Gary J. Passama, President and Chief Executive Officer of NorthBay Healthcare System since 1981, is a veteran of more than 40 years in Northern California health care. He has served as faculty and speaker for programs of the American Hospital Association, Hospital Council of Northern California and the Medical Group Management Association. He is a Fellow of the American College of Healthcare Executives.

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Furry Little Folks

One of the myths a mega-system here in Solano likes to propagate is that its size somehow translates into more efficiency and lower costs. That's despite the fact the premiums its members shell out for its prepaid health plan are typically among the highest.

Its cost structure includes hospitals which it owns. And it is wildly out of whack compared to hospitals which are not owned by health plans. Its leaders are very quietly trying to reduce costs, as all systems are. But turning around a bloated battleship is proving problematic. Their half-hearted measures, including workforce reductions, are too little and maybe too late given the quickly changing dynamics of today's health care landscape.

Becker's Hospital Review, a trade publication, gives further credence to my thesis that the future may not belong to the giant healthcare dinosaurs in our midst but rather to the furry little mammals in the under brush. The furry one would be NorthBay Healthcare. The article, Hometown Healthcare Isn't Dead: Why (Most) Smart Community Hospitals Can Still Thrive, drew my attention because it craftily used the term "thrive."

The article speaks to the issue of why community hospitals may show higher costs on a discharge basis, when in fact they are the low-cost provider comparably speaking. The key point to consider: Community hospitals may have a relatively low numerator in volume, which makes their cost per discharge look higher. Not having the corporate bloat of the big guys makes us little furry competitors more efficient. You have to be very careful when looking at cost or price data because it can be very misleading.

The article goes on to explain how community hospitals like NorthBay Medical Center and NorthBay VacaValley Hospital are better with patient engagement due to their local nature. As I say every month at new employee orientation, we take care of patients like they are our family and friends - and in many cases they are. So the article uses much the same language in describing why community hospitals will prosper. (Sorry, I cannot bring myself to use "thrive.")

This is an important, fundamental difference in our culture and our approach to caring for people compared to the corporate guys.

The article notes community hospitals are not without their challenges - specifically, access to capital to build and grow, as well as human resources. For NorthBay, however, these are manageable. We are very fortunate that we have a great corps of employees who have voted us a Great Place to Work and who are passionate about serving their hometowns. More than four of every five NorthBay employees live in the area we serve. We do not have the periodic labor disruptions the other guys do.

The article concludes that community hospitals' greatest strength is their ability to quickly adapt to change. That's certainly NorthBay's experience.

It is the difference between trying to quickly turn around a battleship - maybe aircraft carrier is a better analogy - and making a course change aboard a nimble destroyer. NorthBay anticipates change and responds much faster and better because we make decisions locally. No need to grind it through a complex bureaucracy headquartered elsewhere. That is a big difference.

It is no accident NorthBay's two hospitals have been Solano's leader and pioneer in establishing such services as trauma, advanced cardiac surgery, stroke care, neonatal care, cancer services and joint replacement services.

We furry little folks at NorthBay have many more new ideas ready to unleash. The dinosaurs will find it difficult to keep pace.