Colorado Healthcare Executives Discuss Financial Implications of the Push from Inpatient to Outpatient Care

I recently attended the 2014 Annual Hospital Executive Forum, sponsored and organized by Colorado Healthcare Strategy and Management (CHSM), the state’s only non-profit organization providing educational sessions on all things healthcare. This year’s forum topic was “Financial Implications of the Push from Inpatient to Outpatient Care”, and the panel of healthcare heavyweights spoke to a sold-out crowd of over 300 attendees.
 
The moderator was Jennifer Aldefer, CEO of HCA-HealthONE’s North Suburban Medical Center, and the panel was comprised of Patrick Green, COO of St. Anthony Hospital, Jim Shmerling, CEO of Children’s Hospital Colorado (CHC), and Sylvia Young, CEO of HCA-HealthONE and HCA Continental Division (8 Denver hospitals and 2 Kansas City hospitals).

The panelists represented three of Colorado’s health care competitors:

• St. Anthony Hospital is the new flagship of Centura Health (not-for-profit), Colorado’s largest health care system;
• Children’s Hospital Colorado is part of the state-wide University of Colorado academic medical care system and is one of two children’s hospitals in Denver (the other children’s hospital is operated by HCA); and
• HCA-HealthONE (for profit) is Denver metro’s largest health system.

The panelists were engaging and candid, and I have paraphrased some of their more interesting comments:

• There are more DaVinci robots in Witchita (6) than in all of Canada. DaVinci has a great sales team and has sold the physicians and patients on innovation. The "innovation arms race will continue".
• In 1987, HCA was the sponsor of Centennial Healthcare Plaza, the nation’s first free-standing emergency department, which is still open and thriving. (The principals of NexCore were involved in the planning and development of this project).
• Children’s Hospital Colorado is very active in telemedicine and has 26 locations in several states.
• The mantra of Centura Health is to take care of patients by developing outpatient facilities where they live, work, and play. Our focus is on prevention, and we want to move upstream of when patients get sick.
• Private exchanges may have more impact than Federal or State exchanges on health care providers.
• More patients signed up for Medicaid than exchanges in Colorado.
• We anticipate an explosion of mid-level providers to make up for the shortage of physicians.
• What we hear from a payer is that they want lower cost, fewer claims.  The patients are asking for a higher value, and our solution is to move patients to a lower cost setting. We want the payer to give Children’s Hospital Colorado risk-based contracts—we want to manage children’s health.
• There has never been a better time to be a patient. The quality is better, there’s more transparency, and more convenience is being offered.
• The medical model and reimbursement must change together, and in the meantime, expect hospitals and physicians to continue to follow the fee-for-service incentives to do more.

One of the overarching takeaways from the conference is that healthcare systems are proactively changing in advance of healthcare reform by shifting as much as possible to outpatient care settings, investing in information technology, and re-engineering their inpatient facilities. However, the business is still fee-for-service, filling beds, and doing procedures. All the executives said that if there is an incentive (payment) for doing the right thing, they will do it. In the meantime more will look the same rather than different. Blog posts RSS