The Times They Are a-Changin'

June 2013

For those who are familiar with the classic song written by Bob Dylan in 1964, those words hold true now more than ever when it comes to the future of our healthcare ministry.

For the past two and a half years, leadership, associates and clinicians at SCL Health have been speaking about the subject of change and transformation and the impact of change on us both intellectually and emotionally. Looking ahead, we are facing a ministry-wide transformational journey as well as a personal transformational journey. During this time of change, we must always keep in mind that patients and their families remain at the center of all that we do.

I must admit that several conversations and experiences I’ve had over the past month have led me to an even more heightened revelation regarding the vast amount of change that is coming so quickly. The changes will impact not only those of us who work in the healthcare industry, but also anyone who utilizes healthcare services. This brings to mind several questions.

  • Are we and our partners ready for all of the changes afoot as a result of the Affordable Care Act?
  • How can we be sure our actions and reactions will truly benefit those who entrust their care to us?
  • How can we ensure that our quality and safety remain world-class, even as we focus on how to better control costs so that our care is affordable and our service to those who are poor and vulnerable remains intact?

The introduction of health insurance exchanges – the entities that are going to be the marketplaces for health insurance options for individuals and small businesses – provides a good example of the amount of change ahead. We recently met with an executive with the Colorado Health Exchange and she expects more than 200 products and benefit plan offerings will be available to consumers this fall. This may not be a remedy to reaching the ultimate goal of nearly universal coverage, but it is most certainly going to disrupt “business as usual” by introducing so many new coverage and network options for people in Colorado; and similar disruption will occur in other states.

The recent article that appeared in The New York Times chronicling the Center for Medicare Services (CMS) release of hospital charge data and price transparency has led to a deluge of local news reports on how our hospital prices stack up in markets across the country. This heightened commentary on hospital charges and the amount of variability in cost for the same procedures in different markets, will certainly bring about change. It’s time for the healthcare industry to embrace the concept of transparency around costs and to help consumers make good decisions about where to get their care – decisions based not only on price but also quality. With high deductible health plans now passing 29-33 percent of the cost of care onto plan members, hospital pricing is having a serious impact on household budgets. We simply must find a way not only to lower the cost of the care, but also work to better explain our cost structures in an era of heightened scrutiny.

These are just two small examples of areas that foreshadow massive changes in U.S. healthcare. Even though I believe we are heading toward fast-moving whitewater, I am energized! I remember the fear and excitement I experienced when working for the U.S. Army Corps of Engineers during college, when one of our more adventurous engineers decided to “shoot the rapids” in the St. Lawrence River in upstate New York with the 14-foot outboard boat in which we were traveling. I was terrified at first, but had no choice but to get focused, do my part in paddling and guiding the boat and go along for the ride of my life! 

So, rather than be fearful, I would urge those of us in the healthcare business to get focused on the course ahead. Our SCL Health mission and vision statements guide us. Our mission statement speaks to “improving the health of the people and communities we serve, especially those who are poor and vulnerable.” Our vision statement speaks to being a “trusted partner,” “sharing accountability with clinicians,” “improving access, quality, health outcomes and affordability,” and “partnering with others who share our vision and values.”

We must have the resolve to persevere and succeed, to work together and to appreciate and rely on our respective roles as we row and steer the raft. Be ready to “expect the unexpected” on this whirlwind journey. The times they sure are a-changin’ – so enjoy the ride! 

Peace and blessings,



Michael A. Slubowski, FACHE, FACMPE
President and Chief Executive Officer
SCL Health