Better health care that costs less
The phrase “rising cost of health care” has become part of the American vernacular. Increased wages due to nursing and primary care shortages are contributing factors, as are hospitals forced to subsidize expenses for Medicaid losses.
But one executive is working to keep costs at a minimum for patients and the multi-facility health care system she represents. Barbara Corey believes that “higher quality will equate to lower cost.” The senior vice president for managed care at WellStar Health Systems in Marietta, Georgia, is a 1987 Harbert College marketing alumna.
“From our standpoint, we work on things like reducing re-admission rates,” says Corey, whose system operates 11 hospitals and a number of primary care and skilled nursing facilities in the greater Atlanta area.
“We’ve built an infrastructure that supports population health,” she explains. “It’s not just about the patients that are in our doctors’ offices, or the patients that are in our hospitals, but what happens to those patients when they leave—making sure that they have their follow-up appointments made. Sometimes patients get out of the hospital and they have a hard time getting that appointment, and then they wind up back in the hospital.
“We work closely with our skilled nursing facilities in the area, making sure that as patients transition from our hospitals to a skilled nursing facility that they are getting the right level of care so they are not right back in the hospital.”
Corey says WellStar invests roughly $4 million annually in resources to help such transitions, which lead to fewer patients bouncing back into the hospital unnecessarily—accruing more expenses.
A large part of Corey’s duties at WellStar is negotiating third-party (insurance company) payer arrangements, including contract management. Agreeing to contracts with multi-million dollar insurance companies takes a bit of savvy at the negotiating table.
“Some of that is being able to be empathetic to the other party, be able to understand and put yourself in the other person’s shoes to figure out what might work for them or both of you,” Corey says. “You know their list of wants, you know your list of wants, and you work from them. It’s important to be able to see it from the other side and be creative in terms of how you might address your needs and theirs.”
Corey notes that negotiating long-term deals is much more than a contract, but a long-term relationship.
“We try not to be too greedy,” she says. “You can win a single negotiation and basically wipe out the other person, but then sooner or later that’s going to come back to bite you. You have to be in a relationship where there are times that you are going to need them to bend, and there’s times where you are going to have to bend. You have to find that right balance between getting your best deal and understanding that you have to live to fight another day on some issues.”
WellStar increased from 5 to 11 hospitals in 2016. Suddenly, Corey’s team had to negotiate health care insurance contracts for the new additions before patient care was disrupted.
“It happened to us on April 1, no less,” she laughs. “The new hospitals came in with no contracts. Because of all the anti-trust rules and regulations, we couldn’t know what they had been previously paying. We didn’t have the data and were blinded in terms of what we could negotiate.”
Instead of taking an expected 12 to 18 months to accomplish, Corey’s team finalized the expanded deal in just six months. “I’m very proud that we were able to open those doors and that we didn’t have patients’ care disrupted because they were out of network with major payers,” Corey says.
Corey, who enjoys attending Auburn University football games, loves the relationship-building aspect of her job, the community accountability aspect of the non-profit system, and watching caregivers go above and beyond for patients.
“Health care can be very frustrating sometimes for folks to navigate,” she adds. “But 98 percent of the caregivers really, really do care about their patients. Sometimes lost in the shuffle of bureaucracy is the dedication and the care that some folks have for their patients.”