The Business of Healthcare

After writing a letter to the editor of our local paper, in response to the downgrading of Highmark by the ratings firm Moody, I awoke with a strong memory from my own career in the health care field.  Between 1987 and 1997, my husband Richard and I fulfilled a dream of cofounding and co-directing a behavioral health care group practice, Iatreia, (named at our son’s suggestion, for “a place for healers” in ancient Greece.)

Not unlike what’s happening currently on healthcare’s medical side, by 1993, the number and complexity of third party payers, extended waits for reimbursements, increased paper work and requirements for quality assurance due diligence, and the refusal of some of our providers to accept the new financial realities of the marketplace, made running the business operations of our clinic a nightmare.

In 1995, in analyzing the clinic’s workflow, I identified 42 steps that were necessary, from the client’s first call for an appointment to the clinic eventually getting paid for services provided. If any of the steps were missing or done out of order, we would not be paid. In this environment where, as some friends suggested, “You’re doing everything right. It just isn’t working,” we began to entertain the possibility of being purchased

One of our first meetings with the company that did eventually purchase us, was held in their offices. The male executives of the company, whom we were familiar with, took this occasion to introduce us to their mid-level managers who were all women. In the opening remarks and introductions, one of the executives kept referring to our clinic as “Richard’s Place.” After his reference to “Richard’s Place” was repeated a half dozen times, the large group meeting broke into smaller groups and I could finally stop biting the inside of my mouth and exhale. One of the women in the smaller group turned to me and asked, “And what do you do at Iatreia?” I responded, “You’ve probably been in health care long enough to appreciate this – I am the co-founder and co-director of “Richard’s Place.”

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