A world that strives not merely to cure disease but to keep people healthy in the first place has long been the vision of Barry Ostrowsky, chief executive of Barnabas Health, the state's largest health care system.
And for years Barnabas has advanced that vision by pioneering sustainable wellness programs like KidsFit, in which dieticians go into Newark classrooms and work side-by-side with teachers to tackle childhood obesity by spreading the word about healthy eating and exercise.
Ostrowsky has just promoted Barbara Mintz, wellness chief at Newark Beth Israel Medical Center, to a newly created position: vice president of healthy living and community engagement. In her new post, Mintz will champion wellness programs throughout the seven-hospital Barnabas system, fostering programs tailored to the different needs of the diverse communities that Barnabas serves, from Jersey City to the Jersey Shore.
“We see ourselves as a beacon of wellness and health education,” Mintz said. “We want to be the place people come to for the information that they need to stay out of the hospital. I know that sounds funny, but that’s really what we are doing.”
Right now, Mintz is assessing the community wellness programs now underway throughout the Barnabas system, so the best ones can be expanded to reach more people.
To date, Barnabas has funded community wellness initiatives out of the operating surplus that it uses to reinvest in all its programs. Ostrowsky said government and commercial payers for the most part still compensate the health care system for curing ailments, not for preventing them.
But Ostrowsky shares the view of many experts that health care is transitioning to a new world, where instead of being paid a fee for every service they provide, health care providers will get a lump sum or “capitated” payment to deliver everything the patient needs — whether it’s an exercise program to strengthen the heart, or surgery to clear clogged arteries.
And Ostrowsky believes when that day comes, the Barnabas focus on wellness could be just what the doctor orders.
Meanwhile, getting the health care system to focus on wellness and prevention alongside traditional “sick care” is a monumental undertaking, Ostrowsky said.
“It has to be about community health, lifestyle, better eating and nutrition and averting illness,” he said.
Medicare and commercial payers in the last couple of years have started supporting “accountable care organizations” that compensate health care providers for improving clinical outcomes and controlling costs, a movement that is in its infancy but has begun showing results.
Ostrowsky pointed out that Barnabas got into the wellness arena years ago, without waiting for health care payers to figure out how to use their dollars to reward the changes that the health care system needs to make. Today, spending on wellness programs represents a small fraction of the resources of the $3 billion Barnabas health care system — but this is where the future lies, Ostrowsky said.
“When you are running an organization like ours, you have to take the plunge to invest in people and invest in positions and you have to accord those positions the authority and the responsibility to make the vision a reality,” he said. “Barbara has been a star for a very long time and has accomplished great things for the communities with which she has dealt. She is the perfect person to take on a system-wide and enterprise-wide responsibility to ensure that this philosophy is turned into operational plans.”
The Beth Challenge is the kind of sustainable program New Jersey can expect to see more of from Barnabas, Mintz said. Modeled on television’s “The Biggest Loser,” it started in 2009 as a weight-loss program for employees of Newark Beth Israel Medical Center
“We thought we would get 50 people to sign up — and we got 500,” Mintz said. One employee lost 200 pounds and avoided weight loss surgery.
“We took the Beth Challenge out into the community, because we need to lead by example,” Mintz said. Barnabas is an academic health care system that trains doctors: “We have all this expertise under our roof and we need to share that with the community.”
Seven Newark churches enrolled in the Beth Challenge, and Barnabas nutritionists visit the churches weekly, teaching classes on healthy eating and lifestyles.
“This is really about taking our clinical teams and putting them in the middle of the population and being there for them in the places where they lead their daily lives,” she said.
First lady Michelle Obama visited the KidsFit program at a Newark school in 2010 as part of her “Let’s Move” campaign, and Mintz has been honored by the American Hospital Association with its NOVA award for excellence, wellness and community education.
Mintz led the Barnabas partnership with the 2014 Special Olympics USA Games that were held in New Jersey in June. Starting last November, a team of Barnabas dieticians and nurses provided wellness counseling to the 265 Team New Jersey Special Olympics athletes, resulting in weight loss and lowered blood pressure for a significant number of the athletes.
And this turned into yet another sustainable wellness program: Each month, a Barnabas dietician is teaching a class at a residence for individuals with developmental disabilities.
Ostrowsky said the appointment of Mintz “is really a major step for us. Not because we just decided to believe in it now; we’ve always believed in it. It’s about putting our money where our mouths are.
“We’ve finally said to an executive: ‘We know you know this stuff. Put together a real operational program, enterprise-wide, hold our colleagues responsible for implementing it and report on a regular basis on how we’re doing at getting it done.’”
Ostrowsky said when it comes to wellness, there is no one-size-fits-all solution — and obesity is a prime example. “The percentage of obese people in this country is off the charts and we know scientifically that obesity leads to every conceivable negative clinical status.” But he pointed out that obesity exists in inner cities that lack supermarkets, as well as suburban areas with lots of places to buy healthy food.
“If people don’t have access to healthy food and we want to talk about healthy food, it’s a pretty empty message until we figure out a way to give them access to healthy food,” he said. But for those who lives in places with lots of grocery stores, “It’s not a matter of access. We have to find a way to encourage them to shop there and buy the right stuff.”
Keeping people well frees up resources the health care system needs to deliver expensive, advanced medical care to those who need it, he said.
“I think you could probably take 20 percent or more of the people that we now serve for sickness and not see them get sick if our programs work over the next five to 10 years,” he said. And by averting illness where possible, “There will be so many more resources available for the people who do get sick. You’ll have more than enough by way of resources to do that — and you’ll have a lot healthier population.”
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