President's Blog
Our Latest Blog
Exciting things are happening at Ocean Medical Center in the world of social media. Our president, Dean Lin, has started a blog that is now open to all team members, physicians, and friends of the medical center!
Read the latest postings below or view the entire blog at http://suitsandscrubs.blogspot.com/.
Suits and Scrubs
A blog written by a hospital president, foodie and snowboarder.
Tuesday, February 21, 2012
Like a Broken Record
When the Clintons proposed the healthcare reform package in 1993 I was working in Washington D.C. as a fellow with the Alliance for Health Reform, a nonpartisan group that was chaired at the time by Senators Jay Rockefeller and John Danforth. I earned just $25 per week and yet it was an exciting time to be exposed to major health policy creation and the overall debate.
The Alliance educated journalists, legislative and opinion leaders on various issues in health reform. One of the briefings that was published during my time at the Alliance was focused on the shortage of primary care physicians. Sound familiar?
The Alliance educated journalists, legislative and opinion leaders on various issues in health reform. One of the briefings that was published during my time at the Alliance was focused on the shortage of primary care physicians. Sound familiar?
Like a broken record, the primary care workforce shortage has been repeatedly analyzed and reported over the years. There are a number of drivers including: declining interest in primary care as a professional goal for medical students; increasing number of physicians projected to retire in the next ten years (up to a third); and increasing clinical demands based on evidence-based medicine for preventive, acute and chronic care.
The primary care gap is becoming more problematic with the aging population and with the anticipation of 32 million of Americans being covered under the Patient Protection and Affordable Care Act. The Washington Post recently published a story that in order for the Obama health reform program to work another 30,000 primary care physicians will be needed by 2015.
Who will provide primary care in the future? How will health systems respond? These are critical questions that need to be answered. As discussed during the team member forums, we are taking appropriate steps though this problem is big enough to encompass other innovative approaches.
The primary care gap is becoming more problematic with the aging population and with the anticipation of 32 million of Americans being covered under the Patient Protection and Affordable Care Act. The Washington Post recently published a story that in order for the Obama health reform program to work another 30,000 primary care physicians will be needed by 2015.
Who will provide primary care in the future? How will health systems respond? These are critical questions that need to be answered. As discussed during the team member forums, we are taking appropriate steps though this problem is big enough to encompass other innovative approaches.
Tuesday, February 14, 2012
Valentine Predictions
Yogi Berra once supposedly said that "prediction is very hard, especially about the future." As it turns out, this malapropism seems pertinent to our healthcare world today. Here is an excerpt from an article by Steven T. Valentine predicting key 2012 healthcare trends.He writes:
1. The Economy
The current economy is slowly improving, yet still fragile with significant exposure to unemployment and the European economy. This will continue to have an effect on the healthcare industry. The failure to address fundamental federal and state government spending issues and restructuring of debt both domestically and globally will impact tax rates and fees, restrict access to capital, decrease portfolio value, and prolong high unemployment. Expect further pressure on balance sheets, operating margins, and reimbursement reduction from government payer sources....
2. HospitalPhysician Alignment
Physician employment will remain the number one method of hospitalphysician alignment. It continues steadily without respect or prejudice to specialty or physician type. There are still independent physician holdouts, and most hospitals must balance a pluralistic approach to meeting the needs of independent as well as employed physicians. The need to achieve clinical integration among both employed and independent physicians must be addressed if hospitals expect to respond successfully to healthcare reform....
3. Healthcare Reform
As expected, key elements of reform are locking into place on schedule. Most notably are forays into bundled payment, narrow network health plan products, ACOs, and value-based purchasing activities. Regulations and formulas that impact provider reimbursement are complicating payment processes and levels, and will become more invasive over the next three years. Health insurance exchanges at the state level loom around the 2014 corner, and many are already in active development. You must monitor this trend closely (it is all about the benefits and network composition)....
4. Revenues and Expenses
Expect in 2012 that per unit revenues will increase at a rate below your cost trends. Medicare payments will increase less than 2 percent, and most states are likely to hold Medicaid reimbursement flat (and in some cases decrease). Commercial payers will likely hold rate increases in the range of 46 percent. We do not expect Congress in an election year to take long-term action on the sustainable growth rate (SGR), although there is a lot of talk and awareness regarding the need to do so. The good news is that if you are aggressively working on quality improvement initiatives, this will help reduce the rate of cost increases. Some payer initiatives do provide for increases in revenues tied to improved quality performance. Value-based purchasing, bundled payment, readmission rate reductions, ACOs, and other risk arrangements have the potential to be financially rewarding to lower-cost, high-quality providers. Reducing costs must be a top operational priority for 2012. At the same time, the rate of patient throughput and occupancy levels must increase in both inpatient and outpatient settings to create economies of scale and to maximize use of resources....
