Life Stories of our Community Care Center Residents.

Yesterday I had the pleasure of attending and listening to the presentations of Professor Nancy Pine’s freshman class of Mt. Union students. Dr. Pine is an Assistant Professor of English and her students were sharing their essays based on the conversations that each student shared with a resident partner from our Community Care Center. In attendance were all the students, many of their partner residents, family and friends, and Colleagues from the hospital staff. As promised there were recollections of happy and joyous moments, hardships, some shedding of tears, much laughter and many of life’s lessons to be shared. You could tell that what started out as part of a course curriculum evolved into much more. For most there seemed to be a true bonding not only of different generations but of friendship.

Thank you to all for this moment of sharing. I hope that Dr. Pine and her students appreciated the experience as much as I did and will consider coming back next year.

Talk to you soon.
Stan

Follow up to April 17th blog….

Well I lucked out because the hospital in Toledo was willing to take a cash payment for the allotted amount stated by our insurance company of $109; remember their list price was $249. If only I could have convinced my daughter to have her x-ray done here before she went back to school; our list price for the same exam is $91 before any adjustment.

If John McCain is going to be successful with his healthcare strategy of less regulation I sure wish he would figure out how to level the playing field for consumers; so that hospitals, doctors and insurance companies had to disclose in advance what services will actually cost out of the consumer’s pocket. I realize for many services it might be a range but for many services it can be an exact price.

Talk with you soon
Stan

Wanted to share some patient compliments I received yesterday…

Wanted to share some patient compliments I received yesterday…

Robert called in to talk about Therapy Services. He said that Erin, the person who took care of him was great and that he was more than satisfied with his care. If he ever needed such services again, he said this would be the first place he would come.

Kathleen wrote regarding our E.R. She said of her first visit to the ACH ER, “Each one (of the staff members) was friendly, caring and most professional. My husband and I were very impressed. A note has been sent to the E. R. also.”

What a great way to end the day.

Stan

A Must Read

April 24th, 2008

“The Third Path…Systematic Change Will Focus on Returning Value” is an article written by Greg Poulsen, SVP at Intermountain Healthcare that appears in Modern Healthcare’s, April 21st issue on page 26.

It is a must read; one of the most insightful, clear, forward-thinking approaches to health care…I hope all of the presidential candidates and their teams start listening, - and that whoever is elected stops listening to the special interest lobbyists.

In his article, for those of you who might not have access to it, he clearly points out that neither a consumer-driven approach nor the concept of universal insurance coverage addresses the core health care challenges we face: that of providing quality and value.

The core flaws, as he points out, are:

1. A fundamental flaw is not one of access or insurance – but rather, one of cost issues, structure and the need to align incentives.

2. Patients who lack complete medical histories must navigate a sea of provider settings. Poor communication increases the chances for errors. There is also a lack of real peer accountability.

3. The current system has powerful incentives to increase utilization; physician fees are affected by treatment decisions. Physicians can substantially increase their incomes by performing procedures versus providing consultations. Patients often request more expensive testing and medications. Finally, physicians with ownership in delivery systems such as ambulatory centers or imaging have their utilization incentives greatly magnified. Most physicians do what is right because they take their professionalism seriously; otherwise we would find our problems to be much greater.

Suggestions:

1. That the payment system move away from the fee-for-service structure to a more bundled approach.

2. Patients need to be motivated to opt for a high value approach.

3. The regulatory environment should change to better facilitate cooperation and coordination among the providers, doctors, hospitals and others.

4. Health information technology and EMRs need to be expanded.

Talk to you soon.

Stan

Become a Knowledgeable Buyer of Medical Services = www.bakboms.com . . . Our New Website!

Last week the health system of which I am pleased and proud to serve as CEO started an ad campaign to help provide consumers with access to pricing information. Our motivation was simple: a win –win situation.

For many of the services we provide, our prices charged to both our insurance companies and consumers have been kept lower than those of many of our competitors for the past several years.

As a Community hospital struggling to make more than a 2% operating margin, we hope to drive more business here, particularly in the areas in which we offer some of the best equipment and prices around -- yet people don’t know how, nor do they have the information they need to shop. Once they experience the value ACH offers and they meet the colleagues who practice and provide the services here, I am confident we will create even more loyal customers.

How ironic: Today I look at an Explanation of Benefits (service) on an x-ray for one of my immediate family members. Of course, this service was performed out of town in one of the most expensive areas of health care in the state, Toledo. The list price here in Alliance is $91.00 for that service, while, at the hospital in Toledo, it’s $249.00. Naturally, my family member’s deductible is not any where near being met, so what will we end up paying?

