Innovation, Disruption Themes of MMS State of the State Health Care Leadership Forum

By Erica Noonan, Vital Signs Editor

Turning his health system into a patient-centered institution on a retail model meant a top-to-bottom reworking of every area, including the shocking move of eliminating wait time for doctor visits and waiting rooms,  said David Feinberg, MD, MBA, president and CEO of Geisinger Health System.

Now when patients call, the first thing they are asked “Would you like to be seen today?” And when they arrive, a smart card in their car alerts the office that the patient will be entering the building in several minutes. Upon arrival, the patient is greeted by a staffer who says “We’ve been expecting you,” and escorts them directly to an exam room where a doctor will meet them.

“Waiting rooms add no value to care,” said Dr. Feinberg, a featured speaker at the 16th Annual State of the State’s Health Care Leadership Forum held Oct. 22 at MMS headquarters in Waltham.

Geisinger calls its initiative “Proven Experience,” and even offers a money-back warranty where patients are asked for detailed feedback on their experience, and unhappy customers are asked how much money they would like refunded. Billing statements are as simple as a restaurant receipt, he said.

“Most patients are much more interested in giving feedback they think will be valued than getting money back,” said Dr. Feinberg. He admitted the unconventional model is “about patients, not doctors.”  He said, “We are here to serve patients, not protect organized medicine or protect doctors.”

The forum also featured Mass. Attorney General Maura Healey, Mass. Public Health Commissioner Monica Bharel, MD, and CVS Health Chief Medical Officer and Executive Vice President Troyen A. Brennan, MD. It was moderated by Jim Braude and Margery Eagan, co-hosts of WGBH’s Boston Public Radio.

Healey spoke about the state’s move to demand more cost and price transparency from health care providers and its impact on the delivery of care. Despite the state’s impressive insurance coverage rate of 96 percent, citizens without coverage remain overwhelmingly Latino and poor, she said. And despite moves to publish price differences between various health systems, unwarranted price variations unrelated to quality measures persist across Massachusetts. “We have more work to do,” she said.

Dr. Bharel spoke about public health trends and persistent health disparities, even in a city with world-renowned medical care. Premature death rates are 50% higher in the Dudley Square neighborhood of Boston than in more affluent suburb of Arlington, just two miles away. “Access isn’t enough,” she said.

Dr. Brennan discussed the expansion of CVS Health Minute Clinics nationwide and how its acute services aim to integrate with traditional practice care via EHRs.  The clinics have no intention of replacing medical practices, he said, but rather “meet a very specific need and we’re very good at it.”

The ongoing push towards integrated care and global budgets may see physicians sending patients to a Minute Clinic near their homes for hypertension monitoring, ensuring medication compliance, or even collaborating with a CVS nurse via telemedicine tools,” he said.

“We are trying to integrate care, not disintegrate care,” said Dr. Brennan.

See  the presentations from the MMS’ 16th Annual State of the State’s Health Care Leadership Forum here.

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