A Personal Note from Jerry Rutherford
September 18, 2011
Posted by chcablogadmin in : Leadership
I was thrilled to find out that the Board and CEO Search Committee selected Mark Wietecha to lead us into the future. I have had the professional pleasure of working with Mark on a number of projects, dating back to 1997, that have created significant value for the CHCA Owner Hospitals. In every situation, I learned a lot and had fun. Mark is a very familiar face to CHCA as well as many of our children’s hospitals. I believe he is uniquely positioned to guide our new organization through the decisions, details and intricacies of the merger and pave the way to accomplish our collective mission. The leadership transition process begins officially September 22, when Mark assumes his new role; but, as you might expect, we’re already off and running with important logistics and communications. I have committed to Mark that I will support him in any way possible to ensure a smooth and seamless transition for him, the children’s hospitals and CHCA staff. I will meet with Mark next week to better understand his perspective on how I can best provide that support.
On a personal note, my time as President and CEO of CHCA has been tremendously rewarding. We’ve gone through a period of change—with more to come—and I’m truly grateful for the support of all CHCA staff and the staff’s ability to remain focused on the needs and priorities of CHCA Owner Hospitals. As the CEOs of these wonderful institutions, I want to thank each of you (and will do so personally when I have the chance to see you) for the support and guidance you’ve provided me. More importantly, I want to thank you for entrusting me with this important interim stewardship role and hope that you have found your trust was well founded.
I would be remiss if I did not recognize the CHCA Senior Team – Barbara Spreadbury, Craig Fischer, David Spizman, Jeff Primovic, Kassandra Jensen, Nancy Vasto and Sandra Tillman. They accepted me wholeheartedly and provided significant guidance, direction and support throughout the process. I also need to recognize Angie Leondedis and Sharon Smith who have been with me throughout, almost daily, to help facilitate open, transparent communications.
I am also thrilled to report that on August 31, we received notification from the Kansas City Business Journal that CHCA was selected as one of the winners in the annual Best Places to Work awards program. CHCA is one of 10 companies in the medium company (50 – 249 employees) category. With Mark’s selection as the new CEO, I’m confident this tradition will be sustained and the future will be exciting.
Warm regards,
JR
add a commentOur Future: A Message from New President and CEO Mark Wietecha
September 18, 2011
Posted by chcablogadmin in : Leadership
(Editor’s note: this memo was sent to all members jointly by NACHRI/N.A.C.H. and CHCA communications staff Friday, September 16, on behalf of Mark Wietecha.)
Our Future
Mark Wietecha, President and CEO, CHCA and NACHRI/N.A.C.H.
Thank you for the opportunity to work with you to advance the success of your institutions through our new organization. It is truly a privilege for me. I look forward to meeting you and better understanding the needs of your institutions over the coming months. Together, we will make great progress in advancing our mission and your success, and most importantly, the health interests and future of children.
Our immediate priorities are to keep the current work initiatives moving and to accelerate the process of bringing our new organization together. It is critical we achieve the best possible impact on the direction of public policy as it relates to the financing of children’s health care, medical education and research. The political process is in full swing, and we are working thoughtfully to fully mobilize our strategy and influence to make a difference. There is much activity underway, and you can expect continued updates over the coming days and weeks.
To accelerate the integration of our new organization, I am working with Peggy Troy and the Interim Management Committee (IMC) to begin the leadership transition. My time commitment will steadily increase over the coming months as I conclude my current duties, and we will continue to rely on Peggy and the IMC’s continuity over this period. Our immediate priorities are to bring together the legacy plans of CHCA, NACHRI and N.A.C.H., to assess how we can be more effective in meeting your needs, and to begin aligning our operating organization and finances. It is our goal to move these processes along on a timely basis, and ensure you – our members – are providing your input on our direction and priorities. This is your organization. We will be working through Jim Mandell and the new Board to reach out to you and define how we expect these initiatives to unfold over the balance of 2011 and over the course of 2012.
Thank you again with warmest personal regards,
Mark
add a commentACO Update: Issue #7
August 28, 2011
Posted by chcablogadmin in : Financial Viability, Healthcare Reform, Leadership
In this edition of ACO Update we talk with Peggy Troy, President and CEO, Children’s Hospital of Wisconsin. Peggy shares their vision and market strategy as well as posing some thoughtful questions about long-term sustainability of children’s hospitals.
