Medical Staff Annual Meeting Update- Clinical & Research News - For and about the Physicians and Researchers of Brigham and Women's HospitalMedical Staff Annual Meeting Update- Clinical & Research News - For and about the Physicians and Researchers of Brigham and Women's Hospital

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Our Future, Our Challenges Our Strategy


Gary Gottlieb presented on the Partners strategic planning efforts during BWH’s
Medical Staff Annual Meeting in December.

“We must lead the way in managing populations, not only as a response to today’s environment, but because it is core to our mission.” – Gary Gottlieb, MD, MBA

As Partners HealthCare shapes its strategic plan to respond to changes in the health care marketplace, staff can count on one thing to remain the same: our mission.

“We are dealing with constrictive resources in the environment around us that will force us to look at how we do what we do,” said Partners HealthCare President Gary Gottlieb, MD. “But we won’t abandon our mission with our strategic planning efforts. It is the foundation of what we do, and we will preserve it.”

Gottlieb presented on the Partners strategic planning efforts during BWH’s Medical Staff Annual Meeting in December, sharing an update on progress made to date and the direction Partners plans to take to adapt to a changing health care landscape and a difficult economy.

Partners embarked on strategic planning initiatives that focused on care redesign and patient affordability last year to address the evolution of the current marketplace at federal and state levels.

“The continued focus on cost will be with us for the long term, and we must respond,” Gottlieb said.

Gottlieb noted that although the specifics and magnitude of payment reform remain ill-defined, it is clear that the marketplace is changing and it is expected the future will be characterized by:

  • reduced utilization driven by payment incentives to reduce waste

  • redistribution of volume driven by capitated provider and patient price sensitivity

  • growth of alliances and networks with more restrictive referral practices


To address this focus, Partners has embarked on several initiatives, including serving as a Medicare Pioneer ACO (see related story) and renegotiating contracts with state commercial payors. In addition, Partners institutions reduced spending by $80 million across the system during the fourth quarter of FY’11. This is the first step toward the overall system reduction plan of $300 million.

Care Redesign

Promoting population-based care is one of the central elements of the strategic plan.

“We must lead the way in managing populations, not only as a response to today’s environment, but because it is core to our mission,” Gottlieb said. “Taking on longitudinal care of patients will fundamentally change how we work: we will need new capabilities in case management, particularly for our highest-risk patients.”

Primary care physicians and specialists must work together seamlessly, and Partners must evolve the incentive structure to reward more focus on prevention and outcomes, Gottlieb said. “We are evaluating our network strategy, our incentive structure and our capabilities to be successful in a model of shared savings.”

He added, “To do this well—and we must do it well to continue to fund our mission—we must have a relentless focus on efficient and effective utilization management. We need to reduce readmissions, shorten length of stay, seek the right site of care for patients and reduce our unit costs.”

In addition, Partners institutions must continue to be the best in the world in episodic care and deliver better outcomes and even better patient experiences. Strategic planning teams are working on condition-specific care redesign and patient experience, including acute myocardial infarction, coronary artery bypass graft, colon cancer, diabetes, stroke and primary care.

Gottlieb shared examples of recommendations from each team. The AMI team, for example, recommended implementing a discharge follow-up program to ensure MI patients receive an immediate follow-up phone call and are seen by a clinician within one week.

“This could reduce readmissions and provide better clinical function, improved survival and a better patient and family experience,” Gottlieb said.

The AMI team is currently researching best practices associated with post-discharge follow-up, defining criteria that would trigger a patient’s enrollment in the program and determining intervention components, staffing requirements and appropriate communication channels.

Patient Affordability

The overall objective of the Partners Patient Affordability effort is to provide appropriate, coordinated, high-quality care to patients at an efficient cost. Partners has set a goal to reduce projected cost growth over the next two to three years by $300 million, or 5 percent of controllable expenses.

“We know payment methodologies will change, and we are watching the market carefully,” Gottlieb said.

Read More:

Partners Selected to Participate in ACO Model