Meet­ing em­pha­sized evo­lu­tion of health­care

Modern Healthcare - - NEWS - Joe Carl­son

Evo­lu­tion of health­care em­pha­sized at an­nual gath­er­ing

Up­heaval—be it po­lit­i­cal, le­gal, so­cial, per­sonal or fi­nan­cial— be­came the over­ar­ch­ing theme of dis­cus­sions in hall­ways and con­fer­ence rooms last week dur­ing the Amer­i­can Col­lege of Health­care Ex­ec­u­tives’ an­nual meet­ing in Chicago.

“As we gather here, with­out ques­tion, dra­matic change is the piv­otal re­al­ity health­care ex­ec­u­tives are fac­ing,” in­com­ing ACHE Chair­woman Gayle Capoz­zalo said in her open­ing re­marks on the first day of the Congress on Health­care Lead­er­ship. “The bot­tom line is, whether or not we em­brace it, the health­care in­dus­try is in the midst of the sig­nif­i­cant and swiftly mov­ing evo­lu­tion of our pro­fes­sional life­times.”

About 4,900 peo­ple at­tended the meet­ing, packing one of the city’s largest ho­tels, the Hy­att Re­gency Chicago. The 2012 at­ten­dance fig­ure was the sec­ond-high­est ever, eas­ily top­ping last year’s 4,500 at­ten­dees, ac­cord­ing to sta­tis­tics pro­vided by the health­care ex­ec­u­tives’ or­ga­ni­za­tion.

The meet­ing took place ex­actly two years af­ter Congress passed of the Pa­tient Pro­tec­tion and Af­ford­able Care Act, which has in­tro­duced a wave of changes to health­care re­im­burse­ment and per­for­mance ex­pec­ta­tions, even though it re­mains hotly con­tested in the fed­eral courts. (See re­lated story, p. 12.) By the end of June, the Supreme Court is ex­pected to is­sue a decision that could leave the 900-page law wholly in­tact, make some changes, or wipe it out en­tirely.

Richard Pol­lack, ex­ec­u­tive vice pres­i­dent for ad­vo­cacy and public pol­icy at the Amer­i­can Hospi­tal As­so­ci­a­tion, said the trade groups’ le­gal an­a­lysts tell him the out­come of the case could be a “slam dunk” in fa­vor of the law’s pro­po­nents, with as many as seven of the nine Supreme Court jus­tices com­ing down in fa­vor of the law.

If the law is up­held, and if Pres­i­dent Barack Obama is re-elected in Novem­ber, then the hospi­tal in­dus­try will have its first real op­por­tu­nity to “fix” pro­vi­sions of the law that neg­a­tively af­fect hos­pi­tals, Pol­lack told his au­di­ence of more than 1,000 ex­ec­u­tives.

How­ever, not all forms of change dis­cussed at the meet­ing were as un­pre­dictable as na­tional elec­tions and the fed­eral ju­di­ciary.

Daniel Cal­la­han, the pres­i­dent emer­i­tus of bioethics in­sti­tute the Hast­ings Cen­ter in Gar­ri­son, N.Y., said health­care ex­ec­u­tives are caught be­tween in­creas­ing de­mands for im­prove­ments in the ef­fi­ciency of health­care de­liv­ery and the use of ev­i­dence- based treat­ments. Yet ad­vo­cates of­ten miss an­other fun­da­men­tal goal: ed­u­cat­ing a gray­ing public that will have “bot­tom­less pa­tient ex­pec­ta­tions” as their life ex­pectan­cies grow.

“The av­er­age per­son is go­ing to die prob­a­bly be­yond the age of 85 soon, with an aw­ful lot of things wrong with them at the same time,” Cal­la­han said.

Alyson Pitman Giles, a past chair­woman of the ACHE, said many ex­ec­u­tives lately have been talk­ing about ad­min­is­tra­tive shake-ups and ex­pe­ri­enc­ing the painful, per­sonal toll they can ex­act.

Giles said she went through her own shake-up in 1988, when her long­time men­tor was ter­mi­nated and Giles found her own job de­moted and re­spon­si­bil­i­ties down­graded.

She urged other ex­ec­u­tives to talk about those hurt­ful and em­bar­rass­ing sit­u­a­tions with oth­ers. “If you haven’t been through what we eu­phemisti­cally call a ‘tran­si­tion,’ you will,” Giles said.

Some­times even vi­o­lent change can hold long-term pos­i­tive ben­e­fits, though. In one ses­sion, ex­ec­u­tives with the for­mer St. John’s Re­gional Med­i­cal Cen­ter in Jo­plin, Mo., de­scribed how they saw their hospi­tal smashed by an Ef5-strength tor­nado and then even­tu­ally knocked down by the wreck­ing ball. (See re­lated story, p. 6.)

Yet hospi­tal CEO Gary Pul­sipher re­peat­edly used the word “blessed” to de­scribe how he felt in the days and months af­ter­ward, as cor­po­rate par­ent Mercy re­sponded with an im­me­di­ate ac­tion plan that will even­tu­ally en­tail spend­ing nearly $1 bil­lion on re­cov­ery and re­build­ing ef­forts.

All the while, the sys­tem con­tin­ued pay­ing its work­ers and com­mit­ted to keep­ing them em­ployed. A foun­da­tion took in $1.7 mil­lion to help hospi­tal em­ploy­ees buy new homes or cars, and the sys­tem con­tin­ues to pro­vide coun­sel­ing for post-trau­matic stress. A new Mercy Jo­plin Hospi­tal is slated to open by 2015.

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