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Lunch with Mimi: Geisinger Western Region CAO Kirk Thomas

on June 29, 2018 2:58 PM

A Huntingdon County native, Kirk Thomas was named chief administrative officer for Geisinger Western Region in October 2017. In this role, Thomas will lead and be responsible for the strategic planning and operations of Geisinger Western Region, which includes Mifflin, Juniata, Centre, Huntingdon, and Clinton counties, including Geisinger Lewistown Hospital and Gray’s Woods, State College.

With more than 1,600 physicians and 30,000 employees, Geisinger Health System has seven hospitals in Pennsylvania and two hospitals in New Jersey, providing care to people in 45 Pennsylvania counties. Geisinger Health Plan provides insurance to residents of 43 Pennsylvania counties and two counties in New Jersey.

A fellow of the American College of Healthcare Executives, Thomas earned a bachelor of science in respiratory therapy at York College of Pennsylvania in 1986 and a master of science in healthcare administration at Independence University Salt Lake City, Utah, in 2006. Prior to this position, he served as vice president of operations at Geisinger Lewistown Hospital for 10 years. He began his career as a respiratory therapist and has managed various departments at the hospital, including overseeing the expansion of the Sleep Lab.

Thomas and his wife, Nanette, live in the Orbisonia area and have two adult children, Cassandra Clark and Ben Thomas.

Town&Gown founder Mimi Barash Coppersmith sat down with Thomas at Faccia Luna to discuss Geisinger’s role as a healthcare provider and major insurer in our community, and how that sets it apart from other organizations in regards to the types of programs Geisinger is able to offer patients.

 

Mimi: You play a very important role at Geisinger, a major provider and insurer for a long time. How long ago did Mrs. Geisinger give the hospital to this community?

Kirk: I believe the date was in the 1915 when the hospital was opened in Danville. Abigail Geisinger is the founder of Geisinger in Danville, actually at the age of 88 years old when the hospital was opened. I always tell people, it goes to show that you're never too old to make a valuable contribution to your community. She was the daughter of a wagon wheel maker. Her first husband passed away. Her second husband was George Geisinger and when he passed away, he left money that he had invested in the coal mine industry.

Although she was pretty well-to-do for that time, she lived pretty frugally. But one thing she had was a car, and she would have her driver take people who needed to go to the hospital in Bloomsburg. And she got to thinking, ‘why do we always have to leave our community to go to a hospital?’ So, she founded the hospital, went to Mayo Clinic and recruited Harold Foss, who was the first head of the hospital. He was a physician from the Mayo Clinic and helped her start Geisinger. Her main charge to him was “make my hospital right, and make it the best.” And that’s really been the driving force behind Geisinger all these years.

Mimi: You're also a significant provider of insurance coverage throughout Pennsylvania.

Kirk: Yes, very significant. That’s where Geisinger has been innovative over the years for bringing its own health plan. One of the big changes in healthcare is going to be paying for the value or outcome of the care as compared to being paid for how much you do.

Mimi: Well that has got to be pretty controversial.

Kirk: It’s really about providing the right care in the right place. In the old days, you took care of sick people and you put them in hospitals.

Mimi: And nobody thought about wellness.

Kirk: Exactly. Nobody thought about wellness and keeping people out of hospitals. Hospitals were paid for what they did in the hospital, but systems like Geisinger are looking at healthcare differently saying, you know what, we don't really want people in the hospitals. We want to keep people well, provide care in a lower cost, higher quality of care environment.

Mimi: I couldn’t help but think as I was preparing for this interview, whether there’s ever been a serious question raised about the provider also being the insurer. Do you see it as an advantage to be able to define exactly what’s needed?

Kirk: Yeah. I will give you an example. Hospitals that don't have healthcare insurance as part of their system, they're still going to make their money by having people in the hospital. Systems like Geisinger are saying, we need to figure out how to lower the cost of health care, improve quality of health or manage wellness, keep people out of the hospital in the lower-cost environments.

Mimi: Can you point to one or two things that you have done to implement such a concept?

