Stay around the world of healthcare long enough and you'll probably feel like you've seen and heard everything before. But the talk coming out of New York City Health and Hospitals Corp. is a refreshing blast of healthcare reform. Let's just hope the overhaul of this bureaucratically bloated healthcare provider is more than mere Big Apple political rhetoric.
HHC President Bruce Siegel, M.D., is the man behind the move to modernize the organizational structure of the nation's sixth-largest hospital-based system. In his attempts to make HHC leaner and more efficient, Dr. Siegel says he will borrow the philosophy of-are you ready for this?-Columbia/HCA Healthcare Corp.
And the cow jumped over the moon.
But let's give the guy a chance. HHC operates 16 acute-care and long-term-care hospitals and numerous clinics. It employs 49,000 people, including 1,200 in its corporate office. Some 600 of those corporate workers already are slated for termination or transfer to hospitals. Dr. Siegel's ambitious goal is to close a $189.8 million deficit in HHC's $3.5 billion budget for fiscal 1995. The corporate moves alone should save $17 million in the next 15 months.
Even more exciting is the organization's newly adopted "guiding principles." Dr. Siegel says HHC must be committed to increasing the quality of care, moving decisionmaking closer to the actual provider of care, responding to the rigors of managed care and building a team spirit among the facilities.
The strategy isn't unlike those of successful integrated delivery systems, including Columbia. But HHC says it will take the concept a step further by privatizing some of its hospitals, outsourcing the purchasing of supplies and entering into joint ventures to build its managed-care capabilities.
Some of these bold ideas are long overdue in the public hospital sector. The reinventing and downsizing of government will require providers to live within their means. Others involved in managing government-supported institutions should pay close attention to the development of the new HHC.