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ABOUT MARK CLEMENT

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Mark C. Clement joined Rochester General Health System (RGHS) as President and Chief Executive Officer, as well as President of Rochester General Hospital, in September 2006.

Under Mr. Clement’s leadership, RGHS has evolved as a clinically and operationally integrated health system that has earned regional and national recognition for excellence in quality, efficiency and value. Rochester General Health System has been recognized for six consecutive years by SDI Health as one of the Top 100 Integrated Delivery Networks in the United States; and several other independent organizations (including Healthcare Informatics and Data Advantage) have named RGHS as a national leader in delivering health care value.

Rochester General Health System, serving the metropolitan community of Rochester, NY, has earned national recognition for excellence in a variety of clinical specialties. Rochester General Hospital, a 528-bed tertiary care facility that is the flagship of the system, has been recognized as one of the nation’s Top 100 Cardiovascular Hospitals nine times – an accomplishment achieved by fewer than two dozen health care institutions. Rochester General Hospital has also been twice consecutively recognized as a Nurse Magnet Hospital, and by the AARP as one of the nation’s Top 125 Hospitals. It has earned rankings from CareChex, the ratings service of the Delta Group, as #1 in New York State / #4 nationwide for Major Cardiac Surgery; #1 in New York State for Heart Attack Treatment; and #2 statewide for both Overall Medical Care and Overall Hospital Care. (RGH led the region in all of these categories.) RGHS was also recognized in September 2011 by WomenCertified as a Top 100 Hospital for Patient Experience.

Other Rochester General Health System affiliates include Newark-Wayne Community Hospital, a 120-bed facility primarily serving New York’s Wayne and Ontario counties; two long-term care facilities; Rochester General Medical Group, consisting of more than 40 practices; the Behavioral Health Network; Independent Living for Seniors, a program which delivers comprehensive services for frail elderly patients while they live independently in their homes; and an Ambulatory Care division that provides a comprehensive network of efficient, superior-quality outpatient care facilities with wide community accessibility.

Under Mr. Clement’s leadership Rochester General Health System has become western New York’s fastest growing health system, with inpatient and outpatient volumes growing by double digits (while area population figures remain flat or in decline). Also since Mr. Clement joined RGHS in 2006, the health system has moved from the fifth to the third largest employer in the Rochester region, with a team of more than 8,000; and revenues increased from $600 million to $900 million.

Mr. Clement is a passionate advocate for innovative practices that improve the quality, efficiency and value of health care. He is a member of the board of directors of the Healthcare Association of New York State (HANYS), a group that represents New York’s hospitals and health systems at all levels of the federal and state government. He is also a member of the boards of directors of the Hillside Family of Agencies and Rochester Business Alliance, and of the board of trustees of Rochester Institute of Technology.

Mr. Clement came to RGHS from Caritas St. Elizabeth's Medical Center in Boston. St. Elizabeth’s, a 500-bed medical center, serves as the hub and tertiary referral center for Caritas Christi's six-hospital system, with major teaching and research programs and an academic affiliation with Tufts University Medical School. While at St. Elizabeth’s, Mr. Clement engineered a successful financial turnaround and helped institute an aggressive and successful physician recruitment campaign.

Prior to joining Caritas, Mr. Clement served as president and CEO of MetroWest Medical Center, a 475-bed, two-hospital system in the western suburbs of Boston owned by Tenet Healthcare, with teaching affiliations with Harvard Medical School, Children’s Hospital, and Beth Israel-Deaconess Medical Center. While at MetroWest, Mr. Clement played a pivotal role in achieving positive financial results; assisted in the successful recruitment of approximately 90 physicians; and dramatically improved satisfaction scores among patients, physicians and employees. He also helped MetroWest achieve recognition as one of Tenet’s “Circle of Excellence” hospitals.

