Medical News: What trends are you seeing in healthcare, as it relates to finance, costs and revenue?

Colleen Swarts: The most significant emerging trend is the nationwide shift to a value proposition for every aspect of care. No longer will be we reimbursed and evaluated by looking at volumes, but instead on our ability to deliver on quality care, carefully measured by outcome metrics.

Our daily work in every healthcare venue: ambulatory, inpatient, outpatient, telehealth, community centers, etc. will have an expectation from consumers and payers to deliver on the value proposition-high quality healthcare at low cost. The rigor of measurement and continued migration of health systems to high reliability organizations will continue and accelerate across our nation.

MN: What deal or transaction (Kentucky or elsewhere) do you find most interesting?

CS: There continues to be consolidation of health systems across the country. Consolidation of payers also continues across the country. Consolidation could bring less competition in the marketplace which may weaken healthcare economics.

Severity of illness continues to rise in regional referral centers as community hospitals struggle with staffing all aspects of the workforce including specialty providers, nurses, pharmacist, therapists and information technology professionals. The volume of transfers to large tertiary systems continues to rise and system coordination is imperative to meet and exceed expectations around value.

MN: What keeps you up at night? What can Kentucky do to create a better healthcare environment?

CS: Several key themes and stressors weigh heavy on my thinking and decision making. First and foremost, I worry that we always have the right staff, in the right amount, at the right time for every patient. Many of our workforce shortages are very real and can impact our quality imperative.

One of the other concerns I have is the escalation of workplace violence in our health systems. Verbal and physical assaults of our team members by patients, visitors, family members are real. We are working very hard to ensure safety at the workplace so our team members feel safe at work and can focus on their work with patients and family members. Kentucky is rich with opportunity to improve our healthcare environment.

One of our key challenges and barriers is the adequacy of care access for all Kentuckians. Improving access to preventive care strategies as well as primary care provision could allow us to take a huge step forward with our healthcare environment.

MN: Are there trends outside the healthcare industry that you would like to see applied to healthcare companies?

CS: We have been working diligently for about eight years to model many of the aspects of Lean thinking and integrate key principles into our everyday work. Some of our key aspects of Lean processes include creating standard work for processes, looking for and eliminating waste, using scientific methods to evaluate and improve throughput across our system, reduction in care variation where appropriate and an organized and rigorous approach to problem solving so the same problems do not keep recurring.

The Lean principles have emerged from industry and have become quite valuable to our thinking when we consider processes across all healthcare systems. Healthcare is also advancing more quickly now with technology integration and leveraging technology to improve effectiveness and efficiency of our models of care.