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The Elections and St. Luke's

By Dr. David C. Pate, News and Community
November 8, 2012

I want to share with you my thoughts about what the elections this week mean for St. Luke's Health System.

Here is the external environment:

  • President Obama has been reelected to another four-year term, the Democrats have the majority in the U.S. Senate, and the Republicans retain control of the U.S. House of Representatives.  We can hope for more bipartisan efforts to solve our nation’s challenges.
  • Our country faces a federal budget deficit of more than $1 trillion for 2012, the need to raise the federal debt ceiling once again, health care spending that exceeds the growth in GDP, and an impending fiscal cliff, a combination of expiring temporary tax cuts and temporary unemployment benefits. There has been one downgrade to our nation’s credit rating and another downgrade is threatened. There is the impending reduction of nearly 30 percent to the physician fee schedule for Medicare, and 2 percent across-the-board cuts to Medicare providers and the military set to begin next year if Congress cannot find other cuts to make.
  • We can expect the Patient Protection and Affordable Care Act to continue to be implemented.
St. Luke’s mission is to improve the health of people in our region.

Our vision is to transform health care by aligning with physicians and other providers to deliver integrated, seamless, and patient-centered quality care across all St. Luke’s settings.

Our strategy is accountable care. For St. Luke’s, accountable care is the Triple Aim of better health, better care, and lower costs. 

As we have developed our strategy and plans, we have identified tactics and initiatives that will ensure our success measured against the Triple Aim and our position as a national leader in transforming and fixing what is wrong with health care, no matter the election results and regardless of whether the health care reform law would continue to be the law of the land or be repealed. 

We realize that health care costs are unsustainable, care is too fragmented, outcomes are too unpredictable, and there is too much waste in the health care system, and that all of this needs to be fixed to best serve the people of Idaho and so that we can be the health care leader we need to be to show others how to solve the challenges that lie ahead of us as an industry.

We are already leading in Idaho and being recognized elsewhere in the country for our innovative programs and early successes. Here are some of them:

Better Health

We have experienced tremendous success in improving the health of our own employees. This is a big strategic advantage going forward, because improving the health of people who are not patients is not a competency or capability that many hospitals or health systems have. 

And our arrangement with SelectHealth is a first, and rewards us for making investments in health and for reducing low value health care costs.

Better Care

Our innovative arrangement with Regence BlueShield of Idaho is focusing on care coordination for those with chronic diseases to see if we can attain better outcomes while reducing the overall cost of their care.

We continue to make strides in developing our clinical integration program that facilitates independent physicians working with us to manage populations of people.  

Our myStLuke's electronic medical record implementation is ongoing, and is creating the foundation to ensure the seamlessness and integration of our care.

I'm also proud of all the improvements that we are making in quality throughout the System. We are saving lives and improving outcomes.  The patients we are privileged to serve are the beneficiaries of this great work.

Lower Costs

We began implementing lean methodology in January of 2010. We are increasing our focus on TEAMwork, which is St. Luke’s version of lean principles, this year to ensure that we are doing everything possible to reduce and eliminate duplication, unnecessary activity, extra inventory, and other forms of waste and inefficiency that do not add value for our patients. TEAMwork will improve our care as well as lower costs.

Here's a great example of how this works. We have had tremendous success with our Center for Spine Wellness and managing back pain conservatively without surgery, resulting in lower costs and just as good, if not better, outcomes for many patients.

We have received $11.7 million in federal grants through the Center for Medicare and Medicaid Innovation for our virtual ICU program, which will make telemedicine services possible for our critical access hospitals in rural parts of the state. This will help us to ensure that we provide specialty services and services from our centers of excellence in Treasure Valley and Magic Valley to underserved areas of Idaho.

We also awaiting word from Medicare as to whether our application to participate in the Medicare Shared Savings Program will be accepted for a January 1 start date. 

If accepted, St. Luke’s would be the only federally approved accountable care organization in Idaho participating in this innovative Medicare program.  This program is important for two reasons: We will track 33 quality measures that are predominantly gauges of ambulatory care that most hospitals are not in the habit of tracking, and the program allows us to share in any savings for this population if we meet the quality measure benchmarks and there are savings to be shared. 

It is very hard to be out front and a leader. It entails taking calculated risks. This is all the more reason that St. Luke’s must lead. If we don’t, no one else in Idaho can or will. The people of Idaho are depending upon us.

You can see that our focus on accountable care through the Triple Aim of better health, better care, and lower costs is a recipe for success, no matter who would have won the election. It certainly is achievable under the current health care reform law and in fact, helps make up for where the health care reform law fell short. 

We can’t, and shouldn’t, look to the government to fix health care. Health care providers should solve the problems with health care, and St. Luke’s can lead the effort. 

I am so proud of everyone at St. Luke’s who works tirelessly to improve health care.  We are making a difference and are well positioned for the future. It will be an exciting journey!

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.