"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Friday, September 5, 2014

Where Did the Summer Go?

I sat down to write my blog this AM, the first of this week and realized that it was already September.  Where the heck did the summer go?  Wow!  This will be my last blog for a while as I will be traveling for the next week and a half.  So, this blog will be a collection of items.

First, many have been asking about my son-in-law, Terrell, and he continues to receive inpatient chemotherapy treatments on almost an every-other-week basis.  Treatments are now scheduled through November.  He is doing as well as can be expected under the circumstances.  He and my daughter are two very amazing people based on how their lives have changed since that mid-February diagnosis and how they are coping.  They have fast become my heroes. We had a chance to visit with them a few weeks ago and I have attached a photo.

Then, there is their dog, Sammy.  Sammy is a fox red lab who is the nicest dog.  He is so nice that their plan is to train Sammy as a therapy dog in the coming months.  They all live in a very nice neighborhood in Charleston, SC.  Sammy is very well trained and never leaves their property unless he is a accompanied by one of them.  Well, that all changed yesterday. Sammy ran away.  They were devastated as they couldn't find him anywhere.  Then, their neighbor from down the street came to their door and said I found Sammy, but you have to see for yourself where he is.  Upon arriving at their neighbor's house there is Sammy doing laps in their swimming pool.  As a retriever, Sammy loves the water and demonstrated that yesterday.  I think that an invisible fence is in Sammy's future.

On a more work related note, yesterday I had the opportunity to hear Anirban Basu, a Maryland economist speak on our global economy, our national economy and our local economy.  His presentation was excellent.  He said that the global economy has rebounded for the most part, but expanding economies of China and India are down this year from previous years.  Anirban said that the next quarter will be strong and the following quarter will be even stronger for the US.  

Corporate profits are at their highest along with stock prices.  Consumer spending, i.e. autos, retail shopping and restaurants, is also up; however, housing, jobs and incomes are down overall.  

He said that Maryland continues to underperform as we are pretty much a government dependent state.  Our state is over dependent on federal government jobs, according to Anirban.  In addition, our lack of energy production and our over regulation make us one of the worst performing states related to economic recovery.  As a state, we rank 43rd in recovery with WV and PA at 36th and 38th respectively.  North Dakota, Texas, Utah and Colorado, because they are energy producing states, are leading in economic recovery.  

Anirban said that what is negatively impacting western Maryland is no ability to have a business formation strategy.  Our young people are forced to leave the area for employment so, there is little to no entrepreneurship among our twenty and thirty-somethings where new business occurs.  In addition, western Maryland needs natural gas drilling in order to have economic recovery.  Unfortunately, Maryland is focused exclusively where the most votes are--Montgomery County, Prince Georges County, Baltimore city and Baltimore County.  If legislation doesn't benefit any of those jurisdictions, it will not pass.  According to Anirban, the state has no interest in seeing any county outside of the previously mentioned succeed.  He said that the statement is harsh but it is reality. 

During the Q&A, he offered the following: the US needs conditional amnesty  through an immigration policy because right now we have none.  That policy should  be socially and fiscally sound and include a a secure border and a well thought out  path to citizenship.  He then commented on our debt and said what is more troubling than our over $17 trillion dollars in debt is our $45 trillion in entitlement commitments to Medicare and Social Security that directly impact our ability to address infrastructure needs in the US, including bridges, roads, the electrical grid and broadband development.  Infrastructure improvements are key for the US to remain competitive in the global market.  No other country has the entitlement burden that the US has now and into the future.

As I mentioned earlier, the presentation was excellent, but at the same time sobering.  If you ever have the opportunity to hear Anirban Basu speak, don't pass it up.  I am excited in that he and I will be speaking at a GE/Sage Group presentation in two weeks in Baltimore with a focus on health care.


I will return to blogging the week of September 22.  Have a good weekend.