Mr. Clement’s more than 25 years of experience in hospital administration also includes an eight year stint as president and CEO of Holy Cross Hospital in Chicago. He successfully led Holy Cross to be a nationally recognized, growing, community-based health system. Under his leadership, Holy Cross was recognized by Hospitals magazine as 1994 Great Comeback Hospital of the Year; by Arthur Andersen and Fortune magazine in 1996 as the winner of the International Enterprise Award for Best Business Practices in Customer Service; and by the Lincoln Foundation on Quality (the Illinois equivalent of the Malcolm Baldridge Award) for Level II Progress to Excellence in 1998. During Mr. Clement’s tenure at MetroWest Medical Center, he was recognized three times as a Circle of Excellence Awardee – presented annually to the highest performing hospitals in the Tenet System. In 2010, he was presented the ACHE Regents Award for distinguished leadership.

Before joining Holy Cross, Mr. Clement held positions at St. Francis Hospital in Blue Island, IL; United Hospital Center in Clarksburg, WV; Champlain Valley Hospital Medical Center in Plattsburgh, NY; and Bethesda Hospital in Zanesville, OH.

A native of Cincinnati, OH, Mr. Clement earned his undergraduate degree and a Masters (MHHA) from Xavier University in Cincinnati.

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CEO Mark Clement Explains the Need for Health Care Reform

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Rebecca Onie: What if our healthcare system kept us healthy?

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Eric Dishman: Health care should be a team sport

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Health Reform Explained Video: "Health Reform Hits Main Street"

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The Affordable Care Act In Plain English

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The vision for patient-centered health care

By Mark C. ClementRochester Business JournalMarch 22, 2013Article 1 of 4

I've previously explored the need for health care reform and the type of health care delivery system that likely will emerge as we aim to reduce waste while improving the quality of care and patient health. What will the new patient-centered delivery model offer, and what will it mean to consumers, insurance companies, employers and health care providers?

Consumer decision-making power: With consumers increasingly paying a larger portion of their health care expenses, they are rightfully expecting more information than ever about the cost, quality and patient satisfaction ratings of providers, facilities and procedures before they make decisions. The future health care delivery model will hold physicians, health care organizations and insurance companies accountable for making this information both transparent and easily accessible to the public.

Taking this a step farther, another innovative consumer decision-making tool in development is the "insurance exchange"; think of it as the Expedia of health care. An insurance exchange is a Web-enabled comparison tool that will equip consumers and employers with a comprehensive, side-by-side comparison of health care plans, annual premiums, deductibles and co-payments, covered services and costs, quality ratings and network providers.

Insurance exchanges will give consumers and employers greater choice, along with the ability to carefully and easily evaluate what is most valuable to them based on a holistic view of all important considerations. As a result, the power and influence over health care decisions and associated costs will gradually shift to consumers. This will create a more rational competitive market where successful health systems will grow and expand based on actual demand for value, quality and proven results.

Expanded provider networks: Another dramatic change to expect is industry consolidation-creating more integrated and accessible care networks with broader geographic reach and a full continuum of care. As we shift from a fee-for-service delivery model to a truly patient-focused system, the lines are quickly fading between inpatient and outpatient care; between rural, suburban and urban health networks; and between stand-alone practices and fully integrated health systems. The pace of this change will accelerate further as providers and health systems attempt to keep up with increasingly strict government mandates for standardized disease management practices, complex and frequent quality reporting demands, expensive clinical and administrative technology requirements (such as electronic medical records), and greater accountability for patient outcomes.

Many successful examples of formal and informal partnerships and affiliations already exist in our region. These partnerships are enabling the best of both worlds for patients: personalized, compassionate in-community care, with direct access to world-class clinical expertise and state-of-the-art medical technology and specialty services. At Rochester General Health System, we have a growing number of private practice affiliations and non-system hospital partnerships, including those with Cayuga Medical Center in Ithaca, Cleveland Clinic, United Memorial Medical Center in Batavia, Clifton Springs Hospital & Clinic, and the Ros-well Park Cancer Institute in Buffalo, to name just a few.

