George Bischalaney, President and CEO, Eden Medical Center

By George Bischalaney, President & CEO, Eden Medical Center

Health care reform is on the agenda, again. The stakes are high, but our President is determined to make some significant changes. As the discussion moves from general to specifics, special interests are staking out their positions. None of the stakeholders—hospitals included—wants to feel the impact or be at a disadvantage.

Amidst the demand for cost reduction and health care coverage for all, there is and must be continued investment in care. Physicians demand it. They expect to be able to practice with state-of-the-art equipment and facilities to produce outcomes that meet national, state and local quality standards. Patients demand it. They want to know that their local hospital has the right number of well-trained staff as well as the latest diagnostic and treatment equipment, and contemporary facilities.

With this backdrop of conflicting needs, Eden Medical Center is about to begin a three-year project that will result in the replacement of the Castro Valley hospital. The project cost is estimated to be $320 million. The current 55-year-old building is anything but contemporary. With few private rooms, small operating rooms and inadequate support space for clinical services, a new hospital is very much needed.

Eden Medical Center has served the community well, but it was not designed for patient comfort and needs, more for staff needs and functionality. While our project may seem ill timed given the uncertainty of hospital reimbursement, we are required to meet California legislated standards for seismic safety in hospitals. And it truly is needed.

We’ll celebrate our long sought goal with a ground-breaking ceremony on July 1st. Then we’ll spend the next three years continuing the investment in the new buildings and equipment, while observing and hoping that decision makers do not enact legislation that essentially penalizes us for the commitment we are making. When we celebrate the grand opening and our new beginning early in 2013, it should be with the same hope and dreams as those who celebrated the first ceremony in 1954.

George Bischalaney, President and CEO, Eden Medical Center

By George Bischalaney, President & CEO, Eden Medical Center

Last week, the Obama Administration kicked off its efforts to address one the President’s stated priorities, health care reform.  What does that mean, and what will be the result? I wish I really knew.

According to the President’s advisers—and Obama himself during the campaign—there is a need to extend health care coverage to millions of uninsured people across the country, while reducing cost and improving quality. Truly admirable goals with which very few could disagree.

Early discussion of President Obama’s plan calls for creating a savings of $634 billion over the next ten years to help fund reform. A recent article referred to this as a “down payment” on the overall expected costs. About half of this amount is targeted to come from reduced payments to Medicare and Medicaid (known as Medi-Cal in California) providers. On the surface, this is a disquieting concept.

Not too long ago, Eden Medical Center was recognized as one of lowest cost hospital providers in California. It should be no surprise that our costs have risen over the past few years. We have invested heavily in new equipment, both in medical technology and information technology, in order to continue to bring state-of-the-art services to our communities, and to provide our physicians and clinical staff the best tools to diagnose and treat our patients.

Last year, our labor settlement with registered nurses resulted in a three-year agreement that will give the nurses a 20% wage increase over the term of the agreement in addition to improved benefits. This kept our wages comparable to other local hospitals.

One of the benefits Eden Medical Center employees enjoy is a fully paid health plan for themselves and their families. Last year, the average cost was approximately $22,000 per year for an employee and family.

Despite these costs, Eden remains one of the lowest cost providers when compared to peer groups throughout the State. But as can be imagined, it is difficult to contain costs in our environment, especially when 60% of our costs are employee-related expenses. We are, after all, a service industry that is people- and technologically-driven.

The early announcements about health care reform create some concern. To expect to realize the savings needed to fund the plan through reduced payments to health care providers is very troubling.

Physicians are increasingly affected by efforts to reduce reimbursement. Many physicians talk of extending their days, working longer hours, much of which is devoted to the increasing amount of paperwork demanded from them. At the same time, we as patients expect them to remain current in the knowledge of new drugs and treatments in order to serve us to the best of their ability. This is resulting in a shrinking primary care base at a time when our population is aging. How does the plan for reform intend to address this?

Government payers of healthcare services for hospitals—the Federal Government for Medicare, and the State for Medi-Cal—are not paying the full cost of care at the present time. For each patient that is covered by Medicare or Medi-Cal, the cost to care for that patient exceeds current reimbursement. Further reductions will increase the gap that is, out of necessity, made up by insured patients—those lucky enough to have coverage through their employers. This is a cycle that needs to be broken if we are to have true health care reform.

The problems with our health care system are very complex. Reducing payments in an attempt to reduce costs will not yield the full reforms that are needed. I can only hope that this is not another piecemeal approach to change. A broader view of the systemic issues is needed. With the President’s staff talking about implementing reforms by the end of this year, it is questionable as to whether or not this will actually occur.

As always, your questions and comments are welcome. We will respond as quickly as possible.

George Bischalaney, President and CEO, Eden Medical Center

By George Bischalaney, President & CEO, Eden Medical Center

This past year was another busy year for our elected representatives, passing another bevy of bills that will impact hospitals and other health care providers. In every case, I have no doubt, each bill was written with some positive motive; to provide better access to health care services, to help control or reduce costs, to protect confidentiality or a patient’s right of choice, or in some cases mandating policies or practices that are costly to implement and monitor and may have a questionable cost benefit to patients.

But will more legislative remedies to the extremely complex and already cumbersome system of health services in California actually improve the patient care experience? One has to wonder.

In most service industries, the consumer helps direct change by withholding use of a service that doesn’t meet his/her needs. This is not as easily done when someone needs medical care. Yet the consumers, our patients, speak to us through direct communication and through their responses to the surveys we send. What we need to do is listen more attentively and respond more appropriately.

At Eden Medical Center we randomly send out surveys to patients who have been hospitalized, patients who use our mental health services, patients who have surgery and leave the same day, and patients who use the Emergency Department. We ask about every aspect of their experience, from the time they are registered through their discharge from the hospital. This includes physician and nursing interactions, quality of food and housekeeping, and the staff that drew blood or took an x-ray. Patients or family members are also invited to write comments, good or bad, and tell us anything else they think we should know about our services.

Hospitals are for the most part, stops of last resort for all. People come here already laden with apprehension, uncertainty and even a certain amount of fear. They have seemingly little or no control over what is about to happen to them or their loved ones. It is our job, our responsibility, to care for them as we would members of our own family.

If more legislation is needed to encourage us or force us to care for patients as we would our own family members, then we deserve what is given us. However, if we truly listen to our patients, our customers, and respond as a service industry that needs to be attentive to the needs of its customers, the industry would be vastly improved in terms of quality care and the patient’s experience. What more is really needed?

As always, we want to hear what you have to say. Please feel free to comment or ask questions in the comment box beneath each post, including this one. We will respond as quickly as possible.