Well according to my EOB, if the service had been provided here, my plan would have covered 100% of the charge at an in-network facility -- it would have paid the full $91.00. But, with regard to the out-of-network facility, I will find out later. My plan did inform me that the usual and customary charge would be $109 – which means that $140 of the list price in Toledo would not even have been paid. I sure wish I’d have known, in advance, which outpatient center to send this family member to --since we will end up paying cash.

Please email me or comment on my blog if you have questions on how to become a knowledgeable buyer of medical services -- and let us learn together.

Everyone that’s taken care of me….the whole bunch…they worked him so hard, it was what he really needed…three stories. It’s what keeps me coming back

“Everyone that’s taken care of me, the whole bunch…you have very special people working here…because of all of them, they have given me a great deal of comfort and peace of mind…I am just not used to seeing that in other places I have been. This is just a very special of caring where everyone really cares.”

As CEO of this hospital, hearing comments from patients and their family members, such as the above words recently used to describe the team of health care professionals and colleagues comprising the ACH family, makes me feel proud to be part of the team.

Every so often things don’t go perfectly, but that too is what makes this place so special. Many of the colleagues I work with, including the physicians who practice here and the volunteers who give us their valuable time, are constantly talking, discussing, and listening to help us deal with all the imperfections and frustrations that our patients and guests deal must endure…for as good as we are, things happen.

Mr. James G. called this week, saying, “The ER team was great…I went to therapy for two weeks, every other day…the passion of the whole bunch taking care of me was obvious.The whole bunch was at it again in therapy.”

I thanked Mr. G. for taking the time to call me and let me know how he felt about the Colleagues caring for him.

I applaud our medical leadership because they are pushing administration and the board to be more public and proactive about Quality issues; encouraging what we do well and highlighting what we need to improve upon. They are working hard at looking at the way medical staff itself conducts it business and have embraced evidence-based medicine, which is not an easy thing to do.

Mrs. R. called to talk about her son’s therapy, saying, “We were so very happy with the services our son received. He had a terrible accident and was treated at Akron Children’s Hospital, but we wanted to be closer to home so we chose Alliance Community. Gail, Erin, Walt, Tiffany. All who called for our son worked him so hard and got him doing things we could not get him to do...he is now able to go back to school. We just felt so very welcome when we came…believe it or not but our son actually looks forward to going back and seeing his friends at therapy. A truly great experience. Thank you for giving us our son back...”

It takes a very special person to admit you could have done better, to apologize sincerely, to show that you care, to be open and honest, to want to improve, to accept constructive criticism, to hold others accountable for trying to be the best, to want to be better…to truly put the patient at the center of what we do. Because of all of you do, thank you for inspiring me to do the same.

Talk to you soon.
Stan

Healthcare is the Economy:

I read, with great interest, Todd Sloane’s editorial entitled “The New Insurance Backlash” in the February 25th issue of Modern Healthcare. To me, one of the most telling lines was, “On January 23, the day Wellpoint reported a 8% gain in 2007 profits (to $3.35 billion), its share price fell by $2.90 because it also reported that it spent almost two cents more of each premium dollar on –wait for it- patient care.”

I truly believe one could make a good argument that healthcare is the number one issue in this year’s election. It is the biggest challenge affecting the ability of both big and small businesses to compete.

Below, I offer my own assumptions or definitions that are necessary to frame my conclusion for a combined Hillary/Obama/Huckabee/McCain plan – one that would fit well with Bernake’s suggestions for stimulating economic growth. So how would this work?

It would work, I believe, in a free market, competitive system. One with a fair and level playing field and--let’s face it-- the consumers of healthcare don’t have the information they need on quality and especially on price (i.e. money they will spend out of their own pockets). We have been preaching transparency, but truly have done very little about it because of all (issues posed by) the special interests; primarily insurance companies. Hilary and Obama would like to limit the amount of premium dollars that go to insurance companies. Under that theory, hospitals and doctors certainly could perform better and if healthcare consumers knew what they had to pay for in advance of many of procedures/tests they would certainly shop around for the best price.

We have been working on quality data for years and if we truly want peer review to work, we must do something about malpractice. However, I am encouraged that some doctors and hospitals are sharing their complication rates and mortality statistics with other key information on their websites. We don’t need a single payer system but we could certainly use a single payment system that is much simpler and makes individuals more accountable for themselves; we do need more of a wellness system than our current sick care system.

There is a lot that could change and bring both parties together and provide the stimulus for doctors and hospitals to improve as well; let’s quit talking about transparency and do something about it.