Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

Friday, August 30, 2019

The art of the deal: How Hackensack Meridian Health CEO Robert C. Garrett approaches M&A

- DEPOSIT PHOTOS

By: Martin Daks / editorial@njbiz.com

Robert C. Garrett knows how to make a deal. As president and CEO of the Hackensack University Health Network from November 2009 through July 2016, he expanded the network through a series of acquisitions, partnerships and affiliations. Then in July 2016, he engineered a combination with Me-ridian Health to create Hackensack Meridian Health (HMH).

During his tenure, the 17-hospital organization – which bills itself as “the state’s largest network” with some 34,000 employees and 500 patient care locations – is still growing.  In 2018, HMH merged with JFK Health, and at the beginning of this year it merged with Carrier Clinic. In July 2019, HMH acquired three nursing home facilities - Prospect Heights Care Center and Regent Care Center in Hackensack, and West Caldwell Care Center. Currently, Garrett said, “we are in active conversations with seven health care organizations in New Jersey,” which have progressed far enough to justify signed non-disclosure agreements.

Growth with a purpose

But growth is about a lot more than just about bragging rights, Garrett insists. “We are not interested in growing just to get bigger,” he said. “Our growth is always strategic and is pursued with a variety of exceptional partners to accomplish this goal: We want to continue providing outstanding care, the best patient experience possible and the best out-comes, or what we call the ‘Triple Aim.’”

Garrett
It’s on ongoing process, with Garrett and his team “constantly scanning” for new opportunities “to enhance care and the patient experience and to improve outcomes,” he added. “We assess where we are today and where we want to be in a year, next year and beyond.”

Sometimes a transaction makes sense because of the location. The JFK deal, for example, “allowed us to fill in the gaps in our network in Central New Jersey with high quality, convenient care and added services including rehab and advanced neurosciences.”

To assess these and other opportunities, Garrett works closely with James Blazar, HMH’s chief strategy officer, and others. In addition to hard numbers and other issues, they examine soft information like “quality, culture and geography,” he said. “Most important is sharing a common commitment to delivering care that is high quality and provides value. Once plans reach a certain level of detail and engagement, we get the board involved.  What’s important here is that we never take a one-size-fits all approach.”

When the fit’s right, it could lead to a deal. But Garrett and his crew don’t limit their thinking to a single dimension. “We are not always looking for a merger or acquisition,” he said. “We believe in taking a much broader approach in partnerships. They come in many forms: a strategic clinical affiliation, a full acquisition, and many points in between including joint ventures and joint operating companies.”

As an example, he pointed to the December 2016 partnership with Memorial Sloan Kettering Cancer Center “to create a uniform standard of care and to expand outpatient options by building a joint venture facility in central New Jersey next year. We also partnered with the New Jersey Institute of Technology [in 2017] to bring forth the next breakthroughs in care delivery.”

Aimed at bringing together experts in science, health care and technology to improve care delivery, the NJIT partnership leverages a $25 million in-vestment fund. It’s already invested in Pillo, a home health robot that automatically dispenses medication, and PurpleSun, which utilizes ultraviolet light technology to reduce the risk of hospital-acquired infections, Garrett noted.

Daring to be different

HMH also broke new ground with the Carrier Clinic merger, which was announced in January and billed as “a rare partnership in the U.S. of a be-havioral health provider and a multi-hospital network.”

Carrier Clinic - HACKENSACK MERIDIAN HEALTH
The deal “is a classic example of how we assessed our goals and went on a mission to find the best partner possible to achieve them,” Garrett said. “We were eager to transform behavioral health care in New Jersey because a record number of people were dying of opioid overdoses and so many patients with mental illness were receiving episodic care, rather than coordinated, high quality care that is essential to improving outcomes. Our goals were very clear: we wanted to expand access to treatment, better coordinate care and innovate treatment.”

With the Carrier Clinic deal in the rearview mirror, “We are on schedule to open our first urgent care behavioral health center in just a few weeks,” he added, noting that plans to create a “destination, comprehensive addiction treatment center,” to be known as The Retreat at Ramapo Valley, are on track too.

