Healthcare Model Affiliation Agreement

A sample document for Healthcare Models and Systems

This agreement, between Twin Peaks Medical Center and Intermountain Healthcare takes effect on May 1, 2019.

General Principles.

All parties will be reasonable relating to the subject(s) of this agreement including participation in care delivery models for the benefit of the involved communities.

Each party will ensure all publications, communications to the media and other professional organizations is done so with each party’s consent.

Each party will implement appropriate policies and procedures to encourage the purpose of the collaborative and to ensure best practices for the benefit of patient care.

Each party will ensure open disclosure of information and sharing of outcome data for the improvement of patient care.

Organization and Structure.

1)      Collaborative Executive Board.

The parties of this agreement will form a Collaborative Executive Board (“Board”):

a)      The board has ultimate authority to resolve all disputes that the Collaborative Committee cannot resolve (duties of the Collaborative Committee are outlined in section 2.);

b)      The board must consist of three (3) representatives from the executive level of each organization / party of this agreement;

c)       A member of the board will serve as the Chair of the Board and will rotate annually between each party of this agreement;

d)      The board is responsible for ensuring this agreement is implemented based on the general principles outlined in this agreement;

e)      The board will operate and provide any actions or decisions based on majority rule of the board members;

f)        The board will ensure any additional affiliates relating to the involved parties must comply with this collaborative agreement;

g)       The board will institute a collaborative committee for the purpose of administering the purpose of this agreement.

2)      Collaborative Committee.

The involved parties of this agreement will organize a Collaborative Committee with the following responsibilities:

a)      Accountable for outlining each party’s responsibilities and required resources from each party;

b)      Responsible for the administration of the collaboration agreement;

c)       Accountable for overseeing any potential research activities that may develop as a result of this collaborative and administer any necessary intellectual property activities involving each party;

The Collaborative Committee shall consist of two members from each participating party, specifically one (1) administrator and one (1) medical staff representative. All members of the collaborative committee shall be appointed by the Collaborative Executive Board.

All parties will be reasonable relating to the subject(s) of this agreement including participation in care delivery models for the benefit of the involved communities.

Each party will ensure all publications; communications to the media and other professional organizations is done so with each party’s consent.

Each party will implement appropriate policies and procedures to encourage the purpose of the collaborative and to ensure best practices for the benefit of patient care.

Each party will ensure open disclosure of information and sharing of outcome data for the improvement of patient care.

Collaborative Data.

The Collaborative Committee will be responsible to determine the type of data that will be share for the purpose of improving patient care. Data shared will only be applicable to those patient cases shared between all involved parties.

Data may include and is not limited to:

1)      Protected Health Information (where PHI is included in data sharing, all parties will ensure compliance to all applicable laws associated with PHI)

2)      De-identified clinical data

3)      Financial data relating to patient care and the costs associated with patient care

4)      Any data shared or obtained for the purpose of publication, all parties agree to maintain IRB rules.

Signature Authority.

Each designee signing below has the authority to sign this agreement on behalf of each respective / involved party:

_____________________(Twin Peaks Medical Center)

_____________________(Intermountain Healthcare)

The key goals for the affiliation and the specific criteria a candidate affiliate must meet are the approaches planned to advance the value or cost-effectiveness of treatment, because they are more prone to bring significance to care consumers, exhibit a business’s greater worth scheme in a viable market, and therefore increase that organization’s market segment. Patients today are insistent on appropriate access, at inexpensive cost, this is imperative for affiliation at TPMC; needs fluctuate completely contingent on location and missions and objectives, this makes it seamless for collaboration that in the past have been rivals. The advantages of a well-defined affiliation are first, connecting the break in know-how and expertise, by affiliating with Intermountain Healthcare gives TPMC a broader range of intelligence and skill to cultivate the organization. Second, a partnership can bring an infusion of money into the organization, this can assist in producing in added sponsors and money to expand the business. Finally, cost savings will permit us to divide the weight for costs and overheads, resulting in considerable savings. The current state of TPMC and the market segmentation currently are a population of 48,000, approximately one-third are uninsured, about 36% are covered by Medicaid, seventy-seven percent o Pine Parrish residents reside in urban areas; the median age for women are 52.2 and men are 47.8. The racial mix of Pine Parrish is 52.4% are African American, 37% are Caucasian, 4.3% are American Indian, 2.6% are Hispanic, 1.2% are Asian, 1.1% are Bi-racial, and 0.6% are classified as other race.

