Some people fear health care reform; I embrace the overall concept. The concept of affordable health care coverage for all, and value over volume, is something I support.

Over the course of several years, the health care industry has been driven into a volume-based delivery system that does not necessarily translate into value or quality.  Approximately nine years ago, after becoming president and CEO of Rush Memorial Hospital, I believed that focusing on value and quality would translate into volume and I was able to test this theory.

Rush Memorial Hospital was struggling financially and had less than a desirable image. I said to senior management that we were going to ignore the budget for one year. Our focus would be on quality, patient safety, patient satisfaction and customer service. If we could improve in all of these areas, the financial numbers would follow. As a result of the hard work by staff members, this theory proved to hold true. 

Rural hospitals have their own unique challenges and concerns that existed prior to the Affordable Care Act. The one common issue we all share is getting others to understand that delivering health care in a rural community differs from that of an urban community. In rural areas, health care reform piles on additional layers of challenges and concerns. I do not see this as a threat, but an opportunity.

Coming from a small rural hospital serving a small rural community, I was certain we could not compete in a volume-driven environment. As a result, recruiting physicians would be difficult because I simply did not have the volume in which to entice physicians to serve our community. As a result, they could not maximize their income. So I took a different approach.  

Nine years ago, my entire focus was on hiring primary care physicians which led to hiring specialists. My goal was to get our physicians to focus on caring for the patient and patient care only; to show physicians that I could improve their overall quality of life by giving them a balance between work and personal life while still earning a good salary. I did not want physicians worrying about productivity, reimbursement and expenses.

Too often, in a volume driven environment, physicians are constantly thinking about the number of patients they see versus focusing on quality care. Rush Memorial Hospital went to a straight (fair-market value) salary with no bonuses or incentives attached. My strategy was to form an integrated team approach between administration, physicians and staff. I knew if a patient-focused environment could be achieved by the entire team, then physicians would work hard and feel a part of the organization without the additional pressures. This concept worked and still is in place today.

In addition, I took the approach that Rush Memorial Hospital could not be everything to everybody. Forming good relationships and partnering with the right hospitals to help provide the services we could not, was important to our survival as well. The hospitals that survive this ever-changing, uncertain environment are the ones that can adapt the fastest to the changes and execute these changes to the patient’s satisfaction. Value-based environments will be more beneficial to rural hospitals because it forces all hospitals to work closely together for the common good of our patients.