Our Take: CommonSpirit launches PHSO to ‘help providers succeed in value-based care’
Chicago-based CommonSpirit Health, the country’s largest Catholic health system and one of the largest nonprofit health systems in the U.S., has established a population health services organization (PHSO) that will offer services to help providers and provider networks “excel in value-based care.”
The PHSO’s services — which include advanced population health analytics, network management, care coordination, data management and analytics, technology infrastructure, and reporting, among others — are intended to expand access to equitable care, improve care quality and outcomes, and lower costs, CommonSpirit said in its announcement.
The new organization will draw upon CommonSpirit’s expertise in existing value-based programs, including full risk-bearing organizations and 10 accountable care organizations. CommonSpirit noted that in the past five years of participation in the Medicare Shared Savings Program, the health system has saved Medicare more than $474 million through proactive outreach and by addressing patients’ behavioral and social needs along with their medical needs.
“The PHSO is a natural extension of our mission and longstanding commitment to providing high quality, equitable care and addressing social determinants of health,” said Wright Lassiter III, CommonSpirit Health’s CEO. “We are leveraging the national scale of CommonSpirit and our expertise in value-based care across diverse, community-based health system environments in order to elevate the standard for health care in the U.S. and help providers succeed in value-based care.”
CommonSpirit Health operates 145 hospitals and more than 2,200 sites of care in rural and urban communities in 24 states. The health system is also one of the largest providers of Medicare and Medicaid services in the country. Consequently, according to CommonSpirit, the new PHSO will serve a more diverse payer portfolio than any other management services organization nationwide.
“We serve diverse communities that include Medicaid, Medicare, and commercial insurance, which means our data are more representative of America than other models primarily focused on commercial insurance,” said Dr. Thomas McGinn, executive vice president of physician enterprise at CommonSpirit Health. “Coupled with our reach across 24 states, we can use the data and tools and access to a broad patient population to take on critical national health issues that require the size, scale, and depth that we can deliver.”
Our Take: CommonSpirit said the PHSO is designed to foster collaboration between independent and employed providers by supporting networks that include both types of physicians. The health system also noted that half of the providers engaged in value-based agreements with CommonSpirit are not employed by the health system, and it expects that segment of the network to grow.
This network growth won’t be a by-product of the PHSO. It’s one of the PHSO’s main purposes, though CommonSpirit didn’t specifically state that. By offering these services to independent physicians in the communities CommonSpirit serves, the health system can grow its provider networks organically, without having to acquire local or regional physician groups.
It’s a strategy CommonSpirit can use to address the dual challenges of physician shortages and rising labor costs while also benefiting the providers who take advantage of the PHSO’s offerings. It’s a relatively unique strategy and one that few other health systems are likely to attempt because they don’t have CommonSpirit’s resources and geographic reach.
The sprawling health system said it focused its efforts on growth and reducing its labor costs, including contract labor, among other objectives to achieve “strong financial performance” in the final quarter of its fiscal year, which ended June 30.
Nonetheless, CommonSpirit reported an annual operating loss of $1.39 billion on revenue of $34.51 billion; in FY 2022, the health system reported an operating loss of $1.29 billion and revenue of $33.91 billion. Investment income of $1.03 billion in FY 2023 helped offset the operating loss; in FY 2022, CommonSpirit lost $971 million on investments.
Salaries and benefits accounted for $18.3 billion of CommonSpirit’s operating expenses in FY 2023, a slight increase from the previous year. In the fourth quarter, the health system reduced its workforce by approximately 2,000 full-time employees in ancillary, support, and overhead functions but increased its clinical staff to keep up with higher volume levels.
“Like the rest of the health care industry, CommonSpirit continues to be affected by inflation, the continued labor shortage, and challenging dynamics with payers,” said Dan Morissette, CommonSpirit Health’s chief financial officer. “Given those headwinds, we continue to focus on initiatives and opportunities that allow us to pursue growth, reduce costs, and increase efficiency, while at the same time investing appropriately in developing the workforce of the future.”
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Medicare’s Historic Prescription Drug Price Negotiations. JAMA, 9.20.23
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Improving US orthopedic care via patient-centric pathways. McKinsey & Company, 9.14.23