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The recommended affiliate based on goals and rationale is Intermountain Healthcare because this affiliation will ensure service access and patient satisfaction and promote and deliver health services to meet emerging demographic and market needs by delivering high-tech developments and ground-breaking solutions that sustain the mandate for excellence for care at a low cost. This healthcare facility works with providers to improve the health of underinsured and underserved; providing evidence-based care that meets individual’s health goals, offering care and information how the patient wants it, and being a community partner, achieving the beneficial goals with the lowest possible fee per individual in the country (“Mission Vision Values| About Us | Intermountain Healthcare”, n.d). Intermountain health’s critical elements are offering information in ways that the patients want, whether by paper, online or both to improve patient experience. Low cost per individual patient care in the nation. Intermountain Healthcare can collaborate to achieve goals for improving by seeking alike solutions that are patient focused,  support clinical workflow and encourage the continuum of care. Intermountain Healthcare has Connect Care Pro which eliminates  usual  obstacles so that they can  obtain the care they require , established to meet the  requirements of rural areas, small hospitals and clinics so they have access to knowledgeable clinicians in areas of mental health, Intensive care, Infectious Diseases, Oncology, and Stroke victims  (“Clinical Services”, 2018). Expertise that is available at Intermountain Healthcare is Empiric Health which uses outcomes to reduce variations and improve costs and outcomes. Cerner is a new technology that makes healthcare more effective, safer and more efficient. These programs would assist TPMC in providing cost effective and improved outcomes in treatment for all patients (“Ventures | About Us | Intermountain Healthcare”, n.d.).  Facilities and technical support will be utilized across the affiliation to achieve goals by assisting caregivers in communicating with patients electronically and in real time; Gives caregivers information to make improved choices in care (“Information Technology | About Us | Intermountain Healthcare”, n.d). Intermountain Healthcare cultural implications of each of the mission, vision, and value statements are creating a highly valued work environment for integrity, employees can supervise themselves with trust the standards are clear, and the penalties are set. Excellence creates an instantaneous impact and is sustainable over time. Accountability shows ownership, to  represent in a way needed to accomplish organizational goals (“Mission Vision Values| About Us | Intermountain Healthcare”, n.d). The advantages of that these cultures present is it creates diversity, increases interpersonal skills, and the understanding views of others. The reason to avoid affiliation with the other candidates is there is severe misalignment in delivering healthcare to the uninsured, or the underserved which is an important in the mission, goals and vision of TPMC.

The proposed affiliation structure that I will support is the joint venture because it allows both parties to stay economical, numerous not-for-profit hospitals have turned to joint ventures with another not-for-profit entity. Nursing executives and Chief Medical Officers need be conscious of the prospects that joint endeavors offer their organizations. These agreements can assist development and increase services and productivity. Advantages of joint ventures involve admittance to new promotional and circulation groups, improved volume, allocation of responsibility with the collaborating organization, access to more funds, including expert personnel, use of the joint venture affiliate’s consumer database and study and advance in outcomes (Hernandez, 2019).

The new vision, mission, and value statement would be as follows Vision Statement: Our vision is to be the unsurpassed front-runner in bettering excellence and decreasing the price of health care for patients in the areas we help. Mission Statement: The Mission of Utah Healthcare is to deliver kind, available, high quality, valued, successful healthcare to the public; to encourage well-being; to teach healthcare specialists; and to join in relevant medical investigation.

The strategy for overall management of the organization is to recognize what the organizations will achieve collectively that they are incapable to accomplish separately, incorporating communal promotion. This will deliver the basis and clarify why this organization was selected, and why it is the top match for TPMC. Then, all healthcare managers should assess quality outcomes and providing low cost care, quality initutive can be enhanced throughout mergers or affiliation. Third, early and ongoing communication with essential residents, and a recurrent communication strategy with repetitive and clear and reliable information has demonstrated to be most efficient in managing the affiliation procedure. Communicating with employees, physician’s, and municipal leads will lessen the fear and anxiety that comes with change (Collins, Gassett and Silva, 2019).

Collaborative decision making is a method of arrangement in which health experts and patients and their family work collectively, often utilizing data and communication to comprehend medical questions and decide the safest path of action. Choice processes directing  complete decisions are significant to organizational achievement, and these procedures take place before decisions are shaped. Therefore, practical conclusions of associations between plan processes and organizational conclusions have significant consequences for healthcare executives and scholars. Managers can gain by understanding whether approach processes improve or obstruct performance. Applying a valued and patient-centered collective decision-making method will depend on solid patient contact. Healthcare professionals working to enhance joint decision-making should influence patient teaching practices, evaluate patient social and individual preferences, and include patient family and caretakers into treatment choices (O’Grady and Jadad, 2019).

