Faced with the challenge of providing health services in an environment of increased competition and reduced reimbursement rates from insurance companies and providers, hospital networks will be forced to change the way they do business in order to survive.
The question for local hospitals is whether the not-for-profit approach used in the past is still valid. More than half of Hudson County’s six hospitals have gone for-profit.
For-profit vs. non-profit
Modeled after similar networks already established in places like California, the local for-profit network called CarePoint Health has brought a new healthcare approach to Hudson County.
The competition among for-profit and non-profit medical providers could benefit Hudson County residents as the two sides upgrade and expand their services in order to be more attractive and competitive.
CarePoint runs three hospitals: Bayonne Medical Center, Hoboken Medical Center, and Christ Hospital in Jersey City.
Another for-profit hospital is Meadowlands Hospital Medical Center in Secaucus.
On the non-profit side are Jersey City Medical Center (part of the Liberty Healthcare system) and Palisades Medical Center in North Bergen.
The hospital networks are developing systems of private practices and stand-alone clinics to provide better and more inclusive services to the public.
CarePoint, in particular, seems to have adopted the California model in taking over many of the burdens that local physicians are faced with, such as billing and record keeping, modernizing offices with new computerized systems that allow doctors to focus on the medical portion of their practices.
The impact of the federal Affordable Care Act – commonly called Obamacare – is not yet known, although medical providers are gambling that it will expand the number of patients covered by some form of insurance and reduce the costly and often less effective dependence of the poor on Emergency Room services.
Obamacare has the potential to provide a huge economic boon to medical providers while cutting the charity treatment costs taxpayers currently pay for.
Here is a rundown of what local hospitals are doing.
One of the leaders in the revolt against poor reimbursements paid by insurance companies, CarePoint has become a cross between an insurance plan management system and a medical provider, incorporating a number of previously stand-alone medical providers and local physician practices.
Christ Hospital, a general medical and surgical hospital in Jersey City with 276 beds, has become the site for CarePoint Breast Center, performing new procedures that have not been available before in Hudson County. With satellite centers in Bayonne Medical Center and Hoboken University Center, the center provides all the resources needed to combat what has previously been considered a fatal disease.
After several months training staff, the hospital has begun its robotic surgery program, and has also conducted more than a dozen surgeries using the new technology. As part of a recruitment effort to attract quality doctors, CarePoint has brought on Dr. Jordan Garrison to oversee its bariatric surgery program, which includes pre and post surgery diet and clinical subversion.
Christ Hospital is also focusing on its radiology department and has undertaken a comprehensive master plan to upgrade it, include a three-dimensional MRI unit, one of the few in the region. The hospital is completing the final phase of infrastructure improvements which includes a renovation of its Emergency Department – which current receives about 50,000 patient visits annually.
This use will grow if the state awards McCabe ambulance the 911 dispatch services for the city of Jersey City. McCabe plans to work with CarePoint.
“The city awarded McCabe the 911 contract and we’re waiting for a review from the Inspector General,” said Peter Kelly, CEO of Christ.
Under terms of the contract, McCabe would take over dispatch services from another provider. The firm already runs those services for Bayonne and Hoboken. Christ is also making some fundamental changes such as the renovation of impatient units. One has been done already; two more are in line to be done shortly.
Hoboken University Medical Center, which is a general medical and surgical hospital in Hoboken with 204 beds, recently opened an obstetric emergency departments (OB-ED) dedicated specifically to pregnancy – the first such facilities in any New Jersey hospital.
While the concept of an OB-ED is not new nationally, it is new to this part of the country, part of a trend towards providing more specific service for expectant mothers.
The hospital recently received a Five Star Ratings for Maternity Care and GYN Surgery from Healthgrades, the leading online resource that helps consumers search, evaluate, compare and connect with physicians and hospitals. The distinction places Hoboken University Medical Center within the top 10 percent of all hospitals evaluated for the exceptional care provided to mothers (during and after childbirth) and to their newborn children.
In the last year, HUMC received accreditation from The Joint Commission on hospital care. Leap Frog also gave HUMC an A-rating this year. The hospital has expanded a number of its programs including those related to family, women’s health and HIV treatment.
The hospital also recently opened a Wound Care Center, which provides concentrated services to those with open wounds, includes two oxygen centers that help wounds heal.
HUMC also has a list of capital improvements, and is moving a number of departments around within the hospital and modernizing them.
