By Diane Carman
While political leaders across the country furiously debate how – or even whether — to provide health care coverage for the uninsured, Denver Health, the state’s largest safety net provider, welcomed a new CEO this week.
Arthur A. Gonzalez will be charged with running a critical institution where 42 percent of its patients are uninsured at a time when state revenue projections are weak and the future of Medicaid expansion is in serious doubt.
He succeeds Dr. Patricia Gabow, who is retiring in September after serving as CEO of Denver Health for 20 years. He will begin the new job Sept. 4.
With the presidential election four months away and the future of health care reform hanging in the balance, “it’s too early to tell” how federal health care reform, including implementation of the Affordable Care Act, will affect safety net providers such as Denver Health, Gonzalez said. “As the federal government looks at the consequences and the fallout of those states that expand Medicaid eligibility and those that don’t, it may change the nature of the rules.”
Measures including funding incentives, withholding other kinds of payments or other means of encouraging states to expand access to Medicaid could be implemented, he said.
“We don’t know what the final reaction will be.”
In the meantime, Gonzalez, who has 39 years of experience in health care administration in Texas, Arizona, Louisiana and, most recently, as CEO of Hennepin Health System Inc. in Minneapolis, said the organization will do scenario planning to prepare for however circumstances change so Denver Health can maintain the services the community needs.
The challenge, he said, will be to maintain quality and expand access while continuing to reduce costs.
Denver Health uses a model that doesn’t just look at a simple formula of cost divided by people served, he said. “We ask, ‘What about the cost of waste?’ ‘What about the cost of rework?’ ‘What about the cost of needless complexity?’ ‘What about harm?’ ”
If those costs can be reduced, “everybody is better off,” he said.
Hubert A. Farbes Jr., chairman of the board of Denver Health and Hospital Authority, emphasized that Gonzalez was the unanimous choice of the board.
“The board is … charged with a mission that we want to preserve our role in the Denver Metro Area and the state as a whole as the safety net institution of choice,” Farbes said. The selection of a new CEO was critical in determining “how we will operate and adjust our operations to maximize the prospect for the institution to survive.”
Despite the pressures on safety net providers, Gonzalez said, “Denver Health is a great model.”
In an effort to maximize efficiency and continuously improve performance, Gabow instituted the LEAN program, a comprehensive strategy developed by Toyota that uses data-gathering to reduce errors, improve patient satisfaction and eliminate waste.
Gonzalez plans to build on that progress, he said. “We want to get everyone working at the top of their license and we want to continue to try to organize teams in better ways. I also hope to become even leaner than we are today.”
The new CEO said he doesn’t anticipate any changes in the role Denver Health plays in the community.
“I don’t see any changes coming in the safety net mission, the medical and health education mission, or the research mission. They are fundamental,” he said. “I recognize that we are not only in and of the community, we are owned by the community. We are here to help the community and collaborating with the community can help us.”
It’s only by continuing and expanding that level of collaboration and listening to people in the community that Denver Health will be able to address the significant health care needs, he said.
And while the future of health care reform is uncertain, especially for safety net providers who are committed to providing universal care despite unpredictable government programs and volatile forces in the health care marketplace, he said he is energized by the challenge.
“I’m the kind of person who doesn’t worry about the doomsday scenario,” Gonzalez said. “I have great faith we’ll get through this. There are a lot of creative solutions. I’m optimistic we’ll get there.”