LACONIA — "I'm picking up the baton Chuck is handing off," remarked Seth Warren, who will take up the reins as chief executive officer of LRGHealthcare next month, succeeding Chuck Van Sluyter, the interim CEO appointed when Tom Clairmont retired a year ago.
Warren and Van Sluyter yesterday discussed the transition together with the strategic plan developed by the Board of Trustees, staff, partners and patients to address the changing health care marketplace.
Warren has spent the last 16 years with the Sisters of St. Francis Health Services, Inc. or Francisan Alliance, a Catholic health care system headquartered in Mishawaka, Indiana consisting of 13 hospitals and numerous clinics, with 18,000 employees, the last six as president of St. James Hospital in Chicago Heights and Olympia Fields, Illinois, a 400-bed teaching hospital. He is well acquainted with the challenges posed by the aging, uninsured and underinsured population served by LRGH as 45 percent of the patients at St. James Hospital were enrolled in Medicare and another 15 percent in Medicaid.
"I came in with my eyes wide open," said Warren, moving Van Sluyter to add "there's no place to hide."
Warren said that the overarching objective will be to provide a continuum of care with the goal of "trying to keep people out of hospital," where both the hospital and its patients incur costs that can be avoided by a regimen of preventive care, managing illness and wellness programs.
The strategic plan sets a number of priorities. First and foremost it calls for assessing the needs of the population LRGH serves and tailoring services to meet them, which will include expanding the walk-in clinic — Convenience Care — along with pediatric and gynecological services. At the same time, in partnership with Genesis Behavioral Health, Horizons Counseling Center and other agencies LRGH will seek to improve and integrate treatment for mental illness and substance abuse mental health in the community.
LRGH will enhance and pursue its collaborative relationships with other healthcare and social service providers in the region to ensure a seamless experience for patients. Tightening communication and procedures between health care providers in different departments within LRGH and with other agencies in the community will improve management of patients and outcomes of treatment. And telehealth services, like those used to treat stroke victims in partnership with Massachusetts General Hospital, will be expanded.
Van Sluyter said that several other initiatives are already underway. The emergency department will be expanded. The debt will restructured. And communications about the treatment and conditions of patients between practitioners within the hospitals will be computerized through a partnership with the Speare Memorial hospital in Plymouth.
Of all LRGH's collaborative relationships the Granite Health Network, a consortium of five of the largest hospitals in the state formed in 2011, is especially promising. The aim of the partnership is to leverage clinical and administrative resources of the members to improve the quality and efficiency of medical services. Van Sluyter said that efficiencies approaching $5 million have already been achieved.
Earlier this year the network announced the Tufts Freedom Plan, a provider-payer insurance company administered by the Tufts Health Plan, in which the 18,000 employees of the five member hospitals will be enrolled. The company will ultimately compete throughout the state with other other health insurance carriers.
Meanwhile, Warren will be faced with improving the financial performance and condition of LRGH in the teeth of what he called "payment pressures — lower, slower, no payment." This week Moody's investment services lifted its negative outlook for nonprofit hospitals, like LRGH, which has been in pace since 2008, noting that prospects have improved especially in states, including New Hampshire, where Medicaid enrollments have been expanded.
Warren said that although reimbursement rates could be higher, as the number of insured patients has grown, the volume of emergency room visits has declined and the opportunity to manage chronic illnesses, sparing patients costly acute care services, is greater. On the other hand, he said that payments to hospitals are more closely tied to the quality of the care they provide — as measured by readmission and infection rates, for example — placing a premium on operating excellence and efficiency.
"Chuck was the change agent," Warren said. "He marked the pathway for me to follow."
"But, you have to implement the plan," Van Sluyter replied, adding that "the higher you climb, the more the horizon embraces."
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