Evidence-based principles, strategies, and tools of effective change management in plain words is a methodical technique to allocating change. It’s an organized way of using means, education, and funds to successfully push organizational triumph. There are several ways to accomplish this first is to identify what will be improved, because most change happens to advance a method, merchandise, or a result, it is vital to link the motivation and to explain ambitions. This likewise includes associating the money and persons that will assist in the development and direct the effort. Next, we must plan for the change, this is the framework that will identify the start, the road to be traveled, and the end point. This comprises defining the project with transparent phases with quantifiable goals, reasons why, gains, and examination. As role of the planning process, source naming and capital are critical components. These can include structure, equipment, and software arrangements. Providing well-defined and honest ways of communication through the change is an essential component in every part of change process. Next observing and handling conflict, needs, and accounting hazards, expecting and planning for conflict by equipping management with means to manage it will assist in an effortless change development. Acknowledging accomplishments is an important portion of any venture, it’s imperative to identify the achievement of groups and people concerned. Change is a continuing process, so the need to assessment, adjustment, and improvement is imperative, strategies may need to be modified throughout the process. this should be interlaced through each step to recognize and eliminate obstacles (Smartsheet, 2019). Tools that can be used according to Creately Blog, 2019 are “Kotter’s change model, ADKAR model, PDSA cycle, Culture mapping, Stakeholder analysis, or Lewin’s Change model”.

To maintain and improve employee satisfaction, engagement, and retention in a culture of change leadership must plainly explain where the organization is moving toward. As with anything else in change communication is key. Employ in-house sources by requesting ideas about how to advance the total environment of the office. Recognize and compensate employee accomplishment, this will promote a culture of quality. Use technology to encourage interaction with employees, this can engross employees with birthday or anniversary messages,  broadcasting incentives and triumphs of employees. This can also deliver inspiration through collective interaction and can nurture an added feeling of business unity (Shetrone, 2019).

Two opportunities and challenges for the affiliation with TPMC are sharing of information and education through electronic medical records, and population health management (American Hospital Association, 2019). Challenges could be the affiliates that don’t offer adequate guidance and encouragement in the initial stages, or dissimilar cultures and managing patterns cause weak integration and collaboration.

The impact the organizational cultures of TPMC and Intermountain Healthcare could have on the future of the affiliation is the capability to motivate, this can make organization members feel they have an elevated degree of chance to influence, the definition is the ability to control worry and believe in the process even when there are no obvious solutions and the future is unsure, this is important since organizations have to become skilled at to stay composed in the face of doubt and sidestep making hasty choices that may not be the most effective long term plan (Zaki, 2019). 

Reasons for termination of the affiliation agreement would be termination by mutual agreement, if the agreement is no longer being adhered to, if the parties have stopped corporate businesses or if the contract can no longer be realistically completed, the organizations may request to officially end the agreement in writing (Kroeck, 2019). ]. Termination due to breach, if the added company ceases to accomplish the explicit rules of the agreement, there is cause to terminate that contract (Quain, 2019).  Finally, change in management of an organization is cause for termination of the affiliation agreement.

A potential exit strategy that is actionable and includes three action steps are to consider your motivation, explore your options, focus on revenue growth, and do the math. Considering your motivation is understanding why you want to exit?, that are the stakeholders hoping to achieve? Exploring your options is vital to frequently examine possible acquiring businesses. Study their acquisition past, the motives behind the agreements, and verify  they meet your standards. Focusing on revenue growth achieving footing within a marketplace is a method to demonstrate that the innovation has promise. As the company grows, these occasions can be expanded into an actionable strategy the backing of the board and stakeholders. Doing the math means to always be prepared with data on similar exit communications including worth and objectives accomplished (VentureWell, 2019).

 Future challenges and opportunities that may arise from the affiliation are patient  compliance, reaching all rural patient populations and underserved residents; The state of Arizona there are 16% of all persons that are uninsured and underserved, Arizona experiences  a uneven supply of providers, currently over 1/3 don’t have a health center that presents a sliding charge plan to uninsured and underinsured patients (Tarango, MS et al., 2019). Opportunities that may arise are the sharing of cost, and quality improvements. Patient compliance could impact quality of life, if patients do not continue to comply with medications, diet, and other recommendations, this will prevent improvement in quality of life. Reaching rural and underserved and providing them with timely quality treatment. The availability of providers for the number of patients to be taken care of in the future, since the current ratio of providers to patients is 39.8 providers per 100,000 patients.

