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Saving an acquired hospital’s local identity


Long Island Jewish Medical Center,  the  Northwell Health hub.

In Becker’s Hospital Review, Michael J. Dowling, President & CEO of Northwell Health, a big system in metropolitan New York,  talks about community hospitals’ local identities  after a big system has acquired them. Northwell has acquired six community hospitals since Mr. Dowling became president and CEO, in 2002.

He says, among other things:

“To me, a community hospital is the principal facilitator of healthcare in a specific neighborhood or metro area. Even though most healthcare is now delivered on an outpatient basis, many people in a given area identify healthcare with their local community hospital.”

“When a health system approaches a community hospital for an acquisition — or visa versa — the question to answer first and foremost is, ‘Can the health system help strengthen the community hospital?’ The goal in these types of relationships is to enhance the quality of care at the local hospital. Health system partners can facilitate that in various ways.”

“It is critical that the health system does not undermine the community hospital’s reputation or take away its local identity.”

Finally: “When acquiring a community hospital, the key is balance. Preserving the hospital’s local identity is important to its staff, providers and patients. Often, the hospital has long served as an emblem of the community and represents an important part of its heritage. But that doesn’t mean the health system can’t or shouldn’t make any changes. The cultures must adapt to fit together, and certain services the hospital offers may be amended. At the end of the day, all of these changes are intended to improve the quality of care at the community hospital while simultaneously strengthening the health system.”

To read the entire Becker’s Hospital Review piece, please hit this link.

Northwell CEO urges regulatory streamlining


In this interview with Becker’s Hospital Review, Michael J. Dowling, president and CEO of Great Neck, N.Y.-based Northwell Health, formerly North Shore-LIJ Health System, talks about his much admired tenure  at the big New York City area system and changes in healthcare.

Becker’s asked him:

“If you could eliminate one of the healthcare industry’s problems overnight, which would it be?”

He answered:

“I would say to reduce the conflicting and over-burdensome array of regulatory demands on healthcare organizations. We are inundated with a plethora of micro-regulations, and that, I think, just makes the business much more complicated than it needs to be. It consumes excess resources and doesn’t do enough to improve outcomes for patients. This is not to suggest that I’m against compliance, but the constant development of dozens of regulations on an ongoing basis makes the machinery of progress move much more slowly than it could.”


“What do you consider your greatest achievement at North Shore-LIJ/Northwell Health so far?”

He answered:

“I think our greatest achievement is the product of multiple players. When you’re part of a team, success isn’t the result of the actions of one person. I would have to say I’ve been very happy with being part of the creation of a culture of innovation, creativity and teamwork. We are an organization that looks forward on how to improve and advance — not constantly looking in the rearview mirror.

“I also believe that, irrespective of how successful one is, you should never be completely comfortable or happy, but always raising the bar. This culture and mindset is what builds long-term sustainability in the organization and allows you to make a difference.”

When healthcare lines become blurred


Lennox Hill Hospital, in Manhattan’s Upper East Side.

This  HealthAffairs blog post by Michael Dowling, president and CEO of   Northwell Health, which serves metropolitan New York,  stems from  “The New Health Care Industry: Integration, Consolidation, Competition in the Wake of the Affordable Care Act,” a conference held recently at Yale Law School’s Solomon Center for Health Law and Policy.

Among his remarks:

“Today, the lines delineating the many different stakeholders in the health business are increasingly blurred. Providers are becoming insurers and insurers are becoming providers. To achieve success in this new paradigm, all of us need to work more collaboratively, with the overarching goal of keeping people well and delivering care more appropriately to those who do get sick or injured. We need to provide people access to better, more-affordable care — outside of the hospital. To offer and manage care across the full continuum, you have to innovate and bring resources and pieces together to address the holistic nature of the person’s condition, not just the episodic nature of illness.”

“As president of the largest health system in New York, I am in the ‘health’ business. By default, that means I am also in the ‘hospital’ and ‘ambulatory services’ business, the ‘insurance’ business, the ‘education’ business, and the ‘research’ business, among others. That’s because all of these pieces contribute to the continuum of providing better health to the communities we serve.”

“We are also partners in an insurance company. People ask, ‘Why did you want to get into insurance?’ Like, somehow, we let the fox into the hen house. The answer goes back to being in the ‘health’ business. We want to have as much control as possible over the premium dollar so that we can manage people’s health and not just manage people’s illnesses. That way, when we reduce the utilization in a hospital, we get to keep some of the savings.”

“The old model was a terrible misalignment of incentives. We could do wonderful things to reduce hospital utilization, but if the insurance companies got the savings and left hospitals with the cost, where did that leave providers or their patients? By effectively being in the ‘insurance business’ and partnering in an insurance company, we can more appropriately align the incentives.”

“When I am asked what Northwell Health wants to be in the long term, my answer is: ‘I want to be in the health business, the health-promotion business, and the wellness business, as well as the illness care business. I want to be able to do all those things well.”’



Trying to rescue ailing Brooklyn hospitals



— Photo by Kingsbrook Jewish Medical Center

Kingsbrook Jewish Medical Center, in Brooklyn.


Becker’s Hospital Review reports on New York State’s efforts to rescue financially troubled hospitals in Brooklyn with millions of dollars in  state support,  including $325 million in 2015. At a recent state budget hearing, Kenneth Raske, president of the Greater New York Hospital Association, made a proposal to help the distressed hospitals survive long term.

The state’s Department of Health says there are 28 Brooklyn hospitals that would likely close without their safety-net status, government subsidies and political pressure.

So Mr. Raske proposed that the state pay the wealthiest hospital systems $2.5 billion over five years to “adopt and adapt these facilities to the new world.”

Becker’s reports that “some large health systems, including New York City-based Mount Sinai Health System and Great Neck, N.Y.-based Northwell Health, want to expand their presence in Brooklyn, making Mr. Raske’s plan popular among the hospitals in desperate need of the financial help.”

“Places like central Brooklyn that don’t have the more attractive payer mix are in a position where it’s more of a challenge to get a larger system interested,” Linda Brady, M.D., president and CEO of Kingsbrook Jewish Medical Center, in Brooklyn, told Becker’s.

“This is exactly why the governor put this in his budget proposal, and it’s why Ken Raske is advocating for this.”



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