At a session at the Becker's Hospital Review Annual Meeting in Chicago on May 17, Chuck Stokes, COO at Memorial Hermann Healthcare System in Houston, and Michael Shabot, MD, CMO at Memorial Hermann shared their thoughts on developing a strategy for a hospital or health system in a panel moderated by Steve Lafar, president of Sg2.
Mr. Stokes began the session by providing an overview of the Houston market. While the area has been somewhat insulated from the economic stress experienced by other markets, the Houston market remains challenging. Roughly 14,300 physicians practice in the area, and interestingly, the average practice size is 1.7 physicians. Nearly half of the some 14,000 hospital beds in and around Houston remain empty on any given day, and more than one-third of patients in the market are uninsured. So how does Memorial Hermann differentiate itself in such a challenging market?
Keeping patients well
It focuses on keeping patients well, or at least is working to move toward that model. "How do we transition from an illness model of healthcare to a wellness model?" asked Mr. Stokes, summarizing a key question many systems will grapple with in the future. Memorial Hermann is working toward this new delivery model through a variety of tactics including instituting patient-centered medical homes, working to reduce readmissions, treating patients at the lowest-cost site of care and dealing with its chronic disease population "on the front-end rather than the back-end," he said. "We have to redeploy the model of care."
Memorial Hermann even goes as far as to try to keep patients out of physicians' offices — sometimes sending nurses to patient homes instead — which Mr. Lafar noted is a very unique approach. It works for Memorial Hermann though, because for unfunded patients — and there are many in Houston — the home is the lowest-cost site of care.
As Memorial Hermann begins to move toward this wellness model, its physicians will play one of the most influential roles in its success. The key lies in getting the fiercely independent physicians in the Houston market to function as a group. According to Dr. Shabot, Memorial Hermann has achieved this by taking "very independently spirited physicians" and turning them into "a very high performing group; not actually a group, but they function as one." Of Memorial Hermann's 5,000-physician medical staff, 4,000 participate in the system's physician organization and 3,600 participate in its clinical integration program, which rewards physicians for meeting certain performance benchmarks.
Memorial Hermann's physician organization emphasizes physician governance; 600-800 physicians are involved in the group's decision making, and physician-led clinical program committees are responsible for setting clinical standards for each of the system's hospital-based and ambulatory programs, holding each other accountable for standards and setting bonus levels, explained Dr. Shabot.
In a nod to the move toward team-based care, the committees now include nurses as voting members. "Not all care [will be] provided by someone with MD after their name," said Mr. Stokes.
While Memorial Hermann has made great strides in its journey toward wellness-based care, it has much work to do, and so do many other health systems. Mr. Lafar urged organizations that have not aggressively defined a strategy for success under future models of care to start today.
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Mr. Stokes began the session by providing an overview of the Houston market. While the area has been somewhat insulated from the economic stress experienced by other markets, the Houston market remains challenging. Roughly 14,300 physicians practice in the area, and interestingly, the average practice size is 1.7 physicians. Nearly half of the some 14,000 hospital beds in and around Houston remain empty on any given day, and more than one-third of patients in the market are uninsured. So how does Memorial Hermann differentiate itself in such a challenging market?
Keeping patients well
It focuses on keeping patients well, or at least is working to move toward that model. "How do we transition from an illness model of healthcare to a wellness model?" asked Mr. Stokes, summarizing a key question many systems will grapple with in the future. Memorial Hermann is working toward this new delivery model through a variety of tactics including instituting patient-centered medical homes, working to reduce readmissions, treating patients at the lowest-cost site of care and dealing with its chronic disease population "on the front-end rather than the back-end," he said. "We have to redeploy the model of care."
Memorial Hermann even goes as far as to try to keep patients out of physicians' offices — sometimes sending nurses to patient homes instead — which Mr. Lafar noted is a very unique approach. It works for Memorial Hermann though, because for unfunded patients — and there are many in Houston — the home is the lowest-cost site of care.
As Memorial Hermann begins to move toward this wellness model, its physicians will play one of the most influential roles in its success. The key lies in getting the fiercely independent physicians in the Houston market to function as a group. According to Dr. Shabot, Memorial Hermann has achieved this by taking "very independently spirited physicians" and turning them into "a very high performing group; not actually a group, but they function as one." Of Memorial Hermann's 5,000-physician medical staff, 4,000 participate in the system's physician organization and 3,600 participate in its clinical integration program, which rewards physicians for meeting certain performance benchmarks.
Memorial Hermann's physician organization emphasizes physician governance; 600-800 physicians are involved in the group's decision making, and physician-led clinical program committees are responsible for setting clinical standards for each of the system's hospital-based and ambulatory programs, holding each other accountable for standards and setting bonus levels, explained Dr. Shabot.
In a nod to the move toward team-based care, the committees now include nurses as voting members. "Not all care [will be] provided by someone with MD after their name," said Mr. Stokes.
While Memorial Hermann has made great strides in its journey toward wellness-based care, it has much work to do, and so do many other health systems. Mr. Lafar urged organizations that have not aggressively defined a strategy for success under future models of care to start today.
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