The hospital is financially solid. Its quality measures in surveys are top-notch. But the health care model that has driven it for the past 129 years -- treating patients after they get sick -- is coming to an end.
"That's not the future," Ostrowsky said.
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Ostrowsky should know. He is president and chief executive officer of
There are easier challenges in the world than the one he has chosen: make health reform work.
It's a challenge that for now has more questions than answers. How do you dismantle the old health care system and replace it with one that focuses on keeping people healthy? How should
He has help.
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"It's really turning into what I would call a high-performance culture," said
Ostrowsky, 66, of
He spoke to the
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Highlights from the interview:
How is health care evolving?
You started with the facility and you kept trying to change the facility without really understanding what the community needs. It was a little bit of a "build it and they will come" mentality. Can't do that anymore, shouldn't do that anymore as far as we're concerned. ... How do you migrate from the current asset base you have to the most appropriate asset base to meet those needs and desires of the community? That's the mode we're in right now. Frankly, I think every health care system ought to be in that mode: Determine what is best for the community of people you serve and try to deliver that. And if you need a different kind of venue or a different kind of communication system or whatever it is that you need, that's where you make your investment as opposed to what you read in the last industry trade journal and say, "Oh we've got to have a left ear clinic because they're opening left ear clinics." But if no one has a left ear problem, why would you need to build a left ear clinic? And it's not easy to do because these are big assets.
Not only physically, but also politically?
Absolutely. To me
How does a hospital like
How do you stop consumers from going to the emergency department, which is expensive, when they should be treated elsewhere?
If they can avert illness, then it's not a matter of if they go to the emergency department or an urgent care center or they go to pharmacy, which has some kind of clinic. To me, those are distractions from the real issue, which is an organization like ours ought to have a strategy to implement its mission keeping people healthy. It's not easy because no one is willing to pay for that right now, meaning I don't get reimbursed by insurance companies to keep somebody healthy and the government doesn't seem to want to pay us to keep someone healthy. They all prefer to pay us when someone gets sick and they want us to spend less when that person is sick. That's where the concentration has been. But an ounce of prevention. If they would take X number of dollars and say, "Here, use it to keep people healthy," actuarially, that will show you eventually spend less on sickness care.
Horizon is partnering with RWJBarnabas on Omnia. Has this issue come up?
If you could change something about Obamacare, what would it be?
The time has come to look at what services people need, what's the best way to deliver those services and how can we more effectively finance the delivery of those services. That's really the key. And some of the services we need to deliver have nothing to do with existing sickness. They have to do with keeping people healthy. If you want to put a strategy together around that, which is what we're attempting to do, obviously we're doing it because I think it makes sense. It think that's the way you look at this problem. You don't simply look at how do you give people access to episodic clinical care? That's not going to be enough. We're never going to be able to afford that. If we don't stop people from getting sick, there will be fewer and fewer resources to take care of people when they do get sick. If you prune out a certain percentage of people and keep them healthy, you'll have plenty of resources to treat sick people.
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