MDNews - Greater Boston

Smith believes the affiliation with Lahey Health will bring many benefits to patients and the community, as well as the hospital. It will provide local access not only to the high-quality community hospital care available at Winchester Hospital, but also to world-class specialists, surgeons and other resources at Lahey Health. Smith says the ability to provide services across the entire continuum of care, from home care and community hospital care to advanced tertiary care at Lahey Hospital and Medical Center, will be essential to the mission he is championing in the affiliation effort: the right care, at the right place, at the right time, every time. "Whatever services patients need will be available to them close to home. High-quality care at a lower cost will provide greater value for patients," he says. "Lahey saw with us a shared vision for the future of health care. They came to us with a very genuine appreciation of the culture of our organization," he says, adding that both Winchester Hospital and Lahey Health are striving to provide high-quality care at the lowest possible cost. Both Lahey Health and Winchester Hospital officials saw that a shared commitment to building a better, more coordinated and integrated healthcare system could better serve surrounding communities. Smith states that a primary goal of the affiliation will be to avoid the "fragmented and duplicative" model of care that has prevailed in the U.S. healthcare system for decades, contributing to unsustainable cost increases. As part of the affiliation agreement signed last September, Lahey Health has agreed to make a significant capital investment in an electronic health record (EHR) system that will allow all providers across Lahey Health to access a patient's medical record. The new EHR system will help reduce costly, inconvenient and duplicative testing, and ensure that physicians have all the information they need to treat their patients. "That's an investment Winchester Hospital could not have made alone," Smith says. With renewed emphasis on preventive care, he says another prime objective is to "keep people out of the hospital — keep them healthy." Winchester Hospital's Center for Healthy Living (CHL) offers many wellness and preventive health programs, including chronic disease management of conditions such as diabetes, congestive heart failure and pediatric asthma; weight management; smoking cessation; and an anticoagulation clinic for patients on blood-thinning medication. The CHL also focuses on community-based care for patients following discharge from the hospital in an effort to reduce readmission and, as a result, costs. "This has been a real focus for us, and we are making progress," says Smith. "We know patients would prefer to be in the comfort of their own home as they recover from hospitalization, and we're working hard to support that." Smith, who earned his undergraduate degree from Brandeis University and a master's degree in Hospital and Health Services Administration from Ohio State University, believes that containing costs is in the best interest of everyone, particularly patients. "The increasing cost of health care is unsustainable," he says. "The rising costs of health care result in less spending on other things that are important to us, such as education and public safety. As healthcare costs go up, the premiums we all pay also increase." In addition to the burden of the rising premiums, patients are now being asked to share an increasing direct financial burden for their health care through higher deductibles and copays. "More and more of the cost is coming directly out of the patient's pocket," Smith says. "Patients are absolutely becoming more sensitive to it. Spending our healthcare dollars more responsibly helps everyone, including providers, payors and patients." Beyond the obvious geographical advantage of affiliating with Lahey Health, the proposed affiliation will provide Winchester Hospital with an equal role in decisionmaking along with other current members of Lahey Health. Smith calls the arrangement a "shared governance model." In addition to Lahey Health's large investment in the new EHR system, the affiliation will give Winchester Hospital the opportunity to reduce costs through economies of scale, the chief executive says. Smith says the federal and state regulatory pressure to move away from a fee-for-service model of healthcare reimbursement to a budget-based model and increased pressure to reduce healthcare costs contributed to Winchester Hospital's decision to seek a long-term strategic partner. He believes that with greater financial risk, the size of an organization's patient population becomes increasingly important to its success. "You've got to have a certain amount of size to balance that actuarial risk," he says. I The CEO Edition I MD NEWS Greater Boston | 19

• Cover