{"id":77,"date":"2014-05-18T11:16:46","date_gmt":"2014-05-18T15:16:46","guid":{"rendered":"http:\/\/blogs.kzoo.edu\/acastorieskzoo\/?p=77"},"modified":"2014-06-01T15:19:39","modified_gmt":"2014-06-01T19:19:39","slug":"it-has-always-been-important-but-now-its-absolutely-critical-that-we-create-connections-within-the-community","status":"publish","type":"post","link":"http:\/\/blogs.kzoo.edu\/acastorieskzoo\/2014\/05\/18\/it-has-always-been-important-but-now-its-absolutely-critical-that-we-create-connections-within-the-community\/","title":{"rendered":"\u00e2\u20ac\u0153It has always been important, but now it\u00e2\u20ac\u2122s absolutely critical that we create connections within the community”"},"content":{"rendered":"

An interview with Frank Sardone, the CEO of Bronson Methodist Hospital in Kalamazoo, Michigan.<\/em><\/p>\n

 <\/p>\n

Student: What was the processes that lead to Bronson spearheading this effort of Enroll Kzoo?<\/strong><\/p>\n

Frank Sardone: Here at Bronson we have a plan for excellence. We have a vision that Bronson will be a<\/p>\n

nation leader in healthcare quality, and we have four strategies to help us achieve this, which<\/p>\n

we call the four Cs, they are clinical distinction, exceptional customer experiences, corporate<\/p>\n

vitality, and community health catalyst.<\/p>\n

So, as part of the community health catalyst initiative we had a task force, with the board<\/p>\n

committee members being, the chair Randy Eberts, Bill Mayer and Amy Terry. They conducted<\/p>\n

a health needs assessment for all the counties we serve, primary ones being Kzoo, Van Buren,<\/p>\n

and Calhoun. \u00c2\u00a0We then documented what were the real needs were from a health needs stand<\/p>\n

point and out of that, emerge a number of priorities; the priorities did differ a little between<\/p>\n

counties, but the one that was consistent and what we wanted to focus on was, access to health<\/p>\n

care. One of the best ways we thought to we could improve access is by getting people enrolled<\/p>\n

in health issuance, and this is what lead to the creation of Enroll Kzoo County. We knew we<\/p>\n

couldn\u00e2\u20ac\u2122t do it alone so we engaged partners in order to help achieve this goal. We thought it is<\/p>\n

important to educate the people about the need for health insurance and most people know that<\/p>\n

but connecting them to actually going through the process of getting it is another matter, so that<\/p>\n

is what we really focused on, providing that technical assistance to get community members<\/p>\n

enrolled.<\/p>\n

\u00c2\u00a0<\/strong><\/p>\n

S: Had Bronson participated in this type of collaborative process before?<\/strong><\/p>\n

F: Yes, a variety of things, things like Healthy Babies, Healthy Starts, over the years there has<\/p>\n

a been a number of collaborative efforts that we have been involved with; which reflects the fact<\/p>\n

that \u00e2\u20ac\u0153we recognize the hospital is one piece of a very complex puzzle and so we need to engage<\/p>\n

other community partners, in fact that effort has even intensified within the hospital, we our held<\/p>\n

accountable not just for the patients stay while there in the in the hospital but also increasingly<\/p>\n

once they go home 30, 60, and 90 days out ,we are measured by that…<\/p>\n

It has always been important, but now it\u00e2\u20ac\u2122s absolutely critical that we create connections within\u00c2\u00a0the community.<\/p>\n

 <\/p>\n

S: How do you think the ACA will affect Kzoo?<\/strong><\/p>\n

F: I think it is very important, for years and I know there has been a great debate on this issue.<\/p>\n

It has become very political and polarizing, my feeling is that the health care industry has been<\/p>\n

advocating for years that one of the flaws historical is, you have the insuranced population and<\/p>\n

the uninsured population, and although the uninsured has access to health care, its usually<\/p>\n

not at the right time or place. Meaning that if people don\u00e2\u20ac\u2122t have insurance they seek health<\/p>\n

care in the E.R, and they are seeking primary care in the ER, and of course we are equipped<\/p>\n

to provide that but the ER dept. is probably the most expensive place for health care to be<\/p>\n

delivered and there are better ways to deliver primary and secondary care other than in the ER,<\/p>\n

as a result there has been a hidden tax on those who have insurance rather it is an individual<\/p>\n

or an employer that provides insurance, because those insurance rates have to somehow<\/p>\n

compensate for those that don\u00e2\u20ac\u2122t have insurance, so there has been this hidden tax that has<\/p>\n

been referred to, and so \u00e2\u20ac\u0153the health care industry has advocated for years that if everyone<\/p>\n

had coverage it would be a more equitable system and I think philosophically we embrace the<\/p>\n

concept that people have a right to health are coverage, but unfortunately it has become very<\/p>\n

politicized, and my feelings is the ACA isn\u00e2\u20ac\u2122t perfect however, I think it takes a big step with the<\/p>\n

requirement that everyone have health insurance, because you really need this large pool of<\/p>\n

everyone being covered for the system to work, so I am generally supportive, I don\u00e2\u20ac\u2122t think the<\/p>\n

law is perfect, but I would rather work on improving it with this starting point because I think<\/p>\n

it has taken this country years, decades getting to this point of finally figuring out a way, other<\/p>\n

people have different opinions, but we finally have gotten something done, now we need to just<\/p>\n

improve it.<\/p>\n

\u00c2\u00a0S: Your thoughts on the possible shortage of primary care givers?<\/strong><\/p>\n

