Foreword
The Time Is Now
You only need to step into an NICU, a rehab
hospital, or a bone marrow transplant unit to
witness how far modern medicine has progressed.
Preemies the size of your palm are going on to
graduate college. HIV is now considered a
chronic disease. Almost 28,000 Americans
received organ transplants last year.
It’s important not to lose sight of the
tremendous ground we’ve gained in our race to
extend life and reduce suffering. The same brand
of courage, the same collaborative spirit, and
the same dogged determination that got us this
far is going to be needed in another vital
undertaking: fixing the disconnects and wasteful
practices that have been created along our path.
Health reform debates have laid bare the current
problems in healthcare delivery, which providers
have long understood: Not enough coordination,
too much variation, too much inefficiency, not
enough automation and, of course, too many
people without insurance coverage.
Solving many of these problems requires a
transformation in the way providers currently
interact and coordinate care across care sites.
Small changes will no longer do. Stakeholders
must change delivery models, realign
relationships, revamp processes, and use IT to
drive out costs.
What is striking about the healthcare providers
that are profiled in this Leadership
report is that they are not waiting for
direction on how to proceed. They are not
waiting for needed payment system modifications.
They have flung themselves head first into
transforming their organizations into the care
delivery systems that will be needed in the
future. In the process, they are improving the
quality of patient care and saving
dollars—which, in turn, is helping them stay
financially afloat during an exceptionally risky
economic period.
Take, for example, Hampden County Physician
Associates. The multispecialty group has pulled
together a range of services that allows it to
manage a patient’s total healthcare needs—and
take advantage of risk-based insurance
contracts. Nurse case managers coordinate the
care of patients with multiple chronic
conditions, which is saving the Massachusetts
medical group $4 million per year (see pages
13-14 and 20-22).
In another example: HealthPartners has increased
the number of patients who receive optimal
diabetes care by 129 percent—saving $15 million
a year. The Minneapolis-based insurer and health
system uses pay-for- performance bonuses to
encourage physicians to adopt evidence-based
guidelines (see pages 14-15 and 22-23).
Or look to Trinity Health, which is rolling out
an electronic health record across all system
hospitals and ambulatory care sites, while also
adopting evidenced-based care protocols. In
2007, the Michigan-based health system saw a 21
percent reduction in severity-adjusted mortality
(see pages 7-9, 28-29 and 33-34).
These are just a few examples of the determined
leadership that is on display in the pages of
this Leadership report. At first blush,
the steps these leaders are taking may not come
off as exhilarating as, for example, the
discovery of a new vaccine or as revolutionary
as say laparoscopy surgery. But the potential
for saving lives and reducing suffering promises
to be just as great.
Catherine Jacobson, FHFMA, CPA
2009-2010 Chair, HFMA
Senior Vice President of Strategic Planning and
Finance, CFO, and Treasurer
Rush University Medical Center
Richard L. Clarke, DHA, FHFMA
President and CEO
HFMA