Thomas Jefferson University Hospital chief rolls out ambitious plans post-merger

Photo from Wikipedia.

If Stephen Klasko, MD, has his way, Philadelphia’s largest health system will reinvent academic medicine.

Klasko, CEO of Thomas Jefferson University Hospital, is pitching several changes to the system as he manages the merger between the top urban academic medical center and the suburban Abington Health hospital system.

For starters, two soon-to-open urgent care centers and community hospitals that will be part of the Abington-Jefferson system plan to invest $20 million in telehealth, bringing the expertise of Jefferson’s 1,000-plus physicians and nurses to patients closer to home.

“I see this as an absolutely seminal moment in healthcare,” said Klasko, a 61-year-old OB-GYN and Philadelphia native who came to Jefferson in 2013 and has called for U.S. healthcare changes since he was head of the University of South Florida College of Medicine a decade ago.

[Also: Tracking 2015 mergers and acquisitions]

Changing healthcare “means everything from literally changing how we select and educate students to changing the most expensive place to can get care, the urban academic medical center,” he said. Jefferson is among the first medical schools factoring in emotional intelligence in acceptance.

“We believe that 65 percent or so of patients who end up in a hospital’s emergency rooms don’t need to be there, and not just because it could not just be five hours of a patient’s life but $1,500 of their deductible.”

A new kind of merger

Jefferson, a five-facility academic medical system flanked by a 950-bed hospital, spent 19 years affiliated with Main Line Health until ending that management arrangement. Jefferson announced the merger with Abington shortly after.

Since then, Klasko has tightened how the health system runs. While Jefferson alone had a board of more than 100 prior to Klasko’s reorganization, the new, five-hospital and $3 billion Abington-Jefferson system will be run by one board of 24 people.

“Our merger with Abington is a totally different model from what’s existed before, where it’s a hub and spoke and a community hospital can send more patients to Philadelphia,” said Klasko, who’s slated to be CEO of the new system.

Follow Healthcare Finance on Twitter and LinkedIn.

The goal, Klasko said, is to to have “hub and hub” model, where patients can consult Jefferson clinicians over an Internet video chat, get specialty care in community-based setting and only come into the hospital if they really need it. Another way to put it is going from “the Blockbuster model to the Netflix model,” he said.

The Abington merger is set to close in May.

That vision of high-tech, personalized healthcare has also brought Jefferson serious donations. Sidney Kimmel, the Philadelphia-born fashion tycoon, donated $110 million Jefferson's medical school in 2013. Early this year, the Marcus Foundation, established by Home Depot co-founder Bernard Marcus, gave Jefferson $14 million to expand its integrative health center in Villanova.

Klasko claims that center will offer “the best of traditional American medicine, traditional Chinese medicine, vitamin therapy, acupuncture, Ayurvedic medicine and a technology-based, home-based telehealth model where people can be part of a club and get wellness services in a way that’s consistent with how they do their banking and everything else.” That grant will also let Jefferson open eastern Pennsylvania’s first PET MRI scanner.

Among other initiatives, Jefferson has a new startup “accelerator zone” to advise and potentially invest in Philadelphia-area health entrepreneurs, and is considering starting what would be greater Philadelphia’s first CT-equipped ambulance for mobile stroke care.

Standing out

Klasko’s restructuring of Jefferson is also a sort of rebranding. The organization purchased the naming rights to a main downtown train station and became the official hospital of the Philadelphia 76rs basketball team. Klasko has become a celebrity in the Philadelphia medical scene, giving TED talks, meeting with dozens of media outlets and widely acknowledging the general frustration Americans have with healthcare.

Whether Klasko’s ideas and Jefferson’s new initiatives translate into better, more affordable healthcare remains to be seen, said Robert Field, a Drexel University health researcher who worked in management at the University of Pennsylvania Health System in the late 1990s. For one thing, Field said, neither Jefferson nor any other regional provider system has made headway in improving patient billing.

Jefferson is also not the only area health system looking to create an integrated health network spanning the suburbs and center city of Philadelphia.

The competition between Jefferson and Penn Medicine “has been explicit,” though still friendly, said Field. But while the two both offer patients many options for advanced care and clinical trials — both, for example, provide access to cancer immunotherapies — Jefferson wants to lead in the move towards retail clinics and telehealth. Greater Philadelphia has dozens of urgent care centers, but only a few that are run by health systems.

In 2010, Klasko and a group of academic medical center leaders were at a conference when Walgreens announced the launch of its walk-in clinics. Klasko remembered many of the deans laughing it off: “What a stupid business model. Who’s going to go to a drugstore to have their kid be seen with an earache?”

[Also: Walgreens cuts ties with two ACOs]

Billions of dollars later, Klasko said, retail primary and urgent care clinics are one of the fastest growing parts of healthcare, and some providers complain that they are taking away high-margin, low-acuity services.

“The reason isn’t because everybody was excited about going to the drugstore to have their kid be seen. The reason was, back then, if your kid had an ear ache you would be told by your pediatrician in many places that we could see you in two days. Well by then, your kid was either better or had gone to the emergency room.”

“The rest of the world has become consumer centric and has absolutely zero patience for waiting 24 hours to do anything,” Klasko said. “Rather than watching other companies make a lot of money because we don’t have our act together, we want to be part of those companies.”

One way to measure Jefferson’s influence and the region’s healthcare progress in the long-term will the success of the Delaware Valley ACO, a Medicare shared savings joint venture between Jefferson, Main Line, Holy Redeemer Hospital , Doylestown Hospital and Magee Rehabilitation. 

The 65,00 patients in the Medicare ACO plus the many commercially-insured patients around greater Philadelphia represent a way to scale consumer-centric healthcare, Klasko said. “Keeping patients out of the most expensive place to get care and treating them at home or in urgent care basically” means “happier patients who are costing less.”

Twitter: @AnthonyBrino