A changing landscape

For all its challenges and complexities, health care transformation also presents tremendous opportunities for hospitals — and their boards.

One area in which this duality is playing out is population health management, increasingly important as value-based payment systems become more common.

In our cover story starting on Page 8, Maggie Van Dyke examines some of the many ways hospitals are trying to increase value. In particular, she details how some organizations are doing their homework before participating in Medicare's Advanced Alternative Payment Models.

"This is not like flipping on a light switch," says Christopher Stanley, M.D., director of health care practice at Navigant. "It usually takes one to three years of capability development and expansion before an organization would want to take on risk, especially downside risk."

Health systems need to invest in a number of skill sets to effectively manage patient populations: clinical integration, data analytics, financial risk management, care management and team-based care. Yet, providers need another essential trait. "One of the most important capabilities that an organization needs is the will to take on this change," says Sandra Van Trease, BJC HealthCare group president.

Partnerships are another critical component of transformation. In an article starting on Page 18, Travis Ansel stresses that boards and executives should have a clear strategy in place when entering into affiliations. Often, the starting point is to decide on clear definitions of concepts like "independence" and "local control" and to clarify just what sort of partnership is under consideration.

On Page 14, Laurie Larson highlights an initiative that fostered partnerships among cities, health care organizations and development agencies to address the social determinants of health in disadvantaged communities. Sponsored by the Robert Wood Johnson Foundation and the Reinvestment Fund, Invest Health has channeled the efforts of multiple stakeholders to improve community health. "This is an opportunity to learn how the whole is bigger than the parts, and that a larger agenda can be a focus for creating change," says Abbey Cofsky, managing director with the foundation.

Innovations like these can point the way for trustees as they adapt to our changing health care landscape.