Five months into the job of overseeing Florida Hospital’s facilities in Volusia and Flagler counties, the mission before regional CEO Rob Fulbright has become clearer. Health care delivery is in the middle of a transformation, he said, and Florida Hospital wants to be a part of the solution for a “broken” system.
Fulbright met with members of The News-Journal’s editorial board last week to discuss, among other things, regional competition in health care and new initiatives to reduce unnecessary visits to the emergency room.
“We have not done historically a very good job policing ourselves. The incentives in health care have not been aligned. Physicians, health plans, hospitals we’re going to figure out and are figuring out how to align those,” Fulbright said.
“What we have to do is bring costs down and quality up. And the twist in that whole transformation is beginning to create healthier communities and not just caring about people when they’re sick.”
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Fulbright should know. An experienced hospital administrator, he arrived in Volusia County after serving in a number of leadership roles in Tennessee and Florida within Adventist Health System the only company for which he’s ever worked. Now he manages the overall strategy of six hospitals, including their newest addition, Florida Hospital New Smyrna.
The industry is challenged to bring the cost of care down while improving quality, he said. Two years ago, Florida Hospital started a “community care” program that identified the top 5 percent of the highest utilizers of health care that come into the 277-bed Florida Hospital Memorial Medical Center in Daytona Beach. The program was later rolled out at their other hospitals in Orange City, DeLand and Palm Coast.
Partnering with Bethune Cookman University, the hospital created so-called health coaches to help guide a group of about 50 of those patients to better decisions.
“The early data on the 50 patients we took over a $1 million worth of costs out of the health care system,” Fulbright said. “And we decreased their admission rate into the hospital by over 60 percent, we decreased their visits by about 20 percent.”
On competition
In keeping with the industry changes, health systems have also been rapidly expanding their geographic footprints. Florida Hospital counts among its facilities a number of outpatient “health parks” and urgent care centers scattered throughout two counties.
At the same time, its main competition, Halifax Health, intends to make a big leap across the county, building an acute care hospital and freestanding emergency department in Deltona. HCA, a for-profit chain with a hospital in Sanford, has also announced plans to construct an emergency room in the same city, encroaching on territory where Florida Hospital is the only major provider.
Deltona residents visited an emergency room more than 40,000 times in the fiscal year ending in June, according to Halifax officials. And a 2014 report by the Department of Health in Volusia County showed that frequent users of emergency departments in the southwest corner of the county were charged prices at least 40 percent higher than any other area in 2012.
Fulbright said the organization welcomes the competition, characterizing their move as a “rallying call” for Florida Hospital to assess its own strategy.
“Freestanding EDs or inpatient beds added is going to force us to carefully look at what we have in that community and how we continue to grow our services,” Fulbright said. “At the end of the day, if they can do that better than we can then it’s a win for the community and if we can do it better than they can then the community wins as well.”
Date: May 29, 2016