Keys to Successful Hospital-Community Health Center Partnerships

May 09, 2014

Key 1: Mutual Respect and Understanding

“You don’t have to invade each other’s governance to partner. Create a joint partnership steering committee that allows each organization’s executive teams to meet regularly, prioritize, and bring information back to the boards.” 

That was the guidance from Jackie Leifer, national expert on hospital and community health center collaborations, during a recent joint educational program offered through a partnership between the Pennsylvania Association of Community Health Centers, The Hospital & Healthsystem Association of Pennsylvania, and Hospital Council of Western PA focusing on establishing successful hospital-community health center partnerships.

Jackie’s comment gets to the heart of one of the biggest partnership challenges I hear from both hospitals and health centers: “hospitals are accustomed to a great deal of control in partnership arrangements and health centers have strict, unwaivable governance requirements.”

From my experience, it’s clear that individual preferences and requirements do not have to be obstacles to good partnerships.

One key to forging successful partnerships is to mutually respect, understand, and honor hospital and community health center requirements.

Key 2: A Three-Way Win

So what is a successful partnership? It’s when you can confirm that the partnership has created a “three-way win”—a win for the hospital and/or health system; a win for the health center; and most importantly, a win for the community and patients served.

Successful partnership models range from working together on the development of a new health center or health center site to meet the needs of the underserved, to residency programs and teaching collaborations, to leasing of personnel or services, to emergency department care coordination, and to development of Accountable Care Organizations.

Successful hospital-community health center partnerships optimize the health center benefits of fairer payment for primary care services, the 340B drug discount program, Federal Tort Claims Act coverage, National Health Service Corps and state loan repayment, and the Vaccine for Children Program.

They build on the health center model of care that offers coordinated medical, dental, and behavioral primary health care services to individuals and families to help them get well and stay well.

Successful hospital-community health center partnerships should result in:

• More services to more patients, or an ability to maintain existing services that were in jeopardy
• Improved care coordination with a reduction in duplication of services
• Improved financial stability and strength of both partners

A second key to successful partnerships is creating a three-way win.

Key 3: A Framework of Trust

While there are certainly defined types of partnerships between hospitals and community health centers, it’s clear that how they evolve is very individual; and that as trust builds and positive outcomes are validated, more opportunities for productive partnership present themselves.

For example, Carolina Health Centers developed a medical home referral collaborative model with Greenville Health System. Over time it has evolved to the point that a health center is located on the hospital campus and a health center care coordinator works with hospital emergency department staff and discharge planners to help individuals without an established medical home to secure one.

The hospital and health center worked together to align incentives. The community health center offers same day primary care at the hospital location, allowing patients who present at the emergency department and screened as not having an emergent condition the option of treatment in the hospital emergency (and they pay for the screening exam and treatment) or referral to the community health center (where they do have to pay for the screening exam).

While there were some initial concerns from hospital emergency department staff and private physicians, the hospital emergency department director is now the strongest advocate for the partnership. Community physicians are pleased because the community health center refers patients with an established medical home back to the hospital. And patients have a say in the care they receive.

The third key to successful partnerships is a establishing that framework of trust, along with a focus on patients and improving the health of the communities.

In Conclusion

The new world of health care into which we have all been thrust is forcing providers across the continuum to learn how to better work with one another. The incentives aren’t yet totally aligned, but are moving in the right direction. Hospitals and community health centers, both critical resources in the community, need to move in the right direction as well.

The Pennsylvania Association of Community Health Centers and The Hospital and Healthsystem Association of Pennsylvania are committed to helping hospitals and health centers interested in partnership to explore the options and opportunities.

Your membership organizations are working better together just as you are, and we’re here to support your efforts through education, resources, and advice. We welcome your questions on potential partnerships and collaborations so that, together, hospitals and community health centers can work to not only survive, but thrive, in this new world of health.