J|Insights: Hospitals under scrutiny – What’s happening

It’s become apparent over the past few months that the perception of hospitals and healthcare providers as a whole has changed.

Even in the last couple of weeks, numerous stories have appeared in the media placing healthcare providers under new levels of scrutiny – and appropriately so. For example:

On top of that, it’s a presidential election year, adding an additional layer of pressure. Our CEO, David Jarrard, thinks that this trend will only increase in 2020. What is going on and how should healthcare leaders respond? Glad you asked…

Read the transcript

David Shifrin: It has become apparent over just the last couple of months that the perception of hospitals and healthcare providers as a whole has changed. What’s going on there?

David Jarrard: I was thinking as we were preparing for this conversation about the media that we’ve seen just in the last two weeks, that have been placing hospitals under what I consider a new level of scrutiny. And it’s just January. I think we’re going to see more and more as we get into the year.

So I began to make just a list of the stories, and I stopped making lists because it was getting too long. But there was Paul Keckley’s piece that said it’s a make or break year for community hospitals. There’s the Bloomberg piece, an excellent piece over the weekend on hospitals going bankrupt across the United States, and closing and leaving poor and vulnerable people without access to acute care. There’s Melanie Evans’ story in the Wall Street Journal reporting on the New England Journal of Medicine piece questioning the value of mergers, and whether they’re actually good for the quality of care that’s delivered. We have other media asking hospitals how they treat patients who are unable to pay their bills, and why they’re taking them to court – as many of them do – and is it a right and fair and just thing to do in light of their mission. And we have other media scrutinizing hospitals across the country on their tax exempt status. Are they earning it? Are they providing services that actually are equal to the benefit they are receiving by not having to pay the taxes from one side or other?

This, the scrutiny on their margins or their wealth is reaching a new level and I think it’s going to continue.

DS: So we’ve got all this increasing scrutiny from so many different sources and so many different angles. And on top of that, we are now rolling into an election year. Talk about how that affects the healthcare landscape and healthcare organizations.

DJ: If you’re running for public office, you listen closely to what the voters are saying, what’s on their mind, what they’re concerned about. And in almost every survey we look at, the ability to pay your medical bill – the cost of care – is the number one, the number two issue on people’s minds.

It’s not lost on the average person that yhe leading cause of personal bankruptcy in the United States is the inability to pay your healthcare bill. And as consumerism causes more and more people to actually fund their care, because they’ve been protected by insurance in the past, it’s moving from concern to anger to rage.

That is a powerful weapon for any presidential candidate to tap into.

DS: So we’ve set the stage with the current landscape at this moment in time. What do health care leaders need to be doing about it?

DJ: Three things: They need to pay attention. They need to watch their weather radar, if you will, and see the big line of thunderstorms moving into their zip code. Because the scrutiny is coming and with it is going to come anger and misunderstanding. And to acknowledge that, not be surprised by it. They need to be preparing for it. Meaning they need to scrutinize themselves before they’re scrutinized by others. How do they treat their patients who are unable to pay? Do they actually provide care that’s in excess of their tax exempt status? what are their malpractice levels? On and on with the list of possible questions you could ask, but it’s right to anticipate, not only so you’re not surprised by it, but also so that your story’s ready for it.

And so you have to take the time when the question comes to answer it, as authentically and transparently as possible, but also proactively and competently.

And then the third thing is not to wait for the questions. Every hospital and health system has a story to tell about who they are and why they are in the care that they provide. For years, so many systems have not had to do it. They’ve been protected. They’ve been sacred ground. They’ve had this hallowed reputation in the community because of their mission and their purpose and, and the great things they do, in their organization. I think that that force field of protection is fading, rapidly.

If you’re a hospital or health system, don’t wait for it to come. Be proactive. Get out into the community and get out with the people who matter to you. Certainly your nurses and physicians, but your lawmakers, regulators, your patients and business leaders. Be the source of truth, be the teacher, be the educator. So when the questions come, it comes in the context that you’ve created. Otherwise, without a context, it becomes a much more difficult situation.

DS: You’ve made the point before that if you don’t tell the story, someone else will, and you may not like the story that they tell.

DJ: There is always a story. There’s always a narrative. The question isn’t whether there’s going to be a story or not about your hospital or your health system or how care should be delivered. The only question is, ‘What is that story going to be?’ If you choose to engage in it, you can shape the story and, as the provider of care in your community, you ought to.

It’s your space to take, but it’s not given any more. You have to earn that place over and over again. And if you choose not to, others will. It could be the insurance company, it could be the new disruptor. It could be Walmart, it could be a labor union. Someone’s going to fill that space with an explanation of what healthcare should be and how you’re delivering it well… or not.

David Shifrin