Hospitals Need ‘Retail Mindset’ Says UCHealth CEO George Hayes

For the past 30 years, George Hayes has been involved in the administrative and operational duties of running hospitals. Prior to assuming his current position, President and Chief Executive Officer of Memorial Hospital (UCHealth), he served as President and CEO of the Medical Center of the Rockies for ten years. During his long tenure of acquiring expertise in the administration of health care delivery, he has witnessed many changes.
In this interview with Catherine Strode, he shares his perspective on the current challenges facing the hospital industry and the health care delivery system. He also shares his thoughts on how hospitals will tackle those challenges most effectively.

As the focus in health care shifts from treatment to prevention, how are hospitals impacted?

“It’s going to have an impact probably more in looking at what is the role of the hospital going forward and where is care delivered.  I think hospitals, in general, probably need to adopt more of a retail mentality. Historically, if people had a health issue they would either go see their physician or go to the hospital.  Now there are so many niche providers out there: urgent care centers, free standing emergency departments, ambulatory surgery centers, endoscopy centers, the Walmarts, CVS pharmacy.  All those different enterprises are getting into health care.  We have to be sensitive to people’s buying decisions. Quality metrics are going to continue to be important, such as infection rates, length of stay. You have more health plans that put more of that responsibility on the individual or have high deductibles where there is going to be more money coming out of pocket on the part of the individual.  They’re going to be much more price sensitive about where they make their buying decisions and where they seek their care.”

What is the role of the hospital today?

“That’s a good question.  I think we’ll always be there for the acute and the seriously ill patients.  But if everything that ‘makes money,’ quote on quote, is provided outside the hospital and all we’re able to do is take care of patients for who we get paid very little, economically that represents a challenge to hospitals going forward.  I think that forces us to think about more of a retail mindset in terms of better meeting the needs from a service standpoint of our patients.  We have to be much more cost conscious than we have ever needed to be in the past.  We have to be focused on providing value to the customers and make it be an experience where they’re not coming in and sitting in a waiting room for two or three hours before they’re getting seen. We have to get them in and get them out, adopt more of that retail mindset to be competitive.”

What other challenges are hospitals facing?

“As an industry, we are going to have to learn to do more with less, and maximize the available resources that we have. I think that will be the biggest challenge for us because no one is looking to pay us more for what we do.  Other challenges are going to be access to capital.  Hospitals are typically very capital intensive entities, requiring ongoing capital in terms of replacing medical equipment as well as the infrastructure itself.  We have to be very focused on being competent on how we are running that portion of the business.”

Are these changes affecting quality of care?

“I think overall hospitals are providing much safer care, better care than we were say 10 or 15 years ago.  The transparency of data, the focus around quality metrics, and the incentives that have been out there are driving the improvement in care. In the case of Medicare, we have to report not only our patients’ satisfaction data but core measure data.  That’s out in public domain and some of our reimbursement is tied to how well we’re doing on those metrics compared to other hospitals around the country.   It kind of puts incentives in place to make us want to focus on those kinds of things and make those kinds of improvements.”

How is the shortage of physicians going to affect the delivery of care?

“I think with the aging of the population, there’s probably going to be a shortage of almost all specialties.  You’ve got 10,000 people a day going onto the Medicare rolls.  That 10,000 a day is going to exist until 2030.  It’s going to be a big impact on the system.  We are seeing that we have to change the primary care delivery model so that the primary care physician would be more of a primary care coordinator and will have medical assistants (MA’s) or nurses that will help with more of the day to day kinds of things.The physician would be the overseer or the one who would be involved with the more complicated cases that require more expertise.  There is a new care delivery model that we’re piloting right now in Denver that involves the use of MA’s.  I think a lot of people are experimenting with different models to try and maximize the scarce resource that physicians represent for many facilities.”