October 7, 2013

Roach: Patient Satisfaction Crucial To Hospitals' Success

With his transition to the role of CEO at Marlborough Hospital still ahead of him next month, Steven Roach, now the CEO of Nashoba Valley Medical Center in Ayer, said it's too early to delve into his vision for the UMass Memorial Health Care affiliate.

But like hospital executives throughout the Bay State, Roach said he had a keen eye on improving patient satisfaction, and specifically, reducing emergency room wait times, during his tenure at Nashoba Valley , and he said that formula must be applied to all hospitals as federal reimbursements for services become tied to patient outcomes and satisfaction.

'The Way To Do It'

"It's really a patient (and) family-centric model where everyone is involved … and information is reflected in a timely fashion back to family members," Roach said. "And that model applies to all hospitals. It's just the way to do it."

With the emergency room serving as the "front door" for all hospitals, Roach said it was crucial to reduce wait times and limit the amount of time patients stay in the emergency room once they had been treated. At Nashoba, Roach set a "wait time" goal of 30 minutes, and seeked to cap emergency room stays at two hours and 20 minutes.

"And it's a struggle to get there, but the ability to get there really improves all the other systems elsewhere in the hospital," said Roach, who estimated that about 75 percent of all emergency room visits are not actually what he would call emergencies.

He said many who seek treatment in hospital emergency rooms do so because they don't have access to a primary care physician, or because they can't get an appointment for two or three days.

Primary Care Shortage Chokes ERs

This ties in with the shortage of primary care physicians that's plagued the health care system across Massachusetts and the nation. Last month, the Massachusetts Medical Society released its 12th annual Physician Workforce Study, which showed the Bay State faced a primary care physician shortage for the eighth consecutive year.

Other Central Massachusetts hospitals have pursued similar emergency room wait-time reductions, seeking to maximize reimbursements from the federal Centers for Medicare and Medicaid (CMS), which determine funding based on outcomes and patient satisfaction. For example, Milford Regional Medical Center will apply state grants awarded in September to redirecting patients not in need of emergency care to a community health center.

This year, hospitals' reimbursements were tied to those factors for the first time, and a number of area hospitals were hit with penalties based on readmission rates, reducing their federal reimbursements. This included penalties of 0.95 percent and 0.91 percent out of the maximum penalty of one percent for UMass Memorial Medical Center and Marlborough Hospital, respectively, making them the two hospitals receiving the largest cuts in Central Massachusetts during the federal government's 2013 fiscal year, which ended Sept. 30.

For fiscal 2014, penalties for those hospitals are set to decline: UMass will be assessed a penalty of 0.73 percent, while Marlborough will receive 0.86 percent.

Roach, who said his primary professional focus is on operational finances, has an extensive background managing hospital budgets. Before he became CEO at Nashoba Valley, a member of the Steward Health Care System, in 2006, he was its chief financial officer and chief operating officer. Prior to that, who worked in administrative roles at Brigham and Women's Hospital in Boston and Emerson Hospital in Concord.

Nashoba Search Is On

Roach said he looks forward to the opportunity to pursue a greater number of hospital programs than he was able to at Nashoba Valley, though he declined to comment on what those will be.

Meanwhile, the search is on for a new CEO at Nashoba Valley. Christopher Murphy, a spokesman for Steward, said the system is looking for "significant input" from the Nashoba Valley medical staff.

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