Neil Meltzer became president and CEO of LifeBridge Health in 2013, just as the Affordable Care Act was kicking in and a few months before Maryland changed its hospital payment system. The Daily Record recently spoke with Meltzer about the changes in health care since then and what patients can expect in the future.
You have witnessed big industry shifts since you took over. Tell us about that.
Rapid changes in health care have challenged all of us to think differently, sparking new ideas and opportunities to improve the health of people in our communities. With my background in public health, I look at the world through that lens, so community has been at the center of everything we do, including substantial investments in IT and Population Health. Through programs such as patient navigators and community health care workers, combined with a renewed focus on primary care and better coordination between health care providers, we are working to keep people well and out of the hospital. We are working closely with our communities on issues ranging from housing and utilities to transportation and food access.
What have been some of the biggest challenges presented by the ACA and the new waiver?
A major challenge has been that we had to take an entirely new approach to the way we have always done business. We have also had to educate our medical staff, employees, board members, partners, patients and communities about what this change means. It’s a very different, but we hope ultimately better, way to provide health care – working to keep people well rather than compensating hospitals for the number of patients they treat. It’s a shift in focus from volume to value. As we work to decrease preventable admissions to our hospitals, we free up resources for our Population Health initiatives. Through these efforts, we calculate that LifeBridge Health has prevented four thousand hospital admissions over the last three years.
What has been the biggest surprise, so far, of your time as CEO?
It’s been amazing to see how fast health care is transforming and how quickly our providers are embracing those changes. Federal and state changes are driving health care, and the center of gravity has been moving away from hospitals and into communities.
Granted there are pressures to reduce costs, however the emphasis remains on improving the quality of care. LifeBridge Health’s Medicare ACO (accountable care organization) was recently recognized by the Centers for Medicare & Medicaid Services (CMS) as a national leader in quality. These ACO groups are still relatively new; most people have probably never heard of a Medicare ACO, which is a group of doctors and hospitals who share medical and financial responsibility for providing coordinated care to Medicare patients.
And, while we talk about numbers and outcomes and quality, we are really talking about people and providing the best care possible for them.
What changes do you anticipate in health care over the next few years? How is LifeBridge Health preparing for them?
Along with the shift from volume to value and the move toward community-focused care, I think technology and precision medicine will also drive change. While we aim to keep people well, when they do need to be in the hospital, we want to offer them state-of-the-art services, whether that’s high-tech imaging to enhance advanced surgeries or genetic testing offering insight into which treatments work best for each cancer patient.
At LifeBridge Health, we also hope to be a part of that innovation. One of our scientists recently filed a patent for a device to monitor cancer cell activity. Our Cardiovascular Institute just presented results of a pilot study with the American Heart Association testing a tele-monitoring system for people with congestive heart failure.
Technology also affects how we interact with our patients and each other. A smartphone app allows patients to schedule their own appointments, and we are working with Baltimore-based Everseat to see how this technology can enhance physician interaction. We are working with Cognizant, a health IT company, on a project to develop an enhanced, integrated communications system, including a 24/7 call center.
Do you expect more consolidation in the health care industry in the coming years? What are some of the pros and cons of consolidation?
With health care changing so quickly, it’s hard to say if there will be more consolidation. I do think there will continue to be increased collaboration and unconventional partnerships.
The Advanced Health Collaborative, launched nearly two years ago, was an alliance between several Maryland health systems to share ideas and innovative approaches in this rapidly changing world of health care. These same systems recently joined LifeBridge Health to become minority owners in Hopkins Health Advantage, a licensed insurance company, allowing us to work together to help people get the most of their Medicare dollars. We think this new benefit will help to improve the health of seniors in our communities.
At LifeBridge Health, we also collaborate with other partners, such as Pulse Ambulance, ExpressCare, FutureCare and others, to enhance the services we offer.
What role do patients have in keeping down the cost of care? What should they be aware of as they navigate the health care system?
Patients have asked to be more involved in their health care, they want to be informed and be part of the decision-making process. Through electronic medical records and other technologies, patients have more access than ever to their own medical information and their health care providers. Patients must be participants in their own health, partnering with their health care teams.
Patients should not just follow doctor’s orders, they should advocate for themselves and feel empowered to do so. They should be open and honest with their provider about their concerns and not leave an appointment without fully understanding what is happening with their health. In the area of improving health, we must all work on maintaining a healthy weight, exercising and stopping smoking (or better yet, never start).
Sinai Hospital recently established an incubator for growing businesses. What are you hoping this effort will achieve?
We see the Sinai Hospital BioIncubator as an investment in the future of the health care as we create new ways to bring cutting-edge treatments to our patients. By having start-up biotech and life sciences companies under the same roof as our researchers and medical teams, we hope to foster collaboration and accelerate new discoveries. The ultimate goal is to improve the lives of people in Maryland and beyond as these emerging businesses work with our physicians on innovative ideas to move medicine forward.
State health care cost regulators have recommended expanding Sinai’s role in the “Safe Streets” program. How has that hospital worked with the program in the past, and what have been the results?
At LifeBridge Health, we know that the health of our communities is only as strong as the wellbeing of its citizens. Sinai Hospital’s Street Violence Intervention Program works collaboratively with Safe Streets to address street violence when patients live within the area of the Safe Streets Park Heights zone. The program’s success, including a 423-day stretch with no firearm-related homicides, makes us optimistic of the potential to expand the program to northern Park Heights, where Sinai Hospital is located.