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New D-H CEO: 'Partnerships with people' and other providers are key to medical center's future

New Hampshire Union Leader

October 15. 2017 1:13AM
Dr. Joanne Conroy, president and CEO of Dartmouth-Hitchcock, speaks during an interview with the Sunday News on Wednesday, Oct. 11, 2017. (DAVID LANE/UNION LEADER)

Dr. Joanne Conroy, who took over the helm of Dartmouth-Hitchcock in August, now oversees a hospital campus that includes nearly 2 million square feet of space in Lebanon and a statewide network of providers that works in partnership with other hospitals. It also operates Cheshire Medical Center/Dartmouth-Hitchcock in Keene, which includes a 169-bed acute care hospital.

Among Conroy's first steps was to find a way to connect with the health system's 18,000 employees. She has been visiting all the hospital's sites and plans to do so every quarter.

"We started something called "Joanne's Journal" that are messages written by me focusing on issues I think employees need to be thinking about," Conroy said last week during an interview with the Sunday News. "Sometimes I react to what goes on in the news because you have to make sure you're relevant. If there was a significant issue that happened in the community I would probably talk about how people were feeling about that."

Although Dartmouth-Hitchcock is the largest private employer in New Hampshire, its influence in the southern part of the state is not as strong. While it operates a 120,000-square-foot outpatient center in Manchester, it does not have a hospital of its own in the region. 

"In the south we don't own a facility, but we have close to 400 providers. And we take care of a significant portion of the populations of Manchester, Nashua and Concord," said Conroy, a 1977 graduate of Dartmouth College. "People are not aware of that because I think people associate health care with a facility with a big sign on it. We are going to be successful by creating partnerships with people."

Part of Conroy's visit to the Manchester last week was to meet with local health executives. She met Wednesday with Doug Dean, president and CEO of Elliot Health System, for example. And she had previously met with Dr. Joe Pepe, president and CEO of Catholic Medical Center.

Conroy also envisions expansion of Dartmouth-Hitchcock's outpatient services at its Manchester location. "We probably see between 20 and 25 percent of the people in Manchester (at the 120,000-square-foot) Dartmouth-Hitchcock outpatient center.) Then we have these multiple facilities that are much closer to the communities in which people live. We probably will be developing the large facility in Manchester, adding capabilities for outpatient surgery and endoscopy, things we can do at a much lower cost in that setting because we're office-based and not hospital-based. That's really the trend. Employers are actually asking patients to move their care to these lower-cost settings."

Conroy's visit came a day before President Donald Trump signed an executive order designed to make it easier for individuals and businesses to buy alternative types of insurances with "lower prices, fewer benefits and weaker government protections," the Washington Post reported. The President also announced he will immediately halt the $7 billion in subsidies to health insurers designed to make coverage more affordable for millions of low-income Americans.

We asked Conroy on Wednesday how the hospital can prepare for the uncertainty about the Affordable Care Act's future when it's not clear what will replace it.

"I remind providers that people are still going to get sick. We're still going to have to care for them. Nothing changes that patient-provider, patient-hospital kind of relationship," Conroy said. "That is a constant that will always be there. We just need to figure out how we're going to manage the cost of that where we deliver care."

More of the burden now lies on the consumer as many employers move to high-deductible plans that reward workers for shopping around for the best price on procedures.

"People have actually become pretty sophisticated consumers now because of the high-deductible plans," Conroy said. "The question is, are we transparent enough in our pricing so they can actually make those decisions efficiently and effectively?"

Conroy looks at patients on a continuum. What they need and what they're willing to pay depends on immediate health needs.

"People move along that continuum according to their level of health. And even within a year, you can see that. We just need to understand the behavior economics around that in order to be there when that patient says they should get that care."

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