Spring/Summer 2013 - Baptist Health Foundation

interviewQAA conversation withSenior Vice President andBHS Chief Financial OfficerGreg JohnstonAs the health care industry faces a time of significant change inpayor reimbursement, Baptist Health System’s Senior Vice President and ChiefFinancial Officer Greg Johnston shares his insight on how the organization is preparingto cope with those changes. After more than 20 years at BHS, he emphasizes that thestewardship demonstrated by the organization’s founders is as important today as it wasmore than 90 years.What kind of changes are comingthat will effect health care deliveryat BHS?Obviously health care reform is goingto be the #1 issue that will impact us in2014. But, there’s still much uncertainty.Alabama has chosen not to expand Medicaid,which was a significant portion ofthe health care legislation and offeredsignificant benefit to both new enrolleesand providers. In opting not to expandMedicaid and receive those federal funds,it has at best delayed— and at worse—denied that benefit.Another aspect of reform establishesthe Federal Insurance Exchange, effectiveJanuary 1, 2014 with enrollment beginningin October 2013. At this point, it is still unclearhow many different insurance productswill be offered or the reimbursementrates. However, we are pretty comfortablethat Blue Cross will be among them.It’s difficult to predict how manypeople covered by the exchange will beformerly employer-insured and how manywill be those that have been insured.In this new environment, the coordinationof care between hospital and physicianis absolutely essential to success.Estimating revenue and patient volumein 2014 is very difficult with so manyunknowns.Reforms also mandated cuts in reimbursementfrom Medicaid and Medicareand those commence in 2014. Weestimate those at about $4 million. UnlessCongress and the President agree topostpone or delay the mandated reforms,Alabama hospitals will get the cuts, butpossibly not the benefits for the Medicaidexpansion.Uncertainty is the name of the game.QAHow has Baptist Health Systemprepared to meet these changes?There is no doubt that the “fee for service”model of payment of the past is going totransition into a different payment modelfor reimbursement. It is a question of “notif, but when.”With the new model, health careproviders will be paid for maintaining thehealth of a population of patients, versus afee for each service provided. It’s a transitionfrom volume to value and representsan allotted amount to care for the healthof a patient.In this new environment, the coordinationof care between hospital and physicianis absolutely essential to success.The new Baptist Physician Alliance is animportant tool in our arsenal to navigatethis new world. This partnership betweenBHS and our physicians will continue toimprove clinical integration. We’re both atthe table to discuss quality issues as wellas cost issues. This impacts our ability toprovide value for the health care dollar.It’s a key initiative to provide quality, costeffectivehealth care for our patients.Another strategic initiative for thisnew environment is our implementationof an electronic medical record (EMR).The timing of our investment in anEMR was dictated by CMS (Centers forMedicare & Medicaid Services) and theirincentive programs for hospitals.After close collaboration with physicians,we chose Epic’s EMR system toprovide the most benefit and quality careto our patients. It’s recognized as thenational leader and “best in KLAS.” (KLASis a firm that monitors and reports on theperformance of health care vendors.)EMRs increase the real-time communicationamong all of the caregivers.That—along with alerts that are built intothe system—help our physicians providethe highest quality of care. That’s somethingwe have always strived for and willalways be our top priority.Q AQA…the work that Baptist HealthFoundation does has never been moreimportant than it is now…Will these changesbenefit our patients?The philosophy for care at BHS hospitalshas always been patient-centered. Yetthere is no doubt that there will be morefocus on patients than ever before. Morethan ever, beyond treating a person’sillness or injury, our goal will be to keeppeople as healthy as possible. There willbe greater focus on preventive health careand providing medical care to managechronic conditions in the most timelymanner. And when needed, to ensure thatexpensive surgeries are provided in themost effective and efficient manner.Will these changes effectinnovation and technology atthe hospitals?Yes, most definitely. Health care reformwill affect and reduce reimbursement forhealth care services. Reduced reimbursementputs a greater strain on our ability toreinvest in innovation, clinical technologyand physical facilities. For that reason,the work that Baptist Health Foundationdoes has never been more important thanit is now and will be in the future.QAinnovation capital to the ministry ofBaptist Health Foundation PresidentMark Belcher often speaks of “innovationcapital.” How important isBaptist Health System?You have only to look at the recently completedPrinceton East Expansion to seehow absolutely essential such dollars wereto the success of that project. The Foundation’scapital campaign made possiblethe new state-of-the-art central steriledepartment and other clinical equipment,a much-needed classroom and a beautifulnew chapel. The more than $5 millionraised through the capital campaign wascritically important to the success of theexpansion project and positioning Princetonto help patients in the future.(continued on page 4)2 Stewardship Spring/Summer 2013 3