What Works Partnerships, Networks and Alliances
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What Works Partnerships, networks and alliances Global lessons and trends KPMG International kpmg.com/whatworks Authors Dr. Mark Britnell Malcolm Lowe-Lauri Chairman and Partner Partner Global Health Practice KPMG in Australia KPMG in the UK Since 2009, he has worked in 60 countries, Malcolm is currently an Advisory Partner in Australia helping governments, public and private sector and is part of KPMG’s Global Healthcare Center organizations with operations, strategy and policy. He has of Excellence. One of his areas of expertise is the a pioneering and inspiring global vision for healthcare in development and implementation of new care delivery both the developed and developing world and has written models to achieve cross-organizational change. A extensively on what works around the world; kpmg.com/ prominent national and international figure, he has whatworks. chaired the UK CEO’s Research Forum and was a member of the NHS Future Forum, advising the UK Mark has dedicated his professional life to healthcare Government on health legislation. and has led organizations at local, regional, national and global levels. He was CEO of high-performing Malcolm has been at the forefront of the NHS’s University Hospitals in Birmingham and master-minded modernization efforts, having helped several UK the largest new hospital build in the NHS. He also ran healthcare authorities deliver change and improve the NHS from Oxford to the Isle of Wight before joining performance, successfully working with multiple the NHS Management Board as a Director-General. He stakeholder groups. Most recently Malcolm was CEO developed ‘High Quality Care for All’ with Lord Darzi and of University Hospitals Leicester (NHS) Trust, England’s has published ‘In Search of the Perfect Health System’ third-largest university hospital trust with US$1 billion a comprehensive assessment of healthcare systems turnover and 11,500 employees, where he turned around across the globe. @markbritnell a failing asset renewal program. © 2015 KPMG International Cooperative (“KPMG International”). KPMG International provides no client services and is a Swiss entity with which the independent member firms of the KPMG network are affiliated. Table of contents Executive digest: Malcolm Lowe-Lauri 04 Six factors for successful partnerships, networks and alliances 06 Successful PNAs require a long-term strategy 08 PNAs are driven by innovation, coordination or new markets 11 Focus on quality, not size or money 16 The best PNAs expand opportunities beyond their original mission 18 Avoiding failure requires strong payer-provider alliances 21 Tension, flexibility and self-criticism are more important than the model 24 KPMG Partnerships, networks and alliances maturity matrix 26 How KPMG can help 28 Contributors 29 © 2015 KPMG International Cooperative (“KPMG International”). KPMG International provides no client services and is a Swiss entity with which the independent member firms of the KPMG network are affiliated. 4 Partnerships, networks and alliances Executive digest Malcolm Lowe-Lauri Healthcare with a purpose — that is where improved service quality and cost effectiveness begins. Hospitals, community healthcare providers and payers must go beyond their borders to create partnerships, networks and alliances (PNAs) in order to achieve an integrated, cost-effective and high- quality service environment. The specific model of collaboration is less important than ensuring the ability of institutions and their professionals to come together seamlessly. Such integration is not simple; it requires healthcare organizations to make purposeful, yet flexible, long-term decisions. © 2015 KPMG International Cooperative (“KPMG International”). KPMG International provides no client services and is a Swiss entity with which the independent member firms of the KPMG network are affiliated. Partnerships, networks and alliances 5 Factors driving coordination their business processes, clinical Achieving benefits of care pathways and their people more When it comes to PNAs, there The provision of healthcare effectively. It is also why payer- are a number of factors that can is becoming more complex provider alliances are becoming influence success. As a starting and specialized, making it increasingly common. point, think strategically about difficult for institutions to match Successful PNA players have what you are doing and how you traditional structures to fit shifting often extended into international are doing it. Be purposeful in your patterns of demand. As a result, efforts in research and education actions — flexible, but focused on organizations around the world and sophisticated commercial the long-term. Successful PNAs are looking to develop PNAs to partnerships with the life often form out of organizations coordinate care across different sciences sector. having an evolving but continuous kinds of providers. strategy. A ‘chop and change’ Avoiding PNA pitfalls approach rarely works. Complementary to this is the When it comes to creating drive for information. Information effective PNAs, the biggest Leadership is also essential. alliances allow participating dangers come from not thinking Ask yourself how active your organizations to obtain wider long-term. The best PNAs have leadership is with external access to data so they can achieve evolved over time and with a partners and whether you are new levels of insight into what shared vision. Hospitals that looking outside your organization they are doing, their patients and move too quickly often find as well as inside. The best leaders the populations they work with. there is little-to-no positive understand their position in the These insights can be critical for impact on their organizations system and how their actions formulating activities that enhance because they did not conduct affect the broader group both the entire system of care. the right due diligence or they positively and negatively. There are also strong legislative did not pay enough attention to Even if you are hesitant about (e.g. Affordable Care Act in the US) governance or defining strategic PNAs, do not let your uncertainty and financial drivers making the outcomes. The message is, pick stop you from considering case for PNAs. Many payers are the right partners, create or join options. Even in cases where the spending more on non-hospital the right networks, or form the operating environment has looked and even non-health services right alliances. unfavorable to collaboration, we to deal with growing volumes Transition can also be a challenge find examples of success. With of patients, while providers are if not planned for in advance. planning and effort, success is swamped trying to deal with Organizations must understand possible. increased volumes with less the need to fully commit to Most of all, do not be constrained money. an environment of shared by your organizational borders, and Everyone needs a better solution. sovereignty, to put their stake do not be distracted by the tyranny That is why these factors are in the PNAs objectives. Without of the present. driving convergence between this buy-in, PNAs can devolve acute care hospitals and primary into focusing on issues within the and community providers — so network instead of on achieving Malcolm Lowe-Lauri that each can better manage strategic objectives. [email protected] © 2015 KPMG International Cooperative (“KPMG International”). KPMG International provides no client services and is a Swiss entity with which the independent member firms of the KPMG network are affiliated. 6 Partnerships, networks and alliances Six factors for successful partnerships, networks and alliances Partnerships, networks and alliances (PNAs) have been a feature of health service organizations in many countries for decades. Around the world they are increasing in number, size and scope and this activity is being accelerated by regulatory changes in marketplaces, such as the Affordable Care Act in the US, care quality scandals like Mid Staffordshire in the UK and the growing international ambitions of some providers. © 2015 KPMG International Cooperative (“KPMG International”). KPMG International provides no client services and is a Swiss entity with which the independent member firms of the KPMG network are affiliated. Partnerships, networks and alliances 7 The rise of networks, both clinical and 1. PNAs are successful when they are organizational, has been a trend driven the product of long-term strategy — by evidence that better quality health demanding vision. services could be secured through 2. PNAs are driven by the need to co-operation and collaboration between innovate, coordinate service delivery providers. or open up new markets. Across the 45 countries in which the 3. Focusing on quality is better than KPMG Global Health Practices operate, Across the 45 countries focusing on size or money. we have rarely found examples of the in which the KPMG successful, stand-alone health system. 4. The best PNAs expand upon When renowned international examples opportunities beyond their original Global Health Practices are examined closely it is clear they are mission. operate, we have rarely embedded in wider systems or have 5. Avoiding failure requires strong created systems of their own. found examples of the payer-provider alliances. Simply put, the successful health successful, stand-alone 6. Tension, flexibility and self-criticism organization is connected. Excellence are more important than the model. health system.