We sat down and interviewed Pete Geier, CEO of the OSU Health System and COO of OSU Medical Center to get his view on healthcare reform and how The Ohio State University Medical Center is positioned to handle the coming changes.
1. Timing-wise, when do you foresee healthcare reform happening and how do you see it affecting the University?
I think it’s happening right now, maybe not from all the provisions of the healthcare reform law going into affect on items like exchanges, but I think a lot of the factors and forces that are not going to go away are already affecting us. Issues like the continuing emphasis on quality, bringing readmissions down, population management, those things are all happening now. So I think the impact of reform is here sooner than I think a lot of people have realized.
2. What do you think healthcare reform means for academic medical centers?
I think there are challenges and there are opportunities. I think academic medical centers are really well positioned. I think OSU is well positioned for a number of reasons: our electronic medical record implementation, our own health plan, and our Faculty Group Practice is integrated into the University and our scores are ranked nationally in the Quality and Safety outcomes by the University Health System Consortium. I think the challenge for academic medical centers is how do you fund the research and teaching missions under healthcare reform, and that will be a challenge for us.
3. Do you have solutions? Or is it kind of a wait-and-see process?
I think the best solution in all of this, and the one thing that isn’t going to go away, is the flight to quality. The focus on quality is going to be everything in the future of health care. That is, how you are going to get paid or not paid, and I think again, we are in great shape and we’ll be able to thrive under that and support teaching and research.
4. What changes do you anticipate seeing, specifically at Ohio State?
I think you are going to see a couple changes, in the College, obviously the change in the curriculum; it has really made it one of the most cutting-edge curriculums in the United States. I think on the clinical side, you are going to see much closer integration of the hospitals and the physicians’ group in terms of managing the clinical operations. In other words, instead of just having hospital leaders, there will be hospital and physician leaders, and we will probably manage less by hospital and more by service line. So managing cancer, heart, neurosurgery, transplant across all of our in-patient and out-patient sites. And in the research area, it’s going to be much greater joint collaboration in colleges across the University in order to compete for large grants. But again, in all of these I feel as though we are pretty well-positioned.
5. What about changes in the state of Ohio? Can you talk about changes with how people perceive their care or how reform will affect the insurance companies and the average person in the state of Ohio?
I think for the consumer there are going to be some wholesale changes. One, the whole system is going to shift toward paying you as an individual for staying out of the hospital. In other words, for wellness, fitness, all the programs are going to be designed to keep people out of the hospital and keep them well, whether it’s diet, exercise or smoking cessation. And then for the chronic, the twenty percent of people with chronic illness, there will be much more intense management of their illness, I think in the future, if someone gets admitted into the hospital, it will be viewed as a failure because we didn’t keep them out of the hospital and keep them well.
6. What is OSU doing to prepare for reform?
A lot of it is still going on. I think a number of things have been done to help us prepare for this; first was the conversion to electronic medical records. You get certification at certain levels, and soon we will be a level seven, which is the highest level you can get in terms of certification, so we will be in the top-five percent nationally. Bringing all the physicians in to have them employed by the Faculty Group Practice and having the OSU Health Plan as part of the Medical Center, that is what we are going to use and turn ourselves into our own accountable care organization. Some of the estimates to set an accountable care organization have been between two and twenty million dollars and we basically already have that, so we don’t have to go into that expense. So I think we are in pretty good shape, but you know it’s a weird time, it’s going to be schizophrenic for a while.
7. What about timing? When do you really see the final product being put into place?
I would peg that at about 2014 for us, and plus 2014 is also when, according to the healthcare reform act, when healthcare exchanges go active. In other words, people can go out and actively pick their health care, so that will be a game-changer.
