House Call: A Conversation With Dr. Gregory Simone

A hospital administrator takes about the implications of healthcare reform.

With more than 11,000 employees, WellStar Health System is big healthcare business for Georgia. From its origins at Kennestone Hospital in Marietta, the system has grown over the last 50 years to include four hospitals, extending out to West Georgia and serving more than 600,000 patients a year.

Georgia Trend’s Ben Young talked to Dr. Gregory Simone, WellStar President and CEO, about the changes that will result from healthcare reform – for his system and others in Georgia.

GT: What are the advantages or disadvantages of healthcare reform for a large health system like WellStar?

Simone: We’ve anticipated change coming on for several years; that’s why we’ve taken the course we have as an integrated health system. We will be better situated in the future than other healthcare systems who were slower to get out of the gate.

We have to wait and see what it will limit us to, in terms of financial impact, and how we can best use our resources for the community. But we fully anticipate that reimbursement will go down while cost will continue to go up. That’s not a good combination.

We have to try to create a cost structure to go down in accordance to the decrease in reimbursement while maintaining a margin to invest in the community needs, which is our mission as a not-for-profit. There’s going to be a lot of pressure on us to do that.

GT: WellStar has hospitals in Austell, Douglasville, Dallas and Mar-ietta. Do you see any physical reconfiguration of your facilities ahead?

Simone: Rather than physical, we will see more of a philosophical reconfiguration to an outpatient, not inpatient, structure. That’s a new trend – a lot of surgery today used to require treatment and overnight stays, and it’s no longer necessary. First, it’s safer to be an outpatient and more cost effective. Second, you will see us building on that to focus more on quality, safety and outcomes. WellStar has been doing it for years, so for us it’s more of a refining process.

GT: Why is it safer to be an outpatient?

Simone: You can get an infection by coming into the hospital. So we need to minimize the patient’s need to come in the first place. Decreasing hospital-acquired infections is something we in administration look at every week, and data is collected all day. In the last two weeks, we’ve only had one infection, whereas at the peak of this infectious process, we would see as many as 60 to 90 cases in a month. Because of the increase in quality, WellStar has dropped those numbers down tremendously.

GT: How will research be impacted by healthcare reform?

Simone: Research is not going away by any stretch. It will likely be expanded into realms that haven’t been considered in the past, such as quality care and convenience. Creat-ing cost-effective venues is a burgeoning area for research. There will be research on creating quality outcomes for an entire community, not [just] individual cases.

We’re very much engaged with Kennesaw State University as far as research and obtaining the statistical correlations we’re looking for. As we’re getting this off on a new ground, we’re delighted with their willingness to join us in research. The KSU WellStar School of Nursing, which we began in 2005, recently had the second or third largest graduation class in the state. We are dedicating a new WellStar College of Health and Human Services at KSU this month. It will enable the school to expand their offerings from nursing to various physical therapies, social work and healthcare specialties. It will also provide clinics for indigent care.

We’re very involved in the educational process. Though KSU is our closest partner, we serve some 2,000 students a year, also at Chattahoochee Technical College, Georgia Highlands College, West Georgia Technical College, Morehouse College, Emory University and Georgia State Univers-ity. Everyone thinks of Emory and Grady as our major medical educators; we’re under the radar.

GT: Will a rising patient population offset the rising cost of healthcare to the practitioner?

Simone: If you’re losing money, you can’t make it up by seeing more patients. We have to get the cost structure under control, through the process. We need to think of getting waste out of the system by no longer concentrating on the hospital, doctor or the system – we need to concentrate on the patient. There need to be no unnecessary tests and no spending of unnecessary resources. If we can’t control costs, the revenue side goes down, so we have to make sure we are focused on outcomes.