Saint Luke’s Health system announces partnership in The BJC Collaborative

KANSAS CITY, Mo. — Saint Luke’s Health System of Kansas City, Mo., BJC HealthCare of St. Louis, Mo., CoxHealth of Springfield, Mo., and Memorial Health System of Springfield, Ill., today announced they have partnered together to create The BJC Collaborative, L.L.C. This new, multi-system Collaborative has been formed to achieve even higher quality care for the patients served by these independent not-for-profit health care organizations.

While remaining independent, the Collaborative members have a footprint of 4,821 hospital beds spanning Missouri, Illinois, and Kansas, and combined annual revenues of almost $7 billion, allowing the members of the BJC Collaborative to focus on achieving savings; deploying clinical programs and services to improve access to and quality of health care for patients; lowering health care costs; and creating additional efficiencies that will be beneficial to patients and the communities served by the member organizations.

The four systems that are part of this new Collaborative are leaders in their regions and have entered into this new relationship with a commitment to doing what is best for their patients. The Collaborative is buoyed by the tenets of the Patient Protection and Affordable Care Act that encourage partnerships and innovation to improve patient outcomes and reduce health care costs. Its members believe they are well positioned to work together to achieve economies of scale, learn from each other and share best practices that will ultimately lead to better patient outcomes, improve health care access and lower costs.

Saint Luke’s Health System is the largest non-profit health care provider in the Kansas City metropolitan area. The system consists of 11 area hospitals and several primary and specialty care practices, and provides a range of inpatient, outpatient, and home care services. It has 9,700 employees and 318 employed physicians. Affiliated with the University of Missouri – Kansas City School of Medicine, Saint Luke’s is renowned for its programs in heart and stroke care, national honors including the Malcolm Baldrige National Quality Award, and consistent top rankings for high-quality health care by Kansas City consumers. Founded in 1882 as a faith-based, not-for-profit organization, Saint Luke’s Health System’s mission includes a commitment to the highest levels of excellence in health care and the advancement of medical research and education.

BJC HealthCare is a 13 hospital system with urban, suburban and rural hospitals serving eastern Missouri and southern Illinois. With nationally recognized adult and pediatric teaching hospitals affiliated with the Washington University School of Medicine, 28,000 employees, approximately 275 employed physicians, as well as behavioral health, corporate, home and community health services, BJC is among the largest non-profit health care organizations in the country.

CoxHealth is Springfield, Missouri’s only locally owned not-for-profit health system. It is accredited by The Joint Commission, distinguished as one of the nation’s Top 100 Integrated Health Care Systems (2006 – 2012), and recognized as a U.S. News & World Report Best Regional hospital. In FY 2011, CoxHealth provided more than $122 million in community benefit to serve the unmet needs of the community. Established in 1906, CoxHealth serves more than 900,000 people in a 25-county service area in southwest Missouri and northwest Arkansas, offering a comprehensive array of primary and specialty care including three hospitals and more than 65 clinics in 20 communities. The health system includes Oxford HealthCare (routinely the nation’s second largest hospital-based home health agency), Home Parenteral Services (home infusion therapy), CoxHealth Foundation, Cox College, CoxHealthPlans and more.

Memorial Health System is a three-hospital, non-profit health care organization serving Illinois patients in a 40-county region. With a teaching hospital affiliated with Southern Illinois University School of Medicine, two critical access hospitals, 6,000 employees, 75 employed physicians and mid-level providers, behavioral health and home services, Memorial Health System is the largest private employer in the greater Springfield area.

Melinda L. Estes, M.D., President and CEO of Saint Luke’s Health System, says the Collaborative will provide numerous benefits for patients, staff and the communities served by Saint Luke’s. “This collaborative provides a unique opportunity for these leading regional health systems to leverage our combined knowledge and resources to ensure we continue to provide exceptional care for the communities we serve,” said Dr. Estes. “Because we share similar missions, we can work together to maximize value for our patients and expand the ways we deliver care.” Dr. Estes also serves as Vice-Chair of the Board for the Collaborative.

“This is a good day for BJC and a great day for patients served by each of our hospitals,” said Steven Lipstein, President & CEO of BJC HealthCare and Board Chairman of the Collaborative. “We are embarking on an innovative journey to work across systems and states in ways that have not been done before. We are confident that being able to learn from others and share what we know will be beneficial to all of our patients.”

Steven Edwards, President & CEO of Cox Health, says the Collaborative will build upon the strengths of the four institutions. “The strength of our collaboration is in building upon the expertise of each member,” says Edwards. “Together we are stronger, and the benefits will be experienced by our patients in greater quality and safety, highly trained professionals and cost effective care.”

“The organizations in the BJC Collaborative share common values and a commitment to be national leaders for excellence in patient care,” said Edgar J. Curtis, President and CEO of Memorial Health System. “Through this collaborative, we will work together to treat more patients, lower our costs and deliver higher quality care. The BJC Collaborative will create many opportunities for us to grow and learn from one another.”

Opportunities that may be explored by the Collaborative include developing and sharing best practices around:

• Population Health Management – population health information & assessment, physician recruitment & engagement strategies and accountable care organization & medical home development

• Clinical and Service Quality – performance improvement, staff development and

• training - including e-learning, management & leadership development, clinical skills training, clinical decision support, safety event reporting and emergency preparedness

• Capital Asset Management – supply chain relationships, facilities design, clinical engineering, technology evaluation, energy conservation and facilities management

• Financial Services – capital resource analysis, treasury operations, revenue cycle, business intelligence and actuarial expertise

• Information Systems and Technology – Meaningful Use of Health IT, data center management, data warehousing, software applications, hardware configurations & emerging technologies and data security & patient confidentiality

Working together on these and other initiatives that are imperative to achieving better patient outcomes and lower costs, the Collaborative will bring sustainable advantages for patients and families that can be replicated by systems across the country.

