Changes Coming to Downtown Louisville for KentuckyOne Health.

Not so bad so far!

I have been scanning the usual media outlets for some clue about what went on at the Tuesday institutional town meetings that Jewish Hospital announced publicly last week. I am finding nothing, nor have I any idea what was discussed.  I have a feeling that if something big had been revealed, that we would have heard of it by now. KentuckyOne and the University of Louisville continue to keep the lid on pretty tight.

What I did find was a YouTube video message from KentuckyOne’s CEO, Ruth Brinkley. It contained nothing particularly surprising or controversial. Its principal function appeared to be to calm employee anxieties that arise naturally during rapid institutional change. It begins by telling the “good news” that half of the $218 million budget deficit has been made up through the hard work and sacrifice of employees, although no details are offered. It restates the obvious, that major change takes time and is difficult. Employees were told that no further large-scale layoffs were anticipated.

Patient referrals and provider recruitment.
Other successes announced include increased referrals to system physicians and mid-level primary care providers through the “Anywhere Care” tele-health initiative or from referrals through HealthGrades. Fifty-eight new primary care providers of a variety of professions have been added to the network.

Employees are told they can help by speaking well of and conveying their pride in the organization to their family and friends. They are urged to select KentuckyOne primary care providers. Suggestions for cost-saving measures from employees are solicited with special recognition awarded for measures that are adopted. Much of the rest of the message is a restatement of the goals of the organization including improving the health of Kentuckians. It is noted that the challenges still facing KentuckyOne are not unique to it. [I agree.]

Changes are on the horizon.
Perhaps the major insight into what is planned is the notice that significant changes are imminent relating to the integration of services within the downtown Louisville medial campus. (Consolidation of cardiac services at Jewish might be an existing example.) Such changes are to be revealed only when they are at the stage of “firm decisions.” I take this to imply that not every medical service will be provided in every institution– an outcome I predicted. Following the debut in Louisville, other areas in the state are slated for similar changes in the name of efficiency.

There was no suggestion of any hospital closings– my speculations were off the mark there. Indeed, it is promised that the Catholic, Jewish and academic cultures of the partner facilities will continue to be brought together. (I suppose there is still some wiggle room there.) Finally, we are told that an overdue community benefit report of the merged institutions will be provided soon.

Why then did CHI come to town?
Neither am I hearing of developments related to the recent visit to Louisville of top management officials from Catholic Health Initiatives. Certainly a lot has been going on recently that CHI and KentuckyOne will have to deal with as partners of the University of Louisville. I suspect that if the mediated discussions between Norton Healthcare and the University of Louisville over the future of Children’s Hospital are not ongoing now, they will never begin. Coincidentally or not, the past and future partnerships of Kosair Children’s Charity are also up for play.

Who has a right to know?
Those involved in these titanic struggles appear to believe that what transpires behind their corporate shields is none of the business of the community. I beg to differ. If you agree with me, help me press for greater accountability and transparency. It is our money, our property, and our health that these parties are playing poker with! Use the comments function below to start.

Peter Hasselbacher, MD
President, KHPI
Emeritus Professor of Medicine, UofL
May 22, 2014

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