St. Mary’s Joint Venture
St. Mary’s Joint Venture
Established in 1999, St. Mary’s PHO is a joint venture between 3 affiliated hospitals; St. Mary’s of Saginaw, St. Mary’s of Standish, and St. Joseph Health System in Tawas and East Michigan Physicians Organization (EMPO) which represents the physician clinical arm of the PHO. Within the PHO are employed and aligned independent physicians who participate in joint hospital and physician contracting; and align economic incentives for improvements in cost, quality, and efficiency by establishing common care delivery models and shared information infrastructure.
St. Mary’s PHO Joint Venture
The collective goal of this joint venture is to foster an empowering environment that enables a community of physicians to deliver high-quality, personalized care for the patients served through highly efficient co-management. This is accomplished by establishing common care management models and shared information infrastructure.
When you join St. Mary’s PHO, you become part our provider network. Our PHO is guided by our mission and values to provide exceptional health outcomes, an exceptional experience for the people we serve, and an exceptional experience for providers, at an affordable cost. We share a common vision and are called to act upon the following ideas and beliefs: service of the poor, reverence, integrity, wisdom, creativity, and dedication. The values are foundational to our work to transform health care and express our priorities when providing care and services, particularly to those most in need.
What is a PHO?
A PHO is an entity that, at a minimum, allows a hospital and its physicians to negotiate with commercial and governmental third-party payers.
In its simplest and more common version, the participating physicians and the hospital develop a model for business terms and reimbursement levels and use those terms to negotiate with payers, when possible.
The PHO analyzes contract terms and conditions offered by payers and transmits its analysis and the contract overview to each physician, who then decides on an individual basis whether to participate with the contract (messenger model), unless the PHO has single signature power. In a messenger model, PHO physician members are not mandated to participate in all PHO sponsored payer programs. In comparison, PHO’s may choose to limit physician participation in certain payer contracts due to payer narrow network performance criteria, financial risk based contracting models, physician lack of engagement with PHO sponsored initiatives focused on quality, cost of care, technology integration and/or education, etc. PHOs allow participating physicians to contract directly with a payer if the PHO does not have an active contract.
PHO’s actively manage the relationship between the physicians and payers.
PHO’s are generally considered the first step on the evolutionary ladder in vertical health delivery system integration with respect to practitioners and facilities.
The successful PHO model collectively focuses on growth through:
- PHO physician membership
- Payer enrollee attribution growth
- Use of affiliated PHO physicians and hospitals for patient care coordination. When a patient selects a physician, they also select a hospital affiliation when there is an organized PHO structure in place.
Mission Statement
The mission of St. Mary’s Physician Hospital Organization is to deliver excellence in patient-centered care for our patients that reflects our faith-based values, is high-quality and cost effective. We will deliver innovative care delivery solutions across the continuum of care. We are stewards of sound fiscal responsibility and develop capabilities to take and manage financial and performance risk for covered populations.