Michelman Inc. CEO Steve Shifman got an up close and personal
look at some of the issues in health care recently when he was hospitalized for
an emergency appendectomy.
While he says his care was excellent, he was amazed at the
communication issues.
“As a business owner and someone who works on aligning everybody’s
interests for a common objective, I was amazed at the information they had and
then astounded that there wasn’t better communication among the practitioners,”
he told attendees of Cincy Magazine’s fourth annual Healthcare Summit in early
December.
Cincy partnered with the West Chester-Liberty Chamber Alliance to
host 2013’s event, which was sponsored by Humana. Three Hundred people
attended.
Shifman, a panelist for the forum, says there was a breakdown in
communication between his nurses and the operating room in preparing him for
surgery.
And after surgery, his nurses had difficulty locating his surgeon
to OK his release.
“I know as a consumer, I’m paying for every minute I’m staying in
the hospital and I was in the hospital a good three-to-six hours longer than I
needed to be because they couldn’t find the surgeon to say I could go home,”
says Shifman. Such gaps in communication contribute to rising health care costs,
says Dr. Derek van Amerongen, vice president and chief medical officer for
Humana of Ohio, and moderator of the panel that included Shifman; Dr. Yousuf
Ahmad, president and CEO of Mercy Health; Greer Glazer, dean of the University
of Cincinnati’s College of Nursing; and Craig Brammer, CEO of the combined
operations of the Greater Cincinnati Health Council, the Health Collaborative
and HealthBridge.
Dr. Ahmad says electronic records systems such as EPIC are
improving communication.
Cincinnati has been a pioneer in many initiatives, like
HealthBridge, a 15-year-old effort by area hospitals and others to spur
development of information technology to transmit clinical data, Brammer
says.
“There’s no question that Cincinnati is uniquely positioned to
navigate the next few years effectively,” he says. There is competition for
health care, he says, “yet a long history of providers working together.”
One example: “We have more certified patient-centered medical home
practices per capita than any market.”
Dr. Ahmad says that Mercy was the first provider in the area to
launch an Accountable Care Organization, which provides incentives for hospitals
and physicians to improve care while keeping costs down.
“It’s fundamentally different and scary,” he says. “But it’s the
right way to go.”
At the same time, there are more tools for consumers.
Brammer outlined the features of yourhealthmatters.org, a website
that tracks the performance of every physician practice in the region based on
outcomes. “You can track the trajectory over time to see if that practice is
getting better.”
The panelists agreed, however, that there is work to do.
“Right now, we still have a system where physicians are paid by
the number of patients they see and hospitals are paid by the number of patients
they admit. Until you fundamentally change that, it’s very difficult to get the
entire system to change,” says UC’s Glazer.
She says UC’s College of Nursing is embracing change, adopting
technology like robots and iPads to improve education, and working in teams, the
way care is increasingly being delivered.
CEOs are increasingly caught between trying to manage expenses and
the rising cost of care for their employees.
Shifman says Michelman came to realize it made more sense to focus
on educating employees on health and wellness.
“We invested in it,” he says. “We totally engaged our organization
and it’s proven to be a big benefit.”
The company has invested in health-club memberships for employees
and brings yoga and strength trainers on site several times a week for employee
sessions.
The food menu at Michelman has changed, too. “Donuts are gone, and
we offer granola, bananas and yogurt,” he says.
As a result of the changes, Michelman’s premiums have risen less
than 10 percent the last few years and the company saw no increase in premiums
the last two years.
More importantly, he says, the company has seen a decline in
absenteeism and employees are more engaged.
The company’s wellness program is now “an [employee] attraction
and retention tool,” he says.
Dr. van Amerongen asked each panelist how changes in health care
would affect their organization over the next five years.
“I have no idea what will happen with Obamacare and the insurance
exchanges,” Shifman says, adding: “In five years we’ll have vastly more informed
employees. We look at our health and well-being programs as a differentiator for
our company.”
Health care classrooms will be totally different, Glazer says.
Instead of being in hospitals, clinical training will increasingly be in places
like Walgreens or out in the community, she says, “where younger people want
their primary care. They want it convenient and low-cost.”
Brammer sees Cincinnati’s programs as a competitive advantage for
local employers in the future. “We’ll know we got there if we have measurably
better outcomes, measurably better quality of care and measurably better total
cost of care.”
A sign of the quickness of health-care changes came two
days after the Healthcare Summit when two of the region’s largest providers
announced a first-of-its-kind local joint venture to provide better care to
patients and employers. St. Elizabeth Healthcare in Northern Kentucky and
TriHealth announced the formation of Healthcare Solutions Network to increase
collaboration between their hospitals.
The new network isn’t a merger. Each hospital group will
continue to manage its own facilities. The new joint venture will offer
managed-care products to employers and the public; create a single integrated
information network for its hospitals and physicians and manage large health
populations through that network; and coordinate select services to adopt the
best practices, improve quality and provide more efficient use of resources.
“We believe this collaborative approach allows us to do
things better together than either of our organizations can do as well alone,”
said John Prout, CEO of TriHealth, which operates Good Samaritan and Bethesda
Hospitals.
Dr. Derek van Amerongen is vice president and chief medical
officer for Humana of Ohio. He oversees the medical management and strategy for
one of the nation’s most innovative health plans.
Dr. van Amerongen has written and presented extensively on
managed care and health topics. He is on the faculty of Xavier University in
Cincinnati in the School of Health Administration.
He has been recognized for his teaching contributions at
both the Johns Hopkins Hospital and the University of Cincinnati School of
Medicine, where he is an associate professor in the Department of Obstetrics and
Gynecology.
Dr. Yousuf Ahmad is president and CEO of Mercy Health, which
operate five hospitals in Greater Cincinnati. Previously, he was the senior vice
president and chief network transformation officer for the central division of
Catholic Health Partners, which operates Mercy Health.
He is responsible for transforming the delivery and
implementation of primary and specialty care throughout CHP’s central division
including physician offices, hospitals, home health, long-term care and other
services.
Craig Brammer was the first person to be named to his current
position as CEO of the combined operations of the Greater Cincinnati Health
Council, the Health Collaborative and HealthBridge in December 2012.
A Cincinnati native, he is responsible for overseeing the
strategy and coordination of the region’s heath improvement initiatives.
Previously, he worked for the Office of the National Coordinator for Health
Information Technology in Washington, D.C.
Greer Glazer is the University of Cincinnati’s seventh nursing
dean and 14th senior leader of the College of Nursing.
She graduated summa cum laude with a bachelor’s degree in
nursing from the University of Michigan and received her master’s and PhD in
nursing with a maternal/newborn focus from Case Western Reserve University.
She was dean of nursing at the University of Massachusetts
from 2004-2011 and has extensive clinical, teaching and research experience.
Steve Shifman is president and CEO of Michelman Inc., a Blue
Ash-based global provider of water-based coatings. Under his leadership over the
last 10 years, Michelman has increased revenues and earnings before interest,
taxes, depreciation and amortization more than 3.5 times and greatly expanded
its presence outside the United States.
He was named the Ernst & Young Entrepreneur of the Year
in the manufacturing category in 2013. He holds a MBA from Xavier University and
a bachelor’s degree from the University of Colorado.