Providing care in nonhospital settings

As president and CEO of Froedtert Health, a Milwaukee-based regional health network, Catherine Jacobson is responsible for five hospitals—including a nationally ranked academic medical center—and nearly 40 health centers and clinics. The following is an edited excerpt from remarks she delivered during an interview at McKinsey’s Healthcare Conference held in Chicago in June 2019.

Audio transcript

Our academic medical centers are full—almost 99 percent full. When you are [that full], though, you have immense motivation to get patients out of the hospital. So we have been very, very thoughtful and intentional—working in population health, working in risk-based scenarios—about moving patients from first inpatient to outpatient [care], and then outpatient [care] to clinics, and then clinics to home.

I think what you’re going to see in the future of academic medical centers is a trend toward aggregation around specialists. And we are starting to demonstrate the value of that: because we [already] do more of it than anybody else, we can do it better—[achieve] better outcomes and at less cost. At the same time, we have to be very, very diligent about moving out [of the hospital] the things that don’t belong there.

We treat over 90 percent of the sickle-cell patients in the state of Wisconsin because we are the urban academic medical center where that [population] is congregated. About six or seven years ago, we opened an outpatient sickle-cell clinic and dramatically reduced inpatient readmissions and emergency-room visits—and saved a lot of money for the Medicaid program in the state of Wisconsin.

We run a 24/7 cancer clinic so that cancer patients can go to a clinic if they’re having an emergency, with the clinicians who know them and the nurse practitioners who know them. And they don’t have to go to the emergency room; they don’t have to get admitted.

So I think that you will see more of that. Even as we aggregate more of the things we do, there are many opportunities for us to take the patient populations that we see and move them to a lower-cost setting.

Listen to the full podcast, “The role of academic-based health systems,” recorded in June 2019 at McKinsey’s 12th Annual Healthcare Conference.