Henry Ford Health System: Accountable Care Organization

Henry Ford Health System (HFHS) is a Michigan not-for-profit corporation governed by a 22-member board of trustees. Advisory and affiliate boards comprising 129 trustee volunteer leaders provide vital links to the communities the system serves. Anchored by the prestigious Henry Ford Medical Group, HFHS is one of the nation's leading comprehensive, integrated health systems.

It provides health insurance and health care delivery, including acute, specialty, primary and preventive care services backed by excellence in research and education. Founded in 1915 by auto pioneer Henry Ford, the health system is committed to improving the health and well-being of a diverse community.

Henry Ford Hospital President and CEO Dr. John Popovich Jr. sought to accelerate HFHS capabilities to deliver greater healthcare value, advancing performance measurement processes and enhancing engagement of independent community physicians. Creating true clinical integration seemed to be a daunting and insurmountable task.

Although HFHS provides firm foundations, the network’s design, development and operation depended on direct physician involvement—those employed by the system as well as independent physicians across southeast Michigan.

With the 1,200-member Henry Ford Medical Group, six hospitals, two nursing facilities, 29 multi-specialty medical centers and a close to 500,000-member health plan, HFHS needed to design and implement a new operating model and provider network responsive to changing market dynamics and able to enhance quality and value for patients and providers.

Enter Accenture. Together, the two entities set out to help develop a network model that culminated in a clinically integrated accountable care organization (ACO). Whether formally initiating an ACO or not, health systems increasingly see that continued pressure on reimbursement, coupled with rising labor, supply and pharmaceutical expenses make it imperative to push for greater cost-effectiveness while improving the quality of care. At the very least, there is a need to develop “ACO-like” competencies.

The Henry Ford Physician Network could be one of the only, and one of the country’s larger, ACOs—a groundbreaking feat in healthcare reform. HFPN exemplifies the clinical integration model, where physicians collaborate in a defined network to improve quality and efficiency. Key components of the network include:

• Metrics — A defined set of 104 assessments, ensuring a minimum of five meaningful specialty-specific metrics for the first year, measure physician performance. Officials also apply quality assessments across the network to physicians to help improve coordination of care, increase quality of care and decrease costs.

• Governance — A 15-member board of trustees with equal representation from independent physician groups and Henry Ford’s own medical practitioners govern HFPN. Committees focused on clinical integration, finance and network administration provide additional oversight and guidance.

• Technology — The network’s connectivity solutions feature four categories of base components and help participants work toward meaningful use. A disease registry helps providers treat chronic diseases and conditions using tools that manage observational, epidemiologic and other data at the point of care. A secure health information exchange (HIE) accommodates the sharing of results and clinical data between the HFHS hospitals, HFPN, and Henry Ford Health System-affiliated providers and patients.

HFPN has had considerable success establishing the right metrics, gaining positive feedback from the U.S. Federal Trade Commission, setting up collaborative work structures and processes, and helping create a shared culture that is centered on quality of care and cost containment.

Since the launch, HFPN has signed up nearly 200 independent practitioners, delivering benefits to physicians across southeast Michigan:

• They become part of a greater commitment to making measurable improvements in the quality of healthcare in the state.

• They access the Henry Ford Medical Group’s clinical research and HFHS’s resources and services, all while maintaining their practices’ current business models.

• They access affordable technology solutions that enable greater efficiency and help practices work toward meaningful use requirements.

Dr. Jerome Finkel, president of Internal Medicine Associates of Mount Clemens and one of the first independent physicians to sign up with HFPN said, "We recognize that patients, insurers and employers in our region are looking for physicians to lead the way in improving health care. Clinical integration is a proven model for doing that."

Physicians inside and outside the Henry Ford system are excited and engaged. And the organization is starting to create a shared culture centered on quality of care and cost-effective care. Although ACOs are in their beginning stages, the HFPN shows what is possible. With the striking successes to date, there is every confidence that Henry Ford will continue to blaze trails that make a difference for patients and payers.