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Lahey Health Reexamines the Appropriate Care Model

John Commins, for HealthLeaders Media, March 12, 2014

We are doing a lot of spine surgery that had to be shipped out before, but now patients are having it done there because we have a Lahey neurosurgeon there. We are doing a lot of cardiovascular implants at local hospitals, like defibrillators, and some cardiology testing that couldn't be done formerly without Lahey physicians and expertise.

HLM: What effect has this push for care settings had on inpatient volumes?

Nesto: For the first quarter of this fiscal year compared to last year, overall in the state of Massachusetts the inpatient census is down 6%. Outside of the top 10 hospitals, most hospitals are in double-digit declines. That is huge for a hospital year over year.

Our community hospitals have increased their censuses but it is not at the expense of Lahey because we are getting their tertiary work that they had formerly sent to four or five hospitals. Our census is about 94% and our CMI tops 1.9 for the past two months.

We have the highest case mix index in the state. So, we are caring for sicker and sicker patients and we have more and more patients in our beds. Beverly is caring for more and more patients, and frankly their CMI has gone up too.

It is really a shift in market share. We are full and Beverly is full because we are doing a better job of retaining patients and keeping them within the system, and somebody else has fewer patients. There is no question about that. The population is not expanding. Our marketing and communications plans are all focused on community-based care.

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