I am an unabashed fan of the Cleveland Clinic and have posted notes about the various innovations that the health system has launched over the years. There are far too many of them to link to here. However, one of my recent notes cited an article about Atul Gawande's idea about the emergence of super-regional medical centers like Cleveland Clinic and the development of the "big med" approach to healthcare delivery (see: The Transition to "Big Med": Need for Emphasis on Standardization and Cost). Here's the last paragraph from that note:
I think that Gawande is generally correct in his assessment. Large “super-regional” health-care systems will compete aggressively on price and drive smaller hospitals out of business or force them to affiliate with these very large health systems. All of us need to ponder how this will change healthcare delivery as it exists today.
There is no question that Cleveland Clinic has acquired smaller hospitals in the Cleveland area and will continue to prosper based on its reputation, innovative track record, and track record for efficiency. Another growth strategy that is now becoming apparent is to bring regional hospitals into its sphere of influence through the establishment of consulting relationships. This idea was discussed in a recent article (see: Cleveland Clinic to work with Toledo-based ProMedica to improve patient care, increase efficiency and reduce costs). Below is an excerpt from it:
The Cleveland Clinic will help the ProMedica health system, based in Toledo, enhance specialty care, standardize medical and administrative procedures and improve patient access to health care. The Cleveland Clinic is expanding its reach once again, this time deeper into Northwest Ohio, where it will offer its expertise to the Toledo-based ProMedica health system. ProMedica, which operates 11 hospitals and more than 300 other health care facilities in Northwest Ohio and Southeast Michigan, will collaborate with the Clinic on improving the quality of patient care, reducing costs and making the services and programs it offers more efficient. The two organizations worked out details in a private memorandum of understanding signed earlier this month....That memorandum means the Clinic will share its expertise with ProMedica including methods for enhancing specialty care, standardizing medical and administrative procedures and improving patient access to health care. The two hospital systems will also explore other ways to work together in the future....The new agreement adds to one made last year in which the Clinic agreed to help ProMedica develop and commercialize new medical technology....[ProMedica] employs nearly 1,700 physicians and more than 14,000 other employees.....In addition to its downtown hospital and 170-acre campus, the nonprofit Cleveland Clinic operates eight other hospitals in Northeast Ohio and one in Florida. It will manage a 364-bed hospital in Abu Dhabi scheduled to open in 2014. The Clinic employs more than 3,000 full-time physicians and researchers and 11,000 nurses.
ProMedica is a slumbering giant in northwestern Ohio, about 116 miles from Cleveland and the Cleveland Clinic. It would probably be too large and cumbersome for the Cleveland Clinic to purchase and digest. The ProMedica culture with physicians in private practice would probably also be incompatible with the Cleveland Clinic culture. Instead, the Clinic has established a relationship with ProMedica as a consultant, introducing some of the tried-and-true solutions it has introduced in its home territory. Meanwhile, it may be able to convince ProMedica to refer some of its patients to Cleveland for selected medical and surgical procedures (e.g., total hip replacements; cardiac stent surgery). Needless to say, such initiatives will be very unpopular with the Toledo orthopedic surgeons and cardiologists. Let's see how all of this turns out.
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