Keeping UMass Memorial fresh
PHOTO/EDD Cote
Richard Siegrist served as a mentor to UMass Memorial CEO Eric Dickson before Siegrist was appointed to the UMass board, and ultimately its chairman.
Eric Dickson receives much of the credit for reversing losses for UMass Memorial Health Care, the region's largest employer and provider of healthcare services, since his arrival as president and CEO in 2013.
But behind Dickson is a board of trustees with vast knowledge of healthcare management and the industry's most pressing concerns, and a chairman with a rich career in healthcare innovation.
In March, Richard Siegrist, a healthcare and technology entrepreneur, was voted chairman by his fellow trustees, for a three-year term. Siegrist began his tenure on the board in 2013, shortly after Dickson became the system's chief executive. A lecturer on healthcare management at the Harvard T.H. Chan School of Public Health, Siegrist was Dickson's mentor when the latter attended the school's master of health care management program for physicians, graduating in 2007.
The smartest person in the room
Knowing his acumen in healthcare innovation, Dickson was eager to appoint Siegrist to a six-year term on the board of trustees, a volunteer position, shortly after he was hired as CEO.
Before becoming chairman this year, Siegrist was the vice chairman, and he serves as chairman of the finance and governance committees at UMass Memorial.
“The board said 'This guy is the smartest person in the room' … so they voted him chair,” Dickson said.
Siegrist brings to the boardroom an impeccable resume, steeped in healthcare finance and technology expertise, with a strong emphasis on improving patient experience.
Siegrist is a healthcare entrepreneur who founded HealthShare Technology Inc., a provider of decision-support software to healthcare industry, in the 1990s.
When WebMD acquired the company in 2005,Siegrist continued in leadership roles, including senior vice president of WebMD Health Services and senior vice president and general manager of WebMD Quality Services.
More recently, Siegrist founded PatientFlow Technology, a patient flow consulting and software solutions company acquired in 2009 by Press Ganey Associates, a major provider of patient experience solutions.
Siegrist went on to serve as Press Ganey's CEO until 2011, followed by a stint as chief innovation officer for the South-Bend, Ind. company.
Becoming patient-centric
At Press Ganey, Siegrist said there was a constant focus on improving patient experience for hospital clients, and that work is ongoing at UMass Memorial. In the four years since he joined the board, Siegrist said there's been a cultural shift in the system's hospitals. By becoming more patient-centric, rather than provider-centric, he said patient outcomes have improved, and providers are happier at work.
Reducing anxiety and easing patients' concerns are vital to a good overall experience, Siegrist said, which is why the system has implemented hourly rounding. Nurses visit every patient, every hour, each day. Regular executive rounding, where hospital executives visit patients, has also been added, along with staff huddles, where executives generate ideas from the frontline staff on how to improve daily operations.
“It comes down to not how much you spend, or having the most fancy facilities. It's how you treat the patients, and how you address their needs,” Siegrist said.
Patient experience is important for the bottom line, because the U.S. Centers for Medicare and Medicaid now penalizes hospitals up to 2 percent of Medicare payments if patient experience surveys show underperformance in more than two dozen categories. Items patients are asked about include pain management and facility cleanliness. Meanwhile, health care is becoming more consumer driven, and health plans are incentivizing patients to seek services from providers delivering high-quality care in low-cost settings.
Leveraging technology
Siegrist said UMass Memorial Health Care is no different from providers across the U.S. facing financial uncertainty as healthcare policy at the federal level is in flux. Providers must adopt the best available technology for efficient healthcare delivery, which also leads to a better patient experience, he said.
The system is inching closer to implementing its new electronic records platform, called Epic, in October. Doctors will no longer have to access multiple electronic records systems to collect information on patients, which Siegrist said is an important step toward improving patient flow.
“It will make it much easier for our caregivers, having one system,” Siegrist said.
UMass decentralization
With revenue and operations on relatively strong footing – the system finished its fiscal 2016 year in October with a $68-million surplus – the challenge is to continuously adapt to pressure on reimbursements. UMass Memorial is particularly challenged, as a large number of its patients are covered by Medicaid, which offers lower reimbursement rates than commercial health plans, and it has high overhead costs, as the region's only hospital equipped with a level-one trauma center and the academic partner to the University of Massachusetts Medical School.
Meanwhile, the system is decentralizing in order to manage expenses, and continuing to grow its services, primarily through affiliations with other providers in the areas of urgent care, physical therapy, imaging, and, most recently, mental health. That's brought out-of-state providers – including for-profit companies – into the nonprofit UMass Memorial network.
“We very carefully vet the partners that we work with,” Siegrist said. “The end result, I believe, is better patient care because of the broader services we provide.”
In April, the system announced it is pursuing an affiliation with US HealthVest, a national provider of behavioral health services, to build a standalone, 120-bed inpatient psychiatric hospital in Worcester.
Of plans to eliminate about half of the 28 inpatient psychiatric beds at the University Campus in Worcester, which are on hold after the state Department of Public Health last month deemed the beds essential for the welfare of the community, Siegrist said the system must balance the need for more medical-surgical services (the closures would make way for a med-surge expansion) with demand for inpatient psychiatric services. While psychiatric services typically generate less revenue than med-surge services, Siegrist said the planned closures are not a financial decision.
Meanwhile, construction of a new ambulatory surgery center is now underway in Shrewsbury. The center is expected to be finished in February 2018, allowing UMass Memorial to move surgeries out of the high-cost hospital settings in Worcester to a location with lower overhead, which means lower costs for health plans, and ultimately consumers.
A return to UMass
Siegrist's tenure as board chairman, and relatively recent appointment to the board, are actually a return to Central Massachusetts health care, in a sense. Siegrist noted his first client after founding HealthShare Technology in the 1990s was the Medical Center of Central Massachusetts, which in the late 1990s combined with Memorial Health Care in Worcester to form UMass Memorial Medical Center.
As the system continues to evolve, Dickson said he's thankful to have a continued mentor in Siegrist. State and federal healthcare finance reform threaten to eliminate vulnerable healthcare players, and Dickson said the next six years will be make or break for UMass Memorial. But with the right leadership, he hopes the system will come out on top.
“We have the most qualified board chair in New England to be leading a health system,” Dickson said. “For me, he's been a godsend, in terms of being a coach.”
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