to be out on a carnival tour,” he says good- naturedly. “Tere are too many variables, too many moving parts, and it’s all sub- ject to the will of the marketplace. No one knows what will really happen.” But he does have a catchy description


of St. Francis’ plan to adjust to looming realities: “We’re doing nothing, and we’re doing


already highly regarded cardiac services, and walking through the dust and clamor accompanying the continuing construction of facilities dedicated to women’s health services—including a maternity ward where, for the first time since the early ‘80s, babies will be born at St. Francis, allowing the institution to provide, as Granger says, “for the entire life cycle of the patient.”


and it’s all subject to the will of the marketplace. No one knows what will really happen.”


everything,” he says. “We’re doing nothing special to prepare for Obamacare that we wouldn’t have been doing anyway. From what I understand, Obamacare includes transparency in hospital (operations), ser- vice and patient satisfaction. We are (all about) transparency and openness. We’re not doing it because of Obamacare. We were doing it long before Obama.” Discussing funding shortages can seem


paradoxical when you’re touring St. Francis’ new Heart Hospital, a 96,000-square-foot state-of-the-art upgrade of the institution’s


“There are too many variables, too many moving parts, -Robert Granger


Granger attributes much of the center’s


construction and service boom to continu- ing capital campaigns and donors, both large and small. Part of the construction was unavoidable, he notes: the original buildings are 60 years old. But, in addition, the administration is trimming back wher- ever it can. “We’re planning and downsiz- ing every day,” he says. “We don’t do layoffs, but we’re constantly looking for positions to be eliminated. But we tend to do that when the positions become vacant.” Te stated principle behind the


Affordable Health Care Act, Granger says, is the heart of his faith-based hospital’s mission: providing good care to the “least among them,” that vulnerable group that the AHCA specifically targets. It’s expen- sive to go to a hospital even if you have good insurance; oſten, the co-pay is as much as 35 percent of the bill. But the ones who are working and have some resources, but not enough to have access to insur- ance, are the ones who most feel the blow of major medical bills. “If you have resources—you’re work-


ing—but you have no insurance, you’re going to get a very large bill from a hospi- tal. You’re just going to get killed,” Granger says. “If this situation is not your fault, we’re not going to gouge you. We’ll dis- count your bill, and you’ll pay about what the insured patient would pay.” It’s not free care, but it might avert a disaster. Last year, St. Francis’ charitable fund kicked in $9 million in this situation. Granger arrived at St. Francis about nine


years ago. Just about that time, he says, the hospital’s board of trustees made a deci- sion to change its business model. “For St. Francis to survive in the future, to be the kind of organization they wanted it to be, they wanted to position it as an integrated service,” he says. “We began working with the doctors, not in the traditional man- ner, but as partners.” Te result, they hope, will be less duplication of services and equipment and a streamlining of billing, records and contracts. (In fact, that reflects a country-wide trend. According to an American Hospital Association report, 32 percent of private practice doctors—seeing increased administrative requirements, a heavy personal workload, and expensive mandated upgrades in technology and education—have joined major medical


44


Columbus and the Valley


AUGUST 2013


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