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St. Luke's and MSSP: Leading Locally to Fix What's Broken

By Dr. David C. Pate, News and Community
December 12, 2012

It is with excitement and a great deal of pride that I share with you the news that St. Luke’s has been accepted into the Medicare Shared Savings Program (MSSP). Our participation as Idaho's first and only MSSP participant was effective Jan. 1.

For a long time, we have known, and I have been saying, that health care in America is broken. St. Luke’s has not been waiting around for the federal government, or any other entity, to fix the problems.

For several years, we have been aligning our clinics and hospitals, practicing lean principles as our TEAMwork way of doing business, improving our patients’ experience, and taking other significant steps toward solving the problems that plague American health care. The Centers for Medicare and Medicaid Services’ MSSP is in keeping with what we have been doing, and gives us an additional approach as we proceed in our transformational journey.

MSSP and several other initiatives that we have recently announced, or which are now in the works, are significant steps in transforming health care in many ways. Those of you who joined me at our fall forums heard me say that there are two important reasons we’re interested in the MSSP: its focus on quality and a new set of 33, mostly ambulatory, measures that will help us to gauge quality, and a payment methodology that finally puts the emphasis where it needs to be, on value.

Participation in MSSP helps us to make the financial shift we must make in keeping with accountable care, our Triple Aim, and offers us the opportunity to share savings payments that we then can invest in the health of the people we serve and in keeping our physician partners whole as we continue to shift our compensation model to reward physicians for the value of their services, not the volume.

St. Luke’s has experienced big successes toward our Triple Aim of better health, better care, and lower cost. Additional progress is anticipated through St. Luke’s Clinic Coordinated Care, the accountable care organization (ACO) St. Luke’s established for MSSP participation.

Through our ACO, we will continue to clinically integrate and to refine and focus on measures of quality, continuous improvement of the patient experience, and application across our sites of TEAMwork and standardization of evidence-based medicine.

A year ago, when we made the decision to pursue MSSP participation, I told St. Luke’s executives that I believed that we should do this not because we could expect any significant financial benefit, but because the investments we would make in this program would serve as our tuition as we learn to provide accountable care to all the populations we serve. 

Which brings me to leadership. Leadership has been on my mind a lot of late. Leadership, in my mind, has everything to do with making difficult and sometimes risky, but necessary, decisions, transparently, honestly, and in the face of easier, more comfortable choices that only perpetuate the status quo.  

Leaders are leaders precisely because they’ve gone in front, a position that’s far easier to criticize than it is to take on. St. Luke’s is becoming an important leader in health care transformation and innovation; in fact, we are the only health system in Idaho that has even made the effort to go through the rigorous and lengthy application and evaluation process to be considered for approval to serve as an accountable care organization for Medicare. 

The leaders of St. Luke’s have truly led. And I consider as leaders every one of the hundreds of people who, directly and indirectly, worked to make our application successful. Thanks to each of you for the work you do every day on behalf of our patients, their families, and our communities.

I also want to recognize two System executives who I assigned to head up our MSSP application process: Dr. Geoff Swanson, vice president for clinical integration, and Mike Reno, vice president for performance excellence. They have spent countless hours working to not only complete the rigorous application process, but to prepare our organization to be successful in this endeavor. Their dedication and leadership made our MSSP participation possible.

There is one more person that I must specifically recognize: System Communications Coordinator Roya Camp. Roya was assigned the responsibility for writing and editing the lengthy, complicated narratives that were required to demonstrate that St. Luke’s really does have the competencies and capabilities to provide patient-centered care, coordinate care, and manage transitions of care. 

I’m proud of you all, no matter your contribution, and I applaud you. Ultimately, it will be the patients that we are privileged to care for that will benefit the most, and I thank you on behalf of all of them. 

Congratulations, St. Luke’s! We are seeing our vision be realized more and more each day!

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.