Case study: Caritas CEO ends required MD referrals

Boston's Caritas Christi Health Care is dropping a strategy that used doctors at its community hospitals to prop up its central tertiary care facility. The health system, one of the few freestanding Catholic healthcare systems in the country, has historically pushed doctors to refer as many patients as they could to St. Elizabeth's Medical Center. This sapped higher-paying procedures from the five community hospitals in the Caritas network.

Now, the system's new CEO, Ralph de la Torre, is breaking with this tradition. De la Torre says the practice of pushing patients from suburban community hospitals to a larger central hospital with more intensive services--known as a "hub and spoke" strategy--hurts the relationship between local doctors, community hospitals and their patients. The move is also an acknowledgment that while St. Elizabeth's can provide expert services, and serves as a teaching hospital for Tufts University School of Medicine, it's not on the level of facilities like Massachusetts General.

De la Torre's shift in strategy is part of a larger package of ambitious plans unveiled since he took over in May. Among other things, he has announced plans for an $18 million upgrade to operating rooms at the system's St. Anne's Hospital, and is talking about turning the emergency department at Good Samaritan Medical Center into a Level One trauma center. He's also announced that he'll keep the system's struggling Carney Hospital open, despite its taking large losses of late.

To learn more about the health system's progress:
- read this article from The Boston Globe

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