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Transitioning From Volume to Value: Lessons Learned From the Dissolution of a Population Health Partnership

Halvorson, Stephanie A.C. MD; Tanski, Mary MD, MBA; Milligan, Lee MD; Yackel, Thomas MD, MDP, MS, MBA

doi: 10.1097/ACM.0000000000002614

In 2017, the authors published an article describing the experiences of Oregon Health & Science University (OHSU) as it adapted to new challenges of changing payment models, the imperative to manage the health of populations, and the desire to compete for statewide contracts. The authors described Propel Health, a multi-institution partnership created in 2013 to deliver the tools, methods, and support necessary for population health management. In the ensuing two years there were considerable changes to the structure and mission of Propel Health, ultimately resulting in its dissolution in January 2018. Using the organizational framework from the original publication, this article shares a number of lessons learned with other academic medical centers as they make the journey toward value-based care and population health management. Examples of lessons learned include ensuring that clinical and administrative leadership are aligned and that shared partnership goals are not eclipsed by local strategic needs. The potential for shared data remains a powerful motivation to partner; however, technology integration can be costly and complex. Once data are available, the ability to respond quickly is a key competency. Understanding individual sites’ needs and capabilities is critical before embarking on shared clinical programs. Best practices from industry-specific experts should be employed. Lastly, it is essential for partners to determine how shared gains/losses will be attributed, and how aggressively risk should be required. Next steps for OHSU, including new, local partnerships, are shared.

S.A.C. Halvorson is associate professor of medicine and chief, Division of Hospital Medicine, Department of Medicine, Oregon Health & Science University, Portland, Oregon.

M. Tanski is associate professor of medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon.

L. Milligan is chief medical information officer, Information Technology Services, Asante Health System, Medford, Oregon.

T. Yackel is professor of medicine, Virginia Commonwealth University, Richmond, Virginia.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Stephanie A.C. Halvorson, Department of Medicine, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Rd., BTE 119, Portland, OR 97239; telephone: (503) 494-1164; email:

Copyright © 2019 by the Association of American Medical Colleges