St. Luke’s Health System is a not-for-profit, community-owned, and locally based hospital system with a vision for navigating today’s radically changing medical world: coordinated care that provides top-notch quality while controlling, and even lowering, costs over the long term.
As St. Luke’s Health System board chairman, and on behalf of my fellow volunteers on the board, I would like to share my feelings, experiences and thoughts about this vision and its importance for the communities that St. Luke’s serves.
Like many of my colleagues, I have been involved as a volunteer board member of St. Luke’s for a long time, serving in a variety of capacities, including one previous term as board chair. My family, like so many others, has been cared for by St. Luke’s through painful, heartbreaking and joyful events — births, surgeries, cancer treatments, diagnostic procedures and deaths of loved ones. I am very grateful to St. Luke’s and the extended St. Luke’s family of physicians and other health care professionals.
I am also grateful that we live in a community with two growing, vibrant health care systems. Saint Alphonsus, which is part of a large national system based in Michigan, and St. Luke’s are both nonprofit organizations committed to providing the best care possible to their patients, regardless of insurance coverage and income level. Both health systems provide millions of dollars of unreimbursed care which must somehow be absorbed.
We all know the following about health care:
• The costs of medical care are skyrocketing.
• The norm for quality care is changing dramatically, with a resulting explosion of medical specialties, new medical devices and drugs and ever-changing understandings of what constitutes high-quality patient care.
• Managing the paperwork and infrastructure around Medicare, Medicaid and insurance coverage has become incredibly complex for hospitals, physicians and patients.
• The federal government will soon decrease reimbursement for doctors and hospitals.
As costs, demand and complexity (both medically and administratively) increase and as government reimbursements decrease, traditional ways of practicing medicine are no longer working to promote health and affordability. The most prominent sign of this shifting landscape is the contentious Affordable Care Act, which will continue to bring massive change.
St. Luke’s has adopted a vision that we believe will enable us to move through this changing landscape of health care, providing coordinated, high-quality care and reducing overall costs. It is a vision premised on the notion that we must find ways to encourage payment for value and outcomes rather than the traditional fee-for-service reimbursement system where physicians and hospitals get paid for every service they provide.
St. Luke’s’ vision involves many specific initiatives, too numerous to comprehensively list here, but includes implementation of:
• Coordinated care across all our service providers and hospitals through electronic medical records, a federal mandate but also a key to quality care in today’s complex health world.
• Coordinated care with the addition of hospitalists, physicians who oversee comprehensive, integrated care for patients in hospitals.
• Coordinated care with the addition of those physician practices that seek us out for affiliation, often because the physicians wish to focus on what they do best: practicing medicine.
• Coordinated care through collaborative arrangements with health insurance companies like Select Health that provide new payment methodologies based on outcomes, not simply fee for service.
Controlling costs is central to St. Luke’s’ vision. The focus is not on the cost of specific, individual procedures, some of which will go up and some down, driven largely by government reimbursement models. Evidence points to significant potential cost savings overall that coordinated, integrated care throughout the system will provide — no duplicate or unneeded testing or procedures and vastly improved efficiencies through initiatives such as the electronic medical records.
Change is always very difficult, and it is easy to be distracted from the big picture. I believe that St. Luke’s Health System has a vision, along with the pragmatic steps that flow from it, to provide the highest-quality coordinated care in a cost-efficient manner, now and into the future.
I am proud to be part of that vision. I entrust my family, my volunteer time and my energy to St. Luke’s, and I have faith our community will embrace the vision.
Tom Saldin is board chairman for the St. Luke’s Health System.
