Posted in DefaultTag on May 25th, 2021 Comments
Tom Robertson, Executive Director of the Vizient Research Institute, sits down with Yale New Haven Health’s CEO, Marna Borgstrom, for a second time. Tom and Marna shift gears to discuss macroeconomic issues affecting the affordability of health care for middle class households.
Marna Borgstrom, MPH
Yale New Haven Health System
Vizient Research Institute
[00:56] Marna has been in academic health care for 42 years, loves it and believes in it for all it does in health care delivery, however she believes health care providers have gotten very insular in the way they look at and provide care.
[01:50] Historically, there’s been an attitude that if health care built systems that suit them, including how they bring people in, that the people or patients would be grateful that the providers are making time to see them.
[3:00] Health care organizations exist for one reason, our patients – whether it’s in education, whether it’s in research or whether it’s in the delivery of care, we exist to provide better health care and a better health care experience to our patients
[5:36] It’s concerning how health care has a negative financial impact people’s lives – some to the point of bankruptcy.
[6:27] The majority of patients care what health care costs. We’re pricing ourselves out of the market because patients don’t know how to assess the value of care.
[7:18] To the average person, value is what you pay because they aren’t able to discern the right diagnosis. It’s a challenge for health care to get the value equation right, because the only thing people can really evaluate is their experience and how we made them feel.
[7:50] Health care may be heading for an all-payer rate-regulated public utility model where providers compete on service rather than on price.
[9:17] At YNHH 65% of patient care is paid by the state or federal government; on Medicare, which is the largest piece, they lose 11 cents per dollar of cost – not price, but cost.
[9:50] With Medicaid, YNHH loses 53 cents on the dollar of cost and not covering their variable costs in most cases.
[13:30] Physicians largely practice in a payer-agnostic way.
[16:06] YNHH spends a lot of time and investment developing talent across the health system.
[16:30] People are rewarded for what they do. We promote people for their potential, and potential is not based on what you’ve done in the past, it’s a cumulative on how you’ve developed and how you do what you do.
[17:00] Important for leadership: 1. lead with humility (no one leads by themselves); 2. be self-aware – you have to be courageous, take thoughtful risks and learn from your mistakes; 3. drive alignment and collaboration with diversity, equity and inclusion; and 4. strive for improvements and innovation.
Links | Resources:
Marna Borgstrom’s biographical information Click here