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."



Susan Croushore 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.
 
 
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