Geisinger Health System

The Geisinger Health System (GHS) is a health care system of northeastern and central Pennsylvania with headquarters located in Danville, Pennsylvania. Geisinger operates a Health maintenance organization.

History of Geisinger

Danville resident Abigail Geisinger, widow of iron magnate George Geisinger, used her fortune to build a hospital intended to be a regional medical center modeled on the Mayo Clinic.

Its primary care facility is the Geisinger Medical Center (GMC) located in Danville, with three other hospitals; Geisinger Wyoming Valley (GWV) and Geisinger South Wilkes-Barre - both located in Wilkes-Barre, and Geisinger-Community Medical Center (GCMC) located in Scranton. There are numerous Geisinger clinics throughout northeastern and western Pennsylvania, located in Wilkes-Barre, Pittston, Mountaintop, Nanticoke, Wyoming, Scranton, Dallas, Plains, Kingston, and other surrounding cities and towns.

Geisinger Health Plan, a subsidiary HMO, was started in 1985.

Merger with Penn State

A milestone in the history of Geisinger Health System includes a failed merger with Penn State/Hershey Medical Center from July 1997 to November 1999. The merger of the two large health care organizations and subsequent failure has provided a valuable reference for other systems with similar plans. The ultimate collapse of the merger has been attributed to the leadership's failure to recognize challenges of cultural differences between the institutions and community acceptance. E.g., academic physicians at the Hershey Medical Center were resistant to the delegation of practice management to which the Geisinger physicians had become accustomed.[1]

ProvenCare

In February 2006, Geisinger launched a new program with the intent of changing how healthcare is provided and paid for in the United States. Called ProvenCare by Geisinger, the program features three key elements: a strict reliance on evidence-based standards in medicine, a fixed-price financial mechanism to pay for certain procedures (such as open heart surgery), and patient engagement/activation.[2] Geisinger says the program is an attempt to give patients the most consistent, comprehensive and effective care possible. ProvenCare has been written about in such publications as New England Journal of Medicine,[3] New York Times,[4] and Pittsburgh Post-Gazette.

Research

Geisinger opened its $21 million Geisinger Center for Health Research on its Danville campus in the spring of 2007. The three-floor, 63,000-square-foot (5,900 m2) facility has achieved a LEED Certification for its environmentally friendly design. Researchers conduct health services, epidemiologic and population genetics research to address problems such as obesity, autism, stroke, diabetes, and hypertension. These projects complement the basic science research at the Sigfried and Janet Weis Center for Research, and the Center for Clinical Studies also on Geisinger’s Danville campus. The current director of Geisinger's Center for Clinical Studies is Peter B. Berger.

Genetics

Geisinger has a large database of electronic health records (EHR), and set up a genetics research program called MyCode in 2007. The use of EHR allows longitudinal study of patient outcomes, in a study called "DiscovEHR".[5][6] The program uses gene sequencing by the biotechnology company Regeneron.[7] Over 200,000 patients submitted genetic samples by 2018.[8] The National Institutes of Health gave a grant of US $5.5 million to the research program in 2016. The program was expanded to whole exome sequencing in 2018.[8] The program offers online continuing medical education to family doctors, and patients can meet with a specialist genetic counselor.

List of Geisinger facilities

Location of Hospitals

  • Geisinger Medical Center (GMC) in Danville
  • Geisinger Wyoming Valley Medical Center (GWV) in Plains Township (Wilkes-Barre area)
  • Geisinger: South Wilkes-Barre Hospital (GSWB) in downtown Wilkes-Barre
  • Geisinger - Shamokin Area Community Hospital (G-SACH) in Shamokin, Pennsylvania
  • Geisinger - Community Medical Center (GCMC) in Scranton, Pennsylvania
  • Geisinger - Bloomsburg Hospital (GBH) in Bloomsburg, Pennsylvania
  • Geisinger - Lewistown Hospital (GLH) in Lewistown, Pennsylvania
  • Geisinger Holy Spirit in Camp Hill, Pennsylvania
  • Geisinger - Atlanticare in Atlantic City, New Jersey
  • Geisinger Jersey Shore Hospital in Jersey Shore, Pennsylvania

On December 4, 2012 it was announced that Geisinger Health System and Lewistown Hospital had signed a non-binding letter of intent for a merger. About the letter, Geisinger's Frank Trembulak said the non-binding refers to the specifics of how the merger will work and that there is a binding agreement to merge.[9] The merger of Geisinger and Lewistown has not been without conflict. Many in Lewistown Hospital's coverage area, especially independent physicians, have strongly opposed a merger with Geisinger. The most prevalent argument is that with the presence of a Geisinger clinic in Lewistown and with Geisinger offering health insurance a monopoly will result from the merger ultimately hurting instead of helping local healthcare.[10][11][12] The full merger and integration of Geisinger-Lewistown Hospital into Geisinger Health System received final approval from the Pennsylvania Attorney General and the Pennsylvania Department of Health and the new Geisinger-Lewistown Hospital became effective on November 1, 2013.

