Duke Medicine, WakeMed to explore ‘collaborations’

Jun. 30, 2014 @ 06:12 PM

Duke Medicine and Wake Med Health & Hospitals have laid the groundwork for discussions about possible future collaborations, the systems announced Monday.
It’s too early to talk about specifics of what possible collaborations they’re exploring, said Dr. William J. Fulkerson, executive vice president for Duke University Health System. But he did say officials are more focused on working together in Wake County and adjacent areas, and that the discussions are not a precursor to a merger.
“I think there may be ways to complement each other in different delivery care models going forward,” Fulkerson said. “We both have assets in Wake County where we deliver care; we may be able to use those more efficiently in the future, (we) may be able to co-deliver care at less cost …”
So far, the systems have set up a framework to guide “exploratory discussions” about possible clinical collaborations, according to the announcements by the systems. With a joint effort, they would be looking to improve care quality and the health of Wake County residents, to meet community needs, and to more efficiently using technology and resources to reduce costs.
The systems have collaborated before. In 2012, they partnered to provide specialty and subspecialty pediatric in Wake County. Duke and its physician group, the Duke Private Diagnostic Clinic, along with WakeMed and WakeMed Physician Practices launched the Duke Children’s & WakeMed Children’s Specialty Clinic.
Based on that experience, Fulkerson said officials from the systems have had further discussions over the past few months about how they could work together to identify needs and work to meet them.
They haven’t brought specialists and administrative experts together yet to develop detailed plans, he said, and don’t a timeline yet.
Generally, Fulkerson said he believes that in the future and in any health care market, providers are going to need to look for innovative ways to provide care at the best value, which he defined as the highest quality care at an affordable price.
“I think you’re seeing organizations all around the country beginning to work closely with each other to try to achieve those things at the kind of scale that’s necessary to do it, and as I said, avoid duplicative efforts where they aren’t necessary it achieve a strong outcome,” he said.
Bob Seligson, CEO of the N.C. Medical Society, said he doesn’t have any details about the systems’ collaboration talks, but said that generally, coordination of resources would be a good thing.
“In health care, the better we work together toward creating a better system for our patients, the better off our state’s going to be,” he said.
Frank Sloan, a Duke University professor health policy and management and of economics, said generally that there’s a larger trend toward integration among health care providers that he said is driven by national policies. But he said economists are suspicious of integration, arguing there is no evidence that it offers efficiency gains.
“I know there are economies of scale, and whether (that) translates to lower prices is a question mark,” he said.
There’s also general pressure among providers to gain market share he said. And health care providers want to be in Wake County for access to its growing population of people, he said, including a “good-sized” insured population. 
Also in Wake County, UNC Health Care operates WakeMed competitor Rex Hospital. In 2011, UNC Health Care System’s board rejected an offer from WakeMed to buy Rex Hospital in Raleigh. WakeMed withdrew the bid 2012 after state lawmakers helped set up a deal between the systems. As part of that deal, UNC Health Care opened a new mental health facility in Wake County to address emergency demand.
In a statement on Monday UNC Health Care said it values “partnerships and collaborations in the Triangle and across the state to improve care for our citizens.”
“We continue to work closely with WakeMed as a primary teaching and training partner for the UNC School of Medicine and share responsibility with them for improvement of the overall health of residents of Wake County,” the statement said.