Frank A. Corvino, Greenwich Hospital, Yale New Haven Health System

Frank A. Corvino

Changing the Healthcare Paradigm

Editors’ Note

Frank Corvino is currently the President and Chief Executive Officer of Greenwich Hospital. He is also Executive Vice President of the Yale New Haven Health System. Before he assumed his current post in 1991, Corvino was Senior Vice President and Chief Operating Officer at the hospital. Prior to coming to Greenwich, Corvino was an Executive Vice President at Our Lady of Mercy Medical Center in Bronx, New York, where he also held other management positions. He earned his undergraduate degree in Pharmacy at Fordham University and completed his graduate training at St. John’s University. Corvino currently serves on the board of the Cabrini of Westchester, HealthEquity, and Connecticut Community Bank.

Institution Brief

Located in Greenwich, Connecticut, Greenwich Hospital (greenwichhospital.org) is a 206-bed community hospital founded in 1903 and serving lower Fairfield County, Connecticut, and Westchester County, New York. A major academic affiliate of Yale University School of Medicine and a member of the Yale New Haven Health System (yalenewhavenhealth.org), Greenwich Hospital has evolved into a progressive regional medical center and teaching institution with an internal medicine residency. The facility represents all medical specialties and offers a wide range of medical, surgical, diagnostic, and wellness programs. Greenwich Hospital completed construction on its main campus in Fall 2005 with the opening of the Thomas and Olive C. Watson Pavilion. Combined with the Leona and Harry B. Helmsley Medical Building, which opened in 1999, the state-of-the-art facility is a model of advanced healthcare design.

Where do we stand today on healthcare delivery?

In general, the healthcare system is still broken, but we’re on our way to making changes that will decrease the cost of healthcare moving forward. I’ve always believed that the only way to decrease healthcare costs is to not incur them in the first place. Institutions today are taking costs out of their hospitals, and becoming more efficient. We’ve already taken out $500 million from a budget of $3.5 billion, and we’re moving toward doing more. Cost reduction is important.

Also, the advent of accountable care organizations, bundle payments, and some of the other vehicles that are being used to keep people out of the hospital will be effective in making us more efficient. If we can manage patients outside the hospital, it goes a long way toward bringing down the cost of healthcare. Reimbursements keep getting smaller, so we have to become efficient in how we manage patient care.

Another key factor is quality, because the public is becoming more educated about risks in hospitals and infection control, and everything is becoming more transparent to the patient.

In general, medicine costs a lot of money, so avoiding readmissions that aren’t necessary, minimizing infection rates, and improving patient satisfaction are all part of a perfect storm of issues providers must address.

The providers who survive will be those who look outside the box and change the paradigm; those that realize the value in developing a strategic outpatient network and managing the health of our population.

Right now, we’re paid by how many procedures we do to a patient, but we’re moving toward a payment system where we’re going to get paid by how healthy the patient is.

We’re getting ready to accept risk and keep our population healthy to address this different reimbursement system, so we have to straddle those two areas until population health becomes more prevalent. It’s a tough time but we’re far advanced from where we were several years ago.

The Affordable Care Act has had an effect on making things happen, but I don’t agree with the whole premise of it. I don’t know what we accomplished other than cutting reimbursement.

The focus is on patient safety now and cost initiatives to take waste out of the system.

Will consolidations lead to a small group of health systems or can independent hospitals survive?

I don’t think independent hospitals will survive. You will see continued consolidation and restructuring of hospital systems.

However, the federal government will not allow it to get to the point where there is not enough choice in the market.

Is the necessary emphasis being given to prevention and wellness today?

The financial incentives haven’t been focused on prevention and wellness in the past, but that is slowly changing. As the financial incentives change, there will be more emphasis on wellness and prevention, because the goal is to keep patients out of the hospital.

What makes Greenwich Hospital so special?

The secret sauce is culture. It’s what brings people in. When you walk into our hospital and experience a warm, caring, I-would-do-anything-to-make-your-stay-comfortable environment, it allows us to continue to grow and be a significant market force in the industry.

We pay a lot of attention to patient feedback. What we hear from our patients is that our staff cares, they will go the extra mile, and they will do whatever it takes.

Our job is to let people know that no matter their illness or what they’re going through, we have their back while they’re in our care, that it’s going to be an exceptional experience, and that they will be more than pleased with everything they received once they leave.

We don’t hire people just because they are technically good, but also because they honestly care about people.

How critical is technology development and does it detract from the human connection?

When you have state-of-the-art technology that helps you help patients, they go hand in hand, because the patient experience is not just about someone knocking on your door and asking before they come in. It’s also about using all the methods available to diagnose you quickly and get you back home.

Information technology is also valuable. At Yale New Haven Health System, we have spent more than a quarter of a billion dollars over the past three years on a new information system. All three hospitals including our 600-member medical group and many of our community practitioners use EPIC, which is looked at as the best electronic health record and information system made today. This means one patient, one record; it’s been a success with staff, to say nothing of the patient convenience. You can get test results and book appointments via this system, and this has contributed to our efficiency.

Will the role of the hospital change going forward?

If we’re successful at keeping people healthy, we’re going to drive ourselves to an outpatient business, which includes outpatient centers, primary care centers, medical homes, and home-care venues. Hospitals that are used to in-patient care will be utilized much less.