Health Care

ValleyCare Transitions to New Model Under Steward

YOUNGSTOWN, Ohio – The CEO of Steward Health Care Network and the presidents of its area hospitals say their goal isn’t to increase the number of patients at the hospitals as much as it is to improve wellness.

The Boston-based health care organization purchased Northside Medical Center in Youngstown, Trumbull Memorial Hospital in Warren, Hillside Rehabilitation Hospital in Howland Township and Sharon Regional Health System in Sharon, Pa., in May, from Community Health Systems Inc. in Franklin, Tenn.

Steward was formed in 2010 with the purchase of six bankrupt hospitals in Massachusetts.

Steward’s CEO, Dr. Mark Girard, and the presidents of Northside, Trumbull Memorial and Sharon Regional met Wednesday with The Business Journal to discuss the transition and plans for the local hospitals.

One of the things we do very well is control costs. So we developed a community-based model centered around the doctor-patient relationship that’s physician-led and that drives value, quality and cost efficiency that’s available to each and every one of the communities that we serve,” Girard said. “The communities that we serve are very similar to the communities here at Northside and at Trumbull and in Sharon, and based on that success that we had in Massachusetts, we felt that our model was a replicable model.”

Steward, Girard said, is a physician led, community-based Accountable Care Organization.

It’s the notion that health-care providers are aligned to drive wellness and prevention, great health and also great care so that if you eventually do get sick we can provide great care as well and be accountable for that,” he explained.

Developed with the passage of the Affordable Care Act in 2010, accountable care organizations embrace payment models that serve as alternatives to the traditional fee-for-service model.

Fees for services, Girard said, provides an incentive for performing procedures and tests.

“In the alternative payment world – things like bundle payment or global capitation payments – physicians are actually incentivized in wellness and prevention,” he continued.

Physicians may sit with a patient to get a better understanding of their behavioral health and physical needs, do appropriate screening and tests and get rewarded for it.

This is an integrated delivery system that’s centered around the doctor-patient relationship and trying to keep people well and also do preventative medicine,” Girard said.

The model offers payment for meeting certain quality and value metrics, including getting rid of waste and “doing the appropriate care in the appropriate locations in the appropriate amount,” he said. Contracts are usually negotiated with commercial payers at the local and state levels or with the federal government.

There’s a blueprint and that’s what they’ve accomplished in the Massachusetts market,” said Ron Bierman, president of Trumbull Memorial Hospital.

The excitement around how we might deliver care is intense because it’s not new,” added Melissa Bennett, president at Northside. “We may be changing pieces of it, but we’re not starting from scratch, so that feels like a huge win for all of us.”

The model works in any economic environment, Girard said, including the uncertain one presented by the recent actions of President Donald Trump’s administration and the ongoing debate over the Affordable Care Act in Congress.

Steward was interested in the four hospitals in the Mahoning and Shenango valleys because the hospitals were similar in size to the ones they already operated and the communities were similar in terms of demographics. The proximity of the local hospitals allows the system to take advantage of the expertise at each, Girard said.

Staffing at all four hospitals is up from what it was beforethe purchase – by 100 or more at some of the hospitals, a combination of full- and part-time personnel – and capital investments are being made at each.

Upgrades include implementation of a proprietary tool – Cares, which is integrated into the patient systems – that takes information from multiple sources and provides prompts to medical personnel regarding past conditions or allergies. Cares gives doctors “a much clearer picture of the totality of taking care of that patient” and helps prevent “untoward complications,” Girard said.

Since May, Sharon Regional has recruited 138 new physicians and has approval to hire 130 full-time staff, Joe Hugar, Sharon’s CEO, said. The hospital, which has a nursing school, is preparing to launch an emergency medical technician program in April.

Northside has added about 50 staff, “all where you would want them to be, in the clinical realm,” Bennett said.

Hillside, which under CHS was operated in affiliation with Trumbull Memorial, was spun off as its own entity when Steward took over and will remain dedicated to providing inpatient and outpatient rehabilitation services, Bierman said. The Howland hospital, like the acute care facilities, is seeing improvements and allocation of resources, and becomes more important under the ACO model because part of Steward’s responsibility is to move patients to the appropriate setting.

Having an acute rehab facility within our market allows us to more readily move the patients from the acute care setting to a rehab setting when it’s appropriate,” he said.

Staff are embracing the changes, the hospital CEOs said. Bierman noted that personnel are seeing new colleagues working alongside them as positions are filled that had been left vacant under the previous ownership and capital dollars are being spent. “Slowly but surely the transition is being recognized,” he said.

Bennett noted Girard and his team have been in the area “pretty much every week” since the takeover.

Staff were “a little surprised” and “a little nonbelieving” regarding the Steward model at first, but that has changed, Hugar said.

I’ve never seen such enthusiasm,” he said. “They have seen almost from Day One that the organization walks the talk and delivers on any quality initiatives that are going to improve our overall operation and safety for our patients.”

Pictured: Ron Bierman, president of Trumbull Memorial Hospital; Melissa Bennett, president of Northside Medical Center; Joe Hugar, president of Sharon Regional Health System; Mark Girard, president of Steward Health Network.

Published by The Business Journal, Youngstown, Ohio.