Hennepin Healthcare, the board that operates HCMC (the Hennepin County Medical Center) and its clinics, is at a crossroads. With the recent departure of its CEO, the choice of the system’s next leader will be crucial.
As an advocate for HCMC, I urged the Legislature to unlock the hospital’s potential by creating a public corporation that would govern its business activities. This change allows the system to more effectively participate and compete in the health care market. But the success of that entity, Hennepin Healthcare — like any other organization — hinges on the vision of its next leader.
I am proposing five key objectives for the CEO to address. Specifically, the to-do list must include:
1) Embrace the mission
Hennepin Healthcare exists for one simple reason: to provide the best health care to all who need it. This is a truly noble endeavor, being carried out in two broad ways: first, by caring for all, regardless of ability to pay; second, by offering specialty care that is vital to the region but too pricey for even the private market, such as burn treatment and hyperbaric chamber therapy.
The economics of doing so is daunting. We know that Medicaid and Medicare reimbursements are insufficient, and we must continue to advocate for policy changes to the national level. We must also maximize state programs that exist to specifically benefit systems like Hennepin Healthcare that have a high percentage of patients on public plans. That said, the next CEO must engage the best experts available to help maximize all available reimbursement for our patients. Opportunities to improve do exist now and must be seized.
2) Control costs and maximize revenue
By all measures, it simply costs too much to provide care at Hennepin Healthcare. This has been a concern for years and has not been adequately addressed. HCMC is not a typical urban hospital, but neither is it totally unique. North Memorial, for example, faces similar challenges but performs better at controlling costs. Concerning revenue, agreements with insurance companies must be scrutinized to ensure that the hospital is being paid as it should be. Some legacy contracts must be updated or ended. The insurance companies know this is true. They need to step up.
3) Improve focus
Simply put, the hospital must stop the culture of introducing superfluous ideas into its activities. There should be room for entrepreneurial efforts where improved care can meet better economics. But those should be few and prove up quickly or end. In that vein, there have been too many examples of doctors and other providers working on grander social welfare issues. Doctors train and are compensated to see patients. Surgeons need to perform surgery and not research affordable housing or spend days with neighborhood focus groups. Hennepin County employees do those things very well.
In addition, dating back years, physicians who work in more than one hospital have had the option of moving some patient procedures, in many cases the more lucrative, to other hospitals. That revenue is lost to Hennepin Healthcare. This “leaking” must stop. Providers working in the system need to be all-in for the home team.
4) Conduct a comprehensive review of the research program
The recent ketamine controversy shed some light on Hennepin Healthcare’s research program. Subsequent reporting of a relationship with the company that makes Tasers raises additional, perhaps even more serious concerns. The next CEO should convene a group to review the entire research agenda. Research has long been an important component of the system. That should certainly continue in cases where it benefits patients and the community. Staying true to that axiom must be the mandate.
5) Right-size the downtown campus
The Hennepin County Board, which owns Hennepin Healthcare and is effectively its landlord and banker, has been very supportive in providing capital to the hospital. The new Outpatient Specialty Center is the most visible sign of that sponsorship. But there are too many buildings on the campus, and most are inefficient. The new CEO must reboot the capital planning process with an eye toward completing a functional, efficient campus on a reasonable timeline. The County Board will surely assist. But the plan must be far more creative and innovative than past efforts.
Hennepin County’s longstanding role in owning a public teaching hospital has been vital to all of Minnesota. The new CEO will inherit a wonderful tradition and must arrive with energy and enthusiasm for a new era. There are thousands of dedicated medical professionals in the Hennepin Healthcare system — and more than a million county residents — waiting to see progress.
Mike Opat, of Robbinsdale, is a member of the Hennepin County Board.