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Our Take: Intermountain, Presbyterian, SSM Health launch member-led company to ‘transform’ digital health care

Oct 11, 2021

Last Tuesday, Intermountain Healthcare, Presbyterian Healthcare Services, and SSM Health announced the launch of Graphite Health, a nonprofit, member-led enterprise that will focus on “health care interoperability challenges.”

The new company is creating a standardized, interoperable data platform and app marketplace to facilitate the distribution of digital health solutions for its member health systems.

Graphite Health’s CEO, Dr. Ries Robinson, who also serves as Presbyterian Healthcare Services’ chief innovation advisor, said, “Right now, when a hospital wants to adopt new innovative solutions, it is hampered by overly cumbersome processes that can require years to implement.”

The announcement noted that health systems spend, on average, up to two years  implementing new apps, and that it can take more than six months just to negotiate contracts and evaluate the security protocols.

Graphite Health will rely on “the collective power, scale, knowledge, and commitment” of its health system members to overcome those challenges.

Members will contribute to the company and commit to using its tools and technology. In exchange, they will benefit from innovations deployed through the Graphite Marketplace, as well as resources that can help them more easily adopt the new capabilities.

The founding members said the new digital health care company will be guided by the Digital Hippocratic Oath, which puts patients’ and providers’ privacy and trust first.

Our Take: Every year we read reports that place the U.S. at or near the bottom of a list of comparable “wealthy” countries when it comes to affordable health care.

Relative to these other countries, the U.S. spends more per capita on health care, as well as an increasing percentage of the nation’s gross domestic product. Much of the excess spending is on administrative costs.

But even though the U.S. spends more on health care than other countries do, that doesn’t translate to better outcomes. In certain metrics, the U.S. actually performs worse.

Politicians talk about potential ways to address the high cost of care, but little gets done. The various factions within the country’s health care system — payers, providers, pharmacy benefit managers, drug companies — point their fingers at each other with blame. Retailers such as Amazon, Apple, and Walmart keep trying to make health care more affordable and more accessible, as do CVS and Walgreens. Progress, however, is painfully slow.

We take our hat off to the health systems that are coming together to tackle the plethora of problems inherent in our national health care system.

Graphite Health is modeled on Civica Rx, a nonprofit founded by seven health systems and three philanthropic organizations in September 2018 to address prescription drug costs and shortages. Intermountain and SSM Health were also founding members of that company. A dozen additional health systems joined Civica Rx in early 2019 and, according to a Forbes article published in September 2020, the company was serving more than 50 health systems as it started its third year of operation.

Like Civica Rx, Graphite Health expects to welcome more health systems, along with philanthropies, as members.

“Graphite Health is more than a new start-up. It represents a new approach to solving one of our long-standing national problems: Health care is too expensive and inconvenient,” said Dan Liljenquist, senior vice president and chief strategy officer at Intermountain Healthcare. “By embracing the collective membership approach, and committing to our Digital Hippocratic Oath, we will ensure patients are treated as people rather than products. By doing so, Graphite Health will accelerate access to valuable digital tools that can deliver better health care outcomes at a lower cost.”

“The promise of digital transformation to reduce real human suffering is too big to quibble over definitions and silos. It is a collective problem that requires collective action. We’re addressing this market failure through a novel utility model that spreads the costs and efforts across a broad set of like-minded stakeholders so everyone can lift together — so everyone can benefit,” said Carter Dredge, SSM Health’s senior vice president and lead futurist.

These days, it’s a relief to read about people and organizations working together to bring about change. We wish them much success.

What else you need to know
Approximately 1,400 unvaccinated employees at Northwell Health lost their jobs last Monday for not complying with New York’s COVID-19 vaccine mandate. A spokesman for Northwell Health, the state’s largest health care provider, said the figure represents less than 2% of the health system’s workforce. Terminated employees can interview for reinstatement within 30 days, he said, adding that “[t]he goal was to get people vaccinated, not to get people terminated.” Northwell issued its own mandate in August.

Based on a listing compiled and updated by Fierce Healthcare, many other hospitals and health systems are also seeing only a small percentage of their employees refusing to comply with vaccination mandates. Smaller hospitals are having a harder time contending with the fallout, with some having to suspend certain services because of a shortage of employees. A considerable number of hospitals and health systems were already significantly understaffed before the various mandates took effect, leading to speculation that the mandates would severely exacerbate the problem.

Anthem and UnitedHealthcare owe hospitals and physicians billions of dollars for months-old unpaid medical claims, according to a Kaiser Health News (KHN) article. Molly Smith, group vice president at the American Hospital Association (AHA), said Anthem and other large insurers are using the pandemic as cover to implement “egregious” policies that are detrimental to patients and hospitals. Citing regulatory filings, KHN reported that 43% of Anthem’s claims for the quarter ending June 30, 2019, had not been paid, and two years later the percentage had increased to 53% — a difference of $2.5 billion. Meanwhile, KHN noted, Anthem recorded profit of $3.5 billion for the first half of 2021. According to the article, 54% of United’s claims were unpaid as of June 30, 2021. Hospitals are seeing an increase in retroactive claim denials by UnitedHealthcare for care provided in the emergency department, AHA said.

St. Louis-based SSM Health is partnering with Optum in a 10-year collaboration to expand access to health care throughout the Midwest. Starting next year, Optum, a subsidiary of UnitedHealth Group, will support certain administrative functions for SSM Health, including inpatient care management and revenue cycle management. They will also work together on a “digital transformation” designed to simplify patient access to care, according to a press release, and both will invest in community health programs to improve access to care for disadvantaged and vulnerable populations. Through an outsourcing arrangement, approximately 2,100 employees of SSM Health will become employees of Optum.

Executive moves

Dr. Francis Collins will be leaving the National Institutes of Health (NIH) at the end of the year. Appointed in 2009, Collins has the distinction of being the longest-serving presidentially appointed director of the NIH, according to a news release. Citing an un-named NIH official, The Washington Post reported that no decision on an interim director has been made.

Dr. Vivek Garg has been appointed the new chief medical officer of Humana’s primary care business, which includes CenterWell Senior Primary Care and Conviva Care Centers. Becker’s Hospital Review reported that he “will primarily lead the organization’s physician team and care models for older adults.” Before taking on his new role at Humana, Dr. Garg held executive positions at CareMore, Aspire Health, Oscar Health, and One Medical Group.

St. Louis-based Mercy announced that its board has named Steve Mackin as the health system’s new president and CEO. On April 1, 2022, Mackin will succeed Lynn Britton, who has served in the dual roles for 13 years, and Britton will become executive chair of the board. Before joining Mercy in 2017, Mackin held a number of leadership positions at Cancer Treatment Centers of America.

Jeff Alter took on the role of CEO at Berkeley Heights, N.J.-based Summit Health on Oct. 4. Dr. Jeffrey Le Benger, who had served as CEO since 2019, when Summit Medical Group merged with CityMD to form Summit Health, transitioned to executive chair of Summit Health Management, according to a press release. Alter’s previous roles include executive vice president of Anthem Health Solutions and president of IngenioRx, Anthem’s pharmacy benefit manager. He was also with UnitedHealthcare for 15 years.

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