Aspen Valley Hospital CEO: Accountability is key to quality healthcare
November 20, 2016
The cost of health insurance keeps soaring. A cloud of uncertainty hangs over the future of the Affordable Care Act. In November, Colorado voters soundly rejected a ballot initiative calling for a single-payer health insurance system that would be funded through a payroll tax.
For David Ressler, the chief executive officer of Aspen Valley Hospital, the ever-changing scenario in the health care arena should be a continuing conversation in Pitkin County, where only Anthem Blue Cross/Blue Shield will be selling individual plans on the state's exchange program in 2017 — and at an increase of 35 percent.
"I won't discuss politics, sex or religion, but I will say it's my fervent belief that both sides of the aisle appreciate the transition the industry is going through, from volume to value," he said. "We as an industry have to be accountable for the overall cost of health care rather than looking at it episodically."
"Accountable" is a word Ressler regularly employs. Hospitals, physicians and health care providers must be held to a higher level of accountability he said, providing quality care and, by doing so, ultimately improving the long-term health of patients so sky-high insurance rates come back down to earth, perhaps sooner than later.
"We as a medical community need to take a look at what we are doing," he said. "We're a cell in a larger organism, and we all need to move away from the environment we're in."
Insurance rates were briefly addressed at an Aspen Chamber Resort Association board of directors meeting in October, where Pitkin County Manager Jon Peacock offered a dim outlook.
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"If you're a family paying $1,500 a month in 2016, you're paying $18,000 a year," he said. "In 2017, that's going to go up over $2,000 a month, over $24,000 a year. That's the same as a $450,000 mortgage."
Ressler, 52, who was the CEO of Aspen Valley Hospital from September 2004 to June 2013, rejoined Aspen Valley Hospital in the identical role in mid-September.
This time around, Ressler said he is better equipped to address the health care crisis because of the experience he gained between Aspen Valley Hospital stints.
As the chief strategy officer at Tucson Medical Center, an accountable care organization, which was the second of its kind in Arizona, Ressler developed an astute understanding of treating patients through lower costs.
The Centers for Medicare & Medicaid Services defines an accountable care organization this way: "Accountable Care Organizations (ACOs) are groups of doctors, hospitals and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors."
"It was one of the first accountable care organizations in the country," Ressler said. "I wanted to learn more about that."
Ressler rose through the ranks, holding the post as chief operating officer and senior vice president at Tucson Medical Center from January 2014 through March 2015.
He returned to Colorado in March 2015 as executive director of three health care groups — Community Care Alliance LLC, Rocky Mountain Accountable Care Organization LLC and San Juan Accountable Care Organization LLC.
In his new role, Ressler's primary ambition for Aspen might come off as lofty, but he doesn't shy away from expressing it.
"It's a vision to make Aspen the healthiest community in the country," he said. "Some of the pieces we have to continue to maintain are our quality and our patient experience. We are doing very well in both regards."
The onus to achieve such an objective can't just fall on Aspen Valley Hospital, said Ginny Dyche, who runs the facility's Community Relations department.
"We want to be the leader in fostering that vision, but we're not going to be able to be all things," she said. "We're not the mental-health experts in the community, but we can help establish this vision."
Ressler cited statistics showing that the cost of 80 percent of health care services aren't related to medical issues. Rather, they are tied to psychological, social and such environmental deterrents as a lack of food and shelter.
"That's just part of this system of care that you can't do with just doctors and hospitals," he said.
Still, Ressler, whose first brush in the industry was as an EMT in Flagstaff, Arizona, said the medical community should focus on urging people to be proactive about their health and well-being, whether it's getting a colonoscopy or a mammogram, or weaning someone off of tobacco.
"We're going to be rewarded not for the services we provide, but the outcome of the patients," he said.
As Medicaid service expands in Colorado, Aspen Valley Hospital is seeing the level of its charity care for the indigent and under-insured drop.
In 2012 and 2013, the hospital wrote off more than $3 million in charity care both years. That figure dipped to $1.7 million in 2013, $1.6 million in 2015, and is $1.5 million through September of this year.