Kirk: Yes. There are pilot programs called the Fresh Food Farmacy in the Northeast. We're getting ready in Mifflin County to roll this out this summer. The Fresh Food Farmacy is food as medicine, which is an interesting concept. It's something you can’t get out of the pill bottle, and how we're looking at it is taking patients that are diabetic where they monitor the blood sugars for something called A1C. We give them a prescription to go to a Fresh Food Farmacy where they get access to healthy foods, diabetic counselors, nutritional information, measuring spoons, and cooking classes. And then what's happened is the patient actually gets enough food, not just for them, but for their family as well, enough food for two meals a day, five days a week. And what we were able to show is their A1Cs are coming into line. We're improving their health, they are losing weight, and we have a lot of success stories.

Mimi: Is this a pilot program?

Kirk: It's been piloted, now we're rolling it out. It’s coming to Mifflin County this summer with hopes of continuing to expand across the system. You’d think that sounds very intensive, but if you look at the costs vs. the cost of unnecessary admissions of someone whose blood sugar is out of control, it’s a much lower cost.

Another thing we are working on in the Western Region is Life Geisinger, a program designed for senior citizens who are qualified for nursing home care, but it's designed to keep them out of a skilled nursing facility and in their home where they want to be. Geisinger is paid by Medicare and Medicaid to take care of what happens. Rather than them being insured, Geisinger takes care of this patient. It’s like an adult daycare. Aids will go into the home in the morning and help an individual get ready for the program if they need help getting dressed and taking their meds. Then we provide transportation to the program. At the program there are day activities, shower facilities, rehab services, and a clinic with a nurse practitioner or a doctor.

Mimi: Where do they do the program?

Kirk: A new three-story building is being built in Lewistown by Primary Health Network. The third floor is a federally qualified health center. Our Life Geisinger program is contracted for the entire second floor.

Mimi: But they go home to sleep?

Kirk: Yes, they go home at night. We can send aides into the home to help. It's generally a five-day-a-week program.

Mimi: So what do these people do on the weekend?

Kirk: They can get other services to help out. Geisinger is paid to take care of the overall patient. I always use the example of patients with lung disease. In the summer, if they don't have air conditioning in the home, they may end up in the hospital a lot because they can't take the heat and humidity; it sort of exacerbates their lung disease. Medicare doesn't typically go buy somebody air conditioning. But with this program, if it helps keep the patient out of the hospital, we can go buy them an air conditioner to put in the home. It's really about taking care of patients where they want to be.

Mimi: Does it cost the patient anything?

Kirk: If they’re Medicare-Medicaid, what we call dual eligible, then I don't believe there's any out of pocket. If they don't have Medicaid, than there is a fee.

Mimi: The fee I assume is lower than all the other options?

Kirk: It’s lower than a nursing home. I looked at the Life program in the Northeast and they told the story of a gentleman who was supposed to go in a nursing home, but didn't want to go because his wife was still at home. Long story short, he's been in the Life program for five years now.

Mimi: You started this program five years ago?

Kirk: The program’s been up there. Ours in Lewistown starts probably in September.

Mimi: I can see where there's a huge need. It’s an interim program. So, you’ve been head of this Western Region, which is a sprawling region. What’s your greatest dream in the process of your leadership of the Western Region?

Kirk: I really want Geisinger to be seen in this Western Region as Geisinger. Sometimes you hear about Geisinger State College or Geisinger Lewistown. It’s not Lewistown, State College, and Phillipsburg. If you go to Geisinger, we provide the same high-quality services wherever you go.

Mimi: If one were to compare who you’re like, would your biggest competitor be UPMC?

Kirk: Yeah, UPMC is a big competitor.

Mimi: Does that cause issues?

Kirk: It keeps you on your toes. (laughs)

Mimi: Competition is good for everybody.

Kirk: It is, and what it's going to do is make organizations like us to become even more innovative. Healthcare is going to keep evolving. It will keep changing at a rapid pace.

Mimi: How do you feel about the destruction of Obamacare? Now there’s no requirement for people to add health insurance if they don’t want it.

Kirk: There were pros and cons to the whole thing. There were some good parts. There were people that got health insurance that maybe didn't have it before. And then there were people that had health insurance and all of a sudden their premiums went up, their co-pays went up.

Mimi: But both of us, I as the consumer and you as the provider, have the desire that everybody should have the opportunity to get quality health care.

