The president of Hartford HealthCare talks about the changes patients can expect as the Patient Protection and Affordable Care Act — aka “Obamacare” — takes effect.

By Cindy Mindell

The word “healthcare” seems to be everywhere: in daily media reports, on the congressional floor, in advertisements, at the dinner table. In the wake of the 2010 ratification of the Patient Protection and Affordable Care Act and the Health Care Education and Reconciliation Act, many Americans have become both more involved in and more mystified by the ever-changing national healthcare landscape.

Enter Dr. Stuart K. Markowitz, senior vice president of Hartford HealthCare and president of Hartford Region, who will take on this sticky wicket on Sunday, Sept. 20 at The Emanuel Synagogue in West Hartford.

“There is a great deal of confusion in the face of the rapid changes taking place in healthcare and I hope to bring some understanding that will help people better navigate their way through their healthcare and wellness needs,” he says.

A native of New York, Markowitz received a BA from the University of Pennsylvania. After earning his medical degree from University of Health Sciences – The Chicago Medical School in 1980, he moved to Connecticut to complete his post-graduate training in radiology at Hartford Hospital. He lives in West Hartford with his wife, Deb, a Glastonbury native. He is the father of four children and a stepson.

Markowitz walked the Ledger through some of the changes in the healthcare world, and how Hartford Health Care is working to help the local community stay healthy.

Q: Describe your duties as president of Hartford HealthCare (HHC) Hartford Region and senior vice president of Hartford HealthCare.

A: As a member of the HHC leadership team, I participate in setting and implementing strategies for the entire system, which includes the entire continuum of care, from primary and specialty care; to acute, inpatient care; to rehabilitation and laboratory services; to behavioral health services; to senior care, including in-home nursing services and skilled-nursing facilities. We set goals for the continuous improvement of safety and quality, for improving the patient experience, for standardizing care across our system, and for growth and enhancing access to care in the communities we serve. As president of Hartford HealthCare’s Hartford Region, I have primary oversight for all operational activities.

Our goal is to achieve what we call “the Five Ones” for our patients: one registration, one electronic health record, one standard of excellence, one bill, and one relationship. We are working on meeting this goal by centralizing services, such as accounting; implementing the Epic electronic health record throughout our organization and even with some community, private-practice physicians; establishing specific standards of care through system-wide clinical councils and disease-management teams. The HHC leadership team is working to bring all HHC members together as an integrated system. Our vision is to be nationally recognized for excellence in personalized, coordinated care. We are leading the way in a new healthcare environment.

One of our main focuses as a system and as the Hartford Region is to enhance patient and community access to care. Hartford HealthCare overall has 12 family health centers, including centers in Avon, Farmington, Plainfield, and Enfield, and is planning more. These health centers include primary and specialty care, as well as services such as rehabilitation and laboratory services. Patients can receive the care they need in their own communities. Increasing access to care improves the health of communities, which is what we are charged with accomplishing in the new healthcare world.

We are moving rapidly from focusing on treating patients when they’re sick to keeping them well by helping them manage their illnesses more effectively. Say you have diabetes. We have care managers in place in some practices who will work with you to ensure that you receive the proper testing, have follow-up physician visits, and take the proper medication to stay as well as possible. In the Hartford Region and in the other Hartford HealthCare regions in the central and eastern parts of the state, we have congestive heart failure clinics in place to help those patients take better care of themselves. We’ve installed the RightCare software program so that we can identify, upon admission, those high-risk patients who will need care once they leave the hospital – and we can arrange that care before they leave. We routinely send patients to Hebrew Health Care in West Hartford, with which we have a very strong affiliation. We are building a world-class, multispecialty Bone & Joint Institute at Hartford Hospital to increase access to innovative musculoskeletal care. We are expanding our Brownstone Clinic to increase access to care for the underserved. As a region and healthcare system, we reach out to communities with health screenings, classes about various health conditions, and other activities.

Our system continues to grow with various affiliations. We’ve positioned a LIFE STAR helicopter at MidState Medical Center in Meriden to improve access to complex care for residents of the central part of the state and beyond. As a system, we established the Hartford HealthCare Cancer Institute, which includes cancer centers at our five hospitals (Hartford, MidState, The Hospital of Central Connecticut, Backus Hospital, and Windham Hospital). The Institute was the charter member of the Memorial Sloan Kettering Cancer Alliance, through which we have implemented MSK standards of cancer care and have access to MSK clinical trial for our patients. This has increased access to the most innovative cancer treatments for Hartford HealthCare patients.

