHQC, Palmetto Health’s physician-led, patient centered, independent medical ACO, a discounted Cerner EHR will be offered to non-employed physicians. Knight says that the ACO will be focusing on effectively managing certain populations like its own employee population of more than 10,000 and patients within its own zip code, which has one of the highest percentages of diabetic amputations in the country.
At Baptist Health System in Birmingham, Al., Scott Fenn is the first person in the chief integration officer role (he also holds the title of vice president), and he is responsible for inpatient and ambulatory clinical strategies and for creating the Baptist Physician Alliance Organization, which is a clinically integrated network of 400 affiliated physicians that will provide the opportunity to share data across many Baptist Health ambulatory clinics located throughout north and central Alabama, four hospitals, and aligned post-acute providers.
“[We’re] really working on collaboration with our doctors through our IT infrastructure committee, which includes the key hospital IT leadership [who envision] how the data should flow, what that looks like with the master patient index, so we can effectively know and manage those we’re going to be covering in the future,” says Fenn.