Building a full continuum of coordinated care, however, is about much more than consolidation. It's about maintaining accountability for managing a patient's health across all of his or her care experiences. Today, patients can have different medical records at several unaffiliated health care facilities with only a piece of their overall health information contained on each record. They also may have redundant and costly lab and imaging work completed for different procedures. And they can have different medications prescribed by different providers without a single record documenting all prescriptions. By expanding and integrating affiliated provider networks, service lines and care facilities, we can ensure that a patient's total health can be seamlessly and efficiently managed as safely and proactively as possible.

Greater shared accountability: Finally, in the not-so-distant future every stakeholder-patients, physicians, employers and insurance companies-will be held more accountable for contributing to good health. Insurance companies will have a full range of consumer incentives and penalties in their plans to encourage and reward healthy behavior while discouraging unhealthy habits, like smoking. More employers will offer robust wellness programs that make it fun and easy for employees to commit to healthier lifestyles. And physicians and health systems will be universally responsible and rewarded for successfully managing patient health based on standardized quality measures and improvement goals.

In Rochester, we are not simply responding to this future. We are imagining and shaping it every day-with measurable and meaningful progress already well under way.

Mark C. Clement is Rochester General Health System president and CEO. This is the third of four articles examining health care reform that will appear over the next several months

 
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Making the shift to patient-centered health care

By Mark C. ClementRochester Business JournalDecember 21, 2012Article 2 of 4

With health care reform here to stay, it's important to understand what model of health care delivery system will likely emerge-and how we will get there.

Today, we have a health care system that is reimbursed based on activity rather than positive results. It is set up to care for patients reactively when they are sick or injured, with little financial incentive or accountability to promote a patient's or community's health or to manage care efficiently

Consider this example: If a patient is admitted to a hospital for congestive heart failure, is treated and sent home, but then is readmitted because his post-hospital condition was not closely monitored or recovery instructions were not followed, the hospital gets paid for both inpatient visits, even though the second visit could have been prevented. Ironically, what the hospital is not compensated for today is the vital in-home care management that could have prevented the readmission-and would have been far less expensive.

Given this reality, it's not hard to understand why a recent Institute of Medicine study found that $750 billion or 30 percent of our nation's health care spending is wasted each year on unnecessary care. And why we have a population that is plagued by costly, yet preventable, health conditions.

As we look to the future, the U.S. health care system must shift from a reactive, disease- and illness-centered model to one that rewards patient-centered care focused on health, wellness and prevention. Providers can no longer be paid solely for services rendered. Instead, they must ensure that services provided are medically necessary, that care delivered is the safest and most effective possible, that patient care is managed to encourage prevention and adherence to treatment plans, and that the cost of care (including prescriptions) represents the most economical options.

Providers will also need to make their costs, quality ratings and patient satisfaction scores easily accessible to the public. This will enable consumers to compare options effectively and make informed health care decisions, just as they do for other significant purchases.

With consumers increasingly being covered by high-deductible health insurance plans, this type of informed decision-making will become the norm-radically changing the health care marketplace and putting the purchasing power in the hands of consumers, where it belongs. According to the Rochester Business Alliance's 2011 Health Benefits Survey, 46 percent of employers offered high-deductible insurance options in 2011-up from just 15 percent in 2009-and the percentage is expected to continue to climb dramatically.

Through health care reform legislation, Medicaid and Medicare have begun this paradigm shift. Compliance measures at the state and federal level will increasingly reward or penalize providers based on their performance tied to safety, clinical results, health and wellness, patient satisfaction and cost. However, Medicaid and Medicare alone cannot drive the kind of systemic change required to reshape and sustain a patient-centered health care model that fosters improved health, efficiency and the highest standards of clinical care. This requires innovation and leadership from local health care systems around the country in partnership with private insurers, employers, physicians and, yes, patients too.

An example in our community is the Accountable Care Partnership, newly formed between Rochester General Health System and the Greater Rochester Independent Practice Association. Consisting of 900 employed and private practice physicians, it is the only partnership of its kind in our area.

As the Rochester Business Journal reported several weeks ago, RGHS and GRIPA have entered into an innovative agreement with Excellus BlueCross BlueShield that begins on Jan. 1. This partnership will improve the health of our community and help control the spiraling cost of health care by creating a continuum of care accountable for delivering high-quality, cost-effective results to both the patient and the partnership. Expect similar accountable care programs to be established throughout our community in the future.

