Win-Win
How a JV Model Delivered Results for Both Parties
Sylvia Young, MSHA, FACHE
President, HCA Continental Division
1 |
Table of Contents
1.
HealthONE Today
2.
How Did We Get Here?
3.
Community Benefit
2 | IT&S Strategy & Planning
HealthONE Today
3 | IT&S Strategy & Planning
HealthONE Today
HealthONE Assets
4 |
6
Acute Care
Hospitals
1.8K
1
Children’s
Hospital
3K
1
Rehabilitation
Hospital
1
Behavioral Hlth
Campus
Beds
Affiliated
physicians
12
8
Imaging
Centers
Freestanding
ERs
4
Trauma
Centers
137
Employed
Physicians
19
Surgery
Centers
10K+
Employees
HealthONE Today
HealthONE Assets and Access Points
HealthONE Outreach Clinic
CODOC Telemedicine Site
Airlife Helicopter location
HealthONE Today
HealthONE Business Development
Clinic
HealthONE Affiliate Hospitals
•
5 | IT&S Strategy & Planning
Collaborative Care Service
menu
• Internal Consultation
• Service line Affiliations
• Parallon Relationships
• CHC Relationships
HealthONE Today
Market Share
35%
-48 BPS
HCA Current 4 Qtrs
31.6% 31.6% 32.4% 32.4%
30%
2015
Q1
25%
2015
Q2
2015
Q3
2015
Q4
Despite increasing market
pressure, HealthONE maintains
strong market position.
+36 BPS
20%
+10 BPS
15%
+77 BPS
10%
-8 BPS
-45 BPS
5%
-22 BPS
0%
HealthONE
2013
6 |
2014
2015
Centura
SCL
University of Colo
Health
Denver Health
Children's Hosp
All Other
HealthONE Today
Denver’s Quality Leader
Quality Metric
HealthONE
HCAHPS - Overall Rating
73%
IP Core Measure – Inpatient
Composite
99.81%
OP Core Measure – Average Time
To Pain Management
37 min
Composite Hosp Acquired
Infections
Hospitals with “A” Leapfrog Rating
ER – Arrival to Greet
7 |
.704
50%
(3 of 6)
6.5 mins
HealthONE Today
Physician Engagement
Physician Satisfaction 2016 - Overall 7 of 8 Hospitals Greater than 75%ile
Place to
Practice
Administration
Patient
Safety
Nursing
Care
Quality of
Care
>90th Percentile
75th - 90th Percentile
<75th Percentile
8 |
HealthONE Today
Increasingly Engaged Employees
78%
77%
76%
75%
74%
73%
72%
71%
70%
69%
2013
2014
2015
HealthONE
9 |
2016
How Did We Get Here?
10 | IT&S Strategy & Planning
How Did We Get Here?
The Denver HealthCare Market Pre-JV

Pre-HCA the market consisted mainly of
independent hospitals or systems of two to
three facilities

In 1993, Swedish Medical Center and the
P/SL Healthcare System merge to form the
non-profit HealthONE

HCA enters the market in 1993 with the
acquisition of Galen Healthcare with intent
for future expansion

Rose is acquired by HCA in 1995 and the
Rose Foundation is funded with $170-million

In 1996, Catholic Health Initiatives (St.
Anthony Central, St. Anthony North and
Mercy) and the PorterCare Health System
(Porter, Littleton and Avista) joined together
to form Centura Health under a JOA

Exempla Healthcare formed in 1998,
bringing together St. Joseph Hospital and
Lutheran Medical Center

