Risant Health’s 4 Criteria as It Looks to Grow Beyond Geisinger, Cone Health
Jaewon Ryu, M.D., J.D., the CEO of Risant Health, spoke at last week’s Population Health Colloquium in Philadelphia about the four key criteria that the organization is considering as it looks to add more health systems beyond Pennsylvania-based Geisinger and North Carolina-based Cone Health.
Risant is the nonprofit organization created by Kaiser Foundation Hospitals to expand and accelerate the adoption of value-based care in diverse, multi-payer, multi-provider, community-based health system environments. Last year Ryu transitioned from the role of CEO at Geisinger to being CEO of Risant.
In a discussion with David B. Nash, M.D., M.B.A., founding dean emeritus of the Jefferson College of Population Health, Ryu discussed why Geisinger was interested in joining with Kaiser initially and why work on population health models will be even more important going forward.
Ryu explained that Geisinger had a longtime focus on value-based care and population health, but it was in a multi-payer environment, where it partners with other health plans, and on the health plan side, it still partners with other health systems and other physician groups. So it is not entirely in a pre-paid, capitated, managed care space. The other half of what it does is still in fee for service. “People in this very Colloquium have talked about the two canoes before,” he said. “Geisinger is the epitome of two canoes, if not more than two canoes. But even within that, we always saw tremendous value in this model of transforming the delivery system center of gravity, so that it's not as downstream, and instead focused on upstream sites of care, getting ahead of disease.”
He said that a few years ago, as Geisinger leaders were reviewing strategic plans, they concluded that although they had done a lot of that work at Geisinger on building the infrastructure for value-based care, they thought it would be great to find a path where they could accelerate that journey, especially if they could connect with an entity that really understands how this is done and brings more expertise. “At the same time, Kaiser Permanente was launching this entity called Risant, which sounded like exactly what we were looking for,” Ryu said. “And from there things seemed to match up really nicely. I think what we're setting out to do is moving further upstream, transforming how care is delivered, bringing down some of those capabilities and expertise from Kaiser, bringing across some of that capability from places like Geisinger and now Cone Health, investing in the tech and processes to systematize a better way to take care of people and doing so in these pluralistic environments.”
Given the current payment and policy situation, Ryu stressed that population health has got to be strategically your North Star if you think about all the things needed to properly take care of populations that are either older in Medicare or poorer in Medicaid. He mentioned that in the last year before any Risant synergies kicked in, Geisinger was turning a positive profit margin, so it could have stayed the course by itself. “But we would not have gotten to that North Star as quickly as we knew we needed to. I think that's the crux of the decision-making algorithm, if you will.”
Ryu also briefly described what interested Cone Health, which is headquartered in Greensboro, N.C. It also has been on a journey toward population health — probably a little bit earlier in the journey than Geisinger, he said, because the size of their health plan has not been as large, but Cone practices population health through partnering with other health plans in a downside risk model as well as a pretty sizable ACO, where they partner with other local community providers, whether it's hospitals or physician groups. It has the same kind of DNA of caring for vulnerable populations and understanding the critical importance of population health, and the desire to look for ways to accelerate those capabilities and transform how care is delivered, he added.
Nash asked Ryu how quickly Risant expects to grow and to describe the criteria they are using to choose partners.
"Our goal is to find five to seven of these systems over the next five to six years,” Ryu responded, “so think of it as roughly one a year."
He laid out four key criteria:
• Mission alignment. He said this probably means they need to be a nonprofit.
• Tied to community. “We also think they have to be deeply tied to the community,” he said. “They have to have a reputation for being the go-to place for their communities around quality, experience, and affordability.”
• Value-based care focus. “They have to be walking the talk on value-based care. I think this is really important. They either have to have their own health plan or a sizable ACO, a lot of downstream risk environments or contracts with other payers,” Ryu said.
• Strong financials. They need to have a solid set of stand-alone financials, Ryu said, in order to be fiscally sustainable. “Obviously the entire industry has come out of a five-year period that's been topsy turvy and disruptive and challenging, but even within that, we know that some have been faster to recover than others, and there's a line of sight to get there,” he added.
Ryu said that if look at the approximately 700 health systems across the country, he estimates that about 5% to 10% would meet those criteria. That means there's probably about 35 to 70 potential health system partners. “Then the question is, who are we a good fit for?”