5. Capital Access
This single factor is driving many organizations to reassess their financial health, given their current margins, critical mass, and market position. Capital access is a key catalyst for mergers, sales, affiliations, and other alliances for many hospitals. Capital access will be more difficult in 2012 than in the recent past because of the economy, weak volumes, deteriorating payer mix, and bad debt....
6. Information Technology
While the past was all about the money, the future is all about the data. Useful, actionable data that informs clinical and financial decisions in real time is now becoming a key driver to increasing revenues and reducing expenses. Good, useful data (clinical and costs) is the gold standard; insurers have the cost side, and they have capitalized on its value in contract rate negotiations. Hospitals and physicians must now compile more robust data that includes both cost and quality. In 2012, Medicare will provide more open access to its databases regarding hospital and physician-specific information. IT systems and strategies must be robust enough to capture enormous amounts of data and quickly translate and integrate it into useful decision-making (clinical and financial) and marketing information....
7. Consolidations, Closures, Alliances, and Mergers
.... Our prediction is that healthcare reform will continue as presently configured, and one out of 20 acute care hospitals could close by the year 2020 ... In many states, expect to see further consolidation and alignment among hospitals and medical groups of all sizes as they join together to improve access to capital, form ACOs with critical mass and broad geographic coverage, achieve cost reductions through economies of scale, and improve bargaining power with payers (which are already largely consolidated). By 2020 most states are likely to have a handful of large systems, with very few true independent hospitals without some type of alignment with other organizations....
8. Clinical Integration and Care-Delivery Redesign
Processes associated with both of these concepts are at the core of the golden triangle of cost-containment, quality improvement, and financial performance. The success of healthcare reform hinges on doing these things well. Success factors for clinical integration and care-delivery redesign in 2012 include focus at all points of the care continuum: primary care (medical home), acute care (throughput and protocol adherence), and post-acute care coordination (case management). This will require more effective coordination of case management, hospitalists, intensivists, and IT decision support and communication functions. They must all be integrated to create seamless delivery and transitions of care. Post-acute care modalities also must be integrated to a greater degree into care delivery processes in order to achieve more cost-effective quality outcomes.
9. Workforce Issues
Operating costs will need to be reduced by up to 1020 percent in most organizations over the next three to five years.... hospitals must create a culture of accountability and ownership at all levels of the organization in order to achieve high-productivity levels and employee satisfaction scores.
10. Smart Growth
Inpatient and select elective outpatient use rates will continue to decline in 2012 due to continued high unemployment, more cost-shifting to employees for benefits and services, and increased price shopping and postponing non-critical medical care. In spite of all the pressures against growth, leadership must discover ways to selectively grow market share that will improve profitability.
Saturday, February 11, 2012
Linsanity
Many people, including myself, love sports for the unexpected victories. The Giant's championship season is an example and so is the surprising rise of New York Knick's Jeremy Lin. Lin was a little known point guard who is now a basketball star generating quite the buzz in New York, the nation and the world. Since he entered the Knicks lineup a week ago he has helped the team win five straight while averaging 26.8 points, eight assists and a shooting percentage of 58 percent.What I like about Lin's story is that he has been consistently underestimated throughout his basketball career before earning "Linderella/ Lincredible/ Super Lintendo/ Linsanity" headlines and winning praise from this NBA great. He received no athletic scholarships out of high school so he landed at Harvard where he had a stellar track record. Still he was undrafted out of college, played for four D-league teams, waived by two NBA teams and was on the verge of being cut by the Knicks until he got his big break on Feb 4th. Lin has proven himself to be a smart, talented player that is here to stay so it's rare and remarkable that he was not discovered until this past week.
As I program my DVR for future "Linsanity" games, it has occurred to me that Ocean Medical Center is undergoing a similar journey. While Ocean has the culture, capabilities and objective recognition of a premier medical center, marketing studies show that our brand recognition can be better. The good news is that we lead the pack when it comes to customer retention which means we offer excellent service. So with this in mind, the key question is how do we improve Ocean's "attraction?" One basic approach involves personal outreach and it came up this past week when David Flood, Michael Oakes, Dr. Brad Pulver and I broke new ground engaging a group of potential donors. These individuals have owned homes for decades along the Jersey Shore and surprisingly many knew little about Ocean Medical Center. Whether it was location, exceptional clinicians, quality outcomes, certifications, etc., folks just did not have the full appreciation. Before our face-to-face meetings, Ocean was unknown at the "end-of-the-bench." After our meetings, Ocean became a hidden gem and everyone was anxious to sign up for a tour of our medical center. We have a great story to tell and I am excited to see Ocean emerge in the marketplace like Jeremy Lin did with basketball.
