Documentary traces Geisinger’s rise in health care industry

March 31--Geisinger Health System premiered its documentary "Reinventing American Healthcare" on Monday night at the F.M. Kirby Center for the Performing Arts in Wilkes-Barre.

The documentary profiled Geisinger's 100-year history and how it transformed from a small, rural hospital in Danville, to a nationally recognized health system.

Geisinger Health System has one of the top spots in the medical care industry, with 23,500 employees that has been lauded as a model in the fast-changing world of health care. It was one of the first health systems with integrated insurance, facilities and doctors.

The health system, which has medical facilities in Danville and Plains Township, serves 2.5 million patients in 44 Pennsylvania counties.

Geisinger Wyoming Valley Medical Center, which opened in Plains Township in 1981, has grown into the largest private employer in Luzerne County and the third-largest employer overall behind the federal and state governments, according to a list of the county's top 50 employers compiled by the state Department of Labor and Industry.

"Reinventing American Healthcare" focuses on the issues troubling the United States health care system and Geisinger's solutions to improve patient care while lowering costs.

In the film, Ralph Pascualy, M.D., chief executive of Swedish Medical Group and senior vice president and physician services of Swedish Health Services, Seattle, Washington, said there's a certain culture around physicians and hospital care that's focused on individual services.

"That culture has to change to looking at the entire health of a human being and how are we thinking about them in a holistic manner," he said. "There has to be a better way to approach healthcare."

Dr. Glenn D. Steele Jr., president and CEO of Geisinger Health System, said in his 15 years' tenure, Geisinger integrated a model in which doctors and hospitals agree to take joint responsibility for keeping patients healthy and sharing in any financial benefits that result.

However, fee-for-service still dominates most health systems across the country, creating incentives for doctors and health systems to provide a growing number of services to patients, whether or not they were necessary, he said. There was either too much, too little or the wrong things being done, he said. He and his colleagues believed Geisinger could be a model that breaks away from that incentive-based practice, he said.

Susan Dentzer, senior policy adviser of the Robert Wood Johnson Foundation who wrote the documentary's script and narrated the film, said Geisinger has a side of the house that provides care and a side of the house that pays the bills, being the insurance provider, she said. Many systems have one or the other, but not both, she said.

"That gives Geisinger a unique place where they can experiment," she said. "What they can do is figure out ways to provide better care that costs less. Often in the health care industry, people pay for health care on a piecework basis -- if you do this to a patient you get a certain amount of money. If you do five things, you get this amount."

Reed Abelson, reporter for The New York Times, said in the film that Geisinger instead created a warranty program that ensures patients pay a fixed amount for a bundle of services rather than paying more if things went wrong and more services were required. Predominantly, health care systems remain operating under what she called "a perverse incentive," in which profits rather than health is the desired outcome.

The documentary features interviews with Geisinger innovators, hospital administrators, physicians and nurses, as well as surgery footage and real-life patient stories. The film will premiere on WVIA-TV at 7:30 p.m.April 23.

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