Modern Healthcare recently ran a thought-provoking article (requires subscription) about the growing number of new types of hospital partnerships. Of particular interest to me is the way in which not-for-profit hospital systems are now sometimes joining forces with for-profit organizations. Amidst an 18 percent jump in hospital deals of all sorts in 2012, according to the article, there were 10 “non-traditional” partnerships involving not-for-profit providers that affected the ownership of some 160 hospitals.
This new trend in the not-for-profit hospital world is at least partly driven, the article points out, by the growing pressures on hospitals to adapt to new cost-lowering reimbursement models at which for-profit organizations may be more adept. At the same time, these new models tend to reward better outcomes and quality, where not-for-profit providers often excel.
These new ownership models require some increased open-mindedness on the parts of not-for-profit hospital systems. But joining up with for-profit organizations is now familiar territory for us at Johns Hopkins Medicine International—we are fortunate to have worked through those traditional misgivings some time ago. Of course, not all of our relationships involve for-profit enterprises. For example, many of our collaborators are governments. But for-profit enterprises are a critical part of our mix, especially given the complexity of delivering high-quality, affordable health care in regions that haven’t previously had access to it.
True, we haven’t had financial ownership in most of the hospital projects on which we collaborate. But even that may be slowly changing, as more health care-related organizations around the world—and not just in the U.S.—recognize that financial incentives aren’t necessarily at odds with better care, and, in fact, better care can be closely aligned with them. That’s why some of our collaborators, reasonably enough, want their partners to have some financial skin in the game. (In much the same way that the U.S. health care system is exploring ways to get patients to have some financial skin in the game, as I wrote in my last post.) We’re cautiously open-minded to these sorts of partnerships, and are exploring them.
It’s important to emphasize that when we collaborate with for-profit organizations, and even when we share in ownership, our dedication to the traditional Johns Hopkins Medicine mission remains our bottom line. For us, it’s about improving health through care delivery, medical education and research. But it’s not as if Johns Hopkins or other not-for-profit hospital systems don’t have to worry about revenues and costs—you better believe we do. It’s just not our bottom bottom line.
By the same token, our for-profit collaborators worry not just about the financial bottom line, but also about the quality and safety of the health care they can provide to their local populations. That’s why we’ve come to collaborate with them. If a potential collaborator doesn’t share that motivation with us, we work hard to find that out fast, and our involvement goes no further.
If new ownership models help further health care goals, I’m all for giving it a go. And I think it’s good that stakeholders at more U.S. hospital systems are coming to feel the same way.1 Comment