SWH: What is your opinion on the national health
bill and how do you think it will play with
Louisiana?
Gary Curtis:
Thats a dicey situation, but Im not going
to avoid it. You would have to say that the bill is not what
anybody really wanted. Its not healthcare reform; for the
most part its insurance reform. Im not the first person to
say that. Its got a number of things that people really like
that I personally like, that probably you all like if you have
kids. Because my kids are now back on my insurance
policy and Im not having to pay $500 a month for both
my son and my daughter. I thought I was being a pretty
good parent and part of corporate America even though
a non-profit part, but Ive started for-profits also, so I
understand the system and the way it works and I partic-
ipated in the insurance policies all my life. Then I find,
just because my kids have aged out, but not enough to
be on their own, we are all paying big prices. So thats I
think a very welcome feature that Middle America, along
with me, really supports. The feature about pre-existing
conditions–in my conscience I cant say that if you hap-
pen to have a history of cancer or breast cancer in your
family that because you change jobs you will never have
health coverage again. My conscience wont let me do
that and I dont think I am very far from the center. So I
think there are things about this bill that are very com-
pelling that at least move us in the right direction,
although in total, theres a lot of stuff hanging off of it that
make a lot of people uncomfortable that we need to look
at. But Im glad to see us taking one step forward rather
than nothing, because thats whats been happening up
until now.
SWH: Theres always been talk about tying
provider compensation to quality care. Is that
really feasible and how do we do that?
Gary Curtis:
Yes. Lets take readmissions for example.
Our project, which was written up in the New York
papers and won an award from CMS, out of the thirteen
or so projects were the poster child for success. It is that
way because the hospitals in the Baton Rouge area
have made it so. The hospitals in the Baton Rouge area
have recognized that CMS, the Feds, are going to come
along and bundle payments. In other words if you go into
the hospital with pneumonia, right now if you get dis-
charged and readmitted they get a whole new DRG
(Diagnosis Related Group) payment every time you
cycle back through. The Feds have said to Baton Rouge
General, to the Lake, to all the five hospitals in our area,
“Were going to move to a payment where were going to
bundle the payment. Were going to pay you maybe 1.3
or 1.7 of a DRG and then its your business to keep that
person out of your hospital.” Now to a hospital that knew
they had very frequent readmissions for a specific diag-
nosis theyre looking at that and saying “Ive been getting
paid every time and now Im getting paid 1.3, 1.5, or 1.7
so Im going to have to take steps here that I havent