Being the first of the three hospitals to be taken over by private owners, Bayonne Medical Center did many of its upgrades early. This year, its most significant physical improvement was to open its Sleep Center and proposed a face lift to its Emergency Department. Among the new equipment is a 64 slice PET scanner. Its radiation oncology center is also relatively new, said Hospital CEO Dr. Mark Spektor.
The hospital, he said, is focused currently on improving quality of customer services, and is instituting new programs for service excellence in the Emergency Room and other parts of the hospital.
A survey on quality in hospitals recently named BMC number 2 in the state for hospitals under 250 beds, and with the top ten in other categories of care.
This focus on quality is also being undertaken at Christ Hospital and Hoboken University Medical Center.
The New Jersey Hospital Association (NJHA) and its Health Research and Educational Trust of New Jersey (HRET) have chosen Bayonne Medical Center’s Neighborhood Health Center as the recipient of the 2014 HRET Community Outreach Award for Improving Access and Quality of Care to Reduce Healthcare Disparities.
The Neighborhood Health Center (NHC) is available to walk-in patients, regardless of geography, that have no medical insurance, and to those with Charity Care and Medicaid. In addition, the NHC has hired a social worker, dedicated to the NHC, to assist low-income, insured, uninsured, and underinsured community members who face barriers to quality care. The NHC also provides coverage for patients who require educational consultations on diabetes education or nutrition counseling.
The program partners with various cultural and religious organizations, local churches and Senior Community Centers, as well as the Bayonne Medical Center Outpatient Pharmacy. The results of the program include a reduction of unnecessary ER visits by over 40 percent, reduction of avoidable admissions by over 60 percent and better overall health outcomes.
Jersey City Medical Center
LibertyHealth-Jersey City Medical Center is a 269-bed teaching hospital that is accredited by the Joint Commission or DNV Healthcare. The center has 474 registered nurses and is located on a 15-acre campus near Liberty State Park. The campus presently includes two facilities: the Wilzig Hospital and the Provident Bank Ambulatory Center. The hospital serves as a regional referral teaching hospital and provides the highest level of care for women and infants, trauma, and cardiac patients.
Last year, the hospital announced that it would become a part of the Barnabas Health family. The State Department of Health and attorney general have approved this transaction. The hospital will remain a not-for-profit organization with a volunteer board of directors accepting a majority of insurance plans.
JCMC became the only hospital in Hudson County to receive four consecutive “A” hospital safety scores from The Leapfrog Group, is the only hospital in Hudson County to ever obtain the Magnet designation for Nursing Excellence, and is currently going through the re-designation process. The hospital also received the American Heart Association/American Stroke Association’s Get With the Guidelines Stroke Gold Plus Quality Achievement Award for the second consecutive year.
This year it also received the New Jersey Business Industry Association’s (NJBIA) “Exceptional Environment Management Strategies Award” for the work of its Green Team for initiatives that address healthy values, environmental conditions and sustainability that educates a wide spectrum of its people.
The hospital’s EMS Department celebrated its 130th anniversary last year. This team was reaccredited by the Commission on Accreditation of Ambulance Services and the National Academy of Emergency Dispatch.
In 2010, JCMC EMS became the first triply accredited EMS agency in the nation and is the only nationally accredited EMS agency based in Hudson County.
Among new services was the “Hand and Upper Extremity Service” for patients with pain and dysfunction ranging from arthritis, to common disorders like carpal tunnel syndrome, to injuries of the shoulder, elbow, forearm, wrist and hand. The service also deals with treating complex wounds with skin grafting and muscle transfer procedures.
The Paulus Hook Stop became the hospital’s second “after hours” urgent care center. More Health Stops openings are planned during 2014.
This year JCMC installed a new 911 system that will take JCMC’s dispatch center into the next generation with photo and text capabilities. JCMC also invested in 17 new emergency vehicles to keep its modern fleet of over 50 emergency vehicles up to date.
The hospital also added additional health care services for women. This includes gynecologic and family planning services, preconception care, care during pregnancy, childbirth and the postpartum period, and breastfeeding support and follow up.
The hospital expanded its cancer, neonatal and heart services, including the addition of a new electrophysiology lab for diagnosing and treating heart arrhythmias. The hospital also opened a new Noninvasive Vascular Laboratory. This allows vascular surgeons to perform non-invasive testing that will evaluate the health of patients’ blood vessels through the use of ultrasound and other physiologic tests.
To improve the lifestyle of its chronically ill patients, many of whom are elderly and frequently return to the ER or the hospital because of their symptoms, the hospital created such programs as “Wealth for Health,” a voluntary rewards program for patients who have been diagnosed with one or more chronic illnesses.
