The 1 thing about healthcare that needs to change: 4 executives weigh in

From the shift to value-based care to increased price transparency, the healthcare industry is in the midst of significant changes that are aimed at efficiently improving care. However, for that goal to be achieved, problems in the industry such as disparity in access to care and confusing billing systems still need to be addressed, according to healthcare executives.

In a panel discussion on Nov. 9 at the Becker's 5th Annual CEO + CFO Roundtable in Chicago moderated by Rhoda Weiss, PhD, nationally recognized consultant, speaker, and author, four great minds in healthcare discussed the changes they would like to see in the industry, what gives them pride in their organizations and the issues that keep them awake at night.

Note: Responses have been edited for length and clarity.

If you could change one thing about healthcare, what would it be?

Eugene Woods, president and CEO of Carolinas HealthCare System (Charlotte): I would say we need to continue to focus on reconnecting with our communities; that's really, really important. There's going to be things that happen in D.C. and other places, but care is delivered locally. We really need to reengage in a new forward-thinking way in our communities. 

Daniel Morissette, senior executive vice president and CFO of Dignity Health (San Francisco): I would change the disparity in access to healthcare. That is really significant. The reason our emergency rooms are full is because of disparity of access.

Barclay Berdan, CEO of Texas Health Resources (Arlington): I'll take a slightly different tact and say the whole billing system. It's just so confusing.

Vicki Harter, vice president of care transformation at Caradigm: If I could change one thing it would be that employer groups, payers and government payment systems would all align on metrics that matter to make it simpler and less burdensome for providers out there.

What gives you pride in your organization?

Mr. Berdan: I'm most proud of the 23,000 some odd employees we have at Texas Health. They have listened, talked to us about how they feel and what they think needs to happen, and we listen to them. We have a very highly engaged workforce and medical community. And that's shown up in the last couple years, we've been fortunate to be on Fortune's best companies to work for list in healthcare for the last few years. That just means we're doing a good job together of following what we call our Promise…which is individuals caring for individuals together. We have a highly engaged workforce that really cares about what they do.

Mr. Morissette: We take all comers at Dignity. I'm really proud of that. The undocumented person who comes in will receive the same quality of care. That's the incredible value set that we have, and I'm very proud of that.

Mr. Woods: There are lots of things to be proud of. I think for Carolinas HealthCare System, as people know in September, there were riots [in Charlotte]… And what I was most proud of was afterwards, I had the chance to walk the halls with my ER team and my trauma team. The fantastic thing about it is we were taking care of police officers, asking if they were OK, and protesters too. I walked inside the halls with the head of the ED and we take care of everyone, no matter what…you look like, 24/7 365 days a year. And when you see that spirit, it's really — with all the noise that goes on and regulation — that's what keeps you connected. I'm really proud of not just Carolinas but the field has a lot to be proud of in that regard.

What are the pressing issues that keep you up at night?

Mr. Morissette: What keeps me up at night is how are we going to make this system work. We're doing a lot of things from a cost structure, efficiency standpoint and those are having a positive impact on our overall results, but California is currently 49 out of 50 states in terms of funding for Medicaid. What keeps me up at night is how do we keep our ministry going and stay financially viable?

Mr. Wood: We're in a fairly resilient healthcare field, but I think about the ACA and the 20 million folks who gained coverage — repeal, what does that look like? Medicaid could be back on the table…the Medicare voucher program could potentially be in play again. All of those are very significant and can keep us up at night now, but the fundamental thing that doesn't change is the concept of affordability and cost. We need to continue to focus on that, the pressure on labor, pharmaceuticals, health IT, and how do we balance that and use that to have a more affordable delivery system.

Ms. Harter: What keeps me up at night is understanding from a population health side how significant the risks and rewards are for organizations. Certainly you can't just throw more bodies at everything in population health, so really, truly finding scalable solutions that continue to evolve with the advanced payment models.

Mr. Berdan: It used to be my choices for president. But generally I sleep pretty well.

*This article was corrected Nov. 15. An earlier version misstated Texas Health Resources employed 4,000 people; the correct figure is approximately 23,000.

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