‘We’ll do a better job managing patients’

CHARTER MEMBER: Lester P. Schindel, left, CEO of CharterCARE Health Partners, speaks with communications officer Brett Davey. Schindel, who started in the role on Nov. 10, says his first tasks are getting to know the marketplace and gathering critical information. / PBN PHOTO/MICHAEL SALERNO
CHARTER MEMBER: Lester P. Schindel, left, CEO of CharterCARE Health Partners, speaks with communications officer Brett Davey. Schindel, who started in the role on Nov. 10, says his first tasks are getting to know the marketplace and gathering critical information. / PBN PHOTO/MICHAEL SALERNO

Lester P. Schindel started Nov. 10 as CEO of CharterCARE Health Partners. The regional health care network operates Roger Williams Medical Center, Our Lady of Fatima Hospital, the St. Joseph Services of Rhode Island, Elmhurst Extended Care and a number of affiliated physician and health providers.
The network went from nonprofit to for-profit ownership in June. Prospect CharterCARE LLC, the new joint-venture company, will do business as CharterCARE Health Partners, and is jointly owned by Prospect and CharterCARE.
Schindel, 59, who lives in Framingham, Mass., most recently oversaw completion of a merger of Steward Holy Family and Merrimack Valley hospitals in Boston before leaving his posts as president and CEO of both in July.

PBN: You have a track record of turning around hospital systems in Massachusetts and Tennessee. Do you expect to apply your skills in operational transformation at CharterCARE Health Partners, and if so, how?
SCHINDEL: My experience has been in developing people – in creating a culture in the institutions I run focused around quality and service. I do that by working with the medical staff [and] employed staff, and I try to create organizational alignment. With that focus on quality, service and people, my organizations tend to operate in a high-quality fashion, while operating efficiently from a cost-basis and are therefore an attractive environment to practice medicine.
One of the things I focus on is to enhance patient quality, patient safety and service.

PBN: What is the most challenging aspect of today’s health care marketplace?
SCHINDEL: The change in the delivery of care. In the past, health care was provided in silos. There was little coordination in subsets of care. Physicians, hospitals, did their thing independently. Today, the responsibility to deliver high-quality, cost-effective care starts in the community with the primary care physicians and continues throughout the systems. We’re going from independence to codependence.
And to people realizing they need to work more in concert with each other.

PBN: Where is there the greatest room for improvement at CharterCARE and how do you plan to address it?
SCHINDEL: I’m too new to know. … The challenges we have [include] new leadership, new ownership; the implementation of going from a nonprofit to a for-profit owner, and going to a system focused on providing high-quality, cost-effective care in an integrated delivery approach. What it involves is setting standards of care, driving results and being accountable for your actions. It’s based on a mindful and analytical decision process. So our charge is to adapt to the changing health care workplace.

PBN: The strategic plan you will help craft anticipates a network of urgent-care centers, diagnostic-services centers and additional physician groups. What stage is this in?
SCHINDEL: That’s one of my first tasks: to get to know the marketplace, gather critical information, bring together key stakeholders and work toward developing a three-to-five year strategic plan in the first three to six months.
One of the key principles I have is to truly be somebody that is adaptive in my management approach, bringing creativity but most of all driving results by setting high standards. By doing that, we can earn the trust and loyalty of our staff and the confidence of the community.

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PBN: What is the most urgent need in health care systems today?
SCHINDEL: The most urgent need is to enable us to be adaptive to the changing insurance market in terms of their benefit structures and still be able to provide high-quality, cost-efficient care. With the growth in high deductibles and copays, [the need is] to continue to provide exceptional care despite the changes.

PBN: How are you preparing your clinicians and staff for potential handling of an Ebola virus case?
SCHINDEL: That’s what’s been the most impressive thing I’ve seen in my time here. The [R.I.] Department of Health came in [in early November] and did stress tests in the emergency departments at both hospitals. They brought actors and recreated a scenario with patients presenting different symptoms, creating a very real-life scenario. Our staff was prepared. They were well-informed and acted impeccably, so much so that DOH really complemented my staff at Roger Williams and Lady of Fatima for their competency and thoroughness.

PBN: As home-based and outpatient care increase, CharterCARE’s Home Health Services appears positioned for growth. To what extent do you anticipate increased demand for home-based care?
SCHINDEL: It’s going to absolutely grow. It’s funny you’re bringing up Home Health. I was just with them. … They’re an impressive group. They provide a good workforce and high patient satisfaction. I think home care will grow because it’s more cost-effective to treat people in their home than in an institutional setting. In addition to being cost-effective, some studies will claim it’s more clinically effective because patients will learn to adapt to their home environment quicker.

PBN: Charity care and bad debt in fiscal 2013 totaled more than $31.4 million, according to your website. How does this compare with other hospital systems and what are you doing to address it?
SCHINDEL: It’s hard to compare because every community is different. Having come from Massachusetts, and prior to Obamacare, we had our own health exchange, so issues had been reduced.
I think what you’re going to see in the future is charity care and bad debt reduced because of patients getting insurance through the [health care] exchange. One thing we’ll see in general is [improvement in] population health. Integrated delivery networks are really focused on population-health techniques and strategies that will really provide better care in the community they’re responsible for.

PBN: Which techniques will you focus on?
SCHINDEL: Working in the community with our medical staff we’ll include areas involving diabetes, heart failure and chronic obstructive pulmonary disease. By working with patients with chronic illnesses and working in our clinics, hospitals and post-acute-care settings, we’ll do a better job managing patients and therefore improve the population’s health. •

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