The hospital continued to build awareness of its online ER appointment system, where patients with minor injuries and illnesses can make appointments online in the hospital’s ER or at its urgent care centers and are seen within 15 minutes.
Working with Barnabas Health, a new pharmacy was built and opened in the lobby providing patients, visitors and employees a convenient place to fill prescriptions.
The hospital has established 30 locations in Jersey City to put hand sanitizers in public locations to help reduce the spread of disease
Palisades Medical Center
Palisades Medical Center, on River Road in North Bergen, features a 202-bed hospital and The Harborage, a 247-bed nursing home and rehabilitation center. With more than 1,300 employees, it is the largest employer in its service area. The annual operating budget is approximately $150 million.
Last October, Palisades Medical Center was named in Modern Healthcare magazine’s “Best Places to Work in Healthcare” Awards. The awards recognize employers for their outstanding performance in economic development, employee retention and satisfaction.
Palisades Medical Center is one of just two organizations in New Jersey to be recognized by the magazine as an outstanding employer in the healthcare industry on a national level.
Last December, Palisades Medical Center officially began construction on its new on-campus Ambulatory Care Center, a 57,000-square-foot facility that will provide up to date ambulatory and specialty care services. Services that will be featured in the new building include a dialysis center, the Hackensack University Medical Center’s John Theurer Cancer Center, an Ambulatory Center for Endoscopy, Cardiology, Gastroenterology, and Orthopedics, and multi-specialty physician practices from Hackensack University Medical Center.
Construction is scheduled to be completed in the fall of 2014. “The new Ambulatory Care Center will expand Palisades Medical Center’s capabilities and provide our patients with convenient access to new, specialty care services that they would otherwise not find in our communities,” said Bruce Markowitz, president and CEO of Palisades Medical Center. “It is critical in today’s healthcare environment to create facilities that support our mission and goals through operational efficiencies, patient comfort, and clinical outcomes. This expansion will also help create a significant number of job opportunities for residents in our community.”
Duke Realty has partnered with PMC to develop a cutting-edge medical facility.
Palisades Medical Center opened a new Pediatrics Unit, reconstructed floor-to-ceiling to provide young patients with rooms designed to enhance the healing process. The new unit also includes expanded amenities, four additional patient beds, a playroom, and a new security system.
PMC has experienced a 77-percent increase in pediatric patients during the past three years.
The grand opening of the new Pediatric Unit is PMC’s latest improvement of services for children. Last year, PMC formed a new clinical affiliation with Hackensack University Health Network that has enabled PMC to reorganize its Neonatal Level 2 Nursery for complex cases.
This past year, the hospital successfully developed and quickly expanded a Graduate Medical Education (GME) Program that is training physicians to become committed to providing superior medical care to the Hudson and southern Bergen County communities. The GME curriculum emphasizes the delivery of compassionate medical care, an active role in patient advocacy, a dedication to community service, a plan for lifelong learning, and a desire for the advancement of medical knowledge.
Meadowlands Hospital Medical Center
MHMC is an acute care, 230-bed hospital located on the shores of the Hackensack River, overlooking the wildlife preserves of the Meadowlands. In December 2010, a group of investors named MHA purchased the hospital and through a number of improvements, large and small, set out to improve its service.
In this last year, MHMC continued its commitment to quality and patient safety. The hospital was honored with an “A” grade in the fall of 2013 updated to The Leapfrog Group’s Hospital Safety Score, which rates how well hospitals protect patients from accidents, errors, injuries and infections. Meadowlands was one of only a few institutions to raise their grades from a C facility to an A facility in just 12 months.
“Patient safety is at the heart of everything we do and the quality healthcare we provide, and this ‘A’ grade is testament to the commitment of our staff in keeping patients safe and happy while in our care,” said Lynn McVey, acting chief executive officer of MHMC.
In an effort to provide the best emergency care to the community, Meadowlands has developed a program in its Emergency Room that limits patient wait times to see medical professionals and receive treatment. For non-critical emergencies, patients will be seen by a triage nurse within five minutes of arrival. Following that initial evaluation, patients will then be seen, evaluated and examined by an emergency room physician within 15 minutes.
For 2014, plans are underway to build a comprehensive cancer care and treatment program. The program will bring advanced treatment together with some of the region’s most experienced oncology specialists, making advanced cancer care more accessible to the community.
Al Sullivan may be reached at firstname.lastname@example.org.