These are just a few of the things we are doing to grow and increase access to care.

Q: What should people know about the changes in the healthcare market?

A: The healthcare market has been going through and continues to go through dramatic change. Almost daily, we see news about hospital mergers, because it is increasingly difficult for single institutions to remain sustainable. We are charged, through the Affordable Care Act and by commercial insurers, with improving the quality of care while reducing the cost of care. To do that, you need scale to purchase goods and services at the best value and to provide services more economically.

Another big change is that patients, now often referred to as “consumers,” face higher deductibles for their care. They are responsible for more and more of the costs. Because of that, they increasingly are shopping around for care – looking for lower prices and hopefully higher quality for services. People can search online for healthcare like they search for an appliance. They can go to Healthgrades, for example, to see how physicians are rated. The Centers for Medicare & Medicaid Services is even rating facilities with stars – like hotels on Travelocity or TripAdvisor. There are websites such as HealthCareBluebook.com and Fair Health Consumer Cost Lookup where you can compare the costs of procedures in your zip code. We see retail clinics everywhere – at Walmart, CVS MinuteClinics, Walgreens, and others. Telehealth is increasing in popularity. You log onto a site and do a doctor visit online. One-third of CVS MinuteClinic telehealth users preferred a video visit to going to the clinic in person, according to a survey of 1,700 MinuteClinic telehealth users serviced by CVS from January to September 2014 and reported in the Journal of Internal Medicine.

We are partnering with many organizations such as CVS to bring healthcare to our communities in new and innovative ways. And our focus is no longer simply on our hospitals. Our focus is on our patients and their needs for wellness and treatment in our communities, for the pre-hospital care, and for the transition from hospitals to interim nursing facilities or back to their homes. We are changing in order to take the best care of our patients throughout their lives.

Q: Some say that the Affordable Care Act was inspired by the objective of healthcare reform but has now morphed into healthcare insurance reform. Do you agree? And, if so, does it matter?

A: Healthcare insurance is changing. The high costs of healthcare are not sustainable. Employers can’t afford the high costs and are paying less for employee benefits. Thus, employees pay higher deductibles and co-pays. Insurance companies are requiring healthcare providers to demonstrate quality and to provide care at a lower cost. Insurance companies are demanding value and demanding that we move from fee-for-service payment to payment for the value we provide. This means that, in order for us to get paid, we must meet specific quality metrics. If we look at Medicare, a government insurance plan, hospitals won’t get paid if a patient is readmitted within 30 days for specific conditions, such as pneumonia and congestive heart failure. Some employers are providing their own insurance for their employees – and employees are paying more. This leads us back to consumerism in healthcare – shopping for the best price for care. This matters because it means we must constantly be looking to reduce our costs and improve the quality of care and the patient experience so we can be the provider of choice.

Q: Does Hartford Hospital have collaborative programs with Israeli healthcare organizations?

A: Hartford Hospital has a strong relationship with Magen David Adom (MDA), the Israeli Red Cross emergency services organization. For nearly five years, Israeli paramedics have been coming annually to our Center for Education, Simulation and Innovation (CESI) to train. CESI is one of the most recognized, innovative training centers in the country and is internationally known. The shared experiences and learnings have been invaluable to MDA and to our LIFE STAR program and we expect this great partnership to continue.

“Hartford Hospital, Hartford HealthCare and the Changing Healthcare Market” with Dr. Stuart Markowitz, senior vice president of Hartford HealthCare and, president of Hartford Region: Sunday, Sept. 20, 9 a.m., The Emanuel Synagogue, 160 Mohegan Drive, West Hartford. For information contact Ken Malley at malleyks@gmail.com.

Dr. Stuart Markowitz will discuss the Affordable Care Act and how it will affect patients at a buffet breakfast hosted by Emanuel Brotherhood at 9 a.m., at The Emanuel Synagogue, 160 Mohegan Dr., (860) 232-6598. Reservations not required.