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December 28, 2009

My Turn: Bassett and Fox's new task is to adapt

This week's "My turn" column is by Dr. William Streck, president and chief executive officer of Basset Healthcare.

The decisions by the boards of A.O. Fox Hospital and Bassett Healthcare to forge a new relationship with Fox as a Bassett affiliate are very timely ones.

This affiliation provides the opportunity to coordinate the delivery of health care services within the region and to support the missions of both organizations.

For Fox, this means serving as a community hospital for the Oneonta region with support of specialty services from Bassett. For Bassett, this means serving as the source of specialty care for the region and continuing the initiatives in research and education that comprise the other missions of Bassett.

For both organizations this means effective use of resources, more convenience for patients and learning from one another as we move forward.

The timeliness of this affiliation is emphasized by the politics of health care regionally and nationally. The continued financial distress of New York state continues to lead to significant reductions in payments for services to hospitals. These changes will be in the millions of dollars for Bassett and proportionally similar sums for Fox and other Bassett affiliates.

Medicare payments are also constrained. In the short term of 2010 and 2011, these reductions will limit all hospitals in ways yet to be fully defined. It will be a very difficult financial environment in the next few years.

Even if there is some recovery in New York state over the next several years, the national reform agenda clearly is one that is directed toward reduction of the use of hospitals.

Medicare is focused on reducing re-admission. There is increasing emphasis on managing chronic disease outside the hospital using services like At Home Care, a long-standing joint effort between Fox and Bassett. The introduction of global payments or other forms of managed care under the direction of systems like the Bassett model are being encouraged, as well.

All of these initiatives will result in fewer hospital admissions and more complete, integrated services to patients outside of hospitals.

So, for Bassett and Fox the task for the future is to adapt to these changes and to craft a system that meets patient needs and is financially viable.

It is a good thing we are starting now because this is going to be difficult work. Fortunately, Bassett is viewed as the type of system that is well-prepared to take advantage of the momentous changes that will occur in the next few years.

The Bassett Healthcare Network is much stronger because of it current affiliates _ O'Connor Hospital, Cobleskill Regional Hospital, Little Falls Hospital, Tri-Town Regional Hospital and Valley Health Services.

The network will be stronger still with the welcome addition of an institution like Fox, which brings a rich history of quality care and community service to our shared enterprise.

Dr. William Streck can be reached at

To write for "My turn," contact Daily Star Publisher Tanya Shalor at or 432-1000, ext. 214.