“We expect to open later this year,” Garrett noted. “When we are fully operational in 2020, we will have 85 beds, and extensive outpatient services all located on a healing 40-acre campus in Mahwah.”
Whenever a CEO engages in M&A or other significant activity, he or she is, to some degree, putting their own reputation on the line. If the strate-gies succeed, the board of directors will pat them on the back – if not, they may be out on the street. Some CEOs respond by playing it safe and maintaining the status quo. But not Garrett.

The way he sees it, “[m]y role as a CEO is to make decisions based on the best information I have at the time, guided by exceptional leaders who are committed to our mission. Opportunities are challenging and exhilarating. To succeed, you have to put yourself on the line and know which idea – out of so many competing possibilities – is worth pursuing.”

His own philosophy can be summed up by a quote from Apple co-founder Steve Jobs that’s displayed outside of Garrett’s office: “People think focus means saying yes to the thing you’ve got to focus on. But that’s not what it means at all. It means saying no to the 100 other good ideas that there are. You have to pick carefully. I’m actually as proud of the things we haven’t done as the things I have done. Innovation is saying no to 1,000 things.”

Saying “no” as well as “yes” helped Jobs to transform an industry and shake up the economy. It seems to be working for Garrett, too.

Wednesday, August 28, 2019

State Supreme Court upholds assisted suicide law

- PIXABAY
By: Daniel J. Munoz / dmunoz@njbiz.com 

The state’s highest court on Tuesday upheld New Jersey’s physician-assisted suicide law, allowing the measure to go forward and doctors to prescribe life-ending medication to certain terminally ill patients.

The decision came hours after an appeals court overturned the lower court’s Aug. 14 ruling by Mercer County Judge Paul Innes blocking the law, arguing Innes’ court “abused its discretion” in issuing the freeze.

Attorney E. David Smith speaks on Aug. 19, 2019. – DANIEL J. MUNOZ
Attorney E. David Smith
speaks on Aug. 19, 2019. – DANIEL J. MUNOZ
Bergen County-based Dr. Yoseff Glassman, along with attorney E. David Smith of Smith & Associates, filed suit to have the law declared invalidated. 

The “Medical Aid in Dying for the Terminally Ill Act” was signed by Gov. Phil Murphy in April and took effect on Aug. 1. It allows terminally ill patients with no more than six months to live to acquire life-ending medication. Patients have to demonstrate that they are mentally sound and are not being coerced into making the decision.

A patient has to wait 15 days between when they request the medication and when a doctor can write a prescription. Innes’ ruling came just at the end of that first two-week waiting period.

A practicing Jew, Glassman argued the law violates his beliefs because even if he did not participate in end-of-life treatments, he would still be forced to take part by handing over medical records to a doctor who would actually issue the prescription.

Pharmacist Manish Pujara, a practicing Hindu, filed onto the suit on Monday, arguing that it also violated his religious beliefs because like Glassman, he would be forced to take part in the assisted-suicide law by turning over medical records to participating doctors and pharmacists.

“We respectfully disagree” with the appellate court’s ruling, Smith & Associates Senior Counsel Richard Grohman told NJBIZ before the Supreme Court decision.

The firm could not be reached for additional comment.

Panel examines the state of health care technology in NJ

From left, Dean Paranicas, Van Ly, Carl Scalzo and Emma Yamada participate in the NJBIZ August panel discussion: Health Care Technology in Somerset on Aug. 27. - KEN KICZALES
By: Anthony Vecchione / avecchione@njbiz.com

Privacy, data security, data quality, mobile apps and wearables dominated a Health Care Technology panel discussion presented by NJBIZ on Tuesday at the Doubletree by Hilton Somerset Hotel.

Moderated by Dean Paranicas, president and chief executive officer of HealthCare Institute of New Jersey, a panel of experts discussed broad themes that impact providers, patients and insurance companies. They also addressed some of the challenges that technology poses for the health care industry.

When it comes to creating networks to share electronic medical records Van Ly, senior director of business development and programs technology at New Jersey Innovation Institute (NJII), said that his experience working with providers indicates that privacy and security are top priorities when it comes to data sharing across networks.

“When it comes to what the individual practices deal with on a day-to-day basis besides clinical care, there is also the business side. In New Jersey, we represent small businesses in these provider offices and when you look at what the insurance companies are looking for about providing quality of care, they benefit from that,” said Ly.

