Hillman 10 Years Of Progress

November 3, 2004
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GRAND RAPIDS — Members of the former Hillman Commission and local hospital officials gathered Wednesday at the Press Club to discuss what has transpired in the 10 years since the release of the Kent County Area Health Care Facilities Study.

In 1993, public concerns about health-care costs and facilities prompted the Alliance for Health to appoint a 23-member commission to look at the state of health care in Kent County and recommend short- and long-term strategies to meet the county’s health-care needs.

The commission, named after its chairman, now retired Senior U.S. District Court Judge Douglas Hillman, met 18 times over 14 months and came up with 72 recommendations.

Lody Zwarensteyn, president of the Alliance for Health, recalled that there was a lot of concern at that time over the proposed replacement of Blodgett Hospital, which was just one of many issues and assumptions on a wide variety of subjects.

Health reform was a huge national issue in 1993, Zwarensteyn recalled.

“There were assumptions that we would, as a community, stress prevention and primary care to a much greater degree — that prevention would reduce the demand of acute care services, and that the trend would be toward more bundling of primary care services outside of the hospital.”

The Hillman Commission’s four principal recommendations were:

  • Form a hospital joint planning board to set long-term strategic planning for all the hospitals in Kent County.

  • Cease plans for major new construction of Blodgett Memorial inpatient facilities.

  • Abandon plans for a Butterworth Hospital satellite facility in southern Kent County.

  • Provide greater access to inpatient psychiatric facilities.

What resulted?

As Hillman explained in a letter to guests at the reunion, although a hospital joint planning board never materialized, Blodgett and Butterworth hospitals took the initiative to merge in 1997 and form Spectrum Health. Instead of building a satellite facility, Butterworth went on to build a facility on the campus of Pine Rest Christian Mental Health Services and set the stage for the sharing of services.

Additionally, St. Mary’s Mercy Medical Center assumed governance of the former Kent Oaks Hospital in partnership with Pine Rest, a move that maintained Medicaid benefits for those in need of psychiatric services because it prevented the “institute for mental disorders” label that would have terminated Medicaid reimbursements.

That partnership was forged out of the Hillman Commission’s recommendations and it has contributed important resources to the mental health community, said St. Mary’s Health Care President and CEO Phil McCorkle.

Dan Holwerda, president of Pine Rest, said he was impressed by the fact that the Hillman Commission did an in-depth evaluation of the whole area of behavioral health and psychiatric services and understood the importance of a strong behavioral health component in the overall health-care delivery system.

“It’s not the norm around the country. Psychiatric services still bear a huge stigma in our country; there are issues where we are very much seen as being a stepsister in the health-care delivery system.”

McCorkle attributed a lot of the changes in Grand Rapids’ health-care system to the work of the Hillman Commission a decade ago. As he sees it, the health-care delivery system here is “tremendously stronger” than ever before.

Among the most profound changes in the health-care landscape have been the birth of facilities, such as the Van Andel Institute, GVSU’s Cook-DeVos Center for Health Sciences and the soon-to-open Richard J. Lacks Cancer Center.

“We are very proud of our costs, our quality and the access that comes along in our health-care system,” McCorkle said. “I believe that our concern and our willingness to allow intense scrutiny has really made our health-care community what it is today. Not many communities are as involved in health-care issues and planning as we are.”

Jeff Padnos, of Louis Padnos Iron & Metal Co., took issue with the suggestion that current health-care costs are something to be proud of. He estimated that the cost of health-care benefits to manufacturing employers like his company are now running more than $5 an hour per person.

“The costs are threatening our ability to provide health coverage,” Padnos commented.

Rick Breon, CEO of Spectrum Health, described the county’s health-care community today as “vibrant, alive, healthy and significant.”

Medical education is going to be critical to the community, he said. He also predicted there will be tremendous opportunities ahead in the area of public health, especially in disciplines such as infant mortality and immunizations.

He said that since 2000, Spectrum has been very active in “meaningful cooperation,” both locally and throughout West Michigan.

“My prospective looking forward is that we will continue to find ways to work together. There are going to be things in high tech that we’ll work together on between facilities, hospitals and physicians.”

There are days when all the hospitals compete against one another with different service lines, Holwerda observed.

“At the same time, we have the opportunity, and I think the insight, to collaborate in a number of different ways,” he added. He noted that today Pine Rest has 45 locations in West Michigan and does a lot of work with Spectrum, Saint Mary’s and Metropolitan.

“As we look ahead to the future, the field of psychiatry has to become more and more integrated into the medical field. How do you integrate psychiatry with neurology, cardiology, and some of the other medical specialty fields? I think we’re going to see a major change in that and that is an area where there’s going to be a lot of focus.”

Breon said some of today’s significant challenges include access to health care and the misuse of emergency medicine.

“A lot of it is because these people don’t have access any other way. The hospitals are providing the safety nets. We have to fix that problem and make sure they have access to physicians, so they’re not coming into the ER being very sick and needing very expensive care.”

He also stressed the impact the country’s aging population is going to have on health care because older people utilize health care more. He expressed concern about lack of access and availability to meet the demands of a growing elderly population as it moves en masse into the health-care arena over the next 10 to 15 years.

Holwerda pointed to the difficulty of recruiting psychiatrists, especially child psychiatrists, and there are fewer and fewer of them coming out of residency programs. He said the areas of regulation and licensing are problematic, as well.

McCorkle said he, too, expects that maintaining adequate manpower will be a continuing problem. Individuals who lack insurance are a real burden on hospitals, he said. Another difficulty is trying to drum up capital to renovate aging facilities and keep up with new technology.

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