Redefining the 'H' commands AHA board's attention, says AHA trustee Bruce Lawrence

The Class of 2018 profiles the women and men who joined the AHA board this year.

The amount of change going on in health care today is greater than anything INTEGRIS President and CEO Bruce Lawrence has seen in his 35 years in the field. Redefining the hospital’s role in this changing health care world is the biggest issue facing the AHA Board of Trustees, he says.

Lawrence points to the demand of managing a growing number of elderly Americans with chronic diseases, patients’ heightened expectations about the care they receive, the shift from volume-based toward value-based payment and caring for a defined population as contributing in significant ways to the transformation of America’s health care. He says the theme of last week’s AHA Annual Membership Meeting – leadership … advocacy … transformation – sums up the association’s charge in helping its members navigate through a rapidly changing health care landscape.

“The AHA has the ability and the vision to lead this transformation,” says Lawrence, who joined the AHA’s board in January.

He says the association has the organizational structure necessary to help its members address today’s challenges, while preparing them for the future. Lawrence chairs the AHA’s regional policy board (RPB) 7, which includes Arkansas, Louisiana, Oklahoma and Texas. Before becoming its chair, he served five years as an RPB 7 member and got to see “first-hand how the AHA uses the RPBs as an information-gathering sounding board” in the policy-making process.

“The power and beauty of the AHA’s organizational structure is that it gets feedback from everyone,” Lawrence says. “While our membership is broad and diverse, the AHA gets feedback from all its constituents in a consistent and effective manner, which makes for thoughtful and deliberate decision making. The process works remarkably well and makes us stronger.”     

Lawrence says one of the biggest changes affecting hospitals is how patients are increasingly becoming genuine health care consumers. “The wave of health care consumerism is here and it is here to stay, and I think it will make things better,” he says. “It will be better for consumers because they are going to understand more about their responsibilities both financially and in terms of their personal health. And it will be better for providers because we will need to be much more conscious and cognizant of what we are charging and what people can afford.”

Lawrence joined Oklahoma City-based INTEGRIS in 2001 and moved into his current position in 2010. Integris is Oklahoma’s largest health system, with hospitals, rehabilitation centers, physician clinics, mental health facilities, independent living centers and home health agencies located throughout the state. With about 9,000 employees, it also is one of Oklahoma’s largest private employers.

While the health system still derives most of its revenues from the fee-for-service payment world, Lawrence says it is moving toward a more value-based, performance-driven future.

For example, INTEGRIS is participating in the Centers for Medicare & Medicaid Services’ (CMS) patient-centered medical neighborhood pilot. The model connects patient-centered medical home primary care practices with other community-based health care providers to create a more efficient, coordinated health care delivery network that is intended to improve care at a lower cost. A total of 90 primary care practices affiliated with 15 health systems in 65 cities are part of the project.

INTEGRIS also is enrolled in CMS’s Comprehensive Care for Joint Replacement (CJR) payment model, which began on April 1. The CJR model will hold hospitals accountable for the quality of care they deliver to Medicare fee-for-service beneficiaries for hip and knee replacements and other major leg procedures from surgery through recovery.

Through this payment model, hospitals in 67 geographic areas will receive additional payments if quality and spending performance are strong or, if not, potentially have to repay Medicare for a portion of the spending for care surrounding a lower extremity joint replacement procedure.

“I embrace those types of changes,” Lawrence says.

He believes there is no better time to be serving on the AHA board. “I think there is going to be some real transformational things happening in health care over the next few years and it is very exciting to be at the table and be a part of that,” he says.