Dr. Laura Forese: The View From The Inside – Bigger, Faster, Smarter

Dr. Laura Forese, MD, MPH the President of the New York Presbyterian Healthcare System, and an alumni of the Columbia University EMPH program, delivered the keynote address today at the 2014 Mailman School of Public Health, Health Policy and Management Conference. She noted how the merger of the different hospitals within the New York Presbyterian Healthcare System was designed in such a way that pulling the system apart would be extremely difficult.  This was done to prevent the pitfalls that other failed healthcare system mergers  have had where different the entities did not get onboard with the establishment and integration of the new healthcare system.

Dr. Forese noted that it is hard for physicians today to practice independently in an integrated healthcare world and maintain good patient care while maintaining a high personal quality of life. There is a benefit for physicians working in larger groups both in terms of enhanced patient care, integration with healthcare systems, having more leverage with payor sources and vendors.

Dr. Forese discussed that for hospitals, the benefit of being in a larger healthcare system allows for more efficient uses of resources within the system including more sophisticated highly specialized and costly medical areas such as burn units. She mentioned that larger healthcare systems give hospitals the ability to serve their patients better and like larger physicians groups give them more leverage with payor sources and vendors. In New York she noted there are going to be five big players in the marketplace, New York Presbyterian, NYU, Northshore LIJ, Mount Sinai and Montefiore. Some of these healthcare systems will be entering into the insurance business. New York Presbyterian will not be going this route and will be focusing on the best in patient care.  Community hospitals in the New York area will continue to be merged and/or closely integrated with one of the five larger healthcare systems.

From a patient perspective Dr. Forese talked about the rise of consumerism. She noted that people are now paying more for their own healthcare and are becoming more saavy consumers. There is also a rise in convenient urgent care centers and night time pediatric centers as well as disruptive technologies with healthcare monitoring that is likely to change how healthcare is delivered to consumers.

Dr. Forese concluded that the changes in healthcare systems especially in the New York area will be rapidly occurring in the next few years as a reaction to the new healthcare environment that requires all providers to be bigger, faster and smarter.


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