Geisinger Health System

Geisinger Health System (GHS) is a regional health care provider to central, south-central and northeastern Pennsylvania and southern New Jersey. Headquartered in Danville, Pennsylvania, Geisinger services over 3 million patients in 45 counties. It has been widely recognized for delivering high-quality care at low cost through an integrated delivery system model of healthcare.[1][2]

Geisinger Health System
Geography
LocationPennsylvania, New Jersey
Organisation
Care systemHealth system
PatronGeisinger Foundation
Links
Websitewww.geisinger.org

History

Geisinger is named after Abigail Geisinger, widow of iron magnate George Geisinger.

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. Geisinger has 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 Health Management Organization (HMO), was started in 1985.

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. Geisinger's Frank Trembulak said the non-binding letter refers to the specifics of how the merger will work and that there is a "binding agreement to merge".[3]

Independent physicians have opposed a merger with Geisinger, stating that with the presence of a Geisinger clinic in Lewistown and with Geisinger offering health insurance, a monopoly might result from the merger, ultimately hurting instead of helping local healthcare.[4][5][6] 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.

From 2001 through mid 2015, Glenn Steele served as Geisinger’s president and chief executive officer.[7] Steele left Geisinger in 2015, with David Feinberg joining as president and CEO.[8] In December 2018, Jaewon Ryu was named interim president and CEO. Prior to the announcement, he previously served as the health system’s executive vice president and chief medical officer since 2016.[9]

In order to "fix the primary care shortage facing the organisation", Geisinger announced in 2019 its Commonwealth School of Medicine will select 40 students and cover their full tuition plus a $2,000 monthly stipend. The students need to commit to work at Geisinger for four years after residency in primary care roles.[10]

Quality and Cost-Containment

Geisinger operates as an integrated delivery system (IDS), a self-contained healthcare ecosystem including administration, payer, and providers to contain the entire patient experience. IDSs are thus able to coordinate care and manage population health, and its incentives are aligned amongst administration, payer, and providers to deliver high-quality healthcare at low cost.[11] Speaking to a joint session of Congress in September, 2009, President Barack Obama cited it as a model for national healthcare reform: "We have long known that some places — like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania — offer high-quality care at costs below average."[1][2]

Several factors have been identified as contributing to its high performance, including its payment of doctors on a flat salary bais instead of fee-for-service (which tends to incentivize volume of care rather than quality);[1] bundled payments for several common procedures (such as heart surgery and prenatal care) to shield patients and the system from paying for complications arising from the original service;[2] establishing checklists of best practices for physicians to follow for specific conditions and procedures to ensure good outcomes for patients;[1][2] and a robust electronic medical record system that minimizes duplication of treatments and tests.[1]

Research

Geisinger opened its $21 million Geisinger Center for Health Research on its Danville campus in the spring of 2007. Researchers conduct health services, epidemiologic and population genetics research.

Genetics

Geisinger has a 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".[12][13] The program uses gene sequencing by the biotechnology company Regeneron Pharmaceuticals.[14] Over 200,000 patients submitted genetic samples by 2018.[15] 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.[15]

List of Geisinger facilities

Location of Hospitals

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:[16]

For comparison, in 2017 the Pennsylvania average operating margin and total margin were 5.15% and 6.62% respectively.[16] The Pennsylvania average uncompensated care percent of NPR was 1.74%.[16] The Pennsylvania average portion of NPR paid by Medicare and Medical Assistance was 34% and 14% respectively.[16] 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.[16]

References
  1. Hurdle, John (December 7, 2009). "Inside a U.S. healthcare "island of excellence"". Reuters. Retrieved 23 May 2019.
  2. Drobnyk, Josh (September 11, 2009). "Why rural Pa. hospital wins praise from Obama. Geisinger strives to make services reliable for every patient, a vice president says". The Morning Call. Retrieved 23 May 2019.
  3. "AG Approves Hospital Merger". Lewistownsentinel.com. Retrieved 3 April 2017.
  4. "Opposition Group Discusses Concerns". Lewistownsentinel.com. Retrieved 3 April 2017.
  5. "Weighs in on Possible Local Hospital Merger". Archived from the original on 2014-02-01. Retrieved 3 April 2017.
  6. "News, Sports, Jobs - The Sentinel". Archived from the original on 2014-02-01. Retrieved 3 April 2017.
  7. Landen, Rachel (July 18, 2014). "Steele to step down as Geisinger CEO next year". Modern Healthcare. Modern Healthcare. Retrieved March 29, 2019.
  8. Robeznieks, Andis (February 23, 2015). "UCLA's Feinberg named Geisinger CEO". Modern Healthcare. Modern Healthcare. Retrieved March 29, 2019.
  9. Vaidya, Anuja (November 9, 2018). "Geisinger taps CMO as interim CEO: 6 things to know". Becker’s Hospital Review. ASC Communications. Retrieved March 29, 2019.
  10. Ramsey, Lydia. "A health system hidden in the heart of Pennsylvania is offering free tuition to its medical students to fix one of the biggest problems in healthcare". Business Insider. Retrieved 6 November 2019.
  11. "Integrated Delivery Networks and their Growing Influence on Regional Healthcare in the US" DRG. Retrieved May 22, 2019.
  12. 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.
  13. 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. PMC 6668033. PMID 29562163.
  14. JON O'CONNELL. "Geisinger receives $5.5M grant". Citizensvoice.com.
  15. "Routine DNA Screening Moves Into Primary Care". Npr.org.
  16. "Pennsylvania Health Care Cost Containment Council Financial Analysis 2017". Phc4.org. Retrieved 2018-08-22.
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