1. If not a merger or acquisition, what is it?

It is an agreement to work together for specified purposes including achieving the "Triple Aim Goals" (high quality, healthier communities and reduced costs), and sharing the expertise, infrastructure and IT technology costs related to participating in new "accountable care" payment plans.  The arrangement is structured through the use of a Limited Liability Company as the legal entity for the alliance organization, with each of the organizations being a members of the entity.  This is a very flexible and commonly used legal structure for organizations working together.  Think of it like a group purchasing organization, i.e., existing member hospitals coming together for specific purposes which ultimately benefit patients. 

2. What is the purpose of this alliance?

The alliance brings multiple health care organizations together to work in new ways for the purpose of advancing the goals of high quality health care services, improved health status of people, and improved efficiency thereby mitigating the upward pressure on health care costs. The alliance will share the expertise, infrastructure and information technology costs of preparing for and managing successfully in an “accountable care” environment. Changes in health care are resulting in the need to analyze patient data in new ways, pro-actively manage the care of groups of patients with chronic diseases, and streamline care as patients move across all settings – all of which has been shown to reduce variation and errors, improve quality and reduce costs. In doing this work better, the members of the alliance will be better able to succeed in emerging payment programs for health care, such as “shared savings programs” in which the economic success of the health care provider depends on better managing care and keeping people healthier.

3. How will this alliance function?

UIHA will create a platform for sharing expertise, selected support services and information technologies, thereby reducing costs for members. Working together in UIHA, members will strive to increase the value to patients and payers of services provided, improve clinical integration between the members, provide more streamlined and coordinated care to patients, and ultimately improve the health of people in Iowa and other regions served.

4. Why did these health care systems decide to formalize an affiliation? 

The healthcare industry is facing many challenges, including escalating costs, fragmentation of care and uncertainties related to emerging health care reform. Collaboration is an important strategy in meeting these challenges and assuring continued high quality care for our patients. It also is important because of the many changes in health care delivery and financing. Broad-based provider networks are critical to success under the new payment systems, and to achieving the goals stated. Working together allows the organizations to achieve the necessary expertise and size – the skill and scale – to be successful into the future and to bring real value to our patients and communities. Specifically, collaboration provides many benefits, including:

  • Promoting clinical integration and improved efficiency, without merger of assets or changes in ownership or control.
  • Sustaining and honoring the members’ local missions and governance authorities, while participating in a larger effort to lead needed changes in the health care system.
  • Creating an infrastructure through which alliance partners/members can share best practices and develop common performance metrics and comparative reporting.
  • Sharing costs, thereby reducing the effective cost per patient for the participating organizations.
  • Encouraging additional health care providers in Iowa and contiguous states to join and participate in these important initiatives.

5. How could this affiliation benefit Iowans?

This alliance brought together many of Iowa’s premiere health care organizations, ultimately providing patients with the best of each organization. By design, the alliance is created to support each member in providing value and in creating person-centered care in a better coordinated system. The work of the Alliance will support the members in their efforts to engage patients in new ways to help them maintain their health, thereby reducing their need for higher levels of health care services. The intention is for patients to benefit from more streamlined and coordinated care, improved clinical integration and sharing of expertise, cost containment efforts and, ultimately, improved health.

6. What efforts are included in this alliance?

Examples of specific UIHA efforts include:

  • Assisting members in developing performance metrics and comparative reporting to support improvement efforts, i.e. using comparative data to identify and share best practices and reduce the variations in care, which will improve quality and lower costs.
  • Developing programs to determine and address the health status of communities served.
  • Developing educational programs for health care providers, patients and consumers.
  • Developing techniques and systems for improving patients’ engagement in managing their health.
  • Sharing the high costs of the information systems and experts needed to analyze clinical data and convert it to information that can be used by physicians and others to improve care and better manage populations of patients with chronic diseases.
  • Sharing expertise and operational costs associated with development of “accountable care” initiatives, enabling the members to evaluate and participate in new payment programs offered by governmental and commercial insurance programs.
  • Strengthening primary care to ensure Iowans have access to a “medical home,” through which they can receive preventive services and improved coordination of care across settings and levels of clinical services and specialties.
  • Collaborating in research initiatives.

7. How will this benefit all participating health systems?

We believe this relationship will have a very positive impact on all participating organizations by assisting them in providing better quality of care, a better patient experience, more efficiencies and, therefore, a more viable and competitive offering of services for the future.

13. What is an ACO?

The Patient Protection and Affordable Care Act, also known as the health care reform law, encourages the formation of Accountable Care Organizations (ACOs) as a new model of care for Medicare beneficiaries. The goals are to reduce fragmentation of care, improve individual and population health and address escalating health care costs. ACOs are the vehicle for joining doctors across multiple specialties, hospitals and other health care organizations together so patients and communities can benefit. ACOs also are a vehicle by which Medicare and private insurance companies will pay doctors and hospitals in the future – based on performance and better care, rather than based on volume, or increased volumes of services.

9. What role will physicians play in the alliance?

Physicians are integral to its success. Many physicians are fully part of the member organizations, through existing leadership roles and contracted and employment relationships. Physicians will be involved in developing all of the programs and initiatives undertaken by the alliance. Lastly, independent physician groups will be welcome to join the alliance and actively participate in our local clinical integration committees.

10. Will any hospitals, clinics or services be closed?

No. The hope is that this alliance will strengthen the members, their affiliate organizations and future members and affiliates, in order to improve Iowans’ access to high quality, affordable care.

11. What will this do to the cost and quality of care?

This alliance will strive not only to help members provide value to patients, but to help patients become better engaged in new ways to help them maintain their health, thereby reducing their need for higher levels of health care services. Each member organization brings successes in improving quality, in streamlining care and in proactively working with patients to improve and maintain their health. Working together to reduce the variation and streamline care has been proven to improve quality and will benefit everyone – the patient, the payer and the community. Some members of the alliance already have demonstrated how costs can be significantly lowered, by doing care better – using medical homes, health coaches, case managers, electronic disease registries and other tools to provide better care “up front,” thereby reducing the use of inpatient hospital care and other more expensive services. In addition to saving money, these programs have significantly improved the quality of life for patients. 

12. Do agreements like this already exist in other states? What is the alliance modeled upon? 

Yes. Similar alliances have been announced by health care providers in most states that border Iowa.

University of Iowa Health Alliance

100 Court Avenue, Suite 405
Des Moines, IA 50309