Methodist Health System emphasizinginnovation in changing climate for care

by Richard D. BrownNebraska Methodist Health

System, formed 3 1 years ago asthe administrative entity for a fam-ily of three hospitals, 21 clinics, anursing and allied health collegeand a medical supply distributor-ship and laundry, remains focusedon innovation while it readiesitself to meet the compliance chal-lenges looming with the rollout of

the Affordable Health Care Act.John M. Fraser, president

and CEO of Nebraska MethodistHealth System and a 36-year in-dustry veteran, uses this analogyto describe what's confronting hisorganization that employs morethan 5,700 in the metro area: "It'slike we're changing tires on a busas we go down 1-80 at 80 miles

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Methodist Hospital President and CEO Stephen L. Goeser, left,with Nebraska Methodist Health System President and CEO JohnM. Eraser ... Poised for changing regulatory environment withoperational efficiencies and facility improvements.

Continued from page 1.per hour."

Fraser, who has been with MethodistHealth System for 22 years, said his orga-nization is ramping up for the myriad ofcompliance reporting and analysis requiredof the 2010 law. Fifteen new positions havebeen created at 85 1 1 West Dodge Road whereemployees provide to each affiliate servicesthat include accounting, Finance, billing, col-lections, management engineering, marketinghuman resources and information technologyand network development.

"We haven't seen the end of additionalnew positions either," Fraser said. "Also theinformation technology challenges are neverending and the new sources of communica-tion available to consumers are a major reasonbehind it."

Methodist Hospital's president and CEOStephen L. Goeser, a 35-year veteran of thehealth care industry, said Methodist is poisedfor the changes coming down from the federallevel because it already has efficiencies inplaces such as its Shared Services Systemsentity — established in 1969 — which is aregional medical and surgical supply distribu-tor and full-service laundry serving about 650health care institutions in a five-state area.

Efforts of a value-analysis team at Meth-odist over the past two years has resulted innearly $15 million in savings.

"We've been working on achieving greatstaffing efficiencies and achieving non-salaryexpense reduction," Goeser said.

He said Methodist Hospital had moredischarges in 2012 than any other hospital,according to Nebraska Hospital Associationstatistics, and is well positioned for the chang-ing regulatory atmosphere of the AffordableCare Act. Professional Research Corpora-tion analysis — based on patient satisfactionsurveys — has top-of-mind awareness (namerecognition) and is the market share leader inthe Omaha-Council Bluffs market.

Fraser oversees affiliates that includeMethodist Hospital, Methodist Women'sHospital, Methodist Jennie EdmundsonHospital in Council Bluffs, 21 MethodistPhysician Clinics in Nebraska and southwestlowa, Nebraska Methodist College-TheJosie Harper Campus, Methodist and JennieEdmundson foundations and Shared ServiceSystems.

Nebraska Methodist Health System isamong the top five employers in the metroarea.

Work is being completed on Nebraska

Methodist Hospital s 700-stall new employeeparking garage. One additional floor wasadded to the structure while reducing itsoverall footprint.

The hospital is a not-for-profit, 423-bedacute care facility with more than 2,000 full-time employees and 451 physicians on itsactive staff.

About 22,000 patients are admitted an-nually.

Methodist Health System has joined withThe Nebraska Medical Center and their affili-ated physicians to form an Accountable CareAlliance. This partnership is being developedto reduce costs to patients and to improvequality and efficiency of patient care acrossthe two health systems.

Fraser said the alliance will be structuredlike an accountable care organization — oneot the models being considered by the federalgovernment under health care reform as a wayto reduce health care costs. Such an entity isan integrated health care delivery system thatrelies on a network of primary care physi-cians, specialists and hospitals that are heldresponsible for the quality and cost of healthcare to a defined patient population.

"It leverages what we are good at andwhat UNMC is good at, raises quality andminimizes cost and controls with payers bothgovernment and private," Fraser said.

Caregivers, he said, are being askedunder the recent federal law to switch froma volume-driven incentive to value/qualityincentive and at a cost-efficient price.

Methodist Hospital, which moved from36th & Cuming streets to its new nine-storytower in 1968, added a second tower in 1981and in 1991 another addition of 55,500 squarefeet was constructed to house the Method-ist Estabrook Cancer Center. An additional20,4000 square feet was constructed nineyears ago to house two new linear accelera-tors, as well as the area's only Leksell GammaKnife.

Goeser, who is in his ninth year withthe institution, said the hospital has been aregional leader in the number of surgeriesperformed. Work was started in January ona two-year construction of a surgical renova-tion and expansion project that is budgetedfor $90 million.

The expansion will include three addi-tional operating rooms, including two heartand cardiovascular suites. While 1 5 operatingrooms will offer more flexibility in schedul-ing procedures, Goeser said another importantimprovement is that operating room size willincrease from 425 square feet to 650 square

feet."Having additional space in each room is

becoming a standard due to the technologysupport machinery needed in each operatingroom," Goeser said.

