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Business Journal: Health care changes offer challenges and opportunities for Conway Regional

Posted: April 11, 2014 - 3:34pm
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Dr. Bart Throneberry, Chairman of the Board of Directors with Jim Lambert, President & CEO.
Dr. Bart Throneberry, Chairman of the Board of Directors with Jim Lambert, President & CEO.

Health care is in transition in Faulkner County.

Conway Regional Health System is accountable to the community to provide high quality, compassionate health care services. The mission statement sets the expectations for every person who wears a Conway Regional badge.

This means the work lives of the Conway Regional staff should be dedicated to making decisions that will lead to the highest quality care for patients in Faulkner and surrounding counties. This level of accountability flows from the board of directors down to everyone in the organization including both clinical and non-clinical staff.

The challenge of delivering on these expectations is growing as we transition into a new era of accountability in providing health care. Health systems are encouraged to provide more creative, smarter answers to delivering on those expectations. The Conway Regional Board of Directors and Executive Leadership Team are tasked with responding to these opportunities.

The way hospitals, physicians and other providers are reimbursed is changing.

Health care reimbursement is transitioning from a fee for service system in which providers (such as Medicare and Medicaid) pay based on the number of services or tests conducted, to a system where providers are paid more for improving outcomes and driving value. Under the new system, providers are being paid based on improved care experiences, improved health of populations and lower per capita costs.

The challenge currently is that most of the payment is based on volume but as more and more of the payment moves to outcomes or improving overall health, providers will have to change their focus and processes to respond. The challenge is to know when to shift from the fee for service model to the value based model when they have conflicting incentives.

Growing government regulations and expectations have begun placing about 5 percent of hospitals’ federal reimbursement at risk annually. Other payers are also moving more and more of their payment to a value based formula. “We have seen and will continue to see different models (such as bundled payments, primary care medical homes and others) as we search for the best way to drive improved outcomes and reduced costs,” said Jim Lambert, Conway Regional Health System’s President and CEO.

The Affordable Care Act has resulted in significant changes in the country’s insurance structure to help many formerly uninsured or under insured people pay for health care. The cost of uncompensated care remains significant for the nation’s health care facilities, including Conway Regional.

In 2013 Conway Regional provided more than $10 million in uncompensated care. This means medical services for which no payment is received. Uncompensated care includes charity care and bad debts.

It remains unclear how much relief the new insurance plans will provide for hospitals, but Faulkner County’s uninsured rate is projected to drop 12 percent by 2019.

Other significant challenges await:

• How does Conway Regional prepare to fulfill its mission in a future world that requires increased integration of clinical services while still being rewarded based on high volumes of procedures?

• There is also the challenge of additional competition which is expected to move from Little Rock into the Conway health care market.

“These are enormous opportunities for Conway Regional to shine,” said Mr. Lambert. “We have always taken the approach that the best health care is always going to be provided by people who have a vested interest in the community. People who are taking care of their family and neighbors are going to be more committed to the health care they are providing. That being said, we knew it was just a matter of time until someone decided to come here. Our best response will center on the five strategic pillars that guide our decisions: quality, service, people, growth and finance.”

Quality

The health system is going to build upon its accomplishments in the area of quality earning a number of national and statewide awards for care and service:

• Number 1 in Arkansas for Major Cardiac Surgery (Healthgrades, 2012-2013)

• Top 10% in State in Patient Safety for General Surgery (CareChex)

• 2013 Recipient of the Arkansas Governor’s Quality Award, Achievement Level

• Top 10 percent in the state for overall medical care, GI care, general surgery and pulmonary care, all in patient safety (CareChex.com)

• Top 100 in the nation for home health (HomeCare Elite)

• Top 100 in the nation in coronary bypass surgery (CareChex)

• 2013 Recipient of the state chapter of the American Diabetes Association’s Cure Care Commitment Award, the ADA’s top award

Physicians and employees are actively engaged in ongoing efforts to enhance the quality of care.

Service

Conway Regional’s goal is to create a culture of service excellence that consistently exceeds expectations. “We will measure that by achieving the top 10 percentile nationally in patient care and maintaining our status of ‘most preferred provider’ in the community,” said Mr. Lambert.

People

Conway Regional depends on the physicians along with nurses, therapists, technicians and a host of other health care employees to provide the care that the community is counting on. We want to be the best place to work for employees and provide the environment for physicians to take care of their patients. The satisfaction of employees and physicians is measured regularly and plans are in place to maintain high levels of satisfaction and engagement.

Financial

Financial goals are tracked and set based on operating margin and other financial benchmarks to ensure the health system has the funds it needs. As a not-for-profit health system, Conway Regional invests income back into the equipment and facilities that are necessary to meet the community’s needs instead of paying shareholders.

Growth

The leadership of Conway Regional is dedicated to making the strategic decisions necessary to grow its services and facilities. To that end, a $32 million surgery and obstetrics addition is now part of the medical center to meet the needs of Conway physicians and the growing numbers of families in and around Faulkner County. “We are also working with the community and our medical staff to determine which services to expand or add based on the needs of the community,” added Mr. Lambert. “While we continue to look for opportunities to add services we know that we can’t, nor should, provide certain high level services such as transplants. It just wouldn’t be appropriate from a quality or cost perspective.”

Conway Regional leadership is also actively researching partnerships and affiliations to complement the health care services currently offered in Faulkner County. “We are simply reaching out to some like-minded health care providers to determine if a partnership or affiliation would be beneficial to Conway Regional, our employees and the community,” said Mr. Lambert. “Our health system board and leadership team are committed to looking for business models that enhance health care services and position Conway Regional to continue our ability to meet the needs of the community now and into the future.”

It is too early to know the result of these efforts, but as Mr. Lambert has said, “Any affiliation would have to enhance the services that are already being offered to our community. It would have to be compatible with our mission of providing high quality, compassionate care.”

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