Don't let the name fool you, Presbyterian Rust Medical Center is anything but tarnished. It is a shiny new high-tech, high-touch facility (actually, it's named in honor of Jack and Donna Rust, who donated $10 million toward construction. Jack, an Albuquerque businessman who served on the Presbyterian Healthcare Services board from 1981 to 1995, died in July).
From healing gardens to noise-reducing walls, sun-drenching windows and private, acuity-adjustable rooms to the innovation lab where big ideas are transformed into small practices, great pains were taken to make this a hospital for the 21st century. So, it may come as a surprise to hear PHS President and CEO Jim Hinton say that if he were sick, the hospital is the last place he'd want to be.
"We are sitting in one of the most state-of-the-art hospitals right now; it's been open less than a year. Still, I'd rather be in my home than in this hospital," Hinton said during a two-hour interview we had in the fall. We sat down to discuss Hinton's vision of health care as he steps into the role of chair-elect of the American Hospital Association.
Now, let me put some context around Hinton's remark. He was referencing PHS' innovative Hospital at Home initiative. The program, developed in conjunction with Johns Hopkins, allows PHS physicians to admit patients to their homes. Yes, their homes.
Part of the home is converted to a hospital room, equipped with all of the necessary gadgets; doctors, nurses and pharmacists round on the patients. This is all done, on average, for $2,000 less than a regular hospital stay. And, Hinton proclaimed, the care is as good, if not better.
Hospital at Home is one piece of Presbyterian's Integrated Care Solutions — concepts that are driving the eight-hospital, integrated delivery system toward the Triple Aim. Want more details? Then flip to the cover story on page 22. What you'll find is a profile of an executive who is passionate about the belief that health systems can "simultaneously improve quality and reduce costs. We see it every day in our system."
Hinton joined PHS 29 years ago and has been a big part of its evolution toward an integrated system. One of his earliest roles was overseeing the organization's efforts to align incentives and operations with physicians. He did so at the same time that PHS was launching a health plan.
"It was absolutely strategic, but it was also opportunistic," Hinton said of the move toward integration.
PHS also has moved very deliberately and very strategically toward a value-driven delivery model. "Today, more than 60 percent of our revenue is budgeted — that is, prepaid or capitated," he said. That's been largely driven by the belief that fee for service is not just unaffordable, but bad for patients.
It's no small coincidence that Hinton will follow Benjamin Chu, M.D., a Kaiser Permanente executive who assumes the AHA chairmanship in 2013. Having successive chairs who come from integrated, value-driven worlds is sure to influence how the field responds to the changing environment.
As Hinton noted, the AHA must continue to advocate for fair payment in the current model, but at the same time make clear that hospitals are ready to "step up" to the challenges that lie ahead. — You can reach me at mweinstock@healthforum.com
