Cleveland’s NY Connection

North Shore-LIJ TV
August 19, 2014
Cleveland Clinic’s Exclusive NY Affiliate

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Crain’s Health Pulse
August 19, 2014
North Shore Partners with Cleveland Clinic

The North Shore-LIJ Health System is becoming an exclusive partner of the Cleveland Clinic for cardiac care. This marks the Cleveland Clinic's first entry into the New York market and the elevation of the North Shore-LIJ Health System to a national brand.

The system will be the exclusive New York partner for cardiac referrals from the Cleveland Clinic's national network of employers—including Wal-Mart and Lowe's—which collectively offer health coverage to millions of workers and dependents. North Shore University Hospital in Manhasset, L.I., will be the destination site for cardiac patients living in New York City, Long Island and Westchester County. The new alliance means the systems will be sharing data and best practices, but only NSUH will be the "destination hospital" for cardiac referrals.

North Shore-LIJ, with 16 hospitals and some 47,000 employees, becomes the second institution to join the Cleveland Clinic's nascent network. MedStar Health, a Washington, D.C.-area system, is the only other member, but the network is expected to grow to 15 institutions by 2015.

"It's a pleasure to be associated with the best of the best," said Michael Dowling, NS-LIJ's chief executive. "This is part of the strategy of preparing for the constant changes going on in health care."
The Cleveland Clinic's direct contracts with large employers like Lowe's, Wal-Mart and Boeing made headlines a few years ago. Under this arrangement, self-funded employers will foot the bill for their workers to travel to the Cleveland Clinic for certain complex procedures, such as heart or spine surgery. The idea is to improve outcomes and save costs for the most complex patients. Some 2.5 million people across the country are now covered by such contracts, according to a NS-LIJ spokesman.

Now, local employers will have the option of sending such employees to North Shore University Hospital, too. "More and more of these national contracts will become a reality," Mr. Dowling said.

"This gives the option for patients who may be part of these contracts to get care closer to home."

"This program with Cleveland allows us to coordinate more care for patients," he said. "We have home care; we have rehabilitation; we have the full continuum of care that a cardiac patient will need."

NS-LIJ first partnered with the Cleveland Clinic two years ago, when the two formed an “innovation alliance” aimed at commercializing new technologies coming out of NS-LIJ's clinical facilities and its research arm, the Feinstein Institute for Medical Research.

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Newsday
August 20, 2014
North Shore-LIJ Partners with Cleveland Clinic on Region's Cardiac Care
by DELTHIA RICKS 
 
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1010 WINS
August 20, 2014
Cleveland Clinic Aligns with North Shore-LIJ

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HealthLeaders
August 20, 2014
Cleveland Clinic Partners with North Shore-LIJ for Heart Care

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Capital NY
August 20, 2014
Why North Shore-LIJ and Cleveland Clinic Are Partnering

North Shore-L.I.J. Health System announced Tuesday that it is partnering with the prestigious Cleveland Clinic for cardiac care, marking a national trend toward long-distance partnerships in the health care industry.

More than ever, employers are taking a proactive role in managing health insurance costs; health systems are desperate for new growth opportunities and there is a concerted push from the federal government to move away from a fee-for-service model and toward bundled payments.

Those factors have led to the proliferation of national specialty networks in which large health systems that are geographically distant form partnerships in one clinical area such as cardiology or orthopedics. These partnerships allow for the sharing of protocols, research and best practices, all of which, in theory, improves patient care.

And they also allow for critically acclaimed hospitals throughout the nation to group together in one network, which can be attractive to a national, self-insured employer looking to negotiate insurance prices with specific health systems.

“This is a trend that is evolving across the country more and more,” said Michael Dowling, C.E.O. of North Shore-L.I.J. “In many ways, it will be driven by what big systems like the Cleveland Clinic and us do, but also by what big employers decide to do.”

Here's how this works in practice: A company such as Boeing—which has an agreement with the Cleveland Clinic—can negotiate one price for a bypass surgery. No surprise fees, no extra costs. It's a concept known as a bundled payment, a model the federal government is experimenting with in Medicare.

That set price would apply to the same procedure at North Shore-L.I.J. The employees have access to a renowned hospital in their area. The hospital has access to a stream of new patients and the employer can more effectively budget its costs, knowing they are providing their workers with hospitals that offer acclaimed clinical care.

“This is a way of controlling the quasi-random variation in prices,” said Francois de Brantes, executive director of the Health Care Incentives Improvement Institute, a nonprofit focused on improving health care quality and affordability. “You're capping your cost per episode so it's not a bad strategy.”

These partnerships create selective networks. Employers can still offer a number of providers for primary care, but when it comes to the very expensive, one-time procedures like a hip replacement, employers can narrow their network and manage their budget without making employees feel cheated.

"This is clearly aimed at the large self-insured employer market," de Brantes said. “By grabbing a marquee brand, you are sending a signal to your employees that this is still about quality.”

The Cleveland Clinic already has deals with corporations including Wal-Mart, Lowes and Boeing. Those employees, of course, live all over the country, which is why the Cleveland Clinic has an interest in partnering with other well-renowned health systems such as North Shore-L.I.J. in New York and the MedStart Heart Institute in Washington.

North Shore-L.I.J. will be the preferred provider for thousands of new patients and can piggyback off the contracts Cleveland Clinic signs with large employers. In exchange, it pays a management fee, which was not disclosed.

