Accelerating value in healthcare

Reprinted with permission from Geisinger Health. This piece was originally published in Beckers Hospital Review on May 16, 2023.

Kaiser Permanente and Geisinger recently announced they will unite (pending regulatory review) with a shared mission to increase the value of healthcare across the country. We, the three authors of this piece, have throughout our careers in health policy worked to improve access and affordability of care, and we all serve on the Geisinger board of directors. We served on the Board because we believe Geisinger has been and will continue to be one of the organizations moving healthcare in the right direction. We write now to share why we believe this new combination is a significant step towards that goal.

For decades, the US healthcare system has been challenged by unaffordable costs and less-than-exceptional clinical outcomes. It doesn’t work well for patients, for providers, or for buyers of care. One underlying problem is a delivery and payment model that can misalign incentives to focus on episodic services and downstream activities rather than total upstream costs, care coordination, and prevention. Health policy analysts have long favored value-based models of care where payment is based on the value or quality of services and outcomes provided and the focus is on promoting health, access and affordability economic.

Adopting this value-based approach countywide has been challenging because it requires a re-engineering of both the payment model and the conventional care model. While there has been some progress, there is still a long way to go. Today, as the news once again documents the healthcare affordability crisis challenging employers, consumers and governments, the time is ripe to accelerate these efforts. The COVID pandemic and its aftermath have also demonstrated the fragility of the traditional healthcare model and its sustainability and effectiveness in improving health across populations and communities.

Despite these and other challenges, we see plenty of reason to be optimistic. Capabilities in clinical practices, technology, data/analysis, consumer insights, and provider enablement have evolved and continue to mature rapidly. Fostering investment in and leveraging these next-generation capabilities can catalyze exactly the kind of transformation needed to enable this healthcare model of tomorrow. They can help us move towards a system of care that achieves better outcomes, increases accessibility, and significantly improves both the patient and member experience.

Enter this transaction. It’s not the typical combination of the healthcare system. The rationale is based on the shared vision of these two organizations to improve and further develop the capabilities that can advance health within a community. Kaiser Permanente and Geisinger bring complementary capabilities and a similar approach to care that may be more broadly applicable across the broader healthcare industry. Kaiser Permanente is the gold standard in what has come to be known as population health within an integrated model of delivery and financing based on innovation and data. Geisinger is a nationally recognized organization that has innovated in a multi-payer, multi-provider framework to advance better health among its populations, including some of its most vulnerable such as Medicare, Medicaid, and rural segments. Both organizations share goals and operating philosophies focused on improving health and well-being rather than treating people primarily when they are sick and in need of hospital care. They also share a commitment to education and research, perhaps best embodied through their respective medical schools and training programs.

If this combination is approved, Geisinger will become the inaugural member of Risant Health, Kaiser’s new health systems division designed to bring the best in population health to multiple markets across the country. The new division will leverage Kaiser’s expertise in integrated, value-based care and coverage and Geisinger’s experience in promoting value-based care in a pluralistic provider and payer model.

Community-oriented participatory health systems, wherever they are located and whatever population they serve, will be supported by world-class expertise on a scale that would otherwise not be possible. The transformation will be enabled by investments in innovative models of care, next-generation technology, facilities and capabilities as well as digital tools that will deliver an improved experience for patients, members and providers.

Geisinger was founded in 1915 by Abigail Geisinger who opened a hospital to serve a small rural community in Danville, Pennsylvania. Her motto was to make him the best. As board members, we have always taken Abigail’s wise and timeless words to heart. We wholeheartedly believe that this partnership will truly pay off as we continue to bring the very best in health, not only to the communities we serve, but to communities large and small across the country.

Dr. Wilensky, Glied and Lee all serve on the board of directors of Geisinger Health.

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