Post-discharge focus can build healthy behaviors and other letters

Regarding the article “Great job reducing readmissions hospitals—but it's about to get harder," nice work bringing us current on the state of readmissions. The post-discharge environment is the only part of clinical care not under health provider control. Building patient self-efficacy among patients to change unhealthy behaviors into new good habits—like reducing salt intake or tracking your weight daily—is one low-cost, high-return way to continue to make progress. And it benefits both the patient and the hospital.

Jon Winder

Wellflix

Durham, N.C.

Regarding the article “Troubled hospital giant CHS looking to sell its business," as care has shifted from hospital inpatient to hospital outpatient and now to nonhospital outpatient/post-acute care, the resulting decline in capacity utilization has made brick and mortar hospitals a rapidly deteriorating asset. And as bundled payments grow as a percentage of revenue, rewarding the most efficient providers, the community hospital sector will continue to decline, except as outpatient affiliates (feeders) of local health systems. Unfortunately, CHS, like HCA and other for-profit hospital operators, has been late to make the transition. It's a fading sector.

Founder and CEO

Monocle Health Data

Atlanta

Regarding the article “Wells Fargo scandal raises heat for Dignity Health CEO, other board members," as they say in business, “the fish rots from the head.” In the 1970s, hospital board members were found guilty of conflicts-of-interest in using such positions of trust for their hospitals to make purchases from themselves and their friends. In the case of Wells Fargo, it's hard to believe the board was not fully cognizant of the extreme antics promoted by its C-suite. As well, given the daily demand of our not-for-profit hospitals, what CEOs enjoy such free time to personally compensate themselves as board members in other industries? To what degree do we continue to tolerate such self-serving relationships?

M.E. Singer