On May 17th, 2017, Jersey Shore Hospital CEO Dave Shannon stated "The board recognized that, you know, long-term viability of small rural hospitals just isn't feasible," and that a merger with Geisinger Health System was planned. It was subsequently reviewed and approved by the Pennsylvania State Attorney, and will formally occur July 1st, 2018.[13]

Location of clinics in Pennsylvania: Altoona, Sayre, Bellefonte, State College, DuBois, Lock Haven, McElhattan, Berwick, Bloomsburg, Catawissa, Millville, Mifflin, Moosic, Dunmore, Dallas, Hazleton, Kingston, Mountaintop, Pittston, Wyoming, Wilkes-Barre, Scranton, Plains, Montoursville, Lewistown, Mountainhome, Mount Pocono, East Stroudsburg, Danville, Kulpmont, Milton, Sunbury, Coal Township, Frackville, Mahanoy City, Orwigsburg, Pottsville, Valley View, Selinsgrove, Lewisburg, Meshoppen, Nicholson, Tunkhannock.

Financials

Financial figures for inpatient hospitals in the Geisinger system in 2017
Hospital Net Patient Revenue (NPR) (thousands) Total Operating Expenses (thousands) Operating Margin Total Margin Uncompensated Care Medicare Share of NPR Medical Assistance Share of NPR Total Operating Revenue (thousands) Operating Income (thousands) Net Income (thousands)
Geisinger Bloomsburg $42,601 $48,017 -8.80% -7.92% 2.44% 31.03% 15.01% $44,134 ($3,884) ($3,525)
Geisinger Community $257,547 $265,595 0.22% 1.50% 1.42% 39.68% 10.57% $266,184 $589 $4,046
Geisinger Danville $1,116,420 $1,046,275 10.50% 12.06% 1.04% 34.04% 10.41% $1,169,017 $122,742 $143,515
Geisinger Lewistown $121,054 $106,284 13.64% 14.60% 2.26% 41.82% 9.58% $123,064 $16,780 $18,175
Geisinger Wyoming Valley $517,784 $465,484 10.79% 12.35% 1.32% 35.19% 10.45% $521,781 $56,297 $65,567
Source: [14]

For comparison, in 2017 the Pennsylvania average operating margin and total margin were 5.15% and 6.62% respectively[14]. The Pennsylvania average uncompensated care percent of NPR was 1.74%[14]. The Pennsylvania average portion of NPR paid by Medicare and Medical Assistance was 34% and 14% respectively[14]. The average payment per inpatient day for Medicare and Medical Assistance was $2,249 and $2,286 respectively, while other commercial payers paid an average of $4,843 per inpatient day[14].

References

  1. ↑ "Archived copy" (PDF). Archived from the original (PDF) on 2008-07-19. Retrieved 2009-05-30.
  2. ↑ Casale AS, Paulus RA, Selna MJ, Doll MC, Bothe AE Jr, McKinley KE, Berry SA, Davis DE, Gilfillan RJ, Hamory BH, Steele GD Jr (2007). "'ProvenCareSM': a provider-driven pay-for-performance program for acute episodic cardiac surgical care" (PDF). Ann Surg. 246 (4): 613–21, discussion 621-3. doi:10.1097/SLA.0b013e318155a996. PMID 17893498. Archived from the original (PDF) on 2010-08-27.
  3. ↑ Lee TH (2007). "Pay for performance, version 2.0?" (PDF). N Engl J Med. 357 (6): 531–3. doi:10.1056/NEJMp078124. PMID 17687128. Archived from the original (PDF) on 2010-08-27.
  4. ↑ Abelson R (2007-05-17). "In bid for better care, surgery with a warranty". New York Times. Retrieved 2010-03-11.
  5. ↑ Dewey, Frederick E.; Murray, Michael F.; Overton, John D. (23 December 2016). "Distribution and clinical impact of functional variants in 50,726 whole-exome sequences from the DiscovEHR study". Science. 354 (6319): aaf6814. doi:10.1126/science.aaf6814. PMID 28008009 – via science.sciencemag.org.
  6. ↑ Abul-Husn, Noura S.; Cheng, Xiping (22 March 2018). "A Protein-Truncating HSD17B13 Variant and Protection from Chronic Liver Disease". New England Journal of Medicine. 378 (12): 1096–1106. doi:10.1056/nejmoa1712191.
  7. ↑ JON O'CONNELL. "Geisinger receives $5.5M grant". Citizensvoice.com.
  8. 1 2 "Routine DNA Screening Moves Into Primary Care". Npr.org.
  9. ↑ "AG Approves Hospital Merger". Lewistownsentinel.com. Retrieved 3 April 2017.
  10. ↑ "Opposition Group Discusses Concerns". Lewistownsentinel.com. Retrieved 3 April 2017.
  11. ↑ "Weighs in on Possible Local Hospital Merger". Archived from the original on 2014-02-01. Retrieved 3 April 2017.
  12. ↑ "News, Sports, Jobs - The Sentinel". Archived from the original on 2014-02-01. Retrieved 3 April 2017.
  13. ↑ "Jersey Shore Hospital Announces Merger with Geisinger Health System". KRISTINA PAPA. Retrieved 22 April 2018.
  14. 1 2 3 4 5 "Pennsylvania Health Care Cost Containment Council Financial Analysis 2017". Phc4.org. Retrieved 2018-08-22.

Coordinates: 40°58′05″N 76°36′15″W / 40.96816°N 76.60423°W / 40.96816; -76.60423

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