Competing Health Care Systems and Complex Patients: An Inter-Professional Collaboration

Key Questions Answered
  • Why, and in what circumstances, should competing health care systems collaborate?
  • What is an example of an effective framework for collaboration?
  • What kind of patient outcomes and cost savings have been achieved through such collaborations?
Key Themes and Takeaways

This resource describes a collaboration between the Cherry Health Durham Clinic (CHDC) and Mercy Health Saint Mary’s (MHSM), which treated an overlapping population of patients with complex needs. This article provides a guide for facilitating inter-organizational collaborative practice.

  • The two competing health systems realized that many of the same patients with complex needs were utilizing their services, and that to stabilize their care they would need to collaborate.
  • The inter-organizational collaboration aimed to create a continuum of care across organizational boundaries to deliver integrated health care to patients.
  • Key elements included patient identification and root cause analysis; shared infrastructure (such as a Business Associate Agreement and integrated patient consent forms); and joint celebration of success.
  • The collaboration resulted in a decrease in average emergency department visits by 28 percent, inpatient admissions by 50 percent, length of stay by 49 percent, and CT scans by 67 percent.
  • Costs decreased by $721,654 in the 12 months after intervention, representing a 51 percent reduction.
Lauran Hardin
Adam Kilian
Kristin Spykerman
Population Addressed
Adults Under 65 with Disabilities
People with Advanced Illness
Frail Older Adults
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Level of Evidence
Promising Evidence
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