New Jersey Hospital Association CEO and President Cathleen Bennett is no stranger to the industry she’s now advocating for — she just switched sides, after serving as commissioner of the Department of Health under former Gov. Chris Christie since 2015.
But, at the start of this year, she went from regulating the industry to taking the helm of a key trade group.
Her arrival also signals a new direction for the association, which went through a strategic planning session and determined it needed to focus more on the things its members have in common.
The position of NJHA head is often described as trying to herd cats — members’ needs and opinions vary based on their circumstances, which are drastically different after the significant consolidation activity in recent years.
ROI-NJ sat down with Bennett to discuss the changes and her new role.
ROI-NJ: How has your perspective changed now that you are on this side of the table?
Cathleen Bennett: I’m definitely learning a new way of sort of approaching things, because I came from a private-sector background, then a state government background and now an association, so it’s a little different. It’s pretty cool making the transition, but it’s a different way of looking at the same puzzles I’ve been working on at different points throughout my career. For me, it was kind of a natural fit; for them, I think I was also a natural fit for the same reason. I think that, when you’re regulating the industry, what you’re taking a look at are the statutory criteria which guide what you can and cannot do. It’s sort of a narrow purview and a narrow opportunity to influence when you’re wearing the regulator hat. And, when you come to this side, the statutory criteria are the mandate of what you must do, but you’re allowed to do whatever you want to do beyond it, in ways.
ROI: You were big on population health when you were in office. What is your new focus?
CB: I think my thoughts around the criticality of population health are as deeply embedded as they’ve ever been. What I discovered after coming to the association is that that’s a commitment that they have as well. What we’ve seen is there has been a pivot, from an association perspective, back to what it was. The mission is to improve the health of the people of New Jersey. There is this recognition that we need to be educating, informing and empowering our residents. They are active in their health and active in their wellness. We want to invest in pre-acute care, not just acute care and not just on the post-acute side. We’re going all-in (on) our commitment to helping keep our community healthy and strong, and want to make sure we’re not just dealing with patients when they are in a disease state, but also in a healthy state. I think our hospitals recognize that, no matter which community they are situated in in the state, they are the anchor institution.
ROI: So, the scale of the organizations within their communities can really drive change. How is this working?
CB: Hospitals are (not) doing this out of necessity. I think this is just the continuing evolution of the system. We started with a system of care that was built around sickness. You went to see a doctor because you were sick. And we injected things like wellness visits. That started coming back because of a new system of care. It’s a real pivot, if you think about what’s happened from an industry perspective. And I’m talking about health care in the broadest sense … when you think about payors and pharma or medical-device companies — any of those entities — or doctors themselves.
ROI: What has spurred this evolution in the system?
CB: Our members recognize the importance of keeping people healthy, and they are making investments on that pre-acute side. They don’t want volume for the sake of volume. They want somebody there because it was an issue that wasn’t preventable. We know 1 in 5 residents is going to be a senior by 2030. If you say that your job is just to drive volume — think about what happens if you’re not driving health and wellness and prevention. Because you’re going to have a rapidly aging U.S. population and you’re going to have one that is going to be bearing a larger burden of chronic disease. That’s not something that our members want to see. That’s why you see this investment that’s taking place around the wellness and prevention side.
ROI: Investments such as?
CB: What you see are a lot of investments being made into, how do you create the right outcomes for patients and do so in a way that is manageable in terms of costs, do so in a way that ensures quality in the delivery of care and ensures that patients are staying safe as you go through this process? In some ways, it’s kind of interesting for me, because we talk about the financing of health care and these new payment systems. But new payment systems mean taking clinical protocols which are clearly defined and delineated. One of the things I’ve seen and seen our members be active in is, how do you get to a system of care or system of providing care where the consumer says, ‘For this investment that is being made, we are getting to the right outcome’? Fee-for-service was really episodic. Now we see it’s not the encounter, it’s the condition that you are having the encounter with that needs attention.
ROI: Speaking of investment, one of the biggest criticisms of the health care industry today is its lack of transparency. Why can’t I buy care the way I buy services at a spa?
CB: Transparency is something that this industry has embraced. I can’t think of another regulated industry that has more information available to consumers, whether through the DOH and all the reports that it publishes or Leapfrog. I think that’s probably one of the things where our members have done a really good job and will continue to work on, too. It’s not as if it’s a one and done. Continuing evolution.
ROI: There’s also a lot of scrutiny on middlemen — which, for providers, means insurers and pharmacy benefits managers. What are your thoughts on that?
CB: We’re lucky in New Jersey to partner with all the sectors involved. But tensions are very real. When you look at things like … automated denial of claims. UnitedHealthcare lost $11.5 million in a judgment because of inappropriate denials. There are also downcodings that take place. Automated tools are in place, and no one is taking a look and saying, is it appropriate? That’s when its problematic. That’s why the conversation is taking place nationally and being replicated in many states.
ROI: You’ve got a new administration with lots of changes coming. What is it like to be a part of that?
CB: One of the things that makes this an exciting time in health care and for NJHA is that we are seeing the next iteration of the system. I think it’s time to be creative and innovative and connect with people in the way that they want to connect with a health system. New tech and new ways of interacting with patients and new ways of staff interacting with patients through tech. That’s across the continuum. I can’t tell you what it will look like in the future, but I can tell you, there lot of innovation taking place and a lot of thoughtfulness around it.
Read more from ROI-NJ:
- At NJHA meeting, health care changes are popular topic
- Ryan, outgoing NJHA head, knows issues remain
- N.J. health commissioner to become hospital association CEO