HJNO Mar/Apr 2024

HEALTHCARE JOURNAL OF NEW ORLEANS I  MAR / APR 2024 17 foresee a much more positive future for the state of Louisiana. Editor Some hospital executives are concerned about a value-based care transition. They understand shifting from a fee-for-service model to value-based care may be challenging for hospitals. Can you please provide some insight into value-based care and how hospitals may be able to adapt? Coffman I really think we need to move to a more value-based environment. The concern, as you pointed out, is the financial impact. There's a bridge that needs to occur. That's why, when I think of the entire state focusing on diabetes management, for example, people are going to get there at a much faster rate than they would if they were just trying to do value-based care or population health on their own. But when you start to think about down- side risk, it's scary because most margins across the nation are razor thin. When you start to think about leveraging an organi- zation with risk, it's scary. I do think we can work toward a value-based environment without having to go from fee-for-service immediately into value-based, meaning 100%. It's going to take time to get there and bridge people, allowing them the opportunity to take investments from the improvements that they're making because in a value-based world, if you performwell, they pay you for that. Balancing that is the tricky part. Editor Well, we all want our hospitals to exist and be there when we need them. Coffman Exactly. And we don't want to put any community or region at risk because of too fast of a shift. Then, to your point, a community loses their hospital, and that's the worst thing that can happen. Editor I'm going to go global for a moment. Recently, the princess of Wales spent 13 days in the hospital for an undisclosed stomach surgery, and the king of England spent three days in the hospital after a scheduled treatment for an enlarged prostate. In U.S. terms, those are amazingly long hospital stays. Are U.S. insurance companies pushing patients out of hospitals too soon for optimal health for our citizens? Coffman Well, I can't speak to what they have or why they were in the hospital that long. I don't have a lifeline to the palace. What I would say is, in some cases, yes. But for the most part, I think we're managing care well within the timeframes. When I think about our bigger challenges with insurance companies, it's trying to play by the rules when the rules are different from one insurance company to the next. It’s the administrative burden that is challenging. And the other piece of that is when you think about the administrative burden, each one has different rules. They may not pay you if a patient is readmitted within 30 days in some cases; in other cases, they will under certain circumstances, or they will 100%. If I were to get my wish, I would want the insur- ance companies to be far more standardized in the way that they work with providers. When things are standardized, you get to an endpoint a lot faster. Editor I understand you are known for emailing “Monday Morning Motivations” to employees each week. They usually end with an inspiring quote. Do you have a favorite? Coffman There are two authors who speak to my heart most. One is MayaAngelou, and the other one is St. Francis of Assisi. I say that because fundamentally, at the core of who we are in healthcare, everybody comes to work wanting to make a difference. Nobody comes to work not wanting to make a difference. For me, I mentioned I have been in faith-based healthcare, and faith is a big part of my life. To be inspired and called to greatness is what both Maya Angelou and St. Francis of Assisi do — they “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” —Maya Angelou call us to greatness. The style of leadership that I practice is what is known as servant leadership, where you place yourself second in service to others. If you were to walk the halls or ask whomever it is you know that works here what our colleagues do, they are very true and humble servant leaders, and it's just a pleasure to watch them go about their day. Editor Lastly, as a seasoned healthcare executive, if you were to sum up your philosophy in a quote, what would it be? Coffman My philosophy is that if you place the patient first, always, everything else will fall into place. Your outcomes will improve. Your collaboration with people who make those outcomes possible will improve. Your financial performance will improve. But you have to focus on the patient always and truly do that in a genuine and authentic way. It just brings people together and takes the controversy out of the discussion. Editor Congratulations on what you've built over there and on the ability to keep control of it and be part of a larger system. Coffman Thank you . n Photos courtesy of St. Tammany Health System.