May 24, 2016

Vanderbilt Health Affiliated Network: transforming health care delivery across the Mid-South

Nearly five years ago a tiny seed of an idea was presented at a Vanderbilt University Medical Center (VUMC) Clinical Enterprise retreat: forming a physician-led network of leading hospitals and physicians to focus on improving the health of communities in Tennessee and beyond.

Nearly five years ago a tiny seed of an idea was presented at a Vanderbilt University Medical Center (VUMC) Clinical Enterprise retreat: forming a physician-led network of leading hospitals and physicians to focus on improving the health of communities in Tennessee and beyond. The benefits and services that would be offered would be affordable, coordinated and tailored to “health” care rather than “sick” care.

A year and a half later, in December 2012, the Vanderbilt Health Affiliated Network launched with four founding hospitals in Middle Tennessee: Vanderbilt University Medical Center (VUMC), Maury Regional Medical Center, NorthCrest Medical Center and Williamson Medical Center.

What it is

A separate entity from VUMC, the network itself is not a provider of health care. Its mission is simple and direct: improving the health of the communities that it touches.

Today, swiftly growing and strategically planned, it’s grown into the largest physician-led network of leading doctors, regional health systems and other health care providers in Tennessee and one of the largest in the nation.

The Vanderbilt Health Affiliated Network currently spans a geographic region that includes Tennessee, portions of Kentucky, Eastern Arkansas, Northern Mississippi and the western portion of Virginia, and is currently composed of 51 hospitals, more than 235 physician practices, 3,500 participating physicians and clinicians, more than 35 urgent care, after-hours and walk-in clinics, and 11 health systems.

VUMC provides the professional expertise, legal framework, IT and other resources to enable clinicians, hospitals and health systems to engage and prosper in population health (improving the experience of health care services as well as overall health for large communities of people while reducing the per capita cost of health care). For patients, this means having access to care that is convenient, preventive, evidence-based, and well-coordinated across all stages of life and for all medical needs.

The network’s strong pediatric program has demonstrated savings three years in a row, and delivered savings at 17 percent below market trend in 2014. These savings were achieved in a broad range of areas that included reduced emergency room costs per 1,000 patients, reduced office visit procedure costs, more effective use of diagnostic imaging, and efficient provider calls that address quality and cost issues in real time.

“The Vanderbilt Health Affiliated Network was originally conceived in anticipation of the changes we saw coming for health care with an eye to better serve patients across a broad geography. The network’s true power is its ability to coordinate care delivery and positively impact the health of large populations,” said C. Wright Pinson, MBA, M.D., deputy CEO and Chief Clinical Officer for VUMC, and Chairman of the Board for the Vanderbilt Health Affiliated Network.

“The health of the people who live in parts of the Southeast is among the poorest in the U.S., and as a result health care costs are high. Meanwhile many physicians and health systems are facing increasing economic pressures and administrative challenges, which in turn are threatening continued access to critical care facilities in smaller communities and rural areas. These trends will only get more challenging as new payment models for providers are implemented,” he said.

“Vanderbilt and its participating hospitals and clinicians are taking on the responsibility to lead that change. We’re empowering clinicians who want to offer their patients high quality care with the resources and structure they need to do this while remaining independent and adaptable to the changing health care marketplace trends.”

Members of the Vanderbilt community and the public will hear more about the network this month as it is introduced to the public through an awareness campaign to explain its structure and offerings.

How it works

Clinicians, hospitals and health systems can join the network by signing participation agreements. Participants include physicians, physician practices, hospitals and health systems that pay dues as network members and agree to abide by a governance structure that has been agreed upon by the network’s Board of Directors.

Once in the network, clinicians:

• Share clinical data securely across the network through a Health Information Exchange

• Participate in quality improvement programs

• Take active roles in network decision-making

• Extend network care coordination programs to their patients

• Benefit from shared savings when the network reduces costs for its patients

The network generates substantial savings for health plans. The revenue earned through shared savings arrangements with these plans is distributed back to participating practices to reward and incentivize improved quality and cost efficiency.

The network delivered approximately 5 percent cost savings to employer and commercial health plans in 2014 – an achievement that netted $10 million in savings for the network’s health plan customers. A pediatric program the network created with Vanderbilt’s employee health plan has delivered a cost savings for three consecutive years, the last of which saw a 17 percent reduction in health care costs for pediatric health plan members.

“Ultimately, as we grow, the network is poised to help change the trajectory of health in the Southeast,” said Mark Cianciolo, MPA, executive director of the Vanderbilt Health Affiliated Network. “We want to reduce the expense and eventually the rates of diabetes, obesity, COPD, heart failure and other chronic conditions. We want to reduce the average spend on health care per person per year while also ensuring we enable families across the region to live healthier lives,” he said.

“While cost savings can be measured, the real impact of providers focused on your health is seen in our patients’ quality of life. This is the essence of population health,” said David Posch, Executive Vice President for Population Health. “These are the goals we’re shooting for.”

The network’s model is being watched from afar. VUMC leaders have been asked to offer advisory services to help organizations implement similar networks in their geographical areas.

“We’re happy to share many of the lessons we’ve learned. We’ve formed robust relationships with other health systems to help them foster high-quality, low-cost care in their communities,” Cianciolo said.

The Vanderbilt Health Affiliated Network now includes:

  • 51 hospitals
  • 235+ practices
  • More than 3,500 participating physicians and clinicians
  • More than 35 urgent care, after-hours and walk-in clinics
  • 11 health systems, including:

— Baptist Memorial Health Care, Memphis, West Tennessee, Mississippi and Arkansas

— Cookeville Regional Medical Center, Cookeville

— Jennie Stuart Medical Center, Hopkinsville, Kentucky

— Maury Regional Medical Center, Columbia

— Mountain States Health Alliance

— NorthCrest Medical Center, Springfield

— St. Thomas Midtown, Nashville & St. Thomas Rutherford, Murfreesboro

— Sumner Regional Medical Center, Gallatin

— Vanderbilt University Medical Center, Nashville

— West Tennessee Healthcare, Jackson and West Tennessee

— Williamson Medical Center, Franklin

  • More than 70 employer health plan customers, with industry-best 90+ percent renewal rates
  • More than 100,000 commercially insured lives currently under management.