Health care is a fast changing industry, and it’s almost hard to distill its change into a few questions.
Hospitals are integrating into larger health care networks, as those networks look at ways to increase their reach through such things as health insurance and outpatient facilities. This comes as the industry contends with changing workforce demands and provisions of the Affordable Care Act that mean radical changes in the way they do business.
And the new landscape mean major shifts for some of the state’s largest employers. There are 219 hospitals in Ohio, and its health care industry directly supports 250,000 jobs — and indirectly supports up to another million.
In the fast-changing climate, Mike Abrams, president and CEO of the Ohio Hospital Association, said the complicated industry has its work set out for it — but there are big opportunities.
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Q: What have health care companies been doing to adapt to the changing industry?
A: Before, we saw a lot of hospitals looking to join networks, but now we’re seeing a lot of those hospital groups forming mega-networks. Here in Ohio we’ve got the Midwest Health Care Collaborative with Premier Health, TriHealth, the Cleveland Clinic and others. And Health Innovation Ohio includes Kettering Health Network, Mercy Health and University Hospital Cleveland.
The partnerships are aimed at saving money and making health care more efficient. The hope is that will pass the cost down to the customer.
Q: What kinds of help has that been?
A: A lot more electronic medical records are being shared. Before, hospitals kept a lot of separate systems and they couldn’t necessarily communicate with each other. In Ohio, about 80 percent of the hospitals are now on the same system.
Generally, the push has been on greater quality and safety in care. Quality used to be a given, but now it’s treated as a discipline. We can study outcomes much more exactingly now, and with things like hospital acquired (conditions), sometimes one hospital will find a simple solution that will cut down on instances — maybe a simple step that reduces pneumonia acquired from a ventilator. They share that now.
A lot of the physicians may have come up in a time before quality was as well analyzed as it is. There’s a push not to compete on quality and safety measures but to collaborate for the greater good.
Q: What areas still need improvement?
A: We’re still working on the infant mortality rate. I think the numbers were that Ohio was 47th or 48th in infant mortality, and 50th in African American infant mortality. Our board was embarrassed by that. We decided to take ownership of it.
We charged every hospital in the state that delivers babies to appoint “safe sleep” champions for example — one staff member responsible to train the staff on safe ways for infants to sleep, and to teach the patients.
Q: How has the Affordable Care Act affected business in Ohio?
A: It has been a national push for health care organizations to take more ownership of health care. Some systems are getting directly involved in the insurance business and the enrollment of people in the health insurance exchanges (like Premier Health.)
Generally, though, we’re now giving people a medical home, and it’s meaning they’re abusing the ER less. When people have a relationship with medical professionals, they don’t need to go to the ER to, say, do a sports physical.
Q: What do you see as the future of health care?
A: We used to measure hospitals by the size of their beds. You heard about a 1,200-bed hospital and said, that’s a large, complicated system where a lot of things can be done, as opposed to, say a 40-bed hospital. But now there are more services and fewer beds in hospitals. Hospital groups are doing a lot more than they used to. Now there’s a risk-bearing entity, a physician care side, and more services at hospitals. In some ways, the hospital is almost the loss leader for the health system, though its role is crucial.
We will continue to see hospitals working to partner more to save money. About 20 percent of the hospitals in the state are financially where they will need to decide on whether to join a larger system or consider their business model in coming years.
There may be a morphing of who is doing what in health care. Doctors, dentists, physicians assistants — more integrated health care businesses means some of these practices might be doing more than they used to.
(The workforce demand) will continue to be major. We need to ensure that we have the medical professionals we need. Part of that is making sure Ohio is a lucrative place, in terms of pay and benefits, to have a health care career. I also think schools struggle to attract good faculty in health care professions.
Date: February 20, 2015