Friday, August 29, 2014

Staying Relevant

In my last blog, I told about the site visit to WMHS by representatives from Cigna, a national health insurer, earlier this week.  In attendance were their Chief Operating Officer for the mid-Atlantic region, finance people, a physician, their director for Care Coordination, two IPA administrators and their director for informatics.  They were exceedingly complimentary of what we have accomplished and how we are approaching "staying relevant."  

In their interactions with hospitals, health systems and physician practices, they are routinely encountering that "deer in the headlights look" from both health care executives and physicians.  There is so much uncertainty as to how to deliver care in this ever changing health care environment.  However, they were so impressed with our transition to value-based care delivery and the associated success that we have been experiencing.  They said that we have figured out how to not only stay relevant, but to continue to challenge ourselves and our entire organization on reducing use rates; further reducing admissions, readmissions and length of stay; focusing on new quality and cost initiatives and the list goes on.  We have been told repeatedly that every hospital should be required to visit with us and learn about our most successful care delivery transition.  Pretty awesome!

Wednesday, August 27, 2014

Learning About Our Amazing Journey

Today is the last scheduled site visit by an external group to WMHS.  Since the spring, we have hosted around ten groups, mostly hospitals and health systems, in order for them to learn about our transition from volume-based or “sick care” delivery to value-based care delivery.  We have hosted groups from all over the State, including representatives from the Johns Hopkins Health System and culminating with a visit from an insurer today.  

Cigna / Healthspring representatives will be meeting with the leadership at WMHS then touring our Center for Clinical Resources.  When the representative from Cigna contacted me for the site visit, he said that they think that they know about value-based care delivery, but they really don't.  Hearing and seeing first hand what we have put in place and how we made the transition would be great for their team in understanding changes in health care.  

We have not been resistant of an prospective group wanting to learn about what we have accomplished.  After all, the August 11, 2014 headline in the Business Insider said, "An Amazing Health Care Revolution Is Happening in Maryland And Almost No One's Talking About It."  That would be us.  Pretty awesome and why not allow others to benefit from our success.  All Maryland hospitals are dependent on the success of the new Waiver so helping other hospitals also benefits us in the long run.


http://www.businessinsider.com/maryland-health-care-revolution-2014-8



Monday, August 25, 2014

Physician Recognition

On Friday evening, we held our Physician Recognition Gala at WMHS.  Physicians were recognized for their contributions to WMHS as well as their years of service.  There were two physicians, Dr. Bob Dawson, a pediatrician, and Dr. Bob Miller, a radiologist, who were recognized for 50 and 49 years of service respectively.  That's remarkable since the recognition is for their time in Cumberland serving our patients for five decades.  

We also selected three physicians for awards, Mane Ictum (Latin for Greatest Impact), Lifetime Achievement and Physician of the Year.  Dr. Nii Lamptey-Mills, one of our newest gastroenterologists, received the Mane Ictum Award.  His impact on our health system and our patients has been just short of amazing.  In addition to his wonderful smile and great disposition, Dr. Lamptey-Mills has been fully engaged and has truly had a significant impact on our patients.  Dr. John Stansbury received the Lifetime Achievement Award as he winds down his practice at Hunt Club after 35 years of serving first at Memorial as an ED doc and then serving in our urgent care practice.  John is so deserving of this award for his care, his compassion and his dedication.  Lastly, Dr. Blanche Mavromatis was selected as Physician of the Year.  Dr. Mavromatis is an excellent practitioner who works in a most challenging specialty, oncology, but does so each day with compassion, attention to every detail and always with a pleasant, but professional demeanor.

In my remarks at the Gala, I failed to recognize the work of the Twelve Physicians who serve on the President's Clinical Quality Council.  These physicians are the movers and shakers as well as our early adopters.  They have embraced the change in health care delivery at WMHS and have positively impacted their colleagues in the organization as we all transition from volume-based care to care that is value based.  These docs have made a significant impact on the organization and for that I am most grateful.


All in all it was a wonderful evening and very well emceed by Dr. Jerry Goldstein, our CMO.


