Published on February 15, 2013

Health care competitors become collaborators

Ashley Gurbal Kritzer
Jacksonville Business Journal

Health reform is taking St. Vincent’s HealthCare President and CEO Moody Chisholm outside of his comfort zone — and he’s OK with that.

St. Vincent’s is one of several hospitals in Northeast Florida that took part in the 2012 Community Health Needs Assessment, which identified the region’s top health priorities and strategies for each hospital to tackle those priorities. Under the Affordable Care Act, nonprofit hospitals are required to conduct an assessment every three years.

“Something we’re trying to do more innovatively is think, ‘How can I work with my traditional competitors?’ rather than always thinking about how to work against them and how to duplicate the same things they’re doing,” Chisholm said.

The health system is also taking part in a bundled payment program with the Centers for Medicare and Medicaid. Bundled payments are one flat, negotiated fee for certain procedures and treatments instead of charging patients and Medicaid and Medicare individually for each service involved in the procedure; in this instance, it’s total joint replacements, spinal injuries and congestive heart failure.

“One thing I like about this is that it forces you to be innovative,” Chisholm said. “And rather than sitting back and being afraid to step out and be innovative because you might shoot yourself in the foot and cost your system millions of dollars, you have to be innovative now to be prepared for all of the new reimbursement models.”

“The primary care expansion efforts are really key. The three big things we deal with are high blood pressure, congestive heart failure and diabetes, and we know that managing those effectively on the front end, getting people the appropriate medications and monitoring their health conditions proactively, really reduces not only the overall cost for everyone, but also really improves the quality of life.”

— Greg Miller, Senior vice president of hospital operations, Shands Jacksonville Medical Center, on the findings of the 2012 Community Health Needs Assessment
By the Numbers: Emergency room visits in Northeast Florida
30 to 35 percent of ER patients are self-pay
36 percent have Medicare or Medicaid
27 percent have commercial insurance
Nassau County has the most self-pay ER patients; Clay County has the fewest.

View slideshow