Cleveland-based University Hospitals has added around 10 hospitals over the last decade, and is now working on changing its model to a more portfolio-centric approach.
During the Becker's 11th Annual CEO+CFO Roundtable, Nov. 13-16 in Chicago, Paul Hinchey, MD, COO of University Hospitals, talked about the system's growth, which will be focused on acquiring patient market share without a huge capital investment next year, and how the system's leadership structure is changing.
"We've shifted to a low-cost patient acquisition model, blue ocean opportunities optimizing what we have in terms of trying to weave these 10 new hospitals into the system and use them effectively, and engage in more partnerships rather than outright purchasing [hospitals]," said Dr. Hinchy. "We are finding ways to engage different partners and really finding partners to cover our weak spots where we're not able to engage our customers as well as we want to, or as quickly as we want to."
The health system is also going through significant operating model transformation to better connect with the community and prepare for a continued tough economic climate. Cleveland and the surrounding areas have a shrinking population overall, but a growing Medicare population, which creates payer mix challenges. Aligning as a system will provide a more consistent and attractive patient experience, and support value-based care initiatives.
"Much like everyone else, we are trying to shift from a hospital-centric approach, and shifting to more of a system view," said Dr. Hinchey. "We are also trying to push our leadership and decision-making down the org chart as much as we can, and we're really trying to shift to a more patient-centric, consumer-centric focus; more service line, less hospital, more ambulatory, less hospital, and trying to decentralize that because we're an academic medical center."
University Hospitals has deployed a dyad model for service line leadership. The service lines, which span the entire system, are led typically by a physician and administrative lead, which is a big change from the hospital-centric model where each facility has their own leadership structure.
"It's a tremendous amount of change to go from that very hospital-centric model and taking some of the control away from that group and giving it to a new group," Dr. Hinchey said. The service line leaders have ownership of the line across the system for a better patient experience.
"We're trying to create an experience from a patient perspective. It's easier to link to services that might have interdependencies across the system than it is to take a bunch of disparate services offered at a site and try to translate that into a patient journey across multiple sites across the system," Dr. Hinchey said.
University Hospitals' growth over the last decade, expedited the need for a new system model. The corporate leadership transitioned from seeing each hospital as a separate entity to thinking about all ORs as one, and all beds as one giant collection of beds across the system. The system model shift also differentiates University Hospitals from Cleveland Clinic, a national brand in the same market.
"We recognize we have some service lines that make lots of money, and we have some that lose lots of money, and it's not about the clinical importance or relevance of those, but it is about the sustainability," said Dr. Hinchey. "We're using our portfolio model to invest scarce resources in a smaller number of assets that is accretive to the bottom line, and that really helps us fund all those other things we want to do and need to do, but really can't afford to do if the other component doesn't work really well."