Ravi Bashyal, MD, is vice-chairman of patient and provider experience, director of outpatient hip and knee replacement surgery and site medical director for Professional Football Hall of Fame Health at NorthShore University Healthsystem, as well as a clinical assistant professor of orthopedic surgery at the University of Chicago Pritzker School of Medicine.
Dr. Bashyal will serve on the panel “CMS Spine, Total Knee Replacements: Smart Steps for a Stellar Program” at Becker’s ASC Annual Meeting. As part of an ongoing series, Becker’s is talking to healthcare leaders who plan to speak at the conference on Oct. 27-29 in Chicago.
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Question: What is the smartest thing you've done in the last year to set your organization up for success?
Ravi Bashyal: I would say a couple things. NorthShore Orthopaedic & Spine Institute is Illinois’ only orthopedic and spine only hospital, and so by setting up our facilities as a center of excellence, that’s really helped set us up for success. It allows us to bring high volume, high volume collaborative care for our patients. By focusing on a narrower breadth of subspecialties — specifically orthopedic surgery and spine surgery — we can really get dialed in on those subspecialties. Having a collaborative approach to surgery is really important. Orthopedic surgery doesn’t live in a vacuum, so we need to collaborate with our partners and that means things like nursing, physical therapy, anesthesia, and pain service. By housing all of thoise geographically in one place and focusing on a narrow subset of types of surgery, that allows us to create great outcomes for our patients and provide individualized medicine.
I would say the other smart thing that we’ve done is starting to look at outside partnerships and understanding how to leverage those. When we can demonstrate that our quality, efficiency and cost metrics exceed those that are around us, it attracts those external organizations. In the past year we’ve had a very successful partnership with Professional Football Hall of Fame Health; it’s an example where our collaborative care has attracted a large national organization that wants to be able to funnel, in this case, their players and former players to a place where they know they can count on excellence across the orthopedic and spine spectrum.
Q: What are you most excited about right now and what makes you nervous?
RB: I’m excited about continuing to leverage our strength as Illinois’ only orthopedic and spine dedicated hospital, dedicating the excellent providers that we have and the culture of collaboration that we have, and really demonstrating that our outcomes and our efficiencies are superior. I think we’re going to continue to attract payers, organizations and patients that are looking for the best individualized care and the best outcomes when it comes to orthopedic surgery and spine surgery.
What’s making me nervous? Medicare is proposing another 8.4% cut to reimbursement rates. We have to be able to take care of our people in our community and ultimately, if that trend continues, I’m concerned about equity and access to care. I think that all of our patients deserve care. I think that patients on Medicare deserve access to the best, but if reimbursements from Medicare continue to trend down, it will be difficult for many organizations to stay afloat. I think that the healthcare industry, the hospital industry and physicians in general are doing a really good job of doing more with less, but there is definitely a limit to how much can be done with less. I think that some of these cuts are very short-sighted and do not fully reflect what is needed to run a health system or health organization. We need to partner with the payer both public and private to find productive ways for us to continue to cut costs and be more efficient, but to do it in a way that’s sustainable for systems while still providing top-notch care for all patients in our communities.
Q: How are you thinking about growth over the next 12 months?
RB: Leveraging our ability to provide center of excellence level care for orthopedic and spine surgery is going to really allow us to attack payers and organizations that want their constituents to receive high quality, cost-efficient care. I think that by continuing to demonstrate our superior outcomes and our collaborative approach to care, we’re in a situation where we’re able to do high volumes of high quality, individualized surgery in a cost efficient manner.
Q: What will healthcare executives and leaders need to be effective leaders for the next five years?
RB: I’m really a big believer that centers of excellence are where healthcare is headed. In light of needing to control costs, one way to do that is by increasing volume, but doing it in a very thoughtful manner; just because you do more doesn’t mean you’re better. Could you do it in a more thoughtful and organized manner than it is? That is what the center of excellence is.
At NorthShore I’m part of the Orthopaedic & Spine Institute, which is one example of that, but we’re also working on a neurological institute which is going to be a sort of separate entity, and a cardiovascular institute that’s a separate entity, where we have the right specialists for those subspecialties all together as part of a larger networking system that ultimately can provide care for really any medical problem that you might have. Setting up these centers of excellence is going to be key for healthcare leaders and executives to succeed in the world of limited resources and needing to be good stewards of the healthcare dollar.
Q: What is your strategy for recruiting and retaining great teams?
RB: I think a lot of that has to do with being collaborative and with being excellent. If you have a center of excellence, I think that people want to be a part of that because there’s a certain culture that goes along with that. Quality attracts quality, and I think if we’re in a position where we’re providing the best, most efficient, most individualized care, there’s pride that goes into providing that care and seeing our patients have those great outcomes. I think that’s our biggest recruiting tool and our biggest retention tool.
We have to also think about other ways in which to retain employees: focusing on work-life balance, making sure they’re being compensated fairly. I think all of those things are important, and ultimately a culture of success and a culture of a center of excellence is the best way we can retain and recruit the best and brightest.