Gary Stuck talks with Chief Healthcare Executive about the merger of Atrium Health and Advocate Aurora Health, value-based care and working to improve health equity.
It’s been nearly a year since the formation of Advocate Health, which is now one of America’s largest nonprofit health systems.
Atrium Health and Advocate Aurora created the new organization through the merger of the two systems in December 2022. Advocate Health operates 67 hospitals and more than 1,000 sites of care. The system employs 150,000 people and has revenues of more than $28 billion.
The merger garnered wide attention because it involved two large systems in different regions of the country. Atrium Health serves North Carolina, South Carolina, Georgia and Alabama, while Advocate Aurora operates in Illinois and Wisconsin. Some analysts have said it could spur other similar deals involving systems in different regions.
Gary Stuck, chief medical officer of Advocate Health, says the consolidation of the two systems has its complexities. Nonetheless, Stuck tells Chief Heatlhcare Executive® that the merger offers great opportunities and he is clearly enthusiastic.
“None of that work is easy,” Stuck says. “But I would say culturally, it's been phenomenal. We're so excited about the future at Advocate Health.”
“These are huge opportunities for us to advance care around improving quality, population health, and even research and health equity. And some of this is landmark leading research in the entire country,” he adds.
Stuck is also excited about emerging academic opportunities, as Advocate Health is teaming with Wake Forest University to build the first four-year medical school in Charlotte, N.C.
In an interview with Chief Healthcare Executive®, Stuck talks about what the systems are learning from each other. He also talks about committing to value-based care and closing disparities in underserved communities.
(See part of our conversation with Advocate Health's Gary Stuck in this video. The story continues below.)
Learning from each other
The formation of Advocate Health offers the chance to offer more services to patients, Stuck says.
“When you have scale, not just for the sake of scale, but for gathering a huge database, having the resources to be successful in care model transformation, and applying a lot of that learning across a large population of 6 million patients, it's a winner,” Stuck says. “We're really excited about it.”
Advocate Health’s two CEOs, Eugene Woods, who was CEO of Atrium Health, and Jim Skogsbergh, the CEO of Advocate Aurora, have led the cultural transformation, Stuck says.
“They have made this more facile, and then we have a tremendous board that understands how hard this work is, and leans in,” he says.
The two systems are gaining new insights now that they have come together.
“We are learning so much from each other, and that scale that we have offers that opportunity to share learnings in the population health world and in value-based care,” Stuck says. “Legacy leaders in value-based care are coming together.”
With the prospect of additional academic and research capabilities, Stuck says, “The future is so very, very bright for our patients. We're very excited about it.”
‘All in’ on value-based care
Advocate Health is deeply committed to value-based care, Stuck says.
He says both Atrium and Advocate Aurora have long been focused on that approach, which prioritizes keeping patients healthy over the fee-for-service model which depends on treating people when they’re sick. Stuck says Advocate Health is seeing the benefits of its work.
Advocate Health’s accountable care organizations generated $128 million in savings through the Medicare Shared Savings Program in 2022, which the system said led the country among integrated delivery networks.
“We're just thrilled that we can honor our patients and actually our taxpayers with those kinds of results,” Stuck says.
Under the program, accountable care organizations can share in the savings they generate for Medicare. The six accountable care organizations received $69.9 million back from the Medicare program, and the system says that money was re-invested in patient care.
Stuck says two of the system’s core priorities are improving healthcare quality and affordability.
“We know that our healthcare system’s too expensive, and that we're on a collision course in the future, and that we have to be some of the change agents,” Stuck says. “So we're committed to our patients to lowering the cost of care, and Medicare Shared Savings is a perfect example where we've shown that commitment. And we've been successful there. And we're going to keep going full steam ahead.”
The shift to value-based care requires a full commitment, Stuck says.
“We say value based care can't be a side hustle,” he explains. “You have to be all in. And when we do earn savings, we reinvest in our people, in our technologies, our infrastructure. These programs take relentless focus, and year-over-year commitment to be successful.”
He also says succeeding in value-based care requires a commitment from leadership and team members throughout the organization.
“This takes teams of folks,” Stuck says. “It's our physicians, it's our nurses, it's our nurse practitioners, our pharmacists, and other care managers. And it takes the vision of what success looks like. And a lot of this is data-driven. So you create transparency, you create priorities, and then everyone's leaning into that. And then as you have success, folks get on the train, so to speak.”
Advocate Health views improving health equity as one of its core pledges, Stuck says. When Atrium and Advocate Aurora announced their intentions to merge last year, they said they would provide $5 billion to improve access and health in vulnerable communities.
“We know that there are many health equity gaps,” Stuck says, “And we know that when we transform care and get out of the old system, and when we lean into value-based care, we're able to close those care gaps that we find in our health equity work.”
The organization has been focused on widespread screening of patients on the social drivers of health. He says that’s been a “big emphasis.”
“We have measures we hold ourselves accountable to make sure that we are reaching out to our patients, asking them what the care gaps are, what do they need, and that might be transportation, that might be access to medication, access to a physician or specialists,” he says.
Advocate has focused on maternal health and hypertension in the midwest, along with improved screening for colon cancer in the southeast, among other goals.
He says it’s important to set priorities and have “data-driven measures” that can be tracked.
It’s also important to share that progress, inside the organization and to the community, he says.
“We're able to drive improvements internally, and show real success there, and still show some of the gaps,” Stuck says. “But having that data that we can transparently share with our caregivers is very important, and then externally to our patients that they can see that we're trying.
“We don't have it knocked out yet,” he acknowledges. “But they can sense that we are on the right path.”