Editor’s note: This story is part of the CDT’s Business Matters special section.
In November, a transition of power occurred.
Steve Brown retired, effective on the first of the month, after a six-year stint as president and CEO of Mount Nittany Health. His replacement, Kathleen Rhine, a Penn State alumna, took over the position on Jan. 30.
But in the intervening time, it was Tom Charles’ role. The former interim president and CEO eschews the spotlight and suits when he can, he says, and is quick to spread credit around.
“Everything we do comes back to our mission,” he said. “And our mission is pretty simple: It’s to make people healthier.”
Yet even upon resuming his previous role as vice president of system development and chief strategy officer, the pressure is still on: November brought that other transition of power, one that will shape the health care industry for the foreseeable future.
In preparing for that future, Charles is approaching the task with a mix of experience, attentiveness and quiet humor.
“Having been in this for 30 years and having lost most of my hair in the process, I can point to so many points during those 30 years where it felt like we were at crucial pivot points and we probably were, and things changed and then things changed again and then again,” he said. “What I’ve learned is there is a constant evolution of things and we adapt to that change, and I’m sure we’ll do the same here, even though it can be a bit unpredictable now to know where we’re going.
“By the end of this year, we’ll be at the end of a decade where we’ve invested almost $300 million in this community,” he continued. “That’s really our commitment, no matter what happens in Washington, is to make those investments and understand what we can do to keep people healthy.”
Q: What are MNH’s goals during the next four years?
A: One component is that people have access to primary care, to medical and surgical specialities when they need it. We operate out of 18 sites across the region, so we have a lot of different locations for convenient access. Our medical group is the largest medical group in Centre County and it’s been growing, and we expect to continue to grow that over the years.
The other part is ensuring access to hospital services and in a convenient way. The last thing people want to do is to have to travel a distance for care, especially when something is seriously wrong. So we are really fortunate in this community to have a large and diverse medical staff — we have more than 300 physicians on staff here at the hospital — and they have been important partners in developing programs here and ensuring that residents in this community and region have convenient access. And that will continue to grow over time, I think. So those are the three buckets that I think I see us continuing to work in.
A: The Affordable Care Act is a very complicated piece of legislation. I don’t know the exact number, but there are almost 100 different provisions in the Affordable Care Act. So when people talk about “repealing the Affordable Care Act,” none of us really know what that means. It’s very difficult to speculate, quite frankly, until the details, the intent become clearer. I think at that point it will be much easier to know what it is that is going to be retained, what is going to be changed and consequently what the impact is going to be for us.
Having said that, as a general principle, it is important for people to have access to care. So whatever happens going forward, it would be my hope that those changes make it easier for people to have access to care, and we don’t make it more difficult going forward.
I think the other two realities that we’re dealing with in this country is one, we have a progressively aging population. Speaking for myself, things don’t work any better the older I get. I know what that means: It means more need for care. So whatever changes happen going forward, I hope it better prepares us as a nation and as a health care system to deal with that reality. The other reality that relates to that is health care is about people taking care of other people. So as the number of people and their need for care grows, we need to have a workforce that is there to take care of those people, and we face continuing challenges in this country with the adequacy and the size of the healthcare workforce. I would also hope that whatever changes that come out of Washington better prepare us to deal with that reality as well.
Q: In health care, there seems to be a shift from a fee-for-services model to more of a value-based model, and using data to track outcomes and judging health care organizations on those outcomes rather than just volume of visits, prescriptions written and so forth. Where do you see that trend heading? How do we expedite our move away from a fee-for-services model to more of a value-based model?
A. That is happening. Part of that has been spurred by some of the things coming out of the Affordable Care Act. And so the future of some of those things may also be tied up in what happens with all of that. I think that’s hard to say, but I think it is important to be attentive to that. I don’t see some of those themes going away, but how that actually happens may be a function of everything that’s tied up in what the administration is trying to do.
One of the things we’re doing is developing resources in our primary care practices. I’ll give you one example of that. We have care managers who are now working with our primary care physicians, so if we have individuals who may have more complex care needs, they may benefit from making sure that problems are prevented before they arise. We’re bringing extra resources that may be able to help with that, and so that’s a great example of trying to identify things before they become too serious, and consequently keep people out of the hospital and get the right outcomes for people with fewer resources.