Dr. Jaewon Ryu, who has served as president and CEO of Geisinger Health since 2019, is responsible for, among many other things, implementing services that allow patients to be cared for at home or in concierge facilities outside of a traditional hospital. The result, the system says, is improvements in outcomes, engagement and affordability.
What data are you using to create your growth strategy?
It comes down to assessing what your communities need as far as services. I think being both a payer and a provider of healthcare, we end up focusing on populations and we know that among our areas in central and northeastern Pennsylvania, some of them skew a little bit older and more rural. The care model needs to be accommodating of those dynamics.
So what we’ve said is if the first century of Geisinger was all about building big buildings and facilities and hiring great people and having state-of-the-art technology and expecting people to come to it, we think the next chapter is all about building clinical programs, capabilities, and meeting people closer to where they are. And we think that’s in the home. We think that’s in the community. We think that’s where people live and work.
Now don’t get me wrong, we’re still going to have to invest in these programs on our big campuses and continue to grow those because people will always get very sick and they’ll need those high-end tertiary services. But at the same time, we know that what really improves health is when we can bring those services and capabilities closer to where people are.
How do you elicit feedback on whether this is working?
We have community advisory boards at each of our campuses. We also have our patient experience and feedback where I think our communities keep us honest.
I’ll give you a great example. With behavioral health, I’d be the first to admit that we have not done a good job keeping up with the demand there. It’s an unfortunate truism that with COVID, demand has skyrocketed. And so that’s been one where we know have to expand capacity, not just on the facility side, but even on the outpatient side, making sure that there are programs to keep people out of hospitals. I think we keep a close ear to the ground, if you will, through a variety of factors to make sure that we’re meeting the needs of the communities we serve.
And we have our own health plan, so we know through the claims data where folks are going and where they feel like their needs aren’t being met through our own delivery system. That also informs where we want to invest more resources to make sure that we’re bringing a comprehensive delivery system for the communities.
Is that how you decided to build a $180 million freestanding orthopedic center
I referenced the fact that we do skew a little bit older as far as our demographic. And we know when we project that out over the next decade, we do have an aging demographic. So when you think about the care model of folks 65 and older, and as that demographic continues to age, I think what I’ll call the wear-and-tear specialties—things that tend to disproportionately plague those who are older—we know that the needs for those things will go up and probably by a considerable amount. One of those is orthopedics. And we’ve had great programs over the years that we can further grow.
Whether it’s our Destination Care Program with employers like Walmart and others, we’ve been pretty successful with doing procedures in a very efficient way, and joints would be a good example of that. So that’s been part of the thinking behind why we’re investing in that new facility. The other is there’s a significant amount of these procedures where we think it actually can generate its own scale by being in its own stand-alone unit. And we know that when you have dedicated units like that, and teams are used to working together and having that continuity of teamwork, we know that good things happen for patients. So for a variety of reasons, this made all the sense in the world for us.
Geisinger made news back in 2018 when you were the first system to offer a money-back guarantee on hip and knee replacements. Will that type of agreement play out in this facility?
Our patients and we all do better when we’re in value-based payment models. The extreme example is when someone is on our own health plan and we have accountability and responsibility for the total cost of care, and we truly manage total health. But even within bundled-payment programs, where we really take responsibility over the entire episode of that procedure, we are incented to make sure that things are done right the first time.
It’s also that we’re managing their pain effectively so that they’re not coming back to the emergency room, needing those things addressed. And I think the extrapolation of that is the money-back guarantee that you referenced. And it’s been in partnership with one of the equipment manufacturers where we feel that good and confident about the ability to be precise with the procedure, to get the best possible outcome, and to have the follow-up services so patients don’t feel the need to have revisions or other complications resulting from that procedure.
We’re still fairly early. It’s a few years in, but it’s been going great so far.
Are there any potential employers that are interested in this facility for services?
We want to continue to build on the program that we currently have with Walmart, Lowe’s, McKesson. There are a handful of employers out there, and we’re one of a handful of systems that participate in this throughout the country. We were one of the first. We started with, I believe it was bariatric and cardiac, and there may have been one or two other programs. But that has continued to expand where now it’s joints and even high-end radiology. They have continued to expand this program and we love it.
It’s encouraged us to focus on reducing unwarranted variation in how we approach elective procedures. It’s making sure that even the pre-op and prep for the procedure is optimizing the patient’s outcomes, as well as of course what goes on in and around the OR, and then what goes on afterwards to make sure that folks are plugged into the right kinds of recovery programs and right kind of follow-up care, to ensure their outcomes are top notch.
Whatever we can do to help them continue to grow that program, we’ve been eager to do. And that’s including analyzing the data, writing it up in various venues, and we plan to continue to do that.
