November 22, 2013
HealthAlliance gets $6.5 million state grant
Originally published in the Kingston Times. Read here.
“Five years in health care is a whole other world,” said David Scarpino, three months in the job as president and chief executive officer at HealthAlliance of the Hudson Valley, the Kingston-based healthcare provider. “It’s no longer about bricks and mortar.”
HealthAlliance announced at a press conference Wednesday, Nov. 20 that the state has awarded it $6.5 million in start-up money to improve the quality and efficiency of patient care, as developed and managed by physicians and supported by a performance management infrastructure. Affiliation with a larger healthcare partner continues to be part of HealthAlliance’s approach. “We want to be the poster child for our approach,” said Scarpino at the press conference.
HealthAlliance has proposed teaming with a network of physicians working in collaboration with it, said Chief Strategy Officer Joshua Ratner. Data in the evolving shared management information system will pull the threads together. This type of coordination is called clinical integration.
In August Scarpino and his team had made a 40-minute PowerPoint presentation to Department of Health in Albany in which they asked the state for support in exploring partnerships with physicians and other providers. The $6.5 million in state support announced this week will enable HealthAlliance to invest the time and seed money in the technology and support systems required to implement clinical integration.
Until very recently HealthAlliance was very much about bricks and mortar. For over a year and a half, the organization unsuccessfully sought state approval — and state money — for an ambitious plan to close its Kingston Hospital campus and consolidate at a renovated former Benedictine Hospital on Mary’s Avenue. Former hospital CEO David Lundquist assured the public that the state was supportive to the plan. The money sought was revised downward from $46.5 million to $20 million. Once sufficiently detailed plans were assembled, Lundquist said, state Department of Health (DOH) approval would surely be forthcoming.
Though proposals to the state about the Kingston one-campus hospital plan were presented, negotiated, revised and reinforced in the past 18 months, state approval never came. The required state contribution to the pot of gold at the end of the rainbow never materialized. The application remained incomplete. (In declining three months ago to respond to a request under the Freedom of Information Act for HealthAlliance’s application, DOH cited a regulation by which it didn’t have to provide information on an incomplete application.)
The new chief executive felt the August HealthAlliance presentation in Albany went well. “They said to us, ‘You finally figured it out, didn’t you?’” said Scarpino with more than a hint of pride in his voice. The $6.5 million Health Efficiency and Affordability Law (HEAL) grant announced Wednesday confirmed Scarpino’s assessment.
Under Scarpino’s new leadership, a plan (referred to in Wednesday’s press release as “an enhanced regional planning approach,”) is emerging, attuned differently to the unprecedented pace of change in the healthcare industry. Though based on the same expectations about a shrinking HealthAlliance role that Lundquist articulated, Scarpino’s goals are no longer being expressed in terms of bricks and mortar. The veteran hospital administrator’s focus is on HealthAlliance’s place in the healthcare world, on its connections with a variety of potential partners, and at the same time, he said in an interview last week, on continued improvements in service to the Kingston-based health system’s customers. In short, emphasis is being placed for now more on coordination of care. The spatial arrangements for the downsized facilities will come later at an unspecified time.
Scarpino disclosed at the press conference that HealthAlliance has lost $3 million this year through October.
Even if it wanted to do so, HealthAlliance couldn’t afford to work toward a model of seamless coordination of care that would seek to put additional healthcare personnel on its own payroll, as many larger hospital systems are currently doing. The required coordination would come from partnerships among providers.
On May 6, HealthAlliance launched a computerized medical information system required to meet the federal standard for electronic health records called meaningful use. By meeting federal criteria for meaningful use, a healthcare provider can become eligible for millions of dollars of governmental incentive payments. Some other hospitals in the region had met the meaningful-use criteria earlier. HealthAlliance more recently implemented a system bought from McKesson Health Systems.
Scarpino and Ratner noted with satisfaction that after the first 90 days of operation “we got our first check.” After a long period of planning and preparation, HealthAlliance had achieved meaningful use in a short time.
With the state grant, HealthAlliance is ready for the next step. It will use its new health information system for pro-active health management. Though no agreement has yet been reached, HealthAlliance is in active discussion with a subsidiary of the Montefiore Medical Center, a large, experienced and influential teaching hospital and healthcare services operator based in the Bronx.