Fraser said the innovations are a continu-ation of a plan to continually assess facilityneeds.

Two years ago the hospital opened a$22 million pathology center and Schen-ken Pavilion on its campus. The facility's42,000-square-foot laboratory serves indi-viduals, physicians, clinics and hospitalsthroughout a three-state area with pathologyservices. Of additional interest is its molecularlaboratory for genetic testing.

Goeser said another important decision,which was made about 12 years ago, involvedconstruction of Methodist Health West, a$17 million ambulatory care center at 162ndStreet and West Dodge Road. Patients therewere among the first in the region to benefitfrom a high-tech networking system thatimmediately transfers filmless digital X-rayimages between medical facilities for fasterdiagnosis and treatment.

"It was innovative at that time for ourtesting site to be away from the hospital,"Goeser said.

Fraser said another innovative step wastaken a year ago when Nebraska MethodistHealth System, The Nebraska Medical Centerand Blue Cross and Blue Shield of Nebraskaannounced the development of a "select-tier"health care network and health care productsunder the name "Select Blue."

"This collaboration is the kickoff to moreaffordable care, which is one of the goals ofhealth care reform," Fraser said. "Independentof an employer-based plan, this providesfamilies and individuals with access to higherquality health care at an affordable price."

The network offers internationally rec-ognized cancer and transplant treatment,leading neurology and cardiology programs,complete women's care and a center of excel-lence for orthopedic and sports medicine andwith better-coordinated care for consumers.

Additional coverage is expected to beadded under the initiative.

Late last month, Methodist Hospital wasinformed that it had earned its third straightMagnet designation from the AmericanNurses Credentialing Center.

Goeser said considerable space wasopened on Methodist's main 84th Streetcampus three years ago with the openingof Methodist Women's Hospital. The newfacility on 38 acres at 192 nd Street and West

Dodge Road last month set records as 381babies were delivered and another 80 werecared for in the neonatal intensive care unit.

More than 1 0,000 babies have been deliv-ered in the facility's first three years.

Sue Korth, vice president and COO ofthe facility, said that while she can't speakto national trends, the concept of a separatewomen's health center is a relatively new ideafor the Midwest.

Methodist Women's Hospital and theMethodist Physicians Clinic Women's Centernearby at 707 N. 192 nd St. provide care forwomen from their teens through their agingyears. A differentiating factor is the "one-stopshop" approach from ob-gyn services, pedia-tricians, family practice, to physical therapiststo pelvic pain and sexual medicine.

"Once we opened our doors we wanted tocontinue being the metro leader in deliveriesand grow to be number one for NICU care,"Korth said. "The two go hand-in-hand."

She said a reason for the record-settingnumbers generated by the NICU is the useof a variety of technology components forsurgical procedures for women such as hys-terectomies and urogynecology procedures,among others.

Korth, who has more than 30 years ofmedical management experience, said thespecialty-focus on the hospital has enabledplanning and procedures to be fine-tuned wellbeyond the latest in technology such as the daVinci robot system for surgical procedures.

Processes are in place for emergencies."A hemorrhage cart, a common word or

statement in a process that alerts the team toa situation at hand . . . these are the key to ourteamwork and addressing a situation," Korthsaid. "These are the difference makers."

Goeser, who joined Methodist Hospitalin 2004 as vice president, said the women'scampus approach also makes sense economi-cally.

Fraser said Council Bluffs' MethodistJennie Edmundson Hospital, which has beenin the Methodist Health System since 1994,is seeing growth as a 230-bed regional medi-cal center serving about 250,000 residents insouthwestern lowa.

It employs a workforce of 430 full-timeand 148 part-time staffers and has 157 staffphysicians. The facility has southwest lowa'sonly accredited cancer program and offersradiation oncology services.

"It's the only hospital in this region thatoffers nationally-accredited cancer and breastcancer programs while also featuring south-west lowa's only advanced wound center,"

Fraser said. "With three hyperbaric chambersavailable, hyperbaric treatments began to beoffered in March of 2010."

Each of the chambers features high-pressure oxygen to facilitate healing of dif-ficult wounds.

Fraser said Nebraska Methodist College,with roots going back to 1 89 1 , has an enroll-ment of more than 700 students, up fromabout 500 in 2011.

"The demand for medical education hasincreased because while the economy may belagging, our industry has continued to showthe need for trained students," he said.

Innovative programs, such as one thatallows a student to graduate with an acceler-ated Bachelor of Science degree in nursingin 15 months, have been important in thegrowth numbers. Admissions officials also

promote nursing's improved compensationpackages nationally which feature a mediansalary of $65,470 for a registered nurse, andthe attractiveness of such work for career-changers who already have a two-year orfour-year degree.

Nebraska Methodist Hospital Foundation,a nonprofit corporation founded in 1977, hasraised more than $121 million from 1997through April of this year.

Rendering of Methodist Hospital's surgical renovation and expansion project.