STORY BEHIND THE SUCCESS NAVIGATING THE CHALLENGES OF REGULATORY CHANGE AND RAPID GROWTH An Interview with Neil Meltzer, President and CEO of LifeBridge Health Today’s healthcare environment is quickly evolving, driven by sweeping regulatory changes, shifting patient demands, advancing technology, and growing competition. How companies adapt to these shifts can mean the difference between success and failure. Such is the case with LifeBridge Health, a leading provider of healthcare-related services throughout the Baltimore region. LifeBridge consists of Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital, LifeBridge Health & Fitness, hundreds of primary care and specialty physicians, and various affiliated health-related partners. The following is an exclusive Q&A with Neil Meltzer, President and CEO of LifeBridge Health, who shares insights on how the organization has successfully adapted to regulatory changes and rapid growth to become one of the most profitable healthcare providers in Maryland. The interview was conducted by Chris Helmrath, Managing Director of SC&H Capital. Q: In recent years, many industries have faced Q: What steps did you take as a result of the A: When we talk about ambulatory care, we ongoing uncertainty and regulatory changes, gap analysis? talk about providing the best value care and healthcare is no exception. Considering to the patient, which means the highest this environment, how has the LifeBridge A: We focused on hiring primary care quality at the lowest cost in the right executive team prepared for the future? physicians. In fact, approximately 25 to 30 setting. Historically, achieving this goal percent of our 550 employed physicians has entailed providing most care in a A: One of the things we have continually are now primary care physicians. We also hospital setting. focused on is the relationship between our partnered with companies in radiology, goals, our strategy, and the needs of our physical therapy, and laboratory medicine, However, in Maryland the industry is patients—not just following the example as well as two surgery centers. regulated, and hospitals are expensive. of other organizations. For instance, when They are treated much like public utilities, the ACA passed back in 2010, rather than For instance, we partnered with with rates set by a commission. Further, collecting and stringing together hospitals ExpressCare to provide urgent care and if a patient is readmitted to a hospital in like many health systems did, we began to Pulse Transport to create our transport the emergency department or an inpatient flesh out a continuum of care. We recognized service. Now we deliver long-term care in setting within 30 days, the hospital doesn’t that healthcare needed to remain local. five facilities and focus on housing and get paid. So, Maryland has an incentive to assisted living. reduce readmissions. To be successful in this this kind of model, you need to control many aspects of the care Q: What are some scenarios of what the When you provide community care, the continuum. We conducted a gap analysis ACA requires in relation to the delivery of rate-setting commission doesn’t have of our care continuum and discovered that quality care, as well as setting, time, and authority over pricing at those sites. although we were sufficient in ambulatory cost? Therefore, you can provide a lower cost services, we weren’t sufficient in urgent care treatment. For example, if a patient or post-acute care. requires cataract surgery or screening SC&H Capital schcapital.com STORY BEHIND THE SUCCESS services for gastroenterology or a Q: The big challenge seems to be affordably move patients between sites, allowing us colonoscopy, it is much less expensive and delivering this type of quality care on a to increase bed capacity at the hospital, disruptive for the patient to receive those nationwide level. What lessons have you provide the appropriate level of treatment services at an ambulatory surgery center, learned to show others it can be done? at the long-term care facility, and worry which is a freestanding facility usually less about the reimbursement issues located in a suburban area. A: One thing we’ve learned is that you must surrounding it. make it a priority to set the right culture. Q: In addition to identifying the right setting We found that providing high-quality care Other steps we’ve taken include creating and cost for the best healthcare value, how in the long term is less expensive than a company to provide home care for has LifeBridge addressed other challenges fixing an immediate problem. We also patients transitioning between the hospital of community care? recognized that to make this work and and long-term care facilities, as well as be cost effective, we need community developing a quality forum to advise other A: A big part of it is prevention and screening, partnerships. long-term care facilities which is a key component of the ACA. We now need to deal with many social Also, while there’s a wealth of community Q: This is a great segue. In 2015, you determinants of health, and if you generally knowledge and services out there, they announced the acquisition of Carroll look at healthcare, only about 30 percent must be effectively coordinated. By Hospital Center, a hospital that has served is related to services provided in a focusing on a model that allows patients the Carroll County community since the hospital setting. Much of the impact on an to remain at home and form relationships 1960s. The acquisition was even named individual’s health is based on where they with community-based services, we have “Deal of the Year” by ACG Maryland. live, how they live, and how they function become the center for coordinating care. Please talk about your accomplishments Meanwhile, we can tap into available from this deal, including how it has helped Our incentive is to keep those patients community resources to provide the right LifeBridge to achieve its goal of improving healthy and at home. It’s better for the kind of services to patients, keeping them the continuum of care. patient and reduces the total cost of care. out of the hospital and lowering the total Unfortunately, there is no one-size-fits- cost of care. A: The acquisition has been great for all solution for preventing patients from LifeBridge and Carroll Hospital, allowing returning to the hospital or providing the Q: Another issue businesses have been both organizations to execute on far right kind of care. Every community has grappling with is how to address more initiatives than we would have as unique issues, and you need to identify the population changes, such as the aging standalone entities. best approach to have a positive impact on Baby Boomer generation. What is patient care. LifeBridge doing to address this challenge? For example, while Carroll Hospital had already created their strategic plan for the For example, our team found a woman who A: Many things, but chief among them next five years, much of what they set out had returned to the hospital 100 times! has been improving the continuum of to do would have been more expensive We went to her home and discovered she care between hospitals, long-term care as a free-standing entity. We identified was a single mother of four with no stove facilities, and home care to decrease significant cost savings by consolidating or knowledge of basic nutrition. So, we hospital readmissions from nursing certain core, back-of-the-house services. purchased a stove, filled her fridge with homes. Further, we invested $250 million for healthy food, sent her to three nutrition facility construction and the expansion of classes, and continue to conduct weekly For instance, there are patients in our three medical services, allowing them to receive home visits. She hasn’t been back to the acute care hospitals that require long-term a state of Maryland grant for the first time hospital once. care. Some would typically not be accepted in over a decade. at other long-term care facilities. However, because we own these facilities, we can (con’t ) SC&H Capital schcapital.com STORY BEHIND THE SUCCESS We also provided clinical expertise, which A: No matter what happens or where you are Q: Anyfinaladviceyou’dliketosharefor Carroll Hospital had been purchasing due in the country, folks relate to their local other businesses experiencing rapid to its location and relatively small size organization. Also, there is no substitute growthorfacingsignificantregulatory and demand for certain key services. And, for high-quality, cost-effective services change? we made a $50 million contribution to the and a dedicated and energized staff. endowment fund of the Carroll Hospital Without either, you can’t move forward as A: Explore and embrace partnerships with Center Foundation, which funds patient an organization. Employee and physician organizations that can provide different care and community education programs. engagement is key. perspectives. With the right partners and expertise, you can more effectively As a result, the deal has better positioned Finally, unless you continue to grow, you navigate industry changes and identify Carroll Hospital and helped us to improve end up fading away. The market is moving potential transactions. In the end, they the continuum of care. Also, since the fast, and healthcare is changing in many can be the difference in finding the right communities that LifeBridge and Carroll ways. We still have board members, time and right opportunity to successfully Hospital served overlapped to a large physicians, and staff who have trouble transform your business. extent, we were able to integrate our wrapping their heads around healthcare medical staff in only a year and a half changes.