Left to Right: Dr. John Stansbury, Dr. Blanche Mavromatis, Barry Ronan, Dr. Nii Lamptey-Mills, Dr. Jerry Goldstein


Friday, August 8, 2014

Are Women Really Smarter Than Men?

The other day, Michelle Obama said at the US-Africa Leader's Summit in Washington DC that women are smarter than men and that they must use their intelligence to effect change.  Interesting point to say the least.  

I am surrounded by women every day.  A mother and two sisters, wife and two daughters and 82% of the employees at WMHS are women.  So, what say me?  Heck yeah, they're smarter.  Actually, the perspective that women bring to most any situation is invaluable.  According to Internet sources, their brains develop faster, they are better at the arts, and they are better at communications, interpersonal skills, relationships and lateral thinking.  They also have a better episodic memory.  

There have been two recent studies, one in Canada and one in England, that show men are just slightly more intelligent than women.  However, a July 2014 article in the Huffington Post has humans being smarter than ever and that women are rapidly catching up to men in areas where they had been superior for years, such as math and science.  Scientists have said that improvements in women's intelligence has a direct correlation to improvements in societal development, such as living conditions, more so than men. 

Nonetheless, it's all pretty fascinating, but my money is still on the women; they are truly an amazing gender; far more fascinating than men.

Thursday, August 7, 2014

What a Week

So, the reason that I haven't been blogging this week is because I have been too, too busy. For Monday, Tuesday and Wednesday there just weren't enough hours in the day.

On Monday, representatives from Johns Hopkins Health System/Bayview Campus came to WMHS to learn about value-based care delivery.  Our team spent around three hours taking them through our journey over the last four years.  The visit ended with a tour of our Center for Clinical Resources.  They were around the eighth hospital or health system to
visit WMHS to learn about our successes, as well as our challenges, under Total Patient Revenue.  There are two more visits scheduled this month. It is so rewarding to be able to tell our story and to repeatedly re-live this pretty amazing journey.

A few weeks ago, we were asked to serve as the site for the Governor and Secretary of Health to present their Governing for Results Tour.   The Governor is making visits around the state providing an overview of his administration's innovative policy efforts.  Quite honestly, I was under the impression that WMHS was serving as a backdrop for the Governor to present his white paper, "A Prescription for Innovation: Maryland's Data Driven Approach to Containing Costs and Advancing Health.”  To my surprise, and to the surprise of everyone else at WMHS, his visit yesterday was more about us than anything else.  

Governor O'Malley touted our success in advancing the Triple Aim of Health Care Reform (Better Quality, Less Cost and a Healthier Community).  He said that we had become a model for the state, as well as the rest of the country, on health care innovation. Secretary Sharfstein said that we are at the cutting edge of health care in our nation.  Wow!  The visit was scheduled to be an hour and it lasted almost two.  We met for almost an hour then he toured the Center for Clinical Resources.  The visit culminated with a press conference.  

It was a tiring three days in that Tuesday was spent preparing for the visit as well as dealing with all of the other issues and challenges of the day. It is truly great to have this health system and our exceedingly creative staff recognized for their amazing work over the last four years.



Friday, August 1, 2014

Oversees Adoption

I learned this AM that one of our employees previously accompanied a team of doctors and nurses to the Philippines on a mission trip.  While there, she encountered a toddler in an orphanage whose arm was badly burned and had to have it amputated.

To make a long story short, she is now in the process of adopting this young girl.  What I find most distasteful is that it is costing her $37,000 to adopt this little girl and it will have taken three years before it's all said and done.  It will be three years that this little girl has to continue to be housed in an orphanage rather than with a loving family and only after everyone "gets a taste" as they used to say on the Soprano's.

The lawyers, various governments, government officials, Catholic Charities, the orphanage and God knows who else get to divvy up the $37,000.  Certainly, a tribute to the employee and her family, but there has to be a cheaper, more expeditious way.