F: Yes, for economically reasons more people have been choosing to go into specialized<\/p>\n

fields instead of primary care so there is a trend right now of having a shortage of primary care<\/p>\n

doctors, one way we are addressing this is by looking at the whole way primary care is being<\/p>\n

delivered, we are emphasizing a team approach, where a physician would be managing and<\/p>\n

supervising the care but the care could be delivered by a nurse practitioner or a physician<\/p>\n

assistants, as well as other members of the team, a lot of the time that physicians spend with<\/p>\n

the patient, maybe could be better delivered by a social worker or a psychologists, we are<\/p>\n

working on developing a model where the patients total needs can be addressed, but the<\/p>\n

physician can be part of the team as opposed to the only one seeing that patient, which can<\/p>\n

result in better care for the patient.<\/p>\n

 <\/p>\n

\u00c2\u00a0S: How will this affect the E.R?<\/strong><\/p>\n

F: We continue to see an increasing amount of patients in the ER, with more people with<\/p>\n

insurance we expect that to even increase more. \u00c2\u00a0The trick is coming up with the right mix of<\/p>\n

care providers, and that\u00e2\u20ac\u2122s why the number one priority under this community healthy catalyst<\/p>\n

goal is improving access, we use this mantra the right care, right time, right place, right cost,<\/p>\n

so we are looking at all the entry points for patients coming into the system, and trying to tailor<\/p>\n

those access points to the patient needs.<\/p>\n

 <\/p>\n

S: Other thoughts on improving access?:<\/strong><\/p>\n

F: We have just recently added what we call fast care, a retail setting in Meijer on Westnedge,<\/p>\n

that provides another option for people who just need like kids needing a sports physical or<\/p>\n

children needing immunizations, simple things that can be delivered by a nurse practitioner,<\/p>\n

we have also extended hours in some of our practices, by including now evening and weekend<\/p>\n

hours, we have also opened a new practice that is piloting this concept where there is a whole<\/p>\n

team approach to care, we are looking at a variety options and we call all of these initiatives<\/p>\n

together, Primary Care 2.0, the advance version of primary care. The other important aspect to<\/p>\n

improving access it the Family Health Center, with the recent grant they received they will be<\/p>\n

able to provide more access to community members.<\/p>\n

 <\/p>\n

S: Do you think education is key to helping people get access?<\/strong><\/p>\n

F: Absolutely, I personally have referred some people to the events, and it\u00e2\u20ac\u2122s so interesting<\/p>\n

to hear the misconceptions, and many people assume they can\u00e2\u20ac\u2122t afford it. I just read in the<\/p>\n

Economist, of the people enrolled so far, over a quarter did not have health insurance before, I<\/p>\n

thought that was a good objective assessment, because again this issue has been so politicized<\/p>\n

and you get information and misinformation, so it was great to see a respected publication<\/p>\n

like the Economist do an analysis. I think we need to give it time; see how it evolves, one of<\/p>\n

the initial criticisms was how many of the 8 million, who have enrolled, are going to pay their<\/p>\n

premiums and there has already been a study done and the insurance companies themselves<\/p>\n

have indicated that there has been a pretty high percentage of people who not only enrolled but<\/p>\n

also are paying their premiums, so that debunks yet another myth about it, the remaining issue<\/p>\n

is whether there will be the appropriate distribution of age ranges, because if it tends to skew<\/p>\n

towards an older population, you are not going to get the appropriate proportion of people, that<\/p>\n

are not heavy utilizers of care, I think it is still early to know the final numbers on what that is.<\/p>\n

 <\/p>\n

S: What do you think some of the biggest barriers were in getting people enroll?<\/strong><\/p>\n

F: Well, certainly the launch was less than perfect; it did slow down the initial enrollment and<\/p>\n

it just fueled the negative arguments about it, so that was one factor. \u00c2\u00a0The second factor is the<\/p>\n

lack of understanding, not understanding what your options are, there is a learning curve, some<\/p>\n

people have never had health insurance so it can be confusing. I think education is the key to it<\/p>\n

and I think having good objective information about what is working and what\u00e2\u20ac\u2122s not working and<\/p>\n

if it\u00e2\u20ac\u2122s not working what do we need to address those issues.<\/p>\n

 <\/p>\n

S: In the end, what is one thing you wish people knew?<\/strong><\/p>\n

F: To do your homework and really get to understand the facts and not be swayed into the<\/p>\n

polarized opinions either way, because I don\u00e2\u20ac\u2122t think it is going to solve all of our problems on<\/p>\n

one hand, but on the other I think there is a lot of good that can come out of it, so I think be<\/p>\n

objective, be patient and really get the facts before making a decision. I have heard a lot about<\/p>\n

how we need to get rid of this act but keep some of the provisions, such as children up to 26<\/p>\n

being able to be covered, people like that part, the objective answer to that though is; is you<\/p>\n

cant have all the provisions that people like, without provisions such as individual mandate<\/p>\n

because you have to have that broad population enrolled in order for the whole plan to work<\/p>\n

economically. In the end, be objective and know the facts.<\/p>\n

 <\/p>\n

Image from mlive.com<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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