HealthAlliant helps communities create long-lasting, systemic change to improve the quality of their healthcare, through three key areas:
HealthAlliant was formed in direct response to the crisis in the U.S. healthcare system and is led and supported by some of the country’s best thinkers relative to health system modernization. Building on extensive experience in healthcare services, technology, and entrepreneurial endeavors, HealthAlliant’s principals invested over $1 million in a two-year research effort to understand the underlying causes of the failing U.S. healthcare system and to develop a solution for lasting change. The resulting collaborative tool, the HealthAlliant Model ™, is used to assist in local community health system modernization, often called Regional Health Information Organizations (RHIOs).
Creating a lasting solution to our healthcare crisis requires agreement among the participants, commitment to see it through, and a sustainable business model to maintain the success of the program. In our experience with efforts in Rhode Island, New York, Washington, Nebraska, Tennessee and Virginia, we have found that a RHIO has the best chance for success if it creates clinical process improvement, physician incentives and ongoing program support, all of which is built on a foundation of a local governance structure, adequate financing and an information technology system that works for doctors, hospitals, insurers and individuals alike.
How Can You Get There?
HealthAlliant has created a step-by-step approach to health system improvement that specifically addresses communities (i.e. state and regional levels) as the locus of governance and change; is comprehensive enough to enable systemic change; and involves world-class resources to assist communities in their planning.
In essence, we help local communities reach out to the key stakeholders in healthcare so that all parties have input and buy-in. This agreement-building process provides a framework for identifying particular issues for that community and creates a team with commitment and resources to accomplish its goals.
Aiding this process is the HealthAlliant Model™, a sophisticated financial and decision-making software that enables community leaders to efficiently examine issues and trade-offs. The Model covers over 2,500 variables which can be adjusted to reflect strategies specific to a particular region. This software produces 10-year financial projections (in GAAP format) including income statement, balance sheet, cash flow, capital requirements, capital expenditures, operating expenses, source and use of capital, return on investment, savings opportunity, and many other specialized analyses. All of this information is vital in articulating a persuasive and well-documented business case. The data that drives the model is thoroughly researched and reference-able.
The HealthAlliant Model™ assists all stakeholders in seeing both the “big picture” and the granularity of alternative approaches. Depending on the approaches selected for an initiative, the HealthAlliant Model™ can project large savings in healthcare costs, with a surprisingly small investment. The benefits can be shared in a manner determined by the participating stakeholders.
HealthAlliant has a special expertise in communicating the business case for health system modernization and the rationale for investment in it.
And, as a non-profit without ties to any particular healthcare information technology supplier, health system or health plan, HealthAlliant is neutral and thus stands to advise RHIOs on the best possible course of action.
RHIO Organization: Planning, Formation, Financing
HealthAlliant’s Three-Part Concurrent Process
HealthAlliant relies on its proven HealthAlliant Model™ in helping RHIOs tailor a local solution to delivering more efficient and higher quality healthcare.
The key elements are Planning, Formation and Financing. HealthAlliant’s multi-faceted approach yields a comprehensive strategic plan and the required financing so that the RHIO can proceed to system-wide implementation. HealthAlliant serves as overall project manager, reporting to the local organization. We have the responsibility of coordinating and integrating all of the various elements of the project into a comprehensive and actionable plan. In addition, we facilitate several elements with the RHIO’s leadership including the creation of the financial models, business models, governance recommendations, clinical interventions, incentive plans, communication plan, fund raising and lobbying.
HealthAlliant works closely with the local community leadership and draws on the expertise of its own seasoned management team, Board of Directors, and Advisory Board, among others.
Each community RHIO is unique, but the following framework outlines a typical effort, organized into three inter-related and overlapping processes.
Part 1: Planning via Thought-Leadership and Strategic Planning
HealthAlliant oversees the Planning through a two-step process of Thought-Leadership meetings that provide high-level education and information, followed by in-depth Strategic Planning that fleshes out a step-by-step program. In our experience, we have found that the local constituent base cannot make fully informed decisions that have a high probability of success unless it has an understanding of the broader, systemic issues.
The Thought-Leadership phase involves a series of focused meetings with key providers, practice groups, plans and employer stakeholders. Inputs will be gathered from each stakeholder group as to desired outcomes and threshold requirements. HealthAlliant then convenes a Healthcare Modernization Summit at which thought-leaders from the various stakeholder groups, as well as national thought-leaders, are brought together to exchange information within the context of a structured agenda. HealthAlliant synthesizes these inputs and requirements and then presents a working model for how the process can proceed.
This process helps develop approaches to the following 11 key areas:
Next, HealthAlliant facilitates a Strategic Planning effort by establishing five Leadership Councils -- Clinical, Information Technology, Management & Governance, Finance and Communication – which coalesce the input from the 11 topic areas. These five groups are facilitated by HealthAlliant and are comprised of team members and subject matter experts from the various stakeholder groups. Each Leadership Council is tasked with developing baseline requirements and strategies for their particular area. The Chairpersons of the Leadership Councils meet together as a group on a periodic basis to update one another and ensure consistency and alignment in the overall effort.
The end product is a prioritized, comprehensive strategic plan and accompanying financial plans for reforming and modernizing the local healthcare system.
Part 2: RHIO Formation
HealthAlliant also leads the formation of a formal Regional Health Information Organization (RHIO) entity for the purposes of: creating a financing vehicle, managing the implementation of the strategic plan created by the Leadership Council(s), and providing ongoing management oversight and governance. This non-profit entity, created from the local decision-making process, provides the self-sustaining legal and operational vehicle to implement systemic change and produces the benefits of more efficient, higher quality care.
Governance practices and policies are incorporated into the RHIO from inception so that it stands up to scrutiny and avoids pitfalls that can face these types of organizations. Among the issues covered in governance provisos are data access, authorization, ownership and management; physician adoption and incentive strategies; proper and flexible allocation of costs and benefits among parties; and regulatory analysis to identify roadblocks and opportunities ranging from antitrust, fraud and abuse, to privacy and intellectual property.
Part 3: RHIO Financing
Concurrent with the Planning and Formation efforts, HealthAlliant develops a range of potential structures and approaches to syndicating an investment in the nascent RHIO, based on our research and experience in attaining financing for other RHIOs. HealthAlliant coordinates all aspects of the investment syndication, enabling the Leadership Council and other local participants to focus on program development.
Funding comes from a variety of public and private and national and local sources and is applied to infrastructure investment, operational start-up costs and related working capital requirements, physician incentives and other financial needs.
Additionally, HealthAlliant has created databases of sources of funding that enable an efficient approach to raising the capital required to launch these initiatives and our network of resources allows us to gain access to many of these.