Health care reform puts spotlight on boards
As the huge impact of government mandated health care reform continues to unfold over America, the focus is increasing on hospital boards and possible collaborations among hospital systems — issues explored last week at the October First Friday Forum sponsored by the Alliance for Health in Grand Rapids.
Members of three such boards explained how the volunteer boards can help and hinder improvements in the health care system, even as the hospital administrators and medical professionals are working to figure out what’s next.
One thing made clear is that serving on a hospital board is extremely complicated, so anyone wishing to serve on one should be prepared to undergo some in-depth education.
Bob Herr, a CPA and member of the Advantage Health board for many years, said a board must help its new appointees to understand what the organization does and the role of the board. If the new board member won’t learn the ropes or lacks interest in the organization, “give them a plaque at the end of the year and thank them,” said Herr — and then get rid of them.
Bruce Neckers, a member of the Holland Home board and an attorney, said that when a health care organization gets in trouble, most of the time it’s over money. Financial issues are the most important ones a board will deal with, he said, although some eyes will inevitably “gloss over” whenever finances come up.
Neckers said some members of boards want to become very active in administrative issues, which is not the board members’ place, and that level of board activity can also lead to hospitals and other health care organizations competing aggressively against each other.
Neckers said several times that board members must “stay at the 3,000-foot level” and not be injecting themselves into the administrators’ roles.
Duplication of services among competing hospitals is one of the factors that add unnecessarily to American health care costs, so the issue of greater collaboration among hospitals and avoidance of competition is a big one. In May, at a major Alliance for Health event, Rich DeVos — himself a hospital trustee — said the communities actually own their hospitals and thus, “you have a role to play.” He noted that because of competition, “there’s a lot of tension between the hospitals.”
“We’ve got to work harder at it — at doing things together,” added DeVos.
The third panelist at the First Friday Forum was Jackie Scott, an attorney and chair of the board at Metro Health Hospital. She said some forms of collaboration among hospitals can be very effective, such as smaller ones sharing their resources for implementation of electronic medical records, which are now a requirement of the federal government.
However, Scott said, there are legal issues that prevent some proposed collaborations. She noted, for example, the anti-trust action by the government that impeded the merger of Butterworth and Blodgett hospitals into the Spectrum Health System — even though Saint Mary’s and Metro Health did not object to the collaboration.
“There’s always some legal obstacle” to joining too many organizations under one roof, said Scott.
She added that there are three hospital systems in the Grand Rapids region today to give the citizens a choice.
“We have an obligation to provide that choice, as well,” she said.
Several times the cost of new hospital technology and skilled professionals trained in its use were cited as one of the main drivers of escalating health care cost. Attorney Carl Ver Beek, who chaired the panel discussion, said use of that new equipment and the employment of specialists to use it is a critical issue that hospital administrators are looking at constantly.
How the community could become involved in that decision-making “is complicated,” said Ver Beek.
The panel was asked if there could be a role for one large community board over all the hospitals in an area. Scott said there is “much input already” on each hospital board, and she wasn’t sure “how many layers there should be.”
“I just don’t know that it’s practical,” she said, noting that much of what boards do now is driven by the community and employers.