Connecticut hospitals are reengineering their organizational structures in an effort to reduce costs, improve efficiency, and better manage their patients’ care.
St. Francis Hospital and Medical Center, for example, has reconfigured its traditional department structure into individual service lines (like oncology, primary care, and cardiology) each headed by a physician and executive director.
Hartford Healthcare is reorganizing its bourgeoning network into three regions — Hartford, Central, and East — and adopting a service line model.
The goal, officials say, is to promote more integrated and collaborative care among doctors, surgeons, nurses and other providers by breaking down silos that have traditionally existed among hospital departments.
The changes reflect how hospitals are prepping for a new era in health care that gradually moves away from the traditional fee-for-service model, to a system that requires (and pays) providers to better manage their patients care.
“This reorients the institution to think in terms of patients and the coordination of their care,” said Daniel P. O’Connell, a St. Francis board director.
Chris Dadlez, St. Francis’ chief executive, said the hospital’s new structure is a contemporary model that tries to link the clinical and business sides of its operation.
The hospital now has 10 service lines. The key is each service line has its own profit and loss responsibilities, which means they track and are held accountable for their own financial and patient outcome performances (like readmissions rates and length of patient stays).
That makes it easier to identify areas that need improvement, Dadlez said.
Service lines must work together to better manage their patients’ care inside and outside the hospital. That includes working with providers like rehab facilities and nursing homes that take care of patients after they leave the hospital.
Dadlez said the new setup streamlines St. Francis’ operations and cuts down on bureaucracy. More importantly, it establishes the infrastructure to better coordinate patient care.
That is key as hospitals take on more of a patient population management role that incentivizes providers to keep people healthy, rather than simply provide sick care, which is the way the system currently works.
The new service lines, Dadlez said, coincides with other innovative models of care St. Francis is experimenting with.
These include accountable care organizations and bundled payment contracts, which try to better align insurers and hospitals around keeping patients healthy.
“You can’t manage populations if you don’ have a service line structure,” Dadlez said.
Meanwhile, Hartford Healthcare’s new regional executive structure will more closely link its array of hospitals and health care facilities, including Hartford Hospital, The Hospital of Central Connecticut, and MidState, Windham and Backus hospitals.
The restructuring includes adoption of three new regions — East, Central and Hartford — that will be overseen by executives within the Hartford Healthcare network.
The biggest change involves current Hartford Hospital CEO Jeff Flaks, who will drop that title to become chief operating officer of Hartford Healthcare. He will oversee the three regions and the creation of Hartford Healthcare’s own system-wide service lines model.
Other executives will take on broader roles. Lucille Janatka, for example, who has been president and CEO of MidState Medical Center, will become president for the Central region, which includes MidState and The Hospital of Central Connecticut.
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