Shared service model
Scarpino came to Kingston in August 2006 after 27 years at St. John’s Riverside Hospital System in Yonkers, a hospital system that includes two hospitals, a school of nursing, a skilled nursing facility and other corporate entities.
Under the Scarpino regime, reducing cost continues to a major goal at HealthAlliance. In an extensive interview last week, Scarpino acknowledged that HealthAlliance will continue to “get smaller.” Indeed, there has been a slow but steady attrition in employee head count. That will continue.
“We want to focus on quality and cost,” explained Scarpino. “We want to reduce cost not through the rationing of care but through a partnership in the coordination of care: physicians, insurance companies, providers like us, and employers. It’s a shared-service model: value equals quality plus cost.”
As chief financial officer at HealthAlliance, Scarpino may have become a bean-counter by profession. But he certainly doesn’t talk like one. “It’s not the core of who we are,” he said in the interview. And he added at the press conference that his goal was “not just caring for you but caring about you.”
Scarpino believes his mission starts with being willing and able to connect on a person-to-person basis. Starting with the 125 patients who come to the emergency room every day, he’s been trying to improve the patient encounter. “It’s based on respect and communication,” he said. “I want them to say, Something has changed. You know what, it’s different.”
The emergence of the state health exchange, changes in the organization of regional specialty care, and the shifting responsibilities of employers and insurers in a changed marketplace have provided a new environment for all the healthcare players, including hospital-based health systems. Finally, individual consumers too are faced with the need to adapt their behavior to the emerging new world.
Scarpino emphasized the climate of constant change in the healthcare industry. Thanks mainly to the longstanding presence of the Institute for Family Health, its network of local primary-care physicians continues to be one of HealthAlliance’s strengths. It is seeking to align and integrate its services with a physician network.
This is the complex context within which HealthAlliance must develop its own strategy, Scarpino said last week. The $6.5 million state grant indicates that it has state support for its approach.
Back in July, new HealthAlliance board Chairman Kevin Ryan disclosed that “affiliation talks” had been going on for several months with potential partners. According to Scarpino, there have since been meetings with six potential partners: Albany Medical Center and St. Peter’s in Albany, HealthQuest in Poughkeepsie, Westchester Medical Center, Hudson Health Partners (a strategic alliance among St. Francis in Poughkeepsie, St. Luke’s-Cornwall in Newburgh and the three-hospital Bon Secours Charity Hospital System in Port Jervis), and finally Montefiore Medical Center. A meeting is scheduled with at least one additional prospective partner.
Though Scarpino emphasized that HealthAlliance “needed to work with a larger system,” partnerships and alliances don’t necessarily mean mergers. In the emerging world of healthcare, the players often come together in new combinations and dissolve old relationships.
With the entire industry committed to medical information systems and HealthAlliance depending on that technology for clinical integration, data handling has become one of the playing fields of the new local healthcare universe. And that requires an experienced information-handling partner.
“We possess the industry expertise, IT methodologies, proven track record and resources to guide your organization through your most sophisticated clinical and financial transformation efforts,” boasts the website of Emerging Health, the Yonkers-based 400-person Montefiore subsidiary that HealthAlliance is getting state money with which to collaborate. Emerging Health promises to come up with solutions to provide hospital management “with increased visibility across your entire healthcare delivery network.”
November 20, 2013
New Priorities to Offer Improved Community Healthcare
Click here to read the official press release.
HealthAlliance of the Hudson Valley is pleased to announce our latest Transformation update:
Our focus moving forward entails a deliberate and community-focused shift in priorities. Better adapting to the healthcare system of the future, this revised course of action will focus on outcomes involving efficient, high-quality care. With $6.5 million awarded by the state, the revised plan will offer a more viable, long-term infrastructure to ensure access and investment in services to our community, better patient care, and an improved patient experience.
We will press ahead with corporate partner discussions with potential affiliates such as Albany County-based Albany Medical Center, Dutchess County-based Health Quest, and Montefiore Medical Center based out of the Bronx.
