The historic transaction that created Ballad Health is the first Certificate of Public Advantage (COPA) approved in Tennessee or Virginia, as well as the largest COPA transaction and the first multi-state COPA in U.S. history. The transaction took three years to complete—starting in April 2015 and closing in February 2018. While ultimately successful, the process wasn’t always easy.
“The fiduciary role of the Board of Mountain States was to, first, ensure the viability of our hospitals,” said Levine. “So there were times leading up to getting the states’ approval of the COPA where we (Mountain States Health Alliance) were constantly measuring whether the merger would have sustained our hospitals better than if we had walked away and most likely sold our system.”
As part of the COPA, Ballad Health has committed to spending more than $300 million in the region of eastern Tennessee and southwestern Virginia over the next 10 years. Some of those investments include improving literacy rates, investing in research at East Tennessee State University and repurposing some hospitals and services to provide new services not currently offered, such as residential addiction recovery.
“The idea behind Ballad Health is that we are no longer a health system, but we are a health improvement organization,” said Levine. “Our goal is to reduce unnecessary utilization, which is not the typical revenue model for investor owned companies. If my admissions decline and I’m succeeding with the investments that I’m making, my board actually views that as a positive. We just have a different business model going forward where our metrics for success are no longer simply based on admissions growth or volume, but on overall investment in the measurable improvement of certain health and well-being indicators of our community.
In looking ahead, Levine wants Ballad Health, and the broader health care industry, to focus more attention on addressing patients’ needs before they enter the hospital as a way to help reduce the enormous cost burden.
“Hospitals do amazing work taking care of people once they are sick, but how do we harness the money we spend upstream before people are sick so we can fundamentally change the cost of health care,” said Levine.
When asked what he would tell those in the audience of emerging leaders in the health care, Levine had some simple advice.
“What people say about who you are as a human being is more important than any one thing you do throughout your career,” said Levine. “Make sure you have integrity in all that you do.”
This executive briefing was part of ongoing programming for the Council’s Leadership Health Care (LHC) initiative, offering members insight from national industry leaders in an interactive setting. For more information about LHC, visit www.leadershiphealthcare.com.