Tuesday, July 23, 2013

Connecting with and educating a segment of the business community on healthcare reform

Last week I participated in a panel for Biz Now, a meeting with real estate brokers, developers and others from the local real estate community and some healthcare leaders. Also on the panel with me from healthcare was Bonnie Phipps, President and CEO of St. Agnes Hospital. The topic for discussion was healthcare real estate. The discussion was lively and centered on the changing healthcare real estate needs as they relate to healthcare reform, the affordable care act, accountable care organizations and value-based purchasing.

I raised the point that it’s a problem that the business community doesn't understand the dilemma of our national healthcare system.  I explained that our country’s need for healthcare reform really has nothing to do with politics. Whether you’re a fiscal conservative or a wide eyed liberal you should be concerned that we’re spending 40% more on healthcare  than any other country.  And, the business community should be demanding reform regardless of whether or not they are for or against the affordable care act. To fight against reform is absurd, especially when healthcare impacts businesses just as much as individuals.

We went on to talk about the playing field and the fact that some Maryland hospitals get higher prices than others, but that with insurance exchanges and the notion of restricted networks, this is starting to change. We also explored the concepts of the GBMC transformation and our focus on the patient centered medical home as the fundamental building block of the healthcare system.  

As I talked about GBMC’s transformation I was extremely proud when Bonnie Phipps told the audience that GBMC is way out in front in the evolution to accountable care organizations and with our work developing the patient centered medical home model. This was really nice to hear and is important for everyone at GBMC to know…

The business community is slowly waking up to the need to demand greater value for their healthcare dollar and this panel discussion was a great exchange of information.  I was glad to have had the opportunity to educate these real estate professionals about the changing tide of national healthcare and GBMC’s role in creating a value-driven system. I believe that there are a few more business leaders who now see a new roadmap for change and their role in designing a new and better system.


  1. Dr. Chessare, I am gratified to know that GBMC is on the cutting edge of the changing healthcare system. Do you think we will ever reach a point in this country where health insurance is NOT an employee benefit? Seems like it would improve the bottom line of every business if health insurance was not tied to employment. But I guess people would start hollering "Socialism" if everyone had government sponsored health insurance... like those on Medicare/Medicaid, right? What a dilemma.

    1. Thanks, Anonymous. We could make great improvements to our system without having it be run by the government. A great example to look at is Germany where the system is not run by the government but rather by a form of employer cooperatives. You may want to read the book "The Healing of America", by T.R. Reid. Mr. Reid studied the healthcare systems of countries throughout the world.
      A single payer system (like we have for people over 65 in the U.S. (Medicare) would certainly drive administrative efficiency but I don't think we have the political will to do this. It is interesting that there is broad support to maintain the Medicare program even though there does not appear to be support to extend it to others.

  2. 40% more on healthcare than any other country is astounding. After working in the hospital setting for over 20 years (9 years at GBMC and 13 years at Hopkins prior), it is more than clear to me that the middle man -- health insurance companies (corporate conglomerates)-- are the cause and also receive a hugh chunk of our "healtcare expenses."

    At Hopkins (where I worked for over 13 years), we would lose money for every patient who had health insurance (broke even for self-pay) and only profited from non-insurable procedures (i.e., cosmetic plastic surgery, laser vision correction). Not to mention employing a whole staff of our own nurse "qualifiers" to debate the insurance companies' nurse "disqualifers" (nurses would get paid more to deny healthcare than dispense heathcare), which also raised the cost of healthcare.

    The only way to justify the expense of patient care was the government-granted research income that paid many of the doctors and support staff salaries -- that is if you are being honest when you state the "actual cost" of each procedure before insurance company adminstered "disallow" charges.

    In the end, our healthcare really is government-sponsored (that is if you want to break even).

    1. Thanks, Anonymous. I agree that there is some room for improvement with the portion of the health care dollar that is spent on insurance overhead but the evidence is clear that the bigger opportunity is in the unit cost of services and in the frequency with which we do certain services that don't actually add to health.


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