Why Westchester?
That was the question that Business Council of Westchester president and CEO Marsha Gordon asked of her guest at last month”™s First Niagara Bank Leadership Conversations program in White Plains. Laura Forese, executive vice president and chief operating officer of NewYork-Presbyterian in Manhattan and a frequent visitor to the county as NewYork-Presbyterian became the parent organization and co-operator of community hospitals in Bronxville and Cortlandt Manor in the last two years, was quick to answer.
“Well, why not Westchester?” she said before a Business Council audience of about 100 people at 42 Restaurant and Events. “Banks go where the money is. Hospitals go where the patients are.”
Forese also cited the county”™s “politically active and engaged community” and its wealth of technology and educational resources. Partnering with those tech companies and academic institutions that provide workforce training, “What can”™t we get accomplished in Westchester?” she asked.
Forese, who has been the hospital”™s public face and ambassador in Westchester in her former position as president of the NewYork-Presbyterian Healthcare System ”” now the NewYork-Presbyterian Regional Hospital Network ”” said 80 percent of patients at NewYork-Presbyterian Hospital in Manhattan came from the city”™s outer boroughs and Westchester. “We decided to move into those key areas,” she said.
Other major metropolitan hospitals have done the same, she noted, referring to Montefiore”™s and North Shore-LIJ”™s expansion into the county as owner or parent organization of community hospitals in Mount Vernon, New Rochelle, White Plains, Sleepy Hollow and Mount Kisco.
Health care consumers “want convenient care as close as they can get to home and work,” Forese said. NewYork-Presbyterian”™s expanded regional network can meet that demand for local care that is both timely and affordable by focusing on “great quality and really paying attention to what families and patients need.”
“We”™re there as a public good to serve our patients,” Forese said. The hospital is a service business, she said, and many of its employees are drawn to it from the hospitality industry.
Forese said employees at NewYork-Presbyterian are reminded, “You have a job because we take care of patients. If you don”™t understand that, it”™s probably not the place for you.”
For an institution such as hers, “The culture is not the bricks and mortar. The culture is the people that are working there,” she said.
With the national focus on health care reform, hospitals must find ways to lower costs while maintaining quality care for patients. “We have to balance that constantly,” Forese said.
As private and federal insurers”™ reimbursements to hospitals have decreased, “There”™s this sort of inexorable pressure down” on hospital costs. “Hospitals have to get used to, and we have for many years, feeling that pressure down,” she said. At the same time, hospital”™s costs for the technology increasingly used in health care are not going down, she said.
“We”™re looking for ways to drive waste out of the system” while providing an efficient level of care, she said. “We”™re constantly testing that: Can we do it more efficiently? Can we do it better and at a lower cost?”
Forese told Gordon in their public conversation that the trend of mergers and acquisitions in the health care industry will continue. Some in the industry have predicted that consolidations will leave 10 or 12 health care systems operating in the nation. “I”™m not sure that makes sense,” she said.
“Economics determine independent hospitals and MDs joining larger institutions,” she said. “Larger organizations have more clout” in the marketplace for health care products and with insurers. “It”™s harder and harder for doctors to be independent” and operate solo practices, she said.
With the effort to lower health care costs and keep people less prone to disease through wellness programs and prevention measures, “I also think this notion of health care as a team sport is really important,” Forese said. That team includes nurse practitioners, pharmacists and other professionals.
“You can see that health care can be distributed so it doesn”™t need to be just in the hospital, it doesn”™t need to be in a doctor”™s office,” she said. “We”™re going to see more of that.”
