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October 27, 2014

Q&A with Patrick Muldoon, President, UMass Memorial Medical Center

PHOTO/MATT VOLPINI Patrick Muldoon, President, UMass Memorial Medical Center, Worcester

Patrick Muldoon

TITLE: President, UMass Memorial Medical Center, Worcester
RESIDENCE: Princeton
EDUCATION: Bachelor's degree, Providence College; MBA, Loyola University, Chicago

Patrick Muldoon took over at UMass Memorial Medical Center last year, a time when the system was beset by labor discord, the onset of the Affordable Care Act (also known as Obamacare) and the 2012 passage of the state's cost-containment law for health care. After serving as president and CEO of HealthAlliance Hospital in Leominster, another division of UMass Memorial Health Care, he has - at least in terms of size - a bigger challenge in Worcester.

This new job is not so new, now that you've been at it for a year. How big of an adjustment has it been?
The most significant change was scope. Here, the mission of the medical center is tripartite: obviously quality clinical delivery, the significant teaching component and, of course, the third is research, (making for) the significant relationship we have with the (University of Massachusetts Medical) school. The basic fundamentals - leading and managing a hospital - are very similar.

Has the change caused you to alter your management style?
I wouldn't say my management style has changed; it probably has consumed more hours of the day being here at the medical center. I manage using the skills that I learned very early on (and I'm) constantly learning, constantly improving.

There appears to be a high level of discontent within the nursing staff, and their union has been vocal about that, this coming a year after a strike was averted. Have you been working to improve relations between management and the nurses?
Health care is a team sport. The nurses are very important. My mom's a nurse; at age 89, she's still a licensed nurse. Two sisters are nurses. I grew up surrounded by nurses. They're a vital element of the health-care team but they're one component of a team. At HealthAlliance, I think I established over a number of years a very healthy relationship with the (Massachusetts Nurses Association). We had our differences but we always found a way to resolve whatever issue was at hand. I hope that I'm able to accomplish that here.

There's a jump in the number of outpatient clinics to treat non-emergency cases. How much of a help is that to emergency room operations here?
Getting into the urgent-care business is something that we're looking at very closely. Right now, we're somewhat one-dimensional; you can come to our emergency department, but there really isn't a fast-track, urgent-care element to that service. Maybe it shouldn't be on this campus. As a matter of fact, we provide medical directorship for CVS Minute Clinics. We see that as a very important part of the continuum of health care. We'd like to get into the urgent-care business (for patients who don't) need to be in our emergency department. It's high cost; it tends to slow down the care that's being delivered.
Where has health care reform made the bigger impact: Increasing the ranks of the insured? Or decreasing patient service revenue?
I would say definitely the former: increasing access. People look at health care reform in Massachusetts and they say, "Well, that's really Obamacare." People forget that we started this in 2006. We had health care reform, universal access. In 2012, we decided how we were going to finance health care reform (cost-containment legislation): How do we pay for 98 percent of the population to have insurance?

But it has been the president's plan, kind of layered on top of what we know as health care reform here in Massachusetts, that has really improved access and it has improved the funding. It has extended the privilege of Medicaid coverage to a much broader population. And that population would usually end up in our free care, or our bad debt expense. And now we're at least getting some Medicaid or Medicaid managed care reimbursement for those patients, significantly (less than) what it costs us, but far better than free care and bad debt.


Patrick Muldoon, UMass Memorial Medical Center

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