Health systems are eager for these types of partnerships, in part because the labor force is shrinking. There are fewer commercially insured patients and roughly 10,000 Americans are enrolled in Medicare every day.

“Employers represent a lucrative market,” said Rob Lazerow, practice manager, research and insights at the Advisory Board Company. “Especially as people get older. More and more, it is important to capture the market share.”

Employers and health systems are also creating specialty networks for orthopedic procedures. Last October, Wal-Mart and Lowes joined the Pacific Business Group on Health Negotiating Alliance, which has deals with hospitals in Baltimore, Missouri, Seattle and California.

And the Cleveland Clinic is part of the National Orthopedic & Spine Alliance, which includes the CORE Institute in Arizona and Michigan, OrthoCarolina in North Carolina and the Rothman Institute in New Jersey and Pennsylvania.

Toby Cosgrove, C.E.O. of the Cleveland Clinic, said he expects oncology could be next as health systems look for ways to attract self-insured employers and commercial insurance companies interested in the bundled payment model.

“What we thought we would do is put together a network of really high quality institutions across the country and then if somebody has a cardiac problem they can go closer to home,” said Cosgrove, who recently made headlines when he told President Obama he'd rather continue his work at the clinic than take over the beleaguered Veterans Administration.

North Shore-L.I.J. and the Cleveland Clinic first partnered in 2012 when the two collaborated to help turn the discoveries made at North Shore-L.I.J.'s Feinstein Institute for Medical Research into diagnostic and treatment options that can be used to improve patient care.

“This takes it to a whole new level,” said Dowling, the North Shore-L.I.J. C.E.O. “If you work with the best, it's the best way to get better. And we are now working with the best.”

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Modern Healthcare
August 19, 2014
Cleveland Clinic Takes Cardiac Network to New York
By Bob Herman

The Cleveland Clinic said Tuesday that it has chosen North Shore-LIJ Health System in Great Neck, N.Y., as its exclusive partner in New York for heart-care referrals.

The regional affiliation has two primary tenets, Cleveland Clinic Heart & Vascular Institute Chairman Dr. Bruce Lytle told Modern Healthcare: enhancing heart-care quality and contracting.

In this arrangement, North Shore-LIJ will treat patients in need of cardiac care who are in Cleveland Clinic's national network of large employers, which includes companies such as retail chains Wal-Mart Stores and Lowe's. Lytle said the heart alliance will also look to contract with accountable care organizations and other entities that may not have the capacity to handle complex cardiology cases.

Consequently, New York patients will not necessarily have to fly to Cleveland for all heart procedures. Cleveland Clinic and North Shore-LIJ will work together to share best practices, coordinate care and develop programs to improve quality and safety outcomes.

Lytle said this type of alliance—called the Cardiovascular Specialty Network—is essential as providers increasingly work together to manage chronic conditions and improve outcomes for their respective populations. North Shore-LIJ has a “history of continuous process improvement,” Lytle said. “They also realize, as we do, that none of us are perfect, and they have the capacity to get better. That's a cultural fit.”

The clinic also said the partnership will advance the triple-aim mentality. “As the delivery of healthcare continues to evolve and medicine moves from an art to a science, it's crucial that healthcare organizations maintain databases to track clinical measures and quality standards,” Cleveland Clinic CEO Dr. Toby Cosgrove said in a statement. “This is how healthcare becomes safer, less expensive and more efficient.”

Dr. Stanley Katz, North Shore-LIJ's senior vice president of cardiovascular services, said the affiliation will be a “huge differentiator in a market well-regarded for the quality of cardiac care.”

Brian Maher, practice manager of the Advisory Board Co.'s cardiovascular division, said that's true. While Cleveland Clinic benefits by extending its presence into local and metropolitan areas—possibly attracting referrals for the highest-acuity heart and vascular services—systems such as North Shore-LIJ are able to use the Clinic's brand and expertise to improve their own heart programs.

 
Cleveland Clinic Heart & Vascular Institute
“Not everyone has the resources or the luxury of building out the most comprehensive program in their market,” Maher said, adding that he expects to see more heart alliances sprout up across the country. “There's a natural opportunity to enter these types of partnerships.”

North Shore-LIJ becomes the second member of Cleveland Clinic's Cardiovascular Specialty Network. MedStar Health, headquartered in Columbia, Md., was the inaugural member in 2013. Cleveland Clinic hopes to have 15 hospitals in its heart network by the end of 2015.

Cleveland Clinic's Sydell and Arnold Miller Family Heart & Vascular Institute also has heart affiliation agreements, separate from its Cardiovascular Specialty Network, with several other systems. Susquehanna Health, Williamsport, Pa., inked the most recent collaboration deal in February.

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New York Business Journal
August 19, 2014
Cleveland Is Coming to New York: A Health Care Tale

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Yahoo Finance
August 20, 2014
Cleveland Clinic, North Shore-LIJ Announce NY Regional Alliance for Cardiac Care

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Cardiovascular Business
August 20, 2014
Cleveland Clinic Picks North Shore-LIJ as NY Partner

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Becker’s Hospital Review
August 20,2014
North Shore-LIJ Joins Cleveland Clinic’s Cardiovascular Specialty Network

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Examiner.com
August 20, 2014
Cleveland Clinic Picks North Shore-LIJ To Be its Exclusive Partner In New York

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Advance for Nurses
August 20,2014
Cleveland Clinic, North Shore-LIJ Create NY Regional Alliance for Cardiac Care

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