In tandem with identifying an affiliate, we will increase our efforts to partner with physicians by developing a formal physician alignment structure, creating a unified network of physicians with access to more tools, new patient care models, and increased coordination and communication. This complete two-step process will allow us to successfully and efficiently evolve with the future of healthcare utilizing measures of success based on quality, cost and convenience.
These preceding stages of affiliating and physician alignment will ultimately serve as forces in determining the outcome of the overall consolidation and facility redesign of HealthAlliance as well as the transformation of the delivery of healthcare in Ulster County.
We ask that you, as our neighbors, friends and family, stay local for your healthcare needs while we evolve and strengthen our services.
September 20, 2012
An open forum was held at 6 p.m. on Thursday, September 20 in the Benedictine Hospital Auditorium.
August 22, 2012
Benedictine Open Forum
An open public forum was held at 6 p.m. on Wednesday, August 22 in the Benedictine Hospital Auditorium.
July 27, 2012
Meeting with Kingston Mayor
On July 27, HealthAlliance announced that CEO David Lundquist met personally with Kingston Mayor Shayne Gallo to discuss the latest preliminary plans.
May 4, 2012
On May 4, HealthAlliance of the Hudson Valley announced that it was exploring options to realign its services to better serve the community.
HealthAlliance has dedicated this space to provide the latest facts on our ongoing consolidation efforts. Please e-mail firstname.lastname@example.org with any questions or feedback.
- What are you using the $6.5 million for?
The majority of the funds will be used in developing our physician alignment process (e.g., IT, org. structure and setup, etc.) with the remaining allocated for the affiliation due diligence fees.
- How long will the affiliation process take?
We don’t have a defined timeline at this point. It is dependent on each of the potential affiliates as well as state and regulatory agencies, though we expect it to take no less than 2 years.
- Does obtaining an affiliate threaten to drive up healthcare costs for the consumer?
This remains to be seen, but whether we are affiliated or not, healthcare expenditures are unsustainable in this country. Current regulations and health policy are focused, overall, on driving down healthcare costs and many insurance companies are already beginning to follow Medicare’s lead in lowering hospital reimbursement rates.
- How will these affiliates positively impact the current quality of services offered by HealthAlliance?
An affiliate will provide access to a potentially greater network of specialists, and a higher level of medical care. In addition to the family practice residency program they may also provide access to additional education or training programs that will bring a new clinical staff to our community.
- What is physician alignment?
Physician alignment is the process of unifying a network of physicians with the goal to improve coordination and communication of patient care and develop best practices while using advanced information systems to measure outcomes.
- How does physician alignment benefit the public?
Physician alignment will help connect physicians’ offices to the hospitals for increased coordination and communication of patient results and other medical information, and it will help ensure that primary care physicians, currently a valuable resource, will continue to practice in our community. By raising the bar, this process also promises to provide physicians with support to deliver the highest quality care.
- What benefit will the physician gain from physician alignment?
Physicians can expect this process to assist them in updating their independent practices. HAHV will assist physicians in the deployment of electronic medical records and quality improvements.
- When do you expect to move back into the stage of facility redesign?
The timing of this stage will be determined by the progress of the affiliation and physician alignment processes as well as the availability of capital for improvements. This will not take place for a while, as we need our partners at the table when we develop our new regional healthcare delivery model.
- Why was this approach not the initial plan? Why is it being proposed just now?
We needed to find a model worthy of accommodating the community’s needs. We were not able to find a model that would allow for that sort of spending, nor any that were financially sound. It did not make sense to design a building on the current model of healthcare that we knew was eventually going to change.
- What is the current status of the Mary’s Ave and Broadway campus now that facility redesign is no longer the next step?
We will continue to focus on reducing costs, improving performance, and increasing our quality and the patient experience on both of these campuses. For the time being, both Mary’s Ave and Broadway will remain operational.
- How will the changes in the executive team affect this process?
We do not plan to replace those executives, as we are attempting to effectively reduce overhead expenses. The change among our executives sets the tone for our organization that we have and will look at every cost and attempt to reduce wherever possible. Despite these changes, the level of leadership between the board and the executive team remains strong.
- Will this process result in layoffs among staff?
We continue to look at the whole organization structure for opportunities to reduce cost, and where possible, reduce positions through attrition.