UC Davis Health Regional Affiliations Officer Maureen McKennan works with colleagues on strategic relationships that enable UC Davis Health to help provide the best care for patients across Northern California. McKennan, a nurse practitioner and attorney, is part of an interdisciplinary team that brings experience and expertise in business development, clinical services, health care law, finances and managed care/payer strategy.
Q. We’ve all heard the catchphrase ‘right care, right time, right place.’ How does a strategic relationship help partners get beyond buzzwords and closer to reality?
A. Our affiliations allow patients to get the health care services that can and should be provided locally at their community hospital. As an academic medical center, we’re building relationships that allow for tertiary and quaternary care to flow to UC Davis Health, while supporting community hospitals to keep patients and perform care that should be best performed in community settings.
Our goal is to combine the individual strengths of UC Davis Health and the local community hospital to best serve patients. We strive to help expand the depth of services provided in a community so that patients can receive more types of quality care locally.
For example, our 24/7 inpatient pediatric telemedicine program allows community physicians to work closely with our pediatric critical care specialists and neonatologists for consults, often reducing the number of babies and children who require transfer to UC Davis Medical Center.
We’re seeking community partners that are committed to working with UC Davis Health to improve the entire continuum of care by making sure our patients get the best care at the most appropriate setting. It’s a win-win for us, for community hospitals, and — most importantly — for patients.
Q. What advantages does a more formal affiliation agreement bring, compared to simply utilizing existing referral and transfer channels?
A. A formal affiliation or service agreement provides necessary structure so that UC Davis Health and community partners can jointly implement clinical, research and educational objectives. As partners, we develop and maintain close working relationships with regular communication. Our affiliates know and work with our physicians and nurses on a regular basis. They have our phone numbers and email addresses and have relationships with our clinicians.
Instead of simply transferring a patient or referring a patient for care, our affiliates can call UC Davis physicians for advice or a telemedicine consult, often allowing patients to safely remain in the local community for care. When patients do require transfers or referrals to UC Davis Health, we have more streamlined communication channels and IT connectivity, whether through telemedicine and/or electronic medical records.
We regularly communicate with our affiliate partners about the patients they transfer or refer, so that community physicians are aware of their patient’s status, and when we repatriate patients back to our local partners it’s done with better coordination of care and complete information about the plan of care.
A. For many community physicians and hospitals, the most significant advantage of an affiliation is maintaining independence, governance, and local control. Affiliations allow for more flexibility with different degrees of commitment and different types of services based on mutual goals. For example, UC Davis Health Cancer Care Network affiliations are structured based on the parties’ needs: two are joint ventures with shared governance and financial risk, while the other four are subscription-type models.
Our goal is to combine the individual strengths of UC Davis Health and the local community hospital to best serve patients. We strive to help expand the depth of services provided in a community so that patients can receive more types of quality care locally, through telemedicine or by having some UC Davis physicians travel to provide onsite care or surgery at community sites.
Q. What are some of the unique strengths UC Davis Health offers as a partner, especially in the changing health care environment?
A. We can offer affiliates access to a unique health care hub with exceptional clinical services, research, education and innovation. We can support workforce development through our innovative medical school and residency programs, nursing school, interprofessional programs and health informatics program. We train physicians, physician assistants, nurse practitioners, nurses and health data analysts. Our unique Community Health Scholars Programs, such as the PRIME programs, train primary care physicians for practice in rural or underserved regions.
Our affiliates also have access to leading-edge technologies such as telemedicine and simulation training in our Center for Virtual Care. Our IT, health informatics and data analysts can help community affiliates use data to provide better care, reduce inefficiencies, support population health and enhance day-to-day operations. Most recently, we’re hosting our Epic EMR at one of our local community hospitals.
A. Community hospitals provide convenient and local access to care. It’s the place you were born, grew up with, and get most of your care. We seek to affiliate so that specialized outpatient care, lower-acuity inpatient care, and emergency services can be provided at these local hospitals that draw patients from surrounding communities. Lower-acuity inpatient care should be provided at local smaller community hospitals, where care is often provided in a more cost-effective setting.
Our partners also offer clinical clerkship rotations for our students and resident physicians to help ensure a wide range of clinical experiences.
Q. In the last few years the country has experienced a series of major changes in how we provide and pay for care. Now there’s significant uncertainty again. Will partnerships and affiliations remain important?
A. As you note, reform is uncertain, unpredictable and ever-changing (and yes, things could change again by the time this article prints). But generally, the path going forward will focus on driving down costs with reforms of payment systems and care-delivery systems — and no matter what the current politics, value-based payments that reward quality and better outcomes are likely here to stay.
Delivery system reform will continue with team-based care, enhanced care coordination, engagement of lower-cost providers, and population health management utilizing health data analytics. Strategic affiliations are advantageous — and frankly, often necessary — in this new environment.
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