Q&A: Boulder Community Health CEO Robert Vissers

Hospital administrators, doctors and health-care providers continue to see rapid changes in the health-care industry. Reporter Beth Potter spoke recently with Boulder Community Health president and chief executive Robert Vissers to get an insider’s view about what to expect at the hospital in the near future.

What can you tell me about Boulder Community Health’s future strategy?

The amount of change and transformation in our industry is unprecedented. The good news is that it hasn’t changed our vision as an organization. Our goal remains the same – to offer the highest quality care for our community. Our desire is to achieve this within the important “triple aim” of health care, which is to offer a better patient experience at a lower cost across the population that we care for.

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A unique component of BCH’s strategy is our independence and our desire to maintain independent, local governance. This not only reflects the values of our community, but we also believe it remains the best way to ensure the health of our community, and is consistent with our belief that BCH is a community asset.
To further achieve our vision, it is critical we continue to move outside the walls of the hospital. Right now, more than half of our business comes from outpatient care, which is a significant shift from the recent past.

Boulder Community Health has partnered with doctors in the region. How does that help strengthen your brand?

We’re really a knowledge industry, and that knowledge and skill resides with our physicians and all of our caregivers. Our ability to partner with our physicians and engage with them makes us a much stronger health system.
Physicians are the real voice of patients. We’re all trying to achieve the same goals. All of the doctors I work with are the same as I am in that we all entered health care to try to make a difference.
Physicians do that every day at the bedside, but there is strong desire to make improvements within our health-care organization and our job is to give them that opportunity. For example, one of the things the hospital is initiating next month is a physician leadership development program, where we’ll work with our physicians and an outside group to allow them to blossom in those roles.

Can you give me examples of how the Affordable Care Act has affected your hospital?

We’re all sharing the financial risk of the health of our population in some way, including patients. Because of high-deductible plans, patients are behaving more as consumers, and they rightly want to know what they’re paying for. Patients will exercise more choice, which requires us to demonstrate that they’re getting that high-value care and quality at a reasonable cost that stands up against other providers regionally and nationally. It has forced us to collaborate with other partners in ways that may not have occurred in the past. For example, there’s far more information shared with payers (insurance plans), and both sides benefit.

We’re partnering more with employers to make sure their employees have access to high-quality care, and remain productive and well.

If we’re going to maintain our independence as a health-care system, we have to embrace our future interdependence on other providers in our community. For example, if we are now responsible for the first 60 days after a patient procedure because of the changes to insurance models, we had better have a good relationship with the skilled nursing facility they transition to. I think these are changes for the better.

How does your background help you navigate the rapidly changing health-care industry?

I have practiced as an emergency physician for almost 25 years in three different states and several different health-care systems. During that time I was fortunate to have a number of leadership roles; from a professor of emergency medicine, to a chief medical officer of a trauma center to the CEO of a large independent physician group. In all of these different roles that I played, the driving force was the opportunity to make a difference and see how we could do things better.
That has given me insight into how closely the goals of doctors and nurses, hospitals and health-care administrators are aligned. When we talk about how to do what’s best for the patient, it’s a very easy conversation.

Tell me how changes in the health-care industry are likely to affect Boulder Community Health’s profit margin?

We’re a nonprofit hospital, so it’s not a profit margin, it’s an operating margin. But we still need that margin to reinvest in bringing care and health to our community. Those margins have always been tight, and I think they’re going to stay that way. That’s nothing new.

Our biggest challenge is navigating the current transition from volume to value. While a lot of our revenue remains volume driven – the more we do, the more revenue we generate – there’s a great deal of pressure to rapidly transition to a value-based system. In this model, reimbursement is also dependent on the quality and safety of the care, and eventually the health you bring to your community. Organizations that succeed in maintaining an operating margin will need to successfully navigate that transition, providing that demonstrable high-quality care, in an efficient and affordable manner.

What else can you tell me about your industry?

What really intrigues and excites me is how these changes are pushing us toward being greater partners with the community. The push toward the care that takes place outside the hospital walls and the creation of health in our community … it’s a really exciting time in health care. We’re fortunate that we’re in a community that’s very engaged and very interested in its health.