Hospital executives face a myriad of challenges in today’s ever-changing healthcare landscape. Managed Healthcare Executive asked some chief executives what their biggest challenge has been, and how they have worked to overcome it. Here’s what they had to say.
1. Serving underserved communities
Alex Hellinger, DPT, MBA, executive director, Lenox Health Greenwich Village, part of Northwell Health, New York, says his biggest challenge has been bringing healthcare back to a community that had recently lost a major hospital and lacked sufficient medical resources.
“When a hospital closes, the vast majority of health providers leave the area, ultimately creating a medical desert,” he says. “My team and I addressed the challenge by building a comprehensive medical network throughout downtown Manhattan in phases, initially opening Manhattan’s first free-standing emergency department and then gradually adding essential services including imaging, ambulatory surgery, orthopedic and rehabilitation programs, as well as primary and specialty care.”
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When building a comprehensive medical center from scratch, Hellinger had to step back and take a fresh look from a patient’s perspective at how healthcare should be delivered. “We fulfilled this objective by implementing services such as telehealth, and a personalized website for physician referrals and home-based healthcare programs,” he says. “The center has positioned itself as a vital community resource by partnering with longstanding neighborhood organizations and offering free public services, such as immunizations and health screenings.”
2. Navigating different payment models
Robert C. Garrett, FACHE, CEO, Hackensack Meridian Health, Edison, New Jersey, has found navigating two different payment models to be a big challenge. “We’re moving from a volume-based environment to a value-based environment,” he says. “Our 17 hospitals need to remain solvent, so we are still reimbursed on a fee-for-service basis to a large extent. If I had to pick a definitive path—to either stay in fee-for-service or go into the value-based world—I would vote for going into the value-based world. That’s because all the incentives are aligned and physicians and hospitals are rewarded for achieving the best outcomes for the people we serve.”
Garrett has found this to be the best strategy when looking to lower the overall cost of care delivery. “To keep the needle moving toward value, we are growing our accountable care organizations (ACOs),” he says, adding that the health system’s best performing ACO saved about $145 million over five years and is among the nation’s top performers. “Beyond ACOs, we are investing in more patient-centered models including bundled payments, shared risk arrangements, and value-based purchasing.”