MGH supervisors and managers convened for a leadership meeting on Feb. 14, Valentine’s Day, to get to the heart of important hospital matters – from recent capacity challenges to preparations for the upcoming Joint Commission survey.
MGH President Peter L. Slavin, MD, opened by thanking Rick Bringhurst, MD, who is stepping down after nearly 10 years as senior vice president for Research. Bringhurst will continue to guide research at the hospital as a senior advisor to the incoming senior vice president, Harry Orf, PhD.
Slavin then turned to a topic that has been at the forefront of many staff members minds: the record level of inpatient activity. Compared to the first quarter of last year, combined inpatient and observation activity is up by 5 percent. He thanked staff for handling recent capacity challenges in a constructive and collaborative way.
Slavin also reported that the hospital finished the first quarter with an operating gain of $69 million, which is about $20 million better than budget. While inpatient and outpatient activity contributed to the positive financial result, Slavin said the primary reason is prior-year settlements with insurers. When these settlements are subtracted, the MGH is essentially on budget. But Slavin pointed out several uncertainties still ahead, including recent changes to the payment method of some of the hospital’s largest payers.
Tim Ferris, MD, medical director of the MGPO and vice president for Population Health Management at Partners, expanded on the topic of new contracts and new payment methods. He gave an overview of past payment mechanisms, describing how the downfalls of capitation led to pay-for-performance, which worked well but had its own shortcomings. Health care is now moving back to capitation, but with new stakes and new strategies to make it successful.
“The main focus should be on reducing the medical expense trend to as close to the rate of general inflation as we can,” said Ferris. “Health care costs have been rising at twice the rate of general inflation.”
To accomplish this, health care organizations must take risks and explore new care models. Ferris cited examples of such models at the MGH and Partners – including the Accountable Care Organization Program, the Partners Strategic Initiative and the MGH Care Management Program.
John Belknap, director of Corporate Compliance, addressed preparations for the upcoming Joint Commission survey. Surveyors are expected to arrive unannounced between now and August 2012. “We want to build on the success of our 2009 survey, when we did very well and received only two direct impact requirements for improvements. Our goal this year is extremely high: We want to get through the survey without any direct impact findings.”
Belknap shared the leading risk factors for direct impact findings at hospitals across the state and the nation. He noted that the Excellence Every Day Communications Subcommittee is working to educate MGH staff about potential risk factors for findings through a variety of outlets, including a redesigned intranet site, http://intranet.massgeneral.org/excellenceeverydayryday.
Belknap closed by offering three key ways managers can help make the 2012 survey successful: ensure the environment of care is safe and accommodating; ensure documentation and record-keeping clearly reflects the excellence of clinical care; and ensure all staff members know what to expect during the survey and can clearly speak to performing their work with Excellence Every Day.
Read more articles from the 02/17/12 Hotline issue.