At Becker's Hospital Review Annual Chief Executive Officer Roundtable on Nov. 14, 2014, a group of hospital industry leaders gathered for a panel discussion about the best ideas for community hospitals today.
The panel included President and CEO of McLaren Lapeer Region Bart Buxton; President and CEO of Sky Lakes Medical Center Paul Stewart; CEO of Steele Memorial Medical Center Jeff Hill; and President and CEO of Kadlec Health System Rand Wortman. McGuireWoods Healthcare Department Chair and Becker's Healthcare Publisher Scott Becker moderated the panel.
The panelists began by discussing their background and strategic plan based on location and forecast for coming healthcare changes. Some plans included new or expanded affiliations with other providers while others have made moves to dominate their marketplace independently. Regardless of the set-up, all four panelists preferred relative autonomy and were bullish on their opportunities to remain independent in the future.
"I think we can stay independent in the long run, but it depends on how you define independence," said Mr. Hill. "We have relationships with multiple regional systems…With a focus on a solid strategic plan and aligning our organization with common goals and holding those that can affect things accountable, I truly think we can remain independent [five to 10 years from now]."
Another big topic the panel touched on was capital expenditures and the ability to acquire financing if necessary.
"We always are faced with capital challenge being a small critical access hospital, but we've been able to leverage our place in the market," said Mr. Hill. "We have significant cash reserves to re-invest in the community. We also partnered with a larger regional facility and leveraged that relationship for IT systems."
Mr. Stewart said he thinks access to capital will grow more difficult as time goes on.
Additional topics discussed during the panel included partnerships with hospitals, health systems and physician groups. Mr. Wortman discussed his hospital's plan to employ physicians; in 2007, the hospital had no employed physician. Now there are around 85 employed physicians.
"We took a leap of faith and decided we could build these practices one or two physicians at a time or we could have a big vision, and we went with the big vision," he said. "We built an infrastructure for 100 physicians when we had none. That is the thing that's made the most difference in our development."
Mr. Stewart mentioned the variety of partnerships his hospital has. "We invest in population health and strategies that accrue back to our physician model," he said. "It's been a challenge. We have a mix of long-term physicians who are driven by the right factors to take care of patients combined with young family medicine residents and primary care physicians and getting them engaged has been a problem."
Mr. Buxton has seen similar trends among young physicians who are interested in becoming employed physicians. "Physicians come to me because they aren't interested in managing their own practice," said Mr. Buxton. "They are interested in practicing medicine and going home. We make it part of their contract to be part of the hospital leadership."
The panelists agreed on the importance of balancing productivity and RVU models with incentivizing physicians to provide high quality care. Some physicians are motivated to drive patient volume and work hard, and some hospital contracts are able to reward that.
"We put in a productivity system where if the physicians don't work as hard, they don't make as much," said Mr. Wortman. "There are quality and productivity aspects. A lot of it comes down to the individual, how hard they want to work and what they are made of. We try to recruit on integrity as much as skill."
The panel closed out by discussing the most important focus for their hospital next year. The panelists mentioned several key initiatives, including:
• Spending time on rural relationships
• Reviewing processes to make them even more lean without workforce reductions
• Manage risk
• Manage the transition from inpatient to outpatient
• Prepare for ICD-10
More Articles on Community Hospitals:
The Future of Community Hospitals: To Sell or Remain Independent
5 Tips for Community Hospital Survival
11 Statistics on EMR Costs at Community Hospitals