The economics of health care is a challenge, panelists agreed during a March 30 discussion at Wagner College.
“In health care, we don’t get paid the way we should,” said Dr. Daniel Messina, president of Richmond University Medical Center on Staten Island. Reimbursements from Medicare and Medicaid particularly “are not catching up,” and thus the number of independent hospitals is declining.
“In Denver, they’re well insured. We make money,” said Dr. Thomas McGinn, chief physician and executive officer of CommonSpirit Health, which operates 2,200 sites in 24 states. “Then we have Arkansas, and we lose a huge amount of money.”
“There’s no silver bullet” to making health care less expensive, concluded Jon Giacomin, chief operating officer of the American Medical Association.
The three panelists spoke with nearly 200 students, faculty and community members in Horrmann Library for “The Business of Health Care,” cosponsored by the Spiro School of Nursing and the Nicolais School of Business. The lecture was funded by the Kaufman-Repage endowment.
“You are going to learn from some very, very important people,” college President Jeffrey Doggett said while providing welcome remarks.
Giacomin, touching on a growing model of providing medical services, said non-hospital “surgery centers aren’t necessarily thinking about the patient, but are actually thinking about the costs.”
However, noted Messina, “the hospital is a shrinking enterprise. More and more is being pushed outside the walls of the hospital,” into sites such as specialty clinics and urgent-care centers.
Giacomin said there are 1.1 million physicians in the United States and more than half are employees of a hospital or health-care company. “Independent practices … find that they can’t compete,” he said, largely because of administrative overhead and insurance reimbursement rates.
Said McGinn to students and health-care providers in attendance: “There will be a dramatic evolution of what your job is going to look like.”
Not all doom and gloom, though — when Driscoll asked the panel to identify some bright spots, Giacomin cited the power of artificial intelligence to reduce administrative work and speed up note-taking so health care professionals can focus on patients. McGinn agreed: “Physicians and nurses have been data-input clerks,” he said, and AI tools have let them shift focus back to providing care.
Messina said more broadly that upgraded technology systems make operating a hospital more efficient.
But he shared with attendees a line he said is at the heart of the business of health care: “No margin, no mission.”
Deans Tooker and Driscoll called the event a success that will inspire more such sessions.
“Today, more than ever, nursing programs must teach about health care as a business and the significant impact it has on patient care,” said Tooker.
“We are very pleased with the level of participation by our students in our nursing, physician assistant and business programs,” Driscoll said. “Their questions and attention greatly impressed the panelists.”
