February 2012

NCH's Vision for the Future: A Relevant System of Care

Northwest Community Healthcare (NCH) President and CEO Bruce Crowther twice held physician town hall meetings to talk about healthcare reform, its impact on NCH, and how physicians play an important role in the organization’s refined vision. Crowther’s goal is to build strong relationships among doctors and to support physicians as they determine where they need to be in order to thrive in the new healthcare reform environment, especially at NCH.

Missed the Physician Town Hall?
Watch the presentation here.

Healthcare Reform
With healthcare representing a significant percentage of the federal deficit, the government has identified a solution that moves the industry’s model of care from an indemnity-based to risk-based reimbursement system. In the big picture – and over time – healthcare reform will roll out a lower-cost model that stresses accountability among care providers and emphasizes population management through standardized care focused on wellness.

“The government is migrating healthcare to a value-based payment system as opposed to the current model that pays on performance and volume,” said Crowther. “The transition is from episode management to health management.”

Crowther explained that this new vision for healthcare looks simple, but is essentially the antithesis of the way medicine is organized today. The current structure has set up each care provider to operate as its own business, whether it is a physician’s practice, the hospital, nursing home, or pharmacy, to name a few. In addition, the system is difficult for patients to navigate and there’s poor connectivity among key players.

System of Care
In response, NCH has refined its mission and is evolving to become a comprehensive patient-centered system of care. NCH - like many healthcare facilities across the country – is establishing a population care management model while also aiming to participate in pilot programs to gain experience with risk contracting.

Right now, NCH is bringing key players together to establish consistency for patients across the care continuum. “The system of care that we’re building will behave as a team that, together, takes accountability for keeping people healthy,” Crowther said. “Our vision is to collaborate with like-minded partners willing to participate in this new approach to healthcare.”

When introducing the system of care model Crowther cleared the air. “We are not having conversations with anyone about mergers,” he said. Crowther added that patients do not define relevancy as a 10-hospital system. Rather, patients identify their personal system of care as being their doctors, their hospital, their nursing home, their insurance carrier and their pharmacy. That’s a reason for NCH’s outreach to neighboring extended care facilities – an effort to open communications and to establish shared protocols.

Options for Physician Alignment
An essential ingredient for building coordinated, accountable care is physician alignment. While the NCH Medical Group serves as a key piece of the overall strategy, Crowther stressed that employment is not the only option. Crowther outlined three different levels of alignment physicians can choose from to meet their individual needs, emphasizing that all physicians are important to NCH.  These include:

  • Employment. The NCH Medical Group will continue to expand, with the goal to reach 125 primary care physicians by 2014. Along the way, specialists will be added as needs arise.
  • Aligned Independents. Physicians retain their autonomy in practice, yet are active participants in the system of care model. Examples of alignment include IT connectivity and agreement to use the same payer contracts and protocols. NCH’s Physician Hospital Organization (PHO) serves as the current model to build upon. Physicians are encouraged to share their thoughts regarding ways in which they would like to see NCH strengthen alignment.
  • Non-Aligned Independents. For those physicians who are not interested in tighter alignment opportunities, NCH will continue to provide traditional services and strive to make it easy for them to practice at NCH.

“At the end of the day, our relationship becomes very important to this future. It’s critical that we connect and work together,” said Crowther. “I ask the medical staff to think about where you want to plug in. I encourage you to identify where your attachment point is, and how we can help you bridge today with tomorrow.”

To discuss your interest in, and ideas for, alignment opportunities, please contact Kelly Raffel, executive director, Physician Services and Operations Integration, at 847.618.5283 or