11 |
Independent hospitals begin talking to one
another about forming systems. Initially
Rose was in discussions with the Adventist
Health System (Porter, Littleton and Avista),
St. Joseph Hospital and Lutheran Medical
Center
How Did We Get Here?
Map of Denver Healthcare
Landscape 1993 Pre-JV
Legend
PorterCare System
P/SL Healthcare System
Independent Hospitals
Catholic Health Initiative
HCA
12 | IT&S Strategy & Planning
How Did We Get Here?
Map of Denver Healthcare Landscape 1998
Legend
Centura Health
Exempla Healthcare
HCA
Independent Hospital
13 | IT&S Strategy & Planning
HCA History in Denver
HCA acquires Galen
Healthcare
(North Suburban
Hospital and Aurora
Regional Medical
Center)
$170-million Rose
Foundation
established
1995
1993
P/SL Healthcare
System and
Swedish Hospital
merge to form
HealthONE
($550m assets and
$350m in debt)
14 |
Preamble for HCA’s Denver
HCA acquires Rose
Sky Ridge Medical
Assets
Medical Center
Center Opens
2003
HCA and
HealthONE form
50/50 Joint
Venture
HealthONE
Alliance was
formed
2011
HCA buyout of
The Colorado
Health
Foundation for
$1.45-billion
HCA Assets
1995
15 |
HealthONE Assets
HCA Assets
• P/SL Healthcare System
• St. Luke’s Hospital
• Presbyterian Denver
• Aurora Presbyterian
• Centennial Medical Plaza
• Bethesda Psychiatric Hospital
• Swedish Medical Center
• AirLife
• Spalding Rehabilitation Hospital
•
•
•
•
•
•
Rose Medical Center
North Suburban Medical Center
Aurora Regional Medical Center
Senior Health Care Centers
Highlands Ranch Medical Plaza
Columbine Psychiatric Hospital
HCA Desires
1995
HealthONE Desires
 Relief from Substantial Debt
 Access to Capital
 Access to Recruitment for
Management
 Ability to Compete in a
Changing Healthcare Market
 Access to Managed Care
Contracts
HCA Desires
 Broader Footprint in Denver
Market
 Increased Efficiencies
 Full-service network
 Market Preference and
Significance
 Day-Day Management
Oversight
A Joint Venture is Formed
16 |
HCA History in Denver
HCA acquires Galen
Healthcare
(North Suburban
Hospital and Aurora
Regional Medical
Center)
$170-million Rose
Foundation
established
1995
1993
P/SL Healthcare
System and
Swedish Hospital
merge to form
HealthONE
($550m assets and
$350m in debt)
17 |
Preamble for HCA’s Denver
HCA acquires Rose
Sky Ridge Medical
Assets
Medical Center
Center Opens
2003
HCA and
HealthONE form
Joint Venture
2011
HCA buyout of
The Colorado
Health
Foundation for
$1.45-billion
How Did We Get Here?
2003
Sky Ridge Medical Center is the Product of a Successful Relationship
 Funded through JV cash
flow
 Original cost $140M, total
investment of $438M YTD
 Opened August 20, 2003
 Opened with - 106 beds,
has grown to 286 beds
 By 2007 hospital reached
business levels anticipated
in 2012
 280 employees upon
opening, now 1,300
employees
18 |
 Two Medical Office
Buildings, added third in
2015
 States largest Spine and
Total Joint Center with
separate entrance
 Dedicated Women’s Center
entrance, largest Birth
Center in Colorado
 Dedicated Pediatric
Emergency Room
 1,200 physicians
How Did We Get Here?
Investment in the Market Since Transaction
$187.30
$150.50
$155.10
2015
$109.60
2011
$114.20
2012
2013
2014
Annual Approved Capital Investment in Millions
19 |
2015
HCA History in Denver
HCA acquires Galen
Healthcare
(North Suburban
Hospital and Aurora
Regional Medical
Center)
$170-million Rose
Foundation
established
1995
1993
P/SL Healthcare
System and
Swedish Hospital
merge to form
HealthONE
($550m assets and
$350m in debt)
20 |
Preamble for HCA’s Denver
HCA acquires Rose
Sky Ridge Medical
Assets
Medical Center
Center Opens
2003
HCA and
HealthONE form
Joint Venture
2011
HCA buyout of
The Colorado
Health
Foundation for
$1.45-billion
Community Benefit
21 | IT&S Strategy & Planning
Community Benefit
The Colorado Health Foundation





22 |
Third largest health-focused foundation in the county, with $2.4 billion in assets.
Operate and fund six graduate medical education residency programs.
Focus on three community outcome areas: Healthy Living, Health Coverage and
Health Care.
Provided over $617-million in grants and contributions from 2006 - 2014
 $4.5-million initiative for Health Places: Designing an Active Colorado, a five year project to
help communities become healthier places to live.
 $7.1-million investment to seed the Colorado Fresh Food Financing Fund, a public-private
partnership to make financing available for grocers that offer affordable and nutritious foods
in areas where such goods are scare.
 $1.5-million, 7-year loan to mStrength, Inc. to boost capacity in delivering their behavioral
health e-platform to generate better mental health outcomes and reduce costs.
 10-year funding commitment to student health and wellness in Colorado’s schools, Support
for the Healthy Schools Initiative.
 $2.9-million in funding to support 20 Colorado primary care practices to improve
team0based care in the clinical setting.
 Three-year, $4-million initiative to create a community0integrated health system.
 $2.75-million Advance Care Planning initiative to improve opportunities and resources for
individuals and families to engage in advance care planning to ensure care in the event of
incapacity or at end of life.
Conclusion
 HealthONE is Denver’s leading hospital system.
 Strong partnerships can evolve into something
greater.
 The community has greatly benefited from this
evolution by gaining an even stronger hospital
system and a well-funded foundation.
23 | IT&S Strategy & Planning