Ly added that patients are receiving high quality of care and providers are motivated to share information across their practices because the patients themselves go across different practices.

However, at the same time, Ly said that keeping the information secure is essential.

Thank you for sharing?

Carl Scalzo, chief executive officer, Online Computers, said that the industry has moved to an open and transparent environment of sharing everything.

“Everybody wants everything on his or her smart phone. They want to know their blood work, the moment the results are in, they want to know how they upload results and get another opinion. It becomes scary because the information that we are trying so hard to protect, we now have our consumers of the information willing to share it. How do we protect that information and how do we share it with our doctors?”

Scalzo pointed out that there are some people who genuinely do not care if some of their information is out there while there is another demographic of people who do not what anybody to know anything and in some cases, they even want to limit information that their doctor sees.

“They want be in control of the information. These things will play out over the next few years and we do not really know where it will end up.”

Emma Yamada, director of cognitive systems and data science at Holy Name Medical Center, said that it is crucial to learn from the mistakes of other industries.

“If our business is bringing all this data together, housing it as a hospital system, aggregating data beyond our individual health system and our individual providers, it is your responsibility to secure it and to make sure people understand how you are using it. It can be challenging from a health care perspective,” said Yamada.

Yamada added that distinctions should be made as to whether the information that is being collected is tied to an individual, or to general demographics.

“You don’t want anybody who is going to insure you to know your specific sleep patterns. But is their value, and can we create a distinction between collecting data somewhat anonymously – so if I know your age, race, zip code and I know your sleep patterns, is that enough for me to do something with it without compromising privacy.”

In past, Yamada noted, there were not good rules in other industries, so everybody collected everything and used it any way they liked.

“Some of those things are changing; new regulations are coming down the pike across industries. New regulations are going to be put in place. People are going to learn to do more with less and value privacy,” said Yamada.

When it comes to the quality of the data, the panel addressed various tools, screens, devices and protections out there that are used to verify quality.

Yamada said that Holy Name spends a lot of time doing data cleaning. Sorting the data and figuring out what is usable and what is not.

“If something is such an outlier or there was some kind of error, there are whole business lines of artificial intelligence dedicated to just cleaning data,” said Yamada.

“What we hope for is that as electronic medical records evolve, we move away from being billing systems to clinical documentation systems. As those evolutions happen, you hope to see the data quality improve. But you have to acknowledge that even with the best system, you still have a human operating that and there is still a chance that they input the wrong value into the wrong field,” Yamada said.

Information in-hand

From a patient perspective, there is evidence to indicate that technology is increasingly contributing to improving the quality of care.

For Ly, it is about the patient having information in their hands.

“It starts with quality. When you talk about quality, you are talking about specific outcomes results that are driven now since we have data based on social factors. If I’m a diabetic and I’m not eating correctly, or exercising and not getting proper sleep based on my wearables, most likely I’m going to have an event at an earlier age than if I take care of myself,” said Ly who added that when it comes quality and technology it starts with self-awareness.

Ly said that he would like to see more of a community connection regarding technology.

For example with wearables Ly said that it would be beneficial if the technology allowed family members to monitor aging parents or grandparents and have access to their patient portal to see if they are being compliant with their medications for instance.

For Scalzo it is about the balance of the data.

“Sometimes having all the information at your fingertips is a little bit on the dangerous side. It can result in too much information and could it lead to self-diagnosis. Where are we on that road? We are empowering ourselves. That is great when you are buying bed or some commodity item, but where does it fall in with our health? It also can result in unnecessary communication with our doctor because we are second-guessing the expert. It is about finding that balance,” said Scalzo.

The panel concurred that technology’s role in health care is likely to increase.

What would they like to see going forward?

Yamada said that she would like to see universal health care blockchain.

“It would mean that everybody’s health care information is stored in one place and the patient is the ultimately decision maker in terms of who sees what and when. It would be a massive undertaking but would be huge for quality value and technology.”

Scalzo asserted that he would like to see more education.

“People leave a discussion more scared than when they walked in when it comes to health care. Educating more toward the positive. How can we do that? How can we educate toward the greater good.”

NIII’s Ly said that he would like to see an application that promotes education and in particular in young New Jerseyans starting in elementary school.

“I never learned about health technology. There is an opportunity to do that in school.”