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Hackensack Meridian Health CEO Addresses Mental Health, Cybersecurity in Davos

By Jack O'Brien  
   January 23, 2020

Robert Garrett, FACHE, talks about meeting with business leaders to address the mental health crisis, reduce cybersecurity risks, and anticipate market changes at the World Economic Forum.

Robert Garrett, FACHE, CEO of Hackensack Meridian Health, is attending the 30th annual World Economic Forum (WEF) in Davos, Switzerland, as part of a panel to discuss the global mental health crisis and talk about topics that intersect with healthcare and business such as cybersecurity risks.

HealthLeaders caught up with Garrett to ask him what his thoughts are on these topics and also about the operating margin pressures on providers, “Medicare for All” proposals, and the increased presence of nontraditional corporate players in healthcare. Garrett currently oversees a 17-hospital system based in New Jersey with nearly $5.6 billion in total patient revenue and more than 700-staffed beds, according to the American Hospital Directory.

Garrett says health systems need to make sure to demonstrate value to consumers by offering the best care at the best price.

"I think traditional healthcare organizations didn't move with the utmost speed when it came to capitalizing on our market or understanding consumer preferences," Garrett says. "Sometimes, having Amazon, Google, or private equity [firms] coming in provides some insight for the healthcare industry to understand what consumers are looking for and to make the right investments."

Below are five thoughts from Garrett about trending healthcare issues along with strategic initiatives Hackensack Meridian has pursued to bolster its operations.

  1. Margin pressures

Garrett says that provider operating margins have been stable over the last few years but feels that the sector is still "very vulnerable." He says this risk has been heightened by the entrance of new players in the ambulatory care space.

Garrett also warns that if provider organizations fail to demonstrate value to consumers, they might invite external price controls, specifically citing the implementation of a Medicare for All system.

His comments echo the findings from a recent S&P Global Ratings report, which stated that provider executives should prepare for changes to reimbursement rates, expense growth, and stable but lower operating margins going forward. 

  1. Medicare for All 

As Democratic presidential candidates offer healthcare policy reforms ranging from the introduction of a public option to a single-payer Medicare for All system, Garrett says he favors a more incremental approach to improving health coverage.

"I personally feel that what we should be doing as a nation is building on the Affordable Care Act (ACA), not necessarily getting rid of it or going to a Medicare for All system. I think the ACA has been successful in providing access to insurance for millions of Americans across the country."

Related: Reduce Health Costs By Nurturing The Sickest? A Much-Touted Idea Disappoints

Garrett says that he believes the ACA can be improved upon by Congress, specifically to align incentives around value-based care, instead of "throwing the baby out with the bath water."

  1. Cybersecurity concerns

Provider organizations are the most targeted organizations for cyberattacks, according to Black Book survey from November, accounting for nearly 80% of attacks.

Garrett says Hackensack Meridian was the victim of a five-day ransomware attack in early December and he was asked by business leaders also attending the WEF to speak about the lessons he learned from the attack.

"[Cybersecurity] is something that healthcare or non-healthcare­–related organizations are struggling with," Garrett says. "They're trying to find the right protection, especially as systems become more interconnected, which is great for your business model, but it also makes you more vulnerable to attacks."

  1. M&A and consolidation

Hackensack Meridian has grown significantly through M&A activity in recent years, Garrett says, which has benefited the organization on both the financial and clinical fronts.

He says that the addition of new hospitals has led to a reduction in clinical variation by sharing best practices within the organization. Garrett attributes Hackensack Meridian's improved patient experience scores to its consolidation efforts.

Related: The Family Wanted a Do Not Resuscitate Order. The Doctors Didn't.

He says that the integration of resources through M&A activity has helped the organization grow and reduce its hospital-acquired infection rates, C-section rates, and mortality rates.

"The key is the integration process because if you don't integrate, then you're not going to see the benefits. You're just getting bigger, but you're not achieving the benefits," Garrett says.

  1. Mental health issues and removing the stigma

As a panelist at the Global Health and Healthcare Governors roundtable at the annual conference, Garrett says the conversation centers on ending the stigmatization of mental health issues, boosting care options for patients, and the growing acceptance of employers offering behavioral health services in employee benefits packages.

Garrett says the panel discussion on global mental health issues will focus on how providers, insurers, and government agencies can collaborate to effectively manage the crisis that affects over 1 billion people worldwide.

Most people don't get treatment, either due to the stigma associated with mental illness or inadequate access to care options, Garrett says, which requires provider organizations to develop innovative and strategic solutions to assist patients.

In June, Hackensack Meridian merged with the Carrier Clinic, a New Jersey–based behavioral health provider. As part of a commitment to further address mental health issues in the Garden State, Hackensack Meridian invested $25 million into the facility and opened a behavioral health urgent care center.

Related: N.J. Merger: Englewood Health to Join Hackensack Meridian Health

Garrett says the initiative guides patients to inexpensive behavioral health services, including psychiatric consultations and telehealth services.

He says he's also encouraged that employers are increasingly covering behavioral health services as part of employee care plans. More than half of employers rated access to behavioral health services as the most critical care access point for their employees, according to a Willis Towers Watson survey released in May.

"One of the other aspects that we're working on is incorporating behavioral health into all of our care plans because there's a realization that it is a chronic condition," Garrett says. "It needs to be coordinated like you would develop a care plan for cancer, diabetes, or heart disease. Only in the last few years has it become a major service line, which means that [it will] get the proper attention and strategic importance that it deserves like other chronic conditions."

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.

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