For nearly two decades, Rochester has pioneered payment reform and cost control by taking a community-based approach to managing population health. In the 1990s, this innovative and collaborative leadership model resulted in health care rates that were more than 30 percent below the national average and 45 percent lower than the rest of New York. Today's imperative for transformative change provides yet another watershed opportunity for Rochester to boldly shape the health care system of the future.

Mark C. Clement is Rochester General Health System president and CEO. This is the second of four articles examining health care reform that will appear over the next several months.12/21/12 (c) 2012 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email service@rbj.net.

 
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The case for reform of our health care system

By Mark C. ClementRochester Business JournalOctober 26, 2012Article 3 of 4

In this election year, opinions are sharp and contrasting when it comes to the subject of health care reform and government's role in the effort. Regardless of where you align politically, it's hard to dispute that the U.S. health care system is in need of dramatic change.

The United States has the most costly health care system in the world, according to the World Health Organization, spending nearly one in five dollars of our economy on health care. While spending nearly twice that of other Western countries on health care, the U.S. ranks only 37th in terms of overall quality and performance-well below countries such as Malta, Oman and Andorra.

Today, U.S. health care debt is the No. 1 reason for personal bankruptcy. It is estimated that approximately $750 billion is squandered yearly on unnecessary medical care, fraud and other waste-30 percent of total annual U.S. health care expenditures.

This model of pay more, expect less is unacceptable and unsustainable, especially as employers and consumers increasingly shoulder more of the health care cost burden.

As one of the wealthiest, most developed nations in the world, with access to the top physicians and state-of-the-art medical technology, equipment and facilities, we can and should expect more-with respect to health care quality, patient safety, accessibility and value. While not a perfect solution, this is the intent of health care reform occurring nationally-and at the state level with Medicaid. And each of us, including doctors, hospitals, consumers, employers, pharmaceutical companies and insurance providers, plays an important role in helping the U.S. health care system meet this expectation.

To fix this complex problem, it's important to understand how we got here. Unlike most retail goods and services, on which the provider and consumer have direct involvement in pricing and payment, the reimbursement model for health care has largely been shaped by health insurance, the primary payer of services. As a result, most consumers and providers have been insulated from the true cost of health care. Traditionally, employers covered the majority of cost for a family's health care coverage, with no real incentive for consumers or providers to be concerned if procedures were medically necessary-or even affordable, since the consumer wasn't paying the bill.

Consider if this scenario were applied to the auto industry. What if every covered member could get any model car for a $250 co-payment and the car dealer was guaranteed the rest of the payment from another party? What's the incentive for either the salesperson or the customer to choose a cost-effective model that meets the need for transportation? There is none. And how does the third party maintain affordable coverage levels when it is increasingly paying for excessive and perhaps unnecessary purchases? It can't.

This is the crisis we face today with U.S. health care. Hundreds of billions of dollars is wasted on inflated prices, fraud, unnecessary procedures and high-cost care for health conditions that are largely preventable-with little incentive for coordination and accountability of patient care. As a result, dramatic cost increases are being shifted to employers and consumers, while the overall health of America continues to decline.

What's the solution? At the heart of health care reform is the premise of shared accountability. We must all take control of both the quality and cost of health care. As consumers, we must improve lifestyle habits that will help minimize costly, yet preventable conditions like heart disease and diabetes. We must also regularly question the necessity of tests and procedures, compare medical options, and ask our doctors and specialists to share lab and test results.

Health care providers, including hospitals and physicians, must be more transparent with patients about the medical need and true cost for recommended care prior to rendering the services-and must be vigilant about doing everything possible to deliver the safest, highest-quality care and customer service to each and every patient served

Insurance providers must establish incentives to move the health care payment model from a fee-for-service reimbursement system, which rewards quantity of procedures, to one that truly rewards outstanding clinical performance and the management and coordination of patient care that ultimately results in better health.

