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St. Luke's Blogs

The Trial, and Why It Matters

By Dr. David C. Pate, News and Community
September 21, 2013

Next week is big for St. Luke’s Health System and the people who depend on us to transform health care, and the country is watching. 

The trial to decide lawsuits brought by Saint Alphonsus Health System, Treasure Valley Hospital, the Idaho Attorney General, and the Federal Trade Commission against St. Luke’s and Saltzer Medical Group begins tomorrow. 

What is this about?

On one level, this dispute is about St. Luke’s relationship with Saltzer Medical Group, which became part of St. Luke’s Dec. 31, and whether the acquisition of SMG gives St. Luke’s so much market power that we could raise prices above competitive levels and whether Saint Alphonsus Nampa’s very survival is threatened.

St. Luke’s is pursuing a strategy of accountable care, and we have been chronicling our journey on my blog for nearly two years. We considered whether to sit back and wait to see how healthcare reform played out or whether to lead the transformation. We decided to lead. 

The benefits we are striving to provide for the communities we serve through accountable care are better health, better care, and lower healthcare costs. We will achieve these benefits through our efforts in clinical integration, alignment with physicians to ensure that they are not penalized for making decisions that offer the greatest value to and are the most cost-effective for patients, and efforts to create value-based insurance products.

In order to achieve our vision and fulfill our strategy, St. Luke’s works with aligned physicians who share our vision for accountable care and who support our efforts around clinical integration, the implementation of evidence-based medicine and practice guidelines, a common electronic health record, and a shift to payment for value from payment for the number of services performed. This philosophical and financial alignment will propel St. Luke’s forward in our efforts to transform health care and make insurance premiums more affordable for Idahoans. 

Further, St. Luke’s believes that part of accountable care and being able to lower healthcare costs is being accountable for improving the health of the population we serve, optimizing the outcomes of care, and assuming financial risk for the cost of care. 

Why is this case garnering national attention?

The reason the rest of the country is interested in the trial has to do with old laws versus newer ones, and the future of health care in America.

So far as we know, this is the first case of its kind to go to trial since the enactment of the federal healthcare reform, and there is a disconnect between what parts of the federal government, including the president, Congress, the U.S. Department of Health & Human Services, and the Centers for Medicare & Medicaid Services, have said they want and what the Federal Trade Commission says it will allow. The question for the court, and for our country, is whether small to mid-sized communities can have access to accountable care. If regulators apply old rigid approaches, it will be difficult if not impossible for any health system outside of the largest American cities to succeed at true healthcare reform.

Why is this case important to Idahoans?

St. Luke’s is innovating and coming up with new programs and initiatives aimed at improving health, improving care, and lowering healthcare costs, and I have been sharing all of these developments on my blog. We have to try something different, to make sure that health care is affordable and accessible for all of us, and St. Luke’s is willing to try. 

St. Luke’s is Idaho’s only locally owned and governed healthcare system, while Saint Alphonsus Health System is part of one of the largest, not-for-profit health systems in the country based in Michigan. We welcome the healthy competition that has existed between our Idaho-owned and –governed system and the folks from Michigan, because we believe we are on the way and on the right path. 

We would hope that the court sees fit to allow us to follow a path we believe is the way to fix what ails health care, on behalf of our friends, neighbors, family members, and communities, the patients who are at the heart and center of all that we do. We are doing the right things for the right reasons and we can be justifiably proud of that. We are committed to our communities and we are in this for the long haul.  

Won’t it be great when Idaho leads the nation, instead of others imposing their reforms on us?

For daily updates from the courtroom, see our News blog at

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.