Integrated Health Network scales back

Integrated Health Network of Wisconsin gave itself the ambitious goal of clinically integrating eight health systems throughout the state to prepare for the expected changes in the way hospitals and doctors are paid.

The network would require the health systems to work toward lessening the variation in how care was provided. It would track their performance on an array of quality and cost measures. And it would build the complex computer systems to collect and analyze information from medical claims and electronic health records.

Its plans may have proven too ambitious.

After investing millions of dollars in technology and years of work, Integrated Health Network is abandoning much of what it envisioned.

Integrated Health Network, based in Brookfield, eliminated 21 jobs out of its staff of about 50 this month, and it expects to employ only a half a dozen or so people a year from now.

Kurt Janavitz, chief executive officer, said the members of Integrated Health Network believe that its information systems and other efforts would duplicate what they are doing in their own organizations.

Integrated Health Networks is one of two statewide networks of health systems — the other is AboutHealth —  that have formed in recent years.

Integrated Health Network’s members include Froedtert Health and the Medical College of Wisconsin; Agnesian HealthCare, which has three hospitals, including St. Agnes Hospital in Fond du Lac; SSM Health, which owns St. Mary’s Hospital in Madison and Dean Clinic; Hospital Sisters Health System, which has six hospitals in Wisconsin, including St. Mary’s Hospital Medical Center and St. Vincent’s Hospital, both in Green Bay; and Ascension Wisconsin, which includes Columbia St. Mary's, Minstry Health Care and Wheaton Franciscan Healthcare.

Janavitz said that there have been some changes in the market since Integrated Health Network was founded in 2010.

The most significant may have taken place this year when Wheaton Franciscan Healthcare’s operations in southeastern Wisconsin became part of Ascension Health.

Ministry Health Care, the parent of Affinity Health, became part of Ascension in 2013 while Columbia St. Mary’s has long been part of Ascension Health.
What is now Ascension Wisconsin plans to integrate the operations of the four health systems. And as part of Ascension Health — which had operating revenue of $21.9 billion in its fiscal year ended June 30 — it has the resources to develop its own information systems and other initiatives.

Those systems were a key element in Integrated Health Network’s vision of clinically integrating the health systems and physician practices in its network.

Integrated Health Network —  founded as Quality Health Solutions —  was working with various contractors to build a data warehouse that would collect and analyze claims and clinical information from its members.

In October 2014, it said it was receiving 450 million rows of data a month and tracking more than 60 metrics.

“It was an expensive proposition, what we pulled together,” Janavitz said.

The information would enable Integrated Health Network to monitor the cost and quality of care provided by its members.

That in turn would enable it to negotiate contracts with health insurers and employers that rewarded health systems and physician practices for meeting certain performance targets. It also planned eventually to negotiate contracts in which the health systems and physician practices would be at financial risk if they didn’t meet certain targets.

Integrated Health Network also expected a strong commitment from its members. Each health system would have two board members, and one of them had to be the chief executive officer. Other committees could include the chief medical officer or chief financial officer of the health system.

The health systems also were expected to work together to share ideas on initiatives such as reducing re-admissions and managing the care of complex patients with multiple diseases.

Integrated Health Network ramped up quickly, employing about 40 people in late 2014 compared with about 10 two years earlier.

The network has negotiated contracts with health insurers, such as UnitedHealthcare and Humana, that cover an estimated 225,000 people in the state

The network was a competitor to AboutHealth, which includes Aurora Health Care, ProHealth Care, ThedaCare, Bellin Health, Marshfield Clinic, University of Wisconsin Hospital & Clinics and Gundersen Health.

The two competing networks had the potential of increasing price competition through health plans tied to each network.

That still could happen. Network Health is owned by Froedtert Health and Ascension. And Aurora and Anthem Blue Cross and Blue Shield in Wisconsin have partnered to start an insurance company, building on an earlier partnership in which Anthem offered health plans tied to Aurora’s network.

And Dean Health Plan, owned by SSM Health, has introduced health plans in the Green Bay area tied to Prevea Health, a multispecialty clinic affiliated with Hospital Sisters Health System.
Those changes have taken place since Integrated Health Network was founded.

That said, employers generally have been wary of health plans tied to limited networks that could force people to change doctors or hospitals.

“It has been very slow uptake,” Janavitz said. “And it’s not just here.”

Going forward, Integrated Health Network will focus on contracting with employers who self-insure, he said. Health plans owned by its members also will contract with the network.

Janavitz expects many of Integrated Health Network’s employees to find jobs with the health systems that belong to the network.

The transition, he estimates, will take 12 months.

“Lot of things to work out,” he said.

Editor's Note: This story was modified for clarity at 1:45 p.m. Thursday.