Health care reform gives us the framework to begin to attack this monumental problem in a way that can create sustainable, long-term solutions. While we may disagree on the methods, the goal is indisputable and one we must address as a nation.

Mark C. Clement is Rochester General Health System president and CEO. This is the first of four articles examining health care reform that will appear over the next several months.10/26/12 (c) 2012 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email service@rbj.net.

 
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Bringing the model health care system to life

By Mark C. Clement and Warren Hern Rochester Business JournalOctober 26, 2012Article 4 of 4

Through a series of articles appearing on this page, we've reviewed the important reasons why our nation's health care system needs to change and what's required to make the shift to a more accountable, patient-centered model that achieves improved health, reduced cost and a better patient experience.

Given the announced plans to bring Rochester General Health System and Unity Health System together, it seemed appropriate to devote the fourth and final article to the topic of hospital consolidation-specifically, why it's occurring at an unprecedented rate nationwide and what we believe are the benefits to the Rochester community as RGHS and Unity collaborate to boldly shape the health care system of the future.

The highest level of health care consolidation occurred during 2012, and it is expected to continue, if not accelerate. As you might expect, health care reform and the mandate to increase quality while driving down cost are propelling this rapid consolidation in the marketplace.

The decision to explore a formal partnership between our two health systems is a natural progression of the collaboration and forward-thinking leadership that has defined health care in our area for many years. Dozens of successful partnerships and affiliations already exist across our region and continue to grow.

Today, because of this leadership, residents enjoy highly efficient, in-community care with easy access to a full and integrated continuum of nationally recognized clinical services. In fact, a new Institute of Medicine study reports that the Rochester area has the lowest overall Medicare spending rate in the nation-a feat health officials attribute to aggressive regional planning. The Institute of Medicine report found that Rochester's Medicare spending rate per beneficiary was $174 lower than the national monthly mean among 306 U.S. regions.

Given the profound implications that provider consolidation and increased scale have for creating high-quality, high-value health care delivery networks, it's clear that the right mergers can and do result in great benefits for patients. Mergers also enable providers to drive down costs by building critical mass and creating economies of scale. First and foremost, though, the goal must always be to develop what's best for patients and for the community as a whole.

Health care reform's current imperative for change is another opportunity for Rochester to lead the nation by creating a model health care system that delivers the best care at the most affordable rates and takes accountability for getting and keeping patients healthy. RGHS and Unity are proud to be working together to help make this change a reality.

As one organization, we will be able to build the information technology, primary care physician network and community-based care management resources required to contribute to a healthier community. Cost savings will also be achieved by integrating infrastructure, streamlining costly overhead, achieving scale-based purchasing economies and avoiding planned capital investments made unnecessary by the complementary nature of our two systems. These cost savings will benefit both local employers and their employees who bear the significant burden of these costs through rising health insurance expenses. We are still developing and quantifying our integration plans, but we expect the gains to be substantial.

As large employers ourselves, we understand the need to control costs and provide value while offering employees access to high-quality health care at competitive rates. In fact, since 2010, both RGHS and Unity have implemented comprehensive employee care management programs that have enabled us to lower annual health care spending while at the same time helping our employees to manage their health better. As a result, RGHS and Unity have experienced a significant decline in annual health care spending growth rates, from 8 percent in 2010 to approximately 2 percent in 2013 (compared with national rates of almost 8 percent in 2010 and 6.3 percent in 2013, according to the Milliman Medical Index). We look forward to collaborating with employers throughout the area to help them achieve similar outcomes in the future.

Through this planned consolidation, Unity and RGHS can contribute to a more competitive and innovative health care marketplace in Rochester. We are pleased to work together with local business leaders, federal and state government officials and health insurance providers to achieve our common goal of providing access to the most affordable and best health care in New York and beyond-all to make Rochester a healthier community.

Mark C. Clement is Rochester General Health System president and CEO; Warren Hern is Unity Health System president and CEO. This is the final article in a series examining health care reform. 10/4/13 (c) 2013 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email service@rbj.net.

 
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HEALTH CARE REFORM INSIDER

Your guide to understanding ObamaCare

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