10 Kentucky Health Systems Form Collaborative

Just as their new governor plans to dismantle a well-functioning state exchange, 10 healthcare systems have formed the Kentucky Health Collaborative, according to statement issued today.

According to a statement from the University of Kentucky, whose health system is part of the collaborative, the group's primary objectives are “raising the standards of care across the state, addressing the Commonwealth’s poor health statistics, and reducing the cost of care through greater operational efficiencies.”

The health systems have hired an industry veteran, William L. Shepley, MHA, MS, as executive director, and selected member Appalachian Regional Healthcare of Lexington as the interim home of the operation. The UK statement said health system CEOs will make up a board of directors.

Shepley, who spent the past year as a consultant after 6 years with WakeMed of North Carolina, described the assignment as “one of the proudest moments of my career.” He has had experience setting up similar collaboratives in the Carolinas, and said in an interview with The American Journal of Managed Care that building relationships is the key to success. “The solutions we expect to develop through the collaborative have worked well for similar networks across the country, and I am honored to be a part of this important process.”

Besides Appalachian, health systems taking part in the launch of the collaborative are: Baptist Health of Louisville, Ephraim McDowell of Danville, LifePoint Health, based in Brentwood, Tenn.; Norton Healthcare of Louisville, St. Claire Regional Medical Center of Morehead, St. Elizabeth Healthcare of Edgewood, The Medical Center at Bowling Green, UK Healthcare of Lexington, and Owensboro Health.

In his statement, Shepley said the collaborative’s governance structure would support other participants regardless of their location, and that more may be added.

The statement did not describe the contractual relationship among the hospitals; in the interview, Shepley said an operating agreement is being finalized, and the formal entity will take effect in early March. Early goals include joint purchasing as well as population health initiatives.

"One piece helps the other piece," he said. Ultimately, he said, the initiative will ask, "What can we do for the individual citizen?"

Shepley said 52 different entities exist throughout the country involving 750 hospitals. Levels of involvement range from shared education efforts to full-blown accountable care organizations (ACOs) with significant shared risk. The nature of the Kentucky effort will be spelled out in the operating agreement, Shepley said. "We're just getting started. All those questions are going to be addressed."

Healthcare advocates in Kentucky have been dismayed that the new Republican Governor, Matt Bevin, has been determined to get rid of Kynect, the homegrown health exchange that serves not only to register residents for health plans under the Affordable Care Act but also market plans to hard-to-reach populations.

The former governor, Democrat Steve Beshear, was determined to extend healthcare and expand Medicaid to drive down Kentucky’s uninsured rate and improve health statistics that were at or near the bottom in almost every category, including diabetes, obesity, and cancer mortality, due to high rates of smoking and high poverty rates.