"Our hospitals realize that we are moving [toward] value-based reimbursements. We have been working for a number of years in a collaborative environment on how to move toward improving quality and safety and also better coordinating care. That challenging transition from volume-based to value-based won't happen overnight. You can't just flick a switch."
Instead, Foster expects to see more and more partnerships developing between hospitals and other health and healthcare organizations to improve community health, particularly for people with chronic or complex illnesses.
"Hospitals are going to be major partners in the community to improve community health," he says. "How do they work with other providers, physicians, home health and nursing homes and the community in general to reach out and keep the patients out of the hospital? This is very much new territory; the value-based approach that asks 'what are we doing for the community' and also tries to focus on those patients who do need the hospitals."
South Carolina's hospitals have been willing to work with other partners, Foster says, because they realize they can't do it alone.
"They have to work with home health agencies and long-term care facilities and primary care physicians. We also have a good relationship with the state office on aging and there are area offices where they can tap into services like Meals On Wheels that traditionally were seen as somewhat separate from the healthcare system. Now we're realizing that they are all interrelated if you are going to effectively manage chronic illnesses outside of the hospital."