References

• American Hospital Association. (2019). Hospital Merger Benefits: Views from Hospital Leaders and Econometric Analysis | AHA. [online] Available at: https://www.aha.org/guidesreports/2017-01-24-hospital-merger-benefits-views-hospital-leaders-and-econometric-analysis [Accessed 7 Feb. 2019].
• Clinical Services. (2018). Retrieved from https://intermountainhealthcare.org/About/Transforming-healthcare/Pro/Services/
• Collins, C., Gassett, L. and Silva, G. (2019). best practices for affiliation agreements between health systems and universities. [online] Marketing.ecgmc.com. Available at: http://marketing.ecgmc.com/acton/attachment/10977/f-04d8/1/-/-/-/-/Article_hfm%20Mag_Seven%20best%20Practices_May%202018_Final_455362.pdf [Accessed 5 Feb. 2019].
• Creately Blog. (2019). 8 Vital Change Management Tools for Effectively Managing Change. [online] Available at: https://creately.com/blog/diagrams/change-management-tools-list/ [Accessed 6 Feb. 2019].
• Henrichsen, RN, MSN, K. (2018). The Healthcare Organization of the Future: Arriving Now. Retrieved from https://intermountainphysician.org/intermountaincmehttps://intermountainphysician.org/intermountaincme/Documents/05%20Henrichsen.pdf/Documents/05%20Henrichsen.pdf
• Hernandez, N. (2019). Pros and Cons of Medical Practice Joint Ventures. [online] Modern Medicine Network. Available at: http://www.physicianspractice.com/operations/pros-and-cons-medical-practice-joint-ventures [Accessed 5 Feb. 2019].
• Information Technology | About Us | Intermountain Healthcare. (n.d.). Retrieved November 15, 2018, from https://intermountainhealthcare.org/about/who-we-are/trustee-resource-center/overview/information-technology/
• Kroeck, L. (2019). Termination of Contract by Mutual Agreement. [online] Smallbusiness.chron.com. Available at: https://smallbusiness.chron.com/termination-contract-mutual-agreement-58305.html [Accessed 8 Feb. 2019
• Mission Vision Values | About Us | Intermountain Healthcare. (n.d.). Retrieved November 13, 2018, from https://intermountainhealthcare.org/about/who-we-are/mission-vision-values/
• O’Grady, L. and Jadad, A. (2019). Shifting from Shared to Collaborative Decision Making: A Change in Thinking and Doing. [online] Journal of Participatory Medicine. Available at: https://participatorymedicine.org/journal/evidence/case-studies/2010/11/08/shifting-from-shared-to-collaborative-decision-making-a-change-in-thinking-and-doing-4/ [Accessed 6 Feb. 2019].
• Quain, S. (2019). Causes for Terminating Legal Contracts. [online] Smallbusiness.chron.com. Available at: https://smallbusiness.chron.com/causes-terminating-legal-contracts-44938.html [Accessed 8 Feb. 2019].
• Smartsheet. (2019). 8 Elements of an Effective Change Management Process. [online] Available at: https://www.smartsheet.com/8-elements-effective-change-management-process [Accessed 6 Feb. 2019].
• Shetrone, A. (2019). 7 Ways to Improve Employee Satisfaction. [online] Inc.com. Available at: https://www.inc.com/guides/201105/7-ways-to-improve-employee-satisfaction.html [Accessed 7 Feb. 2019].
• Tarango, MS, P., Lenartz, MPH, T., Zavala, MPH, C., Mohapatra, MSIOP, C., Roscetti, MPH, A., Drake, MPH, A. and Cluff, R. (2019). Arizona Primary Care Needs Assessment. [online] Azdhs.gov. Available at: https://www.azdhs.gov/documents/prevention/health-systems-development/data-reports-maps/reports/primary-care-needs-assessment.pdf [Accessed 21 Feb. 2019].
• VentureWell. (2019). 9 Steps to Formulating a Successful Exit Strategy – VentureWell. [online] Available at: https://venturewell.org/exit-strategy/ [Accessed 8 Feb. 2019].
• Zaki, W. (2019). Let’s clarify what “dealing with ambiguity” means. [online] Linkedin.com. Available at: https://www.linkedin.com/pulse/20140616070316-30480946-let-s-clarify-what-dealing-with-ambiguity-means [Accessed 8 Feb. 2019].