ProMedica's new alliance is a positive step, Jacobs says

Staff Writer
Columbus CEO

A ProMedica and Cleveland Clinic alliance is a “positive” step, though the full impact of an affiliation announced Thursday remains to be seen, said Dr. Lloyd Jacobs, president of the University of Toledo.

“In these kinds of situations, the devil is in the details. Having said that, my general reaction is positive. I think there’s a lot of potential for great new interactions between and among the entities in the community,” Dr. Jacobs said.

ProMedica and Cleveland Clinic signed a pact to work together in an attempt to improve efficiency and patient care. The alliance could lead to group purchasing, collaboration in technology areas, the sharing of standardized patient-care information, and other combined services.

The alliance is motivated by industry changes, the Affordable Care Act, and a push to contain costs as reimbursements from Medicaid and Medicare don’t keep up with expenses, officials said.

It’s not the first time Cleveland Clinic expressed interest in a Toledo health system. Dr. Jacobs said a Cleveland contingent visited the University of Toledo Medical Center, the former Medical College of Ohio, several months ago to “see if common ground could be developed.”

The two organizations talked about various relationships, including academics and clinical operations, but the university president described the talks as preliminary discussions that failed to find common ground.

Discussions with the university ended mutually, said Eileen Sheil, Cleveland Clinic spokesman. “It was just not the right fit. We talk to organizations all the time,” she said. “You certainly want to explore possibilities, and we do that all the time, all over the place.”

Dr. Jacobs said he doesn’t feel as if Cleveland Clinic chose ProMedica over UTMC.

“I can’t get inside their mind why they chose to do this, but we actually, I think, stepped away from the potential partnership with Cleveland Clinic because it didn’t seem to be a cultural fit,” he said. “Partly, I was worried about their being so big, and we are so small.”

How ProMedica and Cleveland Clinic fit together depends on both organizations carrying out details of the alliance, experts said. Integration isn’t always necessary to become more efficient or make improvements, said Martin S. Gaynor, a professor of economics and health policy at Carnegie Mellon University in Pittsburgh. “Certainly some kind of affiliation might be a good mechanism; it is going to depend on the details,” he said. “They have to really invest in it.”

Such affiliations are more common as organizations face uncertainty over health-care reform, the threat of decreased reimbursements, and how to invest in infrastructure, said Lawton R. Burns, chairman of the health-care management department at the University of Pennsylvania’s Wharton School.

Hospital systems may view alliances as a way to offset risk, generate revenue, or save money, he said. Alliances are “a lower-risk version of consolidating.”

There’s no evidence alliances work, but that doesn’t mean a particular alliance can’t be successful, he said. The average alliance doesn’t improve quality or finances, Mr. Burns said. Success hinges on how those working under the chief executive officers execute plans on an ongoing basis.

For Cleveland Clinic, which built its reputation on excellence in cardiac surgery, such steps can be a way to keep up referrals, Mr. Burns said.

It also could be a way to learn how to serve a more diverse population. Improving patient care is, “at the end of the day, what drives the Cleveland Clinic,” he said.

The clinic does not anticipate a large gain in patients because of the alliance, Dr. Toby Cosgrove, its president and chief executive officer, has said.

Dr. Jacobs said he doesn’?t expect the new relationship to affect UTMC financially, though that too depends on arrangement details. He anticipates it will continue to place students at ProMedica sites.

Mercy, Toledo’s other hospital system, and its parent company, Catholic Health Partners, issued a joint statement saying alliances are “increasingly common” as providers work to improve quality and reduce costs. Spokesmen said officials from both the local system and the Cincinnati home office would not discuss the ProMedica and Cleveland Clinic affiliation beyond a written statement.

Catholic Health Partners is “an active leader” in forming such alliances, the statement said. The organization is pursuing purchase of a minority stake in Akron-based Summa Health System, which includes a network of hospitals and health centers. It also plans to buy Kaiser Permanente Ohio’s health plan and operate an associated medical group practice with 15 locations in northeast Ohio.

Catholic Health Partners expects to finalize both deals by year-end, a Mercy spokesman said. It “has a long history of leveraging our size, scale, and expertise to innovate,” a statement said.

The statement cited the establishment of standards of care to improve clinical quality, safety, and efficiency. “We are creating one seamless electronic health record throughout all [Catholic Health Partners’] care sites in the state. And we’re maximizing cost savings through volume purchasing that can be passed on to those we serve,” the statement said.

The Ohio Hospital Association does not track hospital affiliations within the state, and doesn’t endorse or sanction such arrangements, spokesman John Palmer said.

Staff writer Nolan Rosenkrans contributed to this report.

Contact Vanessa McCray at: or 419-724-6056, or on Twitter @vanmccray.