At Cincy's annual Healthcare Summit event on Dec.
1, 2011, GE Aviation and General Electric Company healthcare manager
Craig Osterhues described the issues facing the healthcare system today
as being much like the years leading up to Bob Castellini buying the
Reds.
In other words, he said, it's time to make a decision to give healthcare a competitive advantage.
"It's an opportunity. So I'd argue if you've been in
Cincinnati for 20 odd years, you saw the Banks, you saw a pile of dirt
if you went to a Reds game. So all through the "¢90s, you saw a pile of
dirt and if you're like me, it drove me nuts, and until Castellini
bought the Reds," he said. That's what got the bulldozers moving.
"We're at the point of 'is Castellini going to buy
the Reds or not?' Are we going to make a decision to tip this market and
make it a competitive advantage," challenged Osterhues.
For the four panelists who participated in the
lively discussion about the future of the Tristate's healthcare industry
(including Susan Croushore, president and CEO of The Christ Hospital;
Dr. James Plettner, board president of Wellington Orthopaedic &
Sports Medicine; Jennifer Swenson, president of Fort Hamilton Hospital;
and Osterhues), the time for change in healthcare is now, with one of
the biggest issues being how to provide the best quality of care at an
affordable price.
"In my simple mind, that's an equation," says
Osterhues. "Value is quality over cost. We need to improve the quality
and reduce the cost so we can improve the value."
But this has to start with changing individuals and health systems, he says.
Dr. Plettner agrees.
"We are breaking the bank with the cost of
healthcare," he said. And it will keep getting worse, Plettner
continued, especially in the areas of end-of-life care and chronic
illness, cardiology and orthopedics, and those services which will
experience an even greater need as the population ages.
"It's very difficult to change this payment
algorithm when you've got one foot in the government sector and one foot
in the private sector," he said.
"And it's been very difficult to define quality when it's on an economic basis."
Trend Towards Alignment
According to Croushore, one cause of this quality
issue could be attributed to the lack of collaboration between
hospitals, doctors and patients.
There's no patient accountability, she says.
Hospitals are getting penalized for readmitting patients and they have
no control over physicians or the patients, especially after they're
released from their care.
"What you're seeing in the market is a push toward
alignment," Swenson says. "How can physicians and hospitals work closely
together to ensure that we both succeed? And that's where we're
headed."
One trend may be more accountable care
organizations, which are essentially models that seek to link provider
reimbursements to quality metrics and reductions in the total cost of
care for a population of patients.
So, if the patient goes to a doctor because he has
the flu, Osterhues said, the doctor should also know the patient is, for
example, hypertensive or diabetic and has not taken his blood pressure
medications lately and could remind the patient.
"They should be proactive in bringing you in," he says. "It's being accountable for a population, it's physician-based." -
is president and CEO of The Christ Hospital. The
555-bed independent teaching hospital is consistently ranked as one of
the Best Hospitals by US News & World Report. It has transformed its
care through the development of regional partnerships, a physician
network and a sophisticated IT platform and has been recognized for
patient safety by the Leapfrog Group.
Craig Osterhues is Healthcare Manager for GE Aviation. Osterhues
is responsible for the value, compliance and satisfaction of the
healthcare delivered to the 23,000 domestic employees. He also serves on
the Board of Directors for the Employer Health Care Alliance and
HealthBridge and is involved in the Cincinnati Aligning Forces for
Quality, Bridges to Excellence and the Hospital Quality Improvement
Project.
Dr. James Plettner is board president and CEO of Wellington
Orthopaedic & Sports Medicine. He uses microsurgical techniques to
perform vascular and nerve surgery for small vessel repair as well as
treating fractures and sprains of the wrist. He is certified in surgery
of the hand by the American Board of Surgery. Dr. Plettner is a graduate
of Vanderbilt University and the University of Cincinnati College of
Medicine. He is a clinical assistant professor of surgery at UC.
Jennifer Swenson is president of Kettering Health Network's Fort
Hamilton Hospital. She brought more than 17 years of experience in
healthcare finances and administration to the job when she was named
president in 2010. Previously, she was chief operating officer at St.
Helena Hospital in Clearlake, Calif.
Dr. Derek van Amerongen is vice president and chief medical
officer for Humana of Ohio. He oversees the medical management and
strategy. He has written and presented extensively on managed care and
health topics. He is board certified in OB/GYN. He holds degrees from
Princeton, Rush Medical College and University of Wisconsin-Madison.
Dr. Derek van Amerongen, vice president and
chief medical officer for
Humana Health Plans of Ohio in Cincinnati, was
the moderator for the Healthcare Summit panel. He asked questions about
the future of the medical industry, technology and healthcare reform
laws, keeping the panelists on topic and the audience engaged.
Humana is a leading health care company that
offers a wide range of insurance products and health and wellness
services that incorporate an integrated approach to lifelong well-being.
By leveraging the strengths of its core businesses, Humana believes it
can better explore opportunities for existing and emerging adjacencies
in health care that can further enhance wellness opportunities for the
millions of people across the nation with whom the company has
relationships.
Read more at Humana.com
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