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Wake Forest Baptist forms research alliance with Cornerstone

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WINSTON-SALEM, N.C. — Staying independent has been the top priority of Cornerstone Health Care PA as the physician group has spread beyond its High Point roots to serve most of the Triad.

However, the launch in April of Cornerstone Health Enablement Strategic Solutions, a wholly-owned management services organization, put the company in the position of needing additional funding to help the unit reach its potential.

Enter Wake Forest Baptist Medical Center, which announced plans Thursday for a “multi-year, multi-million dollar investment” in the Cornerstone unit known as CHESS.

Cornerstone and Wake Forest Baptist said that a business plan for their collaborative effort is expected to be revealed within 90 days.

Dr. John McConnell, chief executive of Wake Forest Baptist, said the center is making the investment as part of its transition toward providing more patient-centered services and developing new models for how services are delivered. The center chose to partner with Cornerstone rather than create such an organization in-house.

“We are embarking on a planning process to determine what specific programs and services will be provided through CHESS in the future,” McConnell said.

Don Dalton, a spokesman for the N.C. Hospital Association, said he is not aware of another affiliation of this kind between an academic medical center and an independent physician group in the state.

In recent years, the formula has been for health-care affiliations to require one group to surrender some or all of its independence to gain supply chain cost savings or secure higher-level management oversight.

Cornerstone, led by chief executive and president Dr. Grace Terrell, has proven to be the exception.

It has practices throughout the Triad, including in Advance, Elkin, Kernersville, Lexington, Reidsville, Thomasville and Winston-Salem. Overall, it has more than 360 physicians and mid-level health professionals representing practices at 85 locations. The CHESS division has 282 employees.

“We do not see large health-care systems as competitors,” Terrell said in an April interview.

“We see them as our partners in providing the best care possible for our patients. For physicians who are not thrilled with the idea of being an employee of a hospital, Cornerstone offers an attractive alternative.”

Potential to lower costs

Health-care officials, whether with hospitals, physician groups or insurers, have rallied around the patient-centered medical home (PCMH) concept for its potential to provide more focused care at a potential lower cost.

The goal is shifting from a traditional fee-for-service model to one that focuses on early intervention and closer monitoring of patients with chronic diseases and monitoring the quality of care provided.

The strategy coordinates hospitals, doctors, rehabilitation centers and other providers to eliminate duplicate procedures, prevent medical errors and keep patients healthier through monitoring their care post-discharge from a hospital.

“It is crucial in this challenging health-care environment for multiple health-care providers to join together and assume accountability for managing and improving health care,” McConnell said.

The initiative began within Medicaid, the state and federal program that provides health care for low-income or disabled people. Physicians are reimbursed through the PCHM format. The expectation is that patients’ co-pays eventually will be lower if they go to a PCMH physician and practice.

However, it is more expensive to reach out to patients and manage their care, and how much private insurers and employers will help pay for the new model is undetermined. Primary-care physicians, who have the core responsibility for the concept, are in short supply.

Cornerstone has formed this year separate partnerships with Blue Cross Blue Shield of N.C., UnitedHealthcare and Optum to create accountable care organizations that employ the PCMH concept.

Novant Health Inc. announced a similar ACO collaboration with Cigna in March. Novant and Wake Forest Baptist are engaged in other PCMH or ACO strategies.

Access to more patients

Cornerstone and Wake Forest Baptist say they believe their collaboration through CHESS will help them better manage large populations of patients with diabetes or heart failure using innovative technologies.

Cornerstone spokesman Eric Neuville said the collaboration will help it better serve patients in its western Triad network. He said the physician group talked with other academic medical centers before choosing Wake Forest Baptist “because it was the best overall fit.”

The groups said one advantage of the partnership is “expand their capabilities to engage in population management and advanced analytics.”

That means Wake Forest Baptist will gain access to Cornerstone patients for research and analytical purposes, including clinical trials.

“We believe that giving Cornerstone physicians and their patients access to Wake Forest Baptist clinical trials would be beneficial to all parties, but we have not outlined the details of that strategy,” McConnell said.

Another Cornerstone initiative, launched in March, involves an outreach clinic focused on getting more adult Medicaid and low-income Medicare patients to participate in regular quality care encompassing the PCMH strategy.

“Those health-care organizations that position themselves to provide the highest quality care for the least expense are far more likely to thrive in the rapidly evolving environment than those who simply do business as usual,” Terrell said.

By Richard Craver/Winston-Salem Journal