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Q&A: An Independent Hospital CEO Talks About the Future

Philip Betbeze, for HealthLeaders Media, August 9, 2013

HealthLeaders: Do you feel you have the right pieces to thrive in a value-based environment? If not, what's missing?

Harrington: At that time [two years ago], we were looking at a lower census and asking ourselves what's causing this and how low will it go. We think that got answered last year. This year, our numbers are up substantially. ER volumes continue to be strong. We're still growing at 13%–17% in the ER. But a big question is why aren't these guys hooking up with a primary care physician instead of using the ED?

One of the reasons we believe we're getting busier is that a lot of the physicians tell their patients if they get sick, to go to the ED. What they should be telling [patients] is that they will deal with their issue. It's a convenience issue because it's a lot easier for them to just tell [patients] to go to the ED. And what's surprising about it is we have our own urgent care, too.

Those numbers are climbing as well. We've brought on more midlevels in the last three years than in the past 10 years prior, and we have a significant number of mature physicians who are now 70 or so and still working. That's good for us. We're competing with the Kaisers, and it's very difficult if you don't have shift work available for your physicians. The medical foundation model is what we're forming. We're trying to move all our docs into that which will create the foundation in 6–9 months.

We think that's important for integration. So to answer your question, I do think we have the pieces but I don't have a real high confidence level. I'm always thinking: do I have enough backup strategies in place? It's more of a feeling than knowing for sure, and it's not unique to us. Is what's happening evolutionary or revolutionary? We think evolutionary. We'll have a number of people in the exchange by '14, but in our county, 20% of the population is uninsured, and another percentage consists of illegals who still won't be covered, so we'll continue our free clinic. We're going to need more primary care physicians but we're competing with heavy hitters.

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1 comments on "Q&A: An Independent Hospital CEO Talks About the Future"


David Hold (8/18/2013 at 9:53 AM)
I was reading your interview with great interest.The problems facing independent hospitals is going to escalate exponentially in the near future. Large operations with expensive equipment and specialist are going to further try to invade their territory. My company over the years has developed systems to address this issues on a competitive basis and keep independent hospitals in charge of their patient flow. Leverage is the only thing that the giants will understand and independent hospitals have the ability to use this against them. As we speak we are implementing a system in which the local hospital will be able to keep control of their patients and be the ones to decide where this traffic is going to go if there is need for better technical expertise or just retain it if there is no such need.