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Speaking before a crowd at St. Matthew's Parish in Bedford on Wednesday night, Northern Westchester Hospital President and CEO Joel Seligman outlined some of the changes in healthcare services under the Affordable Care Act.
One important change is the notion of hospitals, physician groups, academic medical centers and other groups joining together to form accountable care organizations. These ACO's are responsible for the full range of care for a population, and are held accountable for the outcomes and quality of that care.
"I believe this is what our health care system is turning into," Seligman said. "There are a lot of experts now predicting that five to 10 years from now, there will be 200 accountable care organizations in America. That will be the healthcare delivery system."
He said that ACO's have begun forming already, and that most will be responsible for populations of between 250,000 and two million people. He said that the success of these organizations will depend on the health of its patients in the top three to five percent who are the sickest.
"They're financially at risk, so the best thing they can do is keep people healthy," he said.
Seligman compared it to the original idea of health maintenance organizations, which he said got taken over by the insurance industry.
"We'll see if this works or not, but we're back to that model of, let's keep people healthy, let's keep them out of the hospital, and if they need to be in the hospital, let's make sure it's the lowest cost, highest-quality place we can find," he said.
Northern Westchester Hospital was part of a similar organization for the past 15 years called Stellaris Health Network, a network of hospitals with the goal of sharing resources and services. Seligman said that Stellaris never really fulfilled that vision, and disbanded last year. The hospital is now considering its options with an eye toward joining an ACO.
"We're moving to larger organizations, accountable care organizations that will provide population health management, and we want to be a part of that," he said. "Our board is thoughtfully going through the process of where we go from here. Do we remain a standalone hospital? Do we partner with other community hospitals like us? Or do we look for a larger academic medical center and system to partner up with?"
The important factors in the decision include finding a partner that shares NWH's vision for patient-centered care, has access to capital that can be used to help expand services, is based locally and has a strong brand. He said that board members are currently assessing factors and potential partners, and will likely make a decision next year.
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