Faced with new demands, Hudson County’s medical facilities are changing their approach to providing services, tying themselves to institutions with significant resources or upgrading their infrastructure, even in one case establishing their own health care network.
Each of Hudson County’s hospitals has faced challenges including inadequate insurance reimbursements, charity care, and upgrading facilities. Some of them have managed to solve their problems, win awards, and maintain a profit business so they don’t have to face closure.
Hudson County’s new health network
On a cool day in February, three men sat in a wood paneled office on the second floor of Bayonne Medical Center, men who as the respective executive directors of a newly established three-hospital network are on the forefront of changing the medical landscape in Hudson County.
The network, Holdco, owns Christ Hospital, Hoboken University Medical Center, and Bayonne Medical Center, having bought the three entities in the last five years.
Christ Hospital is a 381-bed acute care facility located in Jersey City, offering a broad range of services from primary angioplasty for cardiac patients to intensity modulated radiation therapy (IMRT) for those battling cancer.
Hoboken University Medical Center is a general medical and surgical hospital in Hoboken with 364 beds. Bayonne Medical Center is a 278-bed, fully accredited, acute-care hospital.
The three hospitals have or are in the process of upgrading facilities from emergency room access to specialty care. But as a combined network, they are able to plan out joint operations that will allow them to keep from duplicating services.
“For one thing,” said Peter Kelly, executive director of Christ Hospital in Jersey City, “We’re no longer in competition with each other.”
As stand alone hospitals, the three used to face serious obstacles, each doing battle with insurance companies for reimbursements, each forced to deal with purchase of supplies and hiring of staff on their own. All three struggled to stay open, often relying on state money and inequitable arrangements with insurance companies that left them forced to take bad reimbursement deals just to make sure they could pay their bills. All three hospitals eventually fell into bankruptcy.
Under the new ownership, “We now have the power to leverage,” said Dr. Mark Spektor, executive director of BMC.
This could involve everything from purchasing supplies to dealing with insurance carriers, but more importantly, could allow the three hospitals to build a network based on each hospital’s strength, such as cardiovascular services in Bayonne or maternity in Hoboken.
Known for its oncology radiation center, Christ Hospital – according to Kelly – went from the throes of bankruptcy to profitability in less than one year.
HUMC said the hospitals no longer have to duplicate services and can concentrate resources on what each hospital does best.
Paul Walker, executive director of HUMC, said while each hospital still provides basic services to the community in which they live – such as Emergency Department services – the hospitals can call on each other for more specialized services.
“We call it systemness,” Walker said.
“We’re trying to streamline the process and bring service to where people are.” – Jason Rand
Spektor said the owners have made a significant investment of capital and each hospital in the process of upgrading for the future.
“The goal is to provide services to residents of Hudson County that many people would have to leave the county to get,” Walker said.
The hospitals are in the process of developing a health care system in Hudson County, dedicated to Hudson County, without relying on institutions beyond the boundaries. Spektor said one of the key elements of this unity is clinical integration, which means that all information about a patient is available to all three hospitals, associated clinics, and the doctors so that a patient gets the same level of care and same evidence based treatment regardless of the setting he or she is in. This means whether the patient is in a hospital or a doctor’s office, outpatient or in patient, or even at home.
That’s not all. In the past, all three hospitals have played hardball with insurance companies to get a more livable reimbursement rate. Now, they are establishing their own insurance.
“In three to five years, we might be known as an insurance company that happens to own hospitals,” Walker said.
Providing high quality care is the first building block for the new health care system, Spektor said, but it also has been affordable.
“The trend for the future is value based care,” he said. “We’re just getting ahead of the trend.”
“We’re all learning from each other,” Kelly said.
Walker said that since they are for-profit hospitals, the network will rely less on public money and more on its ability to provide service.
“There are a lot of for-profit hospitals, but in an urban area, this has been unheard of,” he said.
The old model, he said, doesn’t work. When insurance companies were paying so little and hospitals were desperate for cash to pay ongoing bills, no one was looking to the future.
The hospitals are also grooming their own network of doctors, graduates that will be part of long term plans.
