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Our Work

Case Study

“Their expertise in payer and physician alignment have helped us form meaningful relationships, enabling Presence to play an important role in today’s value-based market place.”

Sandra Bruce, FACHE,
President and CEO, Presence Health

Situation

Resurrection Health Care (RHC) and Provena Health merged to become Presence Health in late 2011. We have been providing business advisory services to Resurrection Health Care, based in Chicago, since 2010. RHC wanted to become a clinically integrated organization. RHC was comprised of six acute care hospitals and one long-term acute care facility serving 2.1 million people in discontinuous markets of Chicago. There were over 2,500 physicians affiliated with RHC, predominately independent solo and small group practices, with few employed by RHC.

How we helped

We helped RHC with the development and implementation of a clinical integration initiative. We educated physicians and leaders on key concepts specific to clinical integration and cultural changes required for successful implementation; identified gaps in infrastructure and readiness; assessed their payer relationships and contract performance by payer and product type; developed strategies used to negotiate and implement new payment methodologies; designed the governance and organizational structure; and engaged RHC,  affiliated physicians, and continuum of care components in the formation of the clinically integrated delivery network.

We continue to advise Presence Health on the merger of Resurrection Health Care and Provena Health subsidiaries into one clinical integrated organization. The resulting Presence Health network is a 12-hospital system with more than 3,600 beds, over 22,000 employees, and a medical staff of more than 4,000. The new system will also include 27 long-term care and senior residential facilities, more than 90 primary care and specialty care clinics, and six home health agencies. Presence Health is the leading Medicaid provider and largest not-for-profit provider of behavioral health services in the state. Presence Health will have combined operating revenue of nearly $3 billion. We are also assisting Presence Health with value-based payer strategy development for the new system and continue to provide clinical integration and other business advisory services.