Ph.D. student on the heartbeat of health careDate: 2/10/2014
Ask most on Main Street what an ACO is, and you are guaranteed to get a combination of funny looks and questioning comments.
But that’s likely to change in the very near future as Accountable Care Organizations are popping up all over, destined to play a significant role in how Americans access, and pay for, health care in the future. ACOs bring together doctors, hospitals and other health care providers to offer quality, coordinated care, while rewarding those organizations for improving outcomes and reducing costs.
Marion McGowan knows all about these key components of health care reform. In fact, she’s president and CEO of one — the Lancaster General Community Care Collaborative in Lancaster, Pa. She’s also executive vice president of Lancaster General Health System. In her spare moments, she serves as chief population health officer for the health system, leading efforts to make care and clinical resources more coordinated and effective.
Not surprisingly, the Alvernia doctoral student knows well of the sweeping changes dramatically altering the health care landscape since enactment of the Affordable Care Act in 2010. And as the curtain rises on "Obamacare," the related new approaches are challenging health care administrators like nothing else in their lifetimes.
Population health management is one of the core concepts behind health care reform. It requires both a change in thinking and practice. Instead of thinking in terms of individual patients seeking one-time care, providers now must think in terms of entire populations over their lifetime. And it has fundamentally changed reimbursement to providers, health care who are no longer rewarded for doing more, but for efficiency and quality.
“It moves from a one-time episode of service or one-time interface of service to a life course of service, which is all good for the consumer,” McGowan says. “It requires a radical change in the foundation of the work processes, augmented by technology that is just now catching up, with electronic medical records and population health intelligence systems. And it requires us to have intelligence in a manner which predicts or anticipates people who may have problems so that we can try to intervene before problems exist — and it becomes very costly.”
For example, high-risk individuals with four or more chronic health conditions represent just 3 to 5 percent of those receiving care, McGowan says. But they absorb 40 to 50 percent of health care resources.
“So we have a lot of challenges ahead trying to figure out how to help people engage in their health proactively,” she says. Under the new model, health care systems are charged with not only identifying potential high-risk individuals “before they get there and try to divert the course,but once they’re there to try to find new and more personalized health systems that will support those high-risk individuals to reduce not only the cost, but also to promote the quality of life.”
Despite all of the changes and new responsibilities, McGowan recently took on a couple of new roles — one as chair of the development committee for AllSpire Health Partners, a virtual network of seven health care systems in Pennsylvania and New Jersey working together to improve care and reduce costs. The second new role, as a doctoral student!
To better equip her for the professional challenges ahead, she searched for an academically rigorous program rooted in faith- based values. Her final choice, Alvernia’s Doctor of Philosophy in Leadership program.
McGowan, who received her nursing degree from Carlow University in Pittsburgh before earning her master’s degree in public management/health administration from Carnegie- Mellon University, confesses that it was “a little intimidating to get myself back into a classroom, to find a way to balance work with family life and school.”
She has taken on increasing responsibilities with Lancaster General Health Systems over the past two decades, including serving as president and CEO of Brandywine Hospital in Chester County, Pa., and president of Lancaster General Hospital.
One of the things that spurred McGowan to pursue her Ph.D. in leadership was the realization that reliance on “leadership studies and research is lacking” in the health care industry.
“I really felt there was a gap, not only in my own ability in terms of continuing to grow as a leader, but also particularly in my knowledge of methods and research,” she says. “I hoped that as I went through this, asI orchestrated this role, which has evolved with the changes in health care reform, that I might be able to better develop my ability in the area not only of leadership in general, but of leadership in terms of research. “I particularly noticed that within the industry, especially in application research but in general leadership research as well, there was a gap, and maybe in some small part I could contribute to strengthening it.”
“It is an honor to serve as Marion’s dissertation adviser,” says Spencer S. Stober, professor of biology and educational leadership, who describes McGowan as a visionary leader in the field of health care. Her dissertation is exploring a national sample of mission and vision statements for health care organizations to inform a deeper understanding of visionary leadership.
McGowan credits her “wonderfully supportive and understanding family” — husband, Michael, daughter Amanda, and son Michael — with helping her as she pursues her doctorate. She is still working on her dissertation, under the guidance of Stober, who McGowan calls “enormously intelligent but also enormously humble and well-balanced as an individual. It’s that set of characteristics that serves as an inspiration for me.”