The stronger relationship allows them to rebuild services as well as invest in brick and mortar improvements – such as expanding the Emergency Department at Christ.
Another area is followup care, making certain that when patients leave a hospital they are still being taken care of.
“We have moved into an era of empowered patients,” Walker said. “With information available to them on the internet and elsewhere, they have access to resources. If we do not give them what they need, they will go somewhere else.”
Challenging times for hospitals
During a year when times have proven to be particularly challenging for many hospitals throughout New Jersey, Jersey City Medical Center has enjoyed a banner year, said Joe Scott, FACHE – president and CEO. In addition to ending the year with income exceeding expenses, the hospital continued to attract many top doctors from throughout the area, added new patient services, received recognition from a number of leading impartial sources, and put in motion the plans for making various improvements to the campus.
The Emergency Department added “InQuicker” appointment scheduling to allow people with non-life threatening illnesses to make appointments via a website and to skip the long wait at the Emergency Department waiting room.
The hospital expanded its cancer, neonatal, and heart services (including the addition of a new electrophysiology lab for diagnosing and treating heart arrhythmias), and added an expertise in rheumatology care. Flooding from Super Storm Sandy forced the Cristie Kerr Women’s Health Center to close for a month of major repairs, but services are now fully restored and volume continues to exceed expectations.
JCMC became the only hospital in Hudson County to receive an “A” hospital safety score from The Leapfrog Group, an independent national nonprofit group, for two consecutive times. Also, for the first time, US News & World Report named Jersey City Medical Center to its annual ranking of America’s Best Regional Hospitals.
JCMC received several other awards, including: the American Heart Association (AHA)/American Stroke Association’s Get With the Guidelines-Stroke Gold Plus Quality Achievement Award; the National Research Corporation’s Consumer Choice Award based on its overall quality, best doctors, best nurses and best image or reputation; and a CEO Cancer Gold Standard selection for its efforts to reduce the risk of cancer for employees and their families.
The hospital has conducted a campus master plan and received architectural renderings for a second medical building on campus and a garage to allow for much-needed additional parking.
Rated number one in the county
Palisades Medical Center, located in North Bergen, is a 202-bed hospital that serves a population in Hudson and Southern Bergen Counties and is affiliated with the Hackensack University Health Network. It includes The Harborage, a 247-bed nursing home and rehabilitation center.
A new Pediatrics Unit is under construction, and it is scheduled to officially open the beginning of March. The new unit has been reconstructed from floor to ceiling to provide young patients with beautiful and comfortable rooms designed to enhance the healing process. The new unit includes four additional patient beds, a playroom, and a new security system. PMC has experienced a 77 percent increase in pediatric patients during the past three years.
“Palisades Medical Center's new Pediatric Unit will be the first choice for practitioners and patients alike in Hudson County,” said Omar Baker, MD of Riverside Pediatric Group.
Last June, Palisades Medical Center and Hackensack University Health Network signed an affiliation agreement to collaborate and expand clinical programs and services, further improving the high-quality medical care Palisades provides patients in Hudson and southern Bergen County. The new affiliation agreement will supersede the prior clinical affiliation agreement made between the two medical centers earlier that year.
The State of New Jersey’s annual healthcare report card ranked Palisades as one of the top hospitals in the state and number one in Hudson County. Palisades was also one of only two hospitals in New Jersey to receive a perfect 100 percent score in treating heart attack patients. The state’s annual evaluation showed that The Harborage at Palisades had “Zero Deficiencies” for the third consecutive year.
The New Jersey Hospital Association (NJHA) recently recognized Palisades Medical Center with its 2011 Community Outreach Award for its positive impact in our local communities.
Palisades Medical Center has received the American Heart Association/American Stroke Association’s Get With The Guidelines - Stroke Gold Plus Quality Achievement Award. The award recognizes Palisades Medical Center’s commitment and success in implementing excellent care for stroke patients, according to evidence-based guidelines.
Meadowlands Hospital Medical Center
Meadowlands Hospital Medical Center is a general medical and surgical hospital in Secaucus with about 200 beds.