Kirk: Absolutely. In systems like ours, someone shows up in the emergency room for care, we don’t turn them away. You treat them, you take care of them.

Mimi: Emergency rooms save a lot of poor people’s lives.

Kirk: Sometimes I'll get a request to go talk to a patient concerned about bills, and my quest to them is let us take care of you, we’ll figure that out later. We can help them sign up for things that they may qualify for. Sometimes things go to charity care. Hospitals do a certain amount of charity here that patients can’t pay for and we write that off.

Mimi: What’s that bill amount to every year for Geisinger?

Kirk: It’s in the millions; it’s huge.

Mimi: And I don’t think the public realizes that.

Kirk: We don't advertise that. It’s part of being in healthcare. It means taking care of the communities we serve.

Mimi: One of the fascinating things on your resume is that you went back to college 20 years after you graduated from college. What motivated that?

Kirk: Well, as I went from being hands-on, I slowly started getting into management and was often tasked with troubled areas or areas that needed work. When I went back and looked at my resume, from about 1989 through 12 years ago, I had a promotion about every two years and every two years I was getting something new. So, as I started growing my management role, I got to a point that I had an administrator one time tell me, “You know, you ought to consider going back to college.”

Mimi: Did you do this online?

Kirk: My master's degree, yes. I look back now, I'm not sure how I did it. I had two young children, a busy job, and a very understanding and supportive wife. I did what I had to do. I would get up in the morning before the kids got up to write papers, study, and read. And they would go to bed at night and I would stay up, write papers, study, and read.

I mentor younger people in management today. I encourage them to go sooner, don't wait 20 years, because it is a challenge. But at the same time, if you really put your mind to it, you can do it. I had encouragement early in my career from two administrators.

Mimi: You seem like a very down-to-earth guy in a very important job.

Kirk: I'm just fortunate. I feel fortunate to have the job I have and to be able to get up and do something that I love every day. It's humbling, to say the least.

Mimi: I think when you have a view of the whole picture you’re able to see what’s working and what isn’t. You’re in a strategic decision-making position to make this monstrous area work even better. How do you do that?

Kirk: Well, the last several months since I started the role has been getting out to all the clinics, offices, and learning about the people and processes. It's not something I can do sitting in an office somewhere. How do we make things better for the patients who walk through our doors every day?

Mimi: Do you ever talk about the concerns about the cost of medical care? I’m frightened that the bigger we get, the farther we get away from the personal touch that is your symbol. Is bigger better?

Kirk: At Geisinger, it is true that everything we do is about caring. We strive to keep the patient at the center of all that we do. We have something called Proven Experience that allows a patient to request a refund when their expectations are not met. Becoming part of the system was a good thing. With all of the transitions occurring in healthcare today, we couldn’t continue to offer the services we offer today if we were not part of a larger system. The other thing that will set Geisinger apart from others in the future is the health plan. With a health plan, we're actually incentivized to provide better quality at a better value. That's really what the Fresh Food Farmacy and the Life program is trying to provide this service to actually reduce costs. If we can keep people healthy and out of hospitals, nursing homes, those are lower costs of care.

Mimi: The coverage for the uncovered – how do we take care of that?

Kirk: We’re working with the Primary Health Network in a couple of different places in the system. It is a federally qualified health center. Their main goal is to focus on the uninsured and underinsured. That’s their niche business.

Mimi: In Centre County, we have Centre Volunteers in Medicine, which services a lot of people. It’s supported positively by Mount Nittany and for all I know, Geisinger might support it.

Kirk: Yes, Geisinger supports it. Everything I've learned about Centre Volunteers in Medicine is it’s been very successful, an excellent program for the community. One of the things when you get out into the more rural communities, what becomes more difficult is the volunteer base that it takes to keep that open. In a larger area like State College there are more resources to pool.

Mimi: Around here we have an unbelievable volunteer base.

Kirk: They come together for the common good.

Mimi: You seem to be a very understanding leader. You feel so down to earth.

Kirk: The business we're in is to help and serve people, and it doesn't matter whether it’s patients or the employees I work with. My goal is to find out how I can help them.

Mimi: Well, I want to thank you. This has been enlightening and enjoyable.

Kirk: Thank you so much.

 

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