In the accountable care arena, Colorado has been very progressive. On the July ACO call, Bruce A. Harma, FACHE, Director, Managed Care, Children’s Hospital Colorado, provided an overview of the state’s Medicaid accountable care collaborative as well as his hospital’s accountable care initiatives for the commercial sector. Additionally, he profiled several quasi-governmental agencies working on reform initiatives in Colorado.
I welcome your comments and suggestions as well as your questions. Please feel free to contact me directly.
Jacqueline Kueser, Vice President, CHCA
Jacqueline.kueser@chca.com
CEO Interview Series: Poised for Change
August 28, 2011
Posted by chcablogadmin in : ACO Update, Healthcare Reform, Leadership
The following interview with Peggy Troy, President and CEO, Children’s Hospital of Wisconsin, is another in the series of CEO interviews with Jacqueline Kueser, CHCA Vice President, regarding children’s hospitals’ responses to the current and envisioned health care environment. Peggy candidly shares their post reform strategy, market position strengths and pursuits. – JR
Peggy Troy
Our Vision
Our organization does not intend to merge with an adult ACO, and we are not staying the same. We cannot be successful in the future in our current structure.
We have a vision that the children of Wisconsin are the healthiest in the nation. Our goals for the post-reform environment include:
- Regional independence;
- Meaningful relationships across the state to create necessary infrastructure and reduce costs, and
- An understanding of the implications of leveraging our health plan knowledge to expand our medical risk-taking beyond the Medicaid population.
Benefiting from Reform
The good news: The post reform policies of “no lifetime limits” and not excluding pre-existing conditions have resulted in additional annual revenues for our organization.
The challenges: To focus our efforts in this complex environment, we recently hired a new Advisor on Health Reform. We consider ourselves well positioned to pilot payment reform projects with 44,000 Medicaid HMO lives, 67 primary care physicians, distributed urgent care centers and hospital relationships and a foster care/ adoption program with 3,000 lives. In addition to focusing on payment reform, we are looking at what it takes to become a medical home. We also plan to transition from serving as an episodic and acute care center to a system of integrated care delivery with a high degree of accountability.
In terms of wellness and prevention, we continue our aggressive work in asthma care. Asthma represents 9.5 percent of our admissions, and we’d like to never admit another kid with asthma. We’re working on this through medical homes, case managers and our region’s school systems.
In terms of a payment model, we are working with the new Wisconsin Secretary of Health on ideas for proving a medical home for populations such as foster care children, of which there are 2,000 in Milwaukee County and 6,500 in the state. We’re also evaluating opportunities to expand our program for medical homes for children with special health care needs.
We’re developing an asthma pilot with an insurer in our market, which will share the expenses of a dedicated asthma case manager and share in savings from avoiding unnecessary hospitalization and ED utilization. I’d like to build on this idea and five years from now have different payor relationships and reimbursement structures than today.
This being said, we still must perform heart transplants and we need financial resources for these highly specialized services.
Adult Market Activity and Competition
In terms of pediatrics, I’m messaging to our large adult systems that our organization plans to remain a “Switzerland” among regional health care providers. We’re collaborating with several adult systems and making moves such as agreeing to put our neonatologists and nurse practitioners into adult hospitals. This makes good business sense when close in geography.
Health Plan and Positioning with Payers
We currently have a medical health plan covering pregnant women, children and families. We are evaluating the implications of the reform legislation for expansion particularly in light of the coming 2014 health insurance exchanges. We are gathering information to help us understand the implications of developing a broader insurance product for children. For example, we are reviewing regulations defining pediatric specialists and how they get paid particularly for multi-system conditions. We are concerned about the possibility of Medicaid moving to a block grant which, if not done carefully, could cause real erosion in coverage for children.
Market Positioning into the Future
No road map exists; we are working as an architect in an uncertain world. We need to start thinking differently than bigger is better. We need to adopt new capabilities in care management across settings. We need to switch from episode-centric care–and somehow protect ourselves in the transition–to managing a child’s health needs throughout childhood.
We are studying pediatric data to evaluate why kids come to our hospital. We need to understand our costs and efforts in complex care, secondary care and primary care to better position ourselves with adult providers and employers. We will need to be cognizant of the path as a high-end tertiary provider with a reimbursement base that erodes our ability to fund research and education.
One option for children’s hospitals in general may be to regionalize services to get to the required scale to compete. Only five percent of children need high-end services. This begs the question of how many high-end programs are needed across the country particularly with the shrinking talent pool and the costly infrastructure of these programs. Is regional alignment an option? This could be a great advantage to achieve the necessary scale. In this model, would we be able to create a superstructure that would benefit research, provide for concentration of high-end services, decrease costs and attract talent?