See Q/A for additional details


About The BJC Collaborative

1. Why these four organizations?

Answer: BJC, Cox, Memorial and Saint Luke’s are the leading and largest not-for-profit health systems in their respective regions. The territories they serve are adjacent, largely within the contiguous states of Illinois, Missouri and Kansas, but do not overlap. Each system brings a strong commitment to its unique mission and its local community, and all four systems are highly regarded for clinical quality, patient service, and responsible financial stewardship.

All four systems have boards of trustees that are proactively anticipating the changes to come in American health care. We recognize that medical science and technology are advancing rapidly, making it more and more difficult for smaller health care organizations to keep pace. We anticipate that new payment models, such as accountable care organizations or specialty care bundles or other innovative approaches, will require higher levels of care coordination, sizable investments in information systems, and greater assumption of financial risk. All hospitals will be challenged in the years ahead to improve their outcomes and quality, while reducing the cost of medical care.

These four systems have a history of creating larger clinical platforms that involve bringing previously independent hospitals together for the benefit of their respective communities. Through the Collaborative, these systems expect to improve upon their already diverse and comprehensive offerings of health care programs and services, and focus on the population health in their respective communities in Southern Illinois, Missouri and Eastern Kansas.

2. Is this the first step towards merger?

Answer: No. The four systems have not discussed merger. The Collaborative signals a commitment to working together - under a structure that allows each member to maintain its unique identity, to preserve its independence, and to serve the health care needs of its local communities - while at the same time, deriving both the quality-of-care and financial benefits that come from being part of a larger collaborative enterprise. The four systems will be able to share services, costs and best practices where possible, while retaining independence.

3. Will there be leadership changes?

Answer: No. Each system will continue to operate independently, with local governance and local leadership teams as presently constituted. Initially, the Collaborative will not have employees or a physical location. The CEO of each system and a representative of each system’s board will serve as the voting members of the board of directors of the Collaborative. The work of the Collaborative will be conducted through “operating committees”. Members of each system’s leadership team will be called upon to serve on these committees, bringing to the effort their unique expertise in areas of shared endeavor.

4. How will health system employees be affected by this collaborative?

Answer: Initially, it is anticipated that the work of the Collaborative will be transparent to patients, families and the people who take care of them. The early years will be devoted to capturing opportunities to reduce or share costs in areas such as supplies, energy management, contracted services, equipment purchasing and maintenance, and information technology hardware and infrastructure. We will convene leadership roundtables to share best practices in areas such as regulatory compliance and employee lifelong learning and professional development. We will work together to find new approaches to improving patient care and service and making our hospitals even safer places to receive medical care.

5. How will physicians be affected?

Answer: Physicians will not be affected. However, physicians from among the medical staffs at the four health systems who want to collaborate in the development of clinical programs and services will be encouraged to do so, and will be supported by the Collaborative. Importantly, the granting of medical staff privileges and credentials is unchanged and will continue to be under the purview of each hospital’s board of trustees.

6. Exactly how will this collaboration lead to better patient care? Reduced costs?

Answer: Each of the four health systems has achieved superior quality scores in a number of clinical service areas. Comparing different approaches and measuring patient-specific outcomes will help us determine what works best and why in an effort to replicate best practices. While BJC may have coined the phrase, each system is equally committed to “Making Medicine Better.”

The four systems already have a proven track record of working together as members of VHA, Inc. VHA, and its group purchasing organization, Novation, have already afforded these four systems numerous cost reduction opportunities. The idea is to expand the list of what we can purchase together, what we can develop together, and what we can implement together to realize even greater economies of scale and improvements in patient care services.

7. Are you creating a new, combined group purchasing organization?

Answer: No. All four systems are presently members of VHA, and three of the four (excluding BJC) are co-owners of Mid-America Service Solutions, Inc. However, to the extent that the four systems can adopt standards for certain products, supplies, and equipment – and coordinate the timing of these purchases – there may well be additional opportunity for savings. Examples of opportunities to be explored could be food purchases or data center back-up services.

8. What does this mean for each health systems relationship with their respective Schools of Medicine?

Answer: Each of the four systems involved have affiliations with Schools of Medicine: BJC with Washington University, CoxHealth with the University of Missouri-Columbia, Memorial Health System with Southern Illinois University, and Saint Luke’s with the University of Missouri-Kansas City. Our shared commitment to academic medicine and to education in the health professions is one of the key reasons we have selected one another as partners in this Collaborative. The Collaborative does not change any of these medical school affiliations.

9. Will you have one EMR platform?

Answer: Not for a very long time. Each of the four health systems has already made sizable investments in different software applications that in the aggregate, make up an electronic medical record and allow each of the systems to qualify as a meaningful user of health information technology as defined by the federal government. However, over time, it is quite possible that it will be one of those areas of focus, so we may migrate to common solutions for mutual benefit.

10. Will telemedicine be a part of this collaborative?

Answer: It is too early to identify which clinical programs and services have the greatest potential to benefit from our Collaborative. We will consult with clinicians at each of our respective systems, identify gaps in knowledge or service offerings, and then we will explore how best to meet the needs in our respective communities.

11. Can others join the Collaborative?

Answer: Initially, we plan to spend our time working among these four health systems. In time, if we are successful together on certain initiatives, the members may consider extending invitations to others who may benefit from what we have developed and established.

12. Does this mean the members of the Collaborative will not be partnering with any other health systems in the future?

Answer: Each member will continue to have business relationships with other organizations. However, we are committed to working through this Collaborative in the priority areas we have identified to reduce costs, share best practices and improve quality.