Same Mission, New Course
Date: February 25, 2013
Paul Rothman has called his new position as dean and CEO of Johns Hopkins Medicine his “dream job,” even though he took the reins during an unprecedented time of change in health care. Undaunted by the challenges facing academic medicine, Rothman says he sees opportunities to serve patients in ways that improve both clinical outcomes and the use of scarce health care resources, while enhancing the education of the next generation of physicians and researchers.
A rheumatologist and molecular immunologist, Rothman came to Johns Hopkins in July after having served as dean of the Carver College of Medicine at the University of Iowa and leader of its clinical practice plan since 2008. He previously served as head of internal medicine at the University of Iowa, beginning in 2004, and prior to that as vice chairman for research and founding director of the Division of Pulmonary, Allergy and Critical Care Medicine at Columbia University College of Physicians and Surgeons, where he joined the faculty in 1986.
“A primary focus of health care reform is reducing the cost of medical care,” says Rothman. “This means being more efficient in how we deliver care, decreasing inpatient stays and readmissions, and increasing emphasis on preventive measures and population health.”
At the same time, there are financial headwinds stemming from the fact that Maryland’s Medicare waiver and All-Payer System are at risk, as is federal funding for research. In addition, potential tax reforms could hinder the amount of charitable donations received by Hopkins. “All of this,” says Rothman, “stands to affect how we’ll do business in the age of health care reform.”
In addition to launching a new electronic medical record system (see story here) to help streamline care, he says, Johns Hopkins Medicine has a plan to both augment revenue and reduce expenses over the next several years. Among the components of the plan are increasing efficiency across the health system, continuing local and national/international outreach for the clinical enterprise, and increasing technology transfer to create new revenue streams.
Also under way are plans to leverage transdisciplinary programs such as the Johns Hopkins Community Health Partnership. Under the direction of Rothman and Johns Hopkins HealthCare President Patricia Brown, the partnership aims to improve the quality and efficiency of health care delivered to patients while reducing unnecessary costs. The program was awarded a $19.9 million grant by the Centers for Medicare & Medicaid Services over a three-year period.
The program features many entities working together to better coordinate inpatient services at The Johns Hopkins Hospital and Bayview Medical Center, as well as community-based services for residents in the seven East Baltimore ZIP codes surrounding these hospitals. Participants include the hospitals, The Johns Hopkins University and its schools of medicine, nursing and public health; Johns Hopkins Community Physicians; Johns Hopkins Home Care Group; the Johns Hopkins Urban Health Institute; CMS; the state of Maryland; the city of Baltimore; Priority Partners, a Medicaid managed care organization owned by Johns Hopkins and the Maryland Community Health System; five skilled nursing facilities and several other community organizations.
Rothman and other Johns Hopkins Medicine leaders are also finalizing a strategic plan that includes new models for training medical students, residents and physicians in the delivery of safe, high-quality, cost-effective care.
“Our aim is to become the most effective center for advancing scientific discoveries that benefit the world,” Rothman says, “and as we become the most effective at doing so, we will pass that benefit on to patients and payers.”
Brown says she has enjoyed working with Rothman on J-CHiP and other ventures: “Dr. Rothman came to Johns Hopkins Medicine with a clear vision, enthusiasm and a pure belief in our three-part mission. That’s who we are, and that’s not going to change.”