Q&A with Baylor University Medical Center president
June 26, 2013
by Nancy Ryerson, Staff Writer
John McWhorter has been with BUMC for more than 20 years, working his way through the ranks of the award-winning health care system. He now leads the flagship hospital in Dallas and is helping it tackle the challenges of health care reform and other changes. Recently, he spoke with DOTmed Business News about the successes he’s witnessed and the challenges that lie ahead.
DMBN: Tell me a little about your background. How did you get to where you are today?
JW: I prepared to become a lawyer throughout college but wanted to help people and was always fascinated by hospitals. My grandmother was in a hospital for two months and then I spent the summer as her caregiver when I was 14, which gave me insight into the health care role. As part of my Masters program, each student had to complete one year of training in a hospital. I spent my year at Baylor University Medical center. After spending seven years at Baylor finishing as the President of a small rehabilitation hospital, I left and worked for three organizations in progressively more complicated roles. I returned to Baylor in 1997 as President of a 200-bed community hospital and then relocated to the academic medical center in 2003.
DMBN: What have been some of the highlights of your time at the hospital?
JW: From a personal perspective, helping people and seeing medical miracles occur. Also, having the privilege of recognizing caregivers and support staff who are the true heroes of health care. I especially delight in seeing young leaders develop and advance. We have had three young executives of the year in the DFW area and I had the privilege of mentoring one of them.
From an organizational perspective, our focus on quality and safety has resulted in national awards (NQA and Truven Top 100) and we have been blessed to be recognized as a US News & World Report Top 100 hospital for a decade as well as the National Research Corporation’s top hospital in Dallas for more than a decade.
DMBN: How are the challenges in the health care industry impacting your hospital?
JW: Financial risk will be transitioning downstream from insurance companies and government to hospitals. In general health care systems are ill equipped to manage risk. For example, hospitals are no longer paid if a patient is readmitted to the hospital within 30 days of a discharge for heart failure or pneumonia. What business exists in America that can say “100 percent of the time we will do ‘x’”? Yet, that is the standard the government has set for health care.
Collaboration and new models of sharing risk between hospitals and insurance companies will be necessary to reduce costs, improve quality and add value to the patient. Population-based health management will necessitate access to all elements of the continuum of care starting with primary care and ending with post acute care such as nursing homes and rehabilitation. As a nation, we will have to address end-of-life care and help patients and families develop more comfort with hospice and advance directives. Population-based health management will put pressure on health care organizations to design themselves like insurance companies and put laser-like focus on variation, standardization of care and transparency of outcomes. Population-based care by definition requires access to data and large amounts of population-based data. Most hospitals are not equipped to gather or analyze big data.
In the state of Texas, health care organizations are also confronted with the challenge of serving a population with fewer primary care doctors than the national average and 25 percent of the population lacking any form of insurance.
DMBN: What plans do you have for the future of the hospital?
JW: As discussed, population-based health management and the ability to accept risk with an insurance element will be critical for the future. Developing key services into service lines, institutes, or destination centers will also be critical. The next step in transition of financial risk will likely be bundled payments or the concept of consolidating acute care payment and post acute payment into one episode for the patient.
Click here to see the pictorial for Baylor University Medical Center at Dallas
DMBN: Tell me a little about your background. How did you get to where you are today?
JW: I prepared to become a lawyer throughout college but wanted to help people and was always fascinated by hospitals. My grandmother was in a hospital for two months and then I spent the summer as her caregiver when I was 14, which gave me insight into the health care role. As part of my Masters program, each student had to complete one year of training in a hospital. I spent my year at Baylor University Medical center. After spending seven years at Baylor finishing as the President of a small rehabilitation hospital, I left and worked for three organizations in progressively more complicated roles. I returned to Baylor in 1997 as President of a 200-bed community hospital and then relocated to the academic medical center in 2003.
DMBN: What have been some of the highlights of your time at the hospital?
JW: From a personal perspective, helping people and seeing medical miracles occur. Also, having the privilege of recognizing caregivers and support staff who are the true heroes of health care. I especially delight in seeing young leaders develop and advance. We have had three young executives of the year in the DFW area and I had the privilege of mentoring one of them.
From an organizational perspective, our focus on quality and safety has resulted in national awards (NQA and Truven Top 100) and we have been blessed to be recognized as a US News & World Report Top 100 hospital for a decade as well as the National Research Corporation’s top hospital in Dallas for more than a decade.
DMBN: How are the challenges in the health care industry impacting your hospital?
JW: Financial risk will be transitioning downstream from insurance companies and government to hospitals. In general health care systems are ill equipped to manage risk. For example, hospitals are no longer paid if a patient is readmitted to the hospital within 30 days of a discharge for heart failure or pneumonia. What business exists in America that can say “100 percent of the time we will do ‘x’”? Yet, that is the standard the government has set for health care.
Collaboration and new models of sharing risk between hospitals and insurance companies will be necessary to reduce costs, improve quality and add value to the patient. Population-based health management will necessitate access to all elements of the continuum of care starting with primary care and ending with post acute care such as nursing homes and rehabilitation. As a nation, we will have to address end-of-life care and help patients and families develop more comfort with hospice and advance directives. Population-based health management will put pressure on health care organizations to design themselves like insurance companies and put laser-like focus on variation, standardization of care and transparency of outcomes. Population-based care by definition requires access to data and large amounts of population-based data. Most hospitals are not equipped to gather or analyze big data.
In the state of Texas, health care organizations are also confronted with the challenge of serving a population with fewer primary care doctors than the national average and 25 percent of the population lacking any form of insurance.
DMBN: What plans do you have for the future of the hospital?
JW: As discussed, population-based health management and the ability to accept risk with an insurance element will be critical for the future. Developing key services into service lines, institutes, or destination centers will also be critical. The next step in transition of financial risk will likely be bundled payments or the concept of consolidating acute care payment and post acute payment into one episode for the patient.
Click here to see the pictorial for Baylor University Medical Center at Dallas