In 2012 the hospital opened its Outpatient Center to include OB/GYN, cardiology, gastroenterology, orthopedics, internal medicine, hematology, podiatry, pediatrics and surgery; including bariatric and breast surgery. Surgery patients are provided with concierge service, transportation, and interpreters. The facility also opened a Neuroscience and Cognitive Rehabilitation Center services victims of brain injury, stroke, development disorders and all other neurological illnesses.
Meadowlands also created faculty practice of multi-specialty physicians to serve all clinical needs, established shuttle bus service with two continuous routes that offer transportation to MHMC from six Hudson County towns, and launched a comprehensive EMS service with nine ambulances including three Specialty Care Transport Units/SCTU.
During the year, 805 babies were delivered at MHMC compared to 550 in 2011. The hospital anticipates more than 1,000 births in 2013.
The hospital also anticipates building oncology program, with infusion therapy to begin in 2013, expanding the laboratory into a comprehensive full-service laboratory introducing 40 new tests with all clinical laboratory testing performed on-site.
In 2012 Meadowlands was the highest ranked hospital in Hudson County in 8 of 10 Operational Measures from Hospital Compare, part of the Centers for Medicare & Medicaid Services (CMS). It received a five-star rating for gall bladder (cholecystectomy) surgery outcomes for the second consecutive year from Healthgrades, and was highest ranked hospital in NJ and Above the National Average for Cleanliness from Hospital Compare, part of the Centers for Medicare & Medicaid Services (CMS).
“New Jersey health care consumers demand high levels of service from their hospital, which is why we’re thrilled to see a 4.6 point spike in our overall HCAHPS patient ratings,” said Lynn McVey, acting president and CEO. “Our patients and the community have made MHMC the highest ranked hospital in Hudson County. When new management assumed control of MHMC in December 2010, our goal was to measurably improve the patient experience. Our current data and industry rankings proves we have reached that goal.”
Taking health to the people
Two years ago, an urgent care medical practice, Hoboken Health Stop, opened across from the Hoboken PATH station.
“The concept grew out of the need by the community for additional health care outlets,” said Jason Rand, a principle of the Harrison Rand public relations. “People wanted services that did not require booking an appointment. In most cases, they only had two options for seeing a doctor, getting an appointment or going to a hospital. We wanted to provide another approach, something more accessible, and flexible that meets people’s needs at an affordable cost.”
“We’re trying to streamline the process and bring service to where people are,” he added.
While this is the first of its kind, it is not likely to be the last as the group looks for other sites around the county where people need quick, access to healthcare.
“This is a comprehensive service from flu to cardiovascular to oncology,” he said. “This is for young and old, wealthy or not.”
NHCAC initiatives for 2013
North Hudson Community Action Corp. (NHCAC) announced several major initiatives for 2013, including the establishment of a home for veterans, a new health clinic in Harrison, the creation of a new geriatric medicine program and a new pharmacy at its West New York health center.
“As we start our new fiscal year today (Feb. 1) we have several new programs and services planned for the year that will benefit the people of Hudson County,” said Christopher F. Irizarry, NHCAC President and CEO. “Despite the financial setbacks from Hurricane Sandy, we achieved much success last year, including the opening of our new health center in Englewood and the purchase of our health center building in West New York.”
North Hudson is one of the region’s largest non-profit organizations, and is the largest provider of federally qualified health care in New Jersey. It has 11 health centers in Hudson, Bergen and Passaic counties that last year managed more than 250,000 patient visits, a record for the health centers.
The new homes for veterans’ project, called “Homes for Heroes,” will provide housing for 18 veterans in a building under construction in Union City.
The new health center in Harrison will be housed in the Harrison Health Department with four examination rooms.
The new geriatric medicine program, the agency’s first, will enable its health care professionals to provide primary care services to seniors in a controlled environment tailored to their specific needs.
The new pharmacy at the West New York Health Clinic will enable eligible patients to receive medication at a discounted price, have more convenient access to medicines and allow them to pick up these medicines after their medical appointment.
“Our social service programs continue to serve tens of thousands of people each year, and our health centers are improving and expanding services to enable us to serve even more people in the coming years,” said Irizarry.
Al Sullivan may be reached at firstname.lastname@example.org.