NWI hospitals prepare for changes in the health care industry - March 15, 2015

Courtesy of NWI Times
March 15, 2015 12:00 am  •  Giles Bruce giles.bruce@nwi.com, (219) 853-2584

If there’s one thing Northwest Indiana hospitals expect over the next five years, it’s change.

On a national level, inpatient stays are on the decline as systems are increasingly being incentivized for keeping people out of the hospital. But that also provides an opportunity for hospital systems, which have been busy expanding their outpatient offerings in recent years, in part by buying out independent physician practices.

Northwest Indiana hospitals say they’re well equipped to deal with an industry in transition, and that the changes will ultimately result in them providing better, less costly care in settings most convenient for patients.

Porter Health Care System, which operates hospitals in Valparaiso and Portage, wants to be a destination for people seeking quality care, no matter where they’re from.

“All of our efforts are to move more and more toward the higher level of care, to be a health care system that is sought out by a much wider range than just the local community,” Porter CEO Steve Lunn said. “We want to be that facility where people don’t have to go to Chicago for health care.”

To that end, Porter intends to bring in more specialists and other high-end services over the next five years. Its main facility, Porter Regional Hospital in rural Valparaiso, plans to become a Level III trauma center and neonatal intensive care unit. It is also opening a new, freestanding emergency room in downtown Valparaiso this summer.

The system also will start training medical students from Loyola University this year and hopes to begin hosting medical residents (post-graduates) in 2016 or 2017.

“Rather than recruiting someone from the outside who has no experience with Northwest Indiana, the hope is we can grow and train our own,” Lunn said. “And anytime you’re teaching someone else how to do something you end up doing it better yourself. Having a teaching program at your facility really raises the bar of the quality of care you can provide.”

Lunn said Porter is aggressively recruiting physicians so it has the capacity to treat the aging population of Northwest Indiana, and expanding its outpatient services to make seeking care more convenient and less costly for patients.

He added that Porter is well-prepared as the industry shifts more toward transparency and quality.

“As more and more data comes available through technology and the public reporting of data, the more we seem to challenge ourselves,” he said. “The availability of information that is being put out there has really leveled the playing field for non-teaching facilities or non-urban facilities. We see less and less of that out-migration, because we have the advantage of being more convenient and personable.”

Franciscan Alliance’s mission over the next five years is to become an accountable care organization, said regional CEO Gene Diamond, who oversees hospitals in Crown Point, Munster, Dyer, Hammond and Michigan City.

“The generic concept on an accountable care organization is to manage the health of a population over time in a manner that maintains and improves the overall quality of the lives of the people we care for,” he said.

The federal government is trying to phase out the old fee-for-service system, where providers are paid based on the volume of care they deliver, for a model geared toward quality and value. In ACOs, providers are paid upfront on a monthly basis, so the more efficient and better quality care they provide the more money they get to keep.

Franciscan was one of 32 systems that took part in the Medicare Pioneer program, an Affordable Care Act initiative to determine how ACOs work in practice. Franciscan left that program last year to become part of another Medicare ACO, where it is now responsible for 25,000 patients. The system is also currently providing accountable care through commercial insurers like Cigna and Anthem, as well as Medicaid.

“Under the current, dominant health care delivery system, the hospital administrator drives into the parking lot full of cars early in the morning and says to himself, ‘It’s going to be a great day,'” Diamond said. “Under the new model of health care delivery, the health care administrator drives into work early in the morning, the parking lot is empty and the administrator says, ‘It’s going to be a good day because nobody’s in the hospital, which means we’re not spending extra amounts of money to care for them.'”

“I’ve been a health care executive for 35 years,” he added. “The way we deliver health care today is substantially similar to the way health care was being delivered 35 years ago. That is not going to be the case five years from now and certainly 10 years from now.”

Methodist Hospitals, with campuses in Gary and Merrillville, looked toward its future recently with the appointment of a new CEO, Raymond Grady. Grady, who began in February, says his goals include enhancing services, increasing efficiency and lowering costs.

Looking toward 2020, Methodist Hospitals says it intends to focus on:

• enhancing trauma services and upgrading facilities,
• expanding its community health initiatives to address the needs identified in its community health needs assessments,
• improving patient outcomes through quality and safety initiatives and clinical integration and collaboration with physicians, and
• bringing new services and technology to all the markets it serves.

As for Grady, he comes to Methodist Hospitals with a record of leadership in the Chicagoland health care industry, having been president and CEO of NorthShore University HealthSystem and CEO of Evanston Hospital, its flagship hospital. He has also served as chief administrative officer of Aurora Healthcare, a 15-hospital integrated delivery system west of Chicago.

“I look forward to working closely with the board, the medical staff and the leadership team to lead the organization as it pursues its goals looking toward 2020 and beyond,” Grady said. “My first priority is a review of the long range for its relevance in today’s health-care reform environment.”

Community Healthcare System, which has hospitals in Munster, East Chicago and Hobart, says its major investments over the next five years will be directed at making the organization even more patient-centered, putting systems and technologies in place to help patients become more involved in their care.

“Patients will be connected to their providers in exciting new ways, from texting to remote monitoring and telemedicine, to the use of navigators who will help patients access the services they need,” said John Gorski, chief operating officer of Community Healthcare System.

He said significant changes will result from Community’s efforts to address the interoperability of the many health information systems in use today.

“While we have made improvements by getting clinical information into electronic medical record systems, we will not realize the full potential of these systems until they can communicate with one another,” Gorski said. “For Community Healthcare System, there is no higher imperative than to improve care coordination by ensuring that patients and physicians alike have access to all necessary medical information in one place.”

This year, Community will take the first steps toward interoperability with the installation of new technology that will enable the free flow of health information between its hospitals and its network of physicians.

“With planned enhancements to our health information systems over the next five years, our hospitals and physicians will be able to more easily share critical patient information to inform better decisions and identify gaps in care,” Gorski said. “This new interoperability will enable us to more easily analyze and aggregate health information so that we can improve the quality of care and lower costs.”

By knowing which patients are most at risk, Community says it will be able to work with them to prevent disease or avoid serious complications, most likely in outpatient settings. That will probably mean further expanding the services Community provides outside its hospitals, Gorski said.