Becker's Hospital Review

25 7TH ANNUAL MEETING RECAP surgery patients, who faced $1,000 to $2,000 co-pays under the system's health plan. e program was expanded to all patients systemwide in early April. rough a complimentary app, patients can rate their experience, provide feedback and, using a sliding scale, ask for a refund up to the total amount of their co-pay or deductible. Dr. Feinberg said the app emphasizes good will, which discourages abuse of the honor system. Before moving far along in the app, patients encounter a message that says the relationship is built on trust. So far, Geisinger is finding patients are fair and moderate. Skeptics' predictions that Geisinger would face a steady stream of $2,000 refund requests seem ridiculous in hindsight. From October through mid-March the system processed roughly 74 refunds across a half- dozen sites of care. In that time, it waived nearly $79,812.59 in charges, according to the Washington Post. "We really learned what patients want is to leave positive feedback. When it's negative, it's usually mixed, and almost every single person has only asked for some of the money back," said Dr. Feinberg. One patient le a review highlighting three negative moments during her stay aer bariatric surgery. An IV didn't work and it wasn't fixed for three hours. One nurse didn't smile during her shi, and the patient felt uncomfortable to ask for help to the commode. e construction that was supposed to end at 9 p.m. went until 10 p.m. Aer recapping these lows, the patient asked for a refund of $100 out of $1,000. "is has allowed us, more than anything, to listen to what went wrong and give patients some assurance that we'll make it better next time," said Dr. Feinberg. He has compared the moderate refunds to the likely heier price of bringing in consultants to identify areas for improvement. Looking at it this way, $100 is a small price to pay to learn about three specific deficiencies that occurred on your watch. By putting a price on disappointment, and getting vivid feedback on what letdowns look and feel like, Dr. Feinberg hopes to drive his organization to a relatively straightforward result. "I would like Geisinger to become the most caring organization, period. More caring than anything. We have all the resources. We have no excuse to not get it right," says Dr. Feinberg. "e measure of success is, 'I've never been cared for better.'" n A Lesson From the Past to Predict the Future: How Joel Allison Channels Abe Lincoln to Affect Change By Akanksha Jayanthi H ealthcare is constantly discussed as being in the midst of great change. The way providers deliver care is changing, the way providers are reimbursed is changing, the way patients approach care decisions is changing — the changes are endless. But this era of change shouldn't come as much of a surprise because the industry has forever been evolving. "We are changing rapidly, but we've always changed," said Joel Allison, president and CEO of Dallas-based Baylor Scott & White Health, in his April 28 keynote address at the Becker's Hospital Review 7th Annual Meeting in Chicago. "We're in constant change….You've got to embrace change." Mr. Allison elicited the quote from President Abraham Lincoln to embody this sentiment: "The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew and act anew." In today's healthcare environment, there are four key drivers of change that are moving healthcare toward the industry of the future. The four disruptors, as Mr. Allison called them, are regulation, demographics, economics and technology. Regulatory. "We, next to banks, are the most regulated industry in the country," Mr. Allison said. As such, healthcare organizations are tasked with getting physicians and their teams in line and on board, especially as regulations change. Demographics. As characteristics of the patient population evolve, so will the way in which care is delivered. "I call that consumer disruption," Mr. Allison said. "All the way from us baby boomers who look at it one way, down to the millennials. They're the ones who are going to start changing life." Economics. The way economics in healthcare are functioning now is not sustainable, or efficiently distributed, according to Mr. Allison. "We spend $3 trillion a year on healthcare in this country," he said. "The problem I submit is we don't spend it the right way. $3 trillion is enough to cover every man, woman and child with good quality healthcare." The shift to the outpatient arena will be critical for healthcare organizations, as will engaging in a multifaceted strategy including cost management, improved quality, market coverage, retail healthcare and care coordination, Mr. Allison said. Technology. Technology of the future will eliminate clinical waste and variation, Mr. Allison said, adding this will largely be achieved through standardization, big data and predictive analytics. He also mentioned how Baylor Scott & White Health appointed the system's first chief digital officer, Nick Reddy, who is helping initiate digital initiatives to better engage with patients with projects like booking appointments from smart phones and piloting video visits. These disruptors are accelerating the pace of healthcare's change, which presents challenges and opportunities for industry stakeholders, but Mr. Allison said it is incumbent upon providers to be the ones to take the reins and steer the industry to where they want it to go. "The best way to predict the future is to create it," Mr. Allison said. n

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