HealthLeaders: What will be your biggest challenge in this new role?
Barto: We are moving into an entirely new system of reimbursement in which health providers will be paid for value and outcomes and not for the volume of their services or the number of procedures. As we assume more of this risk, we need to be sure we are providing the best quality of care at the best and most affordable price. It's vitally important that we continue to improve clinical operations to remain financially healthy in this new landscape for healthcare.
One key area of focus is information technology. CHI is spending about $2.2 billion over five years in capital and operating expense on a system-wide, universal electronic health record that will help us improve care and better monitor our patients and our populations. … The challenge is the balance between what we've historically focused on in building integrated systems of care with a hospital-centric model and the focus on population health.
HealthLeaders: With all the priorities competing for capital dollars, how does CHI decide where to invest its funds?
Barto: The decision-making process is a balance between a bottom-up approach and a top-down approach. Our ministries continue to drive the need for investment in terms of replacement capital and growth capital related to their market priorities. At the same time, CHI has a perspective on some of the national capabilities we need to build in order to grow and diversify our geographic footprint as well as the revenue mix across the enterprise—specifically with a focus on growing non-hospital care and other services that enhance patient experience in terms of quality, satisfaction, and outcomes.