Gary Shorb, President and CEO of Methodist Healthcare Corporation on Memphis Medical News

Gary Shorb, President and CEO of Methodist Healthcare Corporation

By: HOLLI W. HAYNIE

Memphis Medical News has launched, "Leaders in Healthcare," a series that provides leaders, from hospital CEOs to practice managers to department heads, a forum to express their strategy and vision for evolving with the industry now and into the future.
Overseeing the a citywide hospital system is no simple task, but it's one Gary Shorb, CEO of Methodist Le Bonheur Healthcare, meets eagerly. Taking what he learned from his position as president of the Regional Medical Center at Memphis, Shorb joined Methodist in 1990 as executive vice president. The knowledge he gained in that role, along with his experience in local community service, he facilitates the evolution of the Methodist faith-based mission of connecting and collaborating with the local community to provide services throughout the Mid-South.

What are key areas of focus within the Methodist system?

One of the things we're very committed to is serving the entire community. We have facilities in all quadrants of our community. As a result of that, we're the largest TennCare provider in the state and the second largest provider of services to charity patients, right behind the Med, in the state. We're very connected to the church and intentional about our faith based connection and mission. That is a big priority for us.
Seven years ago we decided what we were really going to do in a much bigger way was a commitment to academics, to education and research. We signed a partnership agreement with University of Tennessee, and changed the name of the hospital next door to University Hospital. We decided that really for the future, we needed to ensure not just the survival but the actual growth and thriving of the medical school.
Another big priority for us and all health organizations is to continue to work on customer service, on brand standardization, on family centered care, on simplifying our systems and how people access us to make it easier for everyone.

Why is healthcare reform important and how does Methodist strategize facing the challenges of implementation?

It's critical because when you look at how healthcare is financed today and analyze the profit and losses of almost any health system regionally or nationally, you realize there is a significant burden being picked up by private industry and employers. Our healthcare expenditures are at least twice what the other nations are. We've got to solve that problem.
Another thing that has to be addressed is that the reimbursement system for primary care needs to be more effective. We are just going to be in a real crisis if we don't address the fact that most primary care physicians, if they're in private practice, haven't had a pay increase in almost seven years. If you talk to medical students, nobody is getting into primary care. We're trying to address it tactically.
Part of the problem with primary care in this market is it's made up of groups of physicians that are anywhere from three to seven doctors. As a result, when it comes to market positioning with managed care companies, they don't have any leverage. We're trying to bring about 30 to 40 (established primary care doctors) together now. (In a larger group) you've got more ability to put some types of ancillary testing in your offices, which is a way a lot of the specialists make a lot of their supplemental revenue. It's a real important issue for the future and something we have to continue to work on.
We're working with private practice docs, the University of Tennessee to help them recruit more primary care and we're working with Christ Community Health. This is all to stabilize the base of primary care for everybody.

How is Methodist moving to improve outreach efforts and access to care?

We're partnering with our physicians, which is key to any chronic disease process of improvement that we try to implement. We're also partnering with organizations like the Healthy Memphis Common Table, Church Health Center, and are more engaged now than ever with Christ Community Health Services – we've done things to help them increase more physicians to improve access. Within the walls of the hospital we have a quality initiative that takes a look at how we are caring for chronic disease patients, and all patients, using some of the industry best practices, evidence-based practices.
In addition to providing access to services through hospitals, clinics and extended care, we're also engaged with congregations and trying to promote wellness. We started the Congregational Health Network – we're trying to help those members of the connected congregations navigate the health system, whether it's ours or someone else's. We now have 130 congregations signed up in the network. We're trying to get that to 400.

How is Methodist advancing in the technology and transparency age?

When you look at where we are relative to other health systems, in implementing information technology, we're definitely in the top quartile. Seven years ago – we had to make a decision – either to continue to do a piecemeal effort by buying different tools for different hospitals – or were we going to try to do an enterprise wide system, and we adopted the latter. It's the right thing to do. I fundamentally and firmly believe that it will change healthcare over time. It's going to take us time to really learn how to use it more as a tool. Honestly, I would have thought we wouldn't be this far ahead. I would have thought more organizations would be ahead. This past 18 months, it has really taken off. Methodist North was first to go fully live. Next implementation will be Le Bonheur, then Methodist Germantown, then Methodist University Hospital.
As a community we're way ahead of any other community on (the technology and transparency) front with RHIO (Regional Health Information Organization) and as part of the Mid-South eHealth Alliance. We're sharing information from our emergency departments, which is almost unduplicated everywhere.

What advice do you have for healthcare leaders of the future?

I think one of the biggest issues that has to be addressed is the total lack of alignment we have between physicians, managed care organizations and hospitals. It's all right now, activity driven, instead of outcome driven. We've got to figure out how we're going to come together with some shared responsibility, shared financial incentive, to change the focus to outcomes and results. (It's about) changing focus to outcomes, efficiency of care, fewer unnecessary tests, shorter length of stay, more attention to infection rates, things that really extend care and are costly. It's really hard to do.
We're in to a disastrous situation economically if we can't solve that. I think we as providers know best how to do it. We're fortunate to have Health Choice, a physician/hospital organization. If we're going to get it done it's going to be through that organization. We need to figure out some solutions for the challenges of the future.