Catching up with Florida Gov. Rick Scott, and what healthcare providers need from Kentucky’s next governor

Nov 2nd 2015

Florida Gov. Rick Scott was recently on his road show to recruit and sell the Sunshine State like never before. He also decided to send letters to Kentucky business leaders inviting them to the Sunshine State for expansion, while making time for face-to-face meetings.
Gov. Scott bragged (accurately) about the hundreds of tax reductions he and his team have passed, the new and improved bond ratings, the job creation and the reason he believes he will not need Medicaid expansion. Why? Because everyone will have a job before he leaves office!
Signature is still a large health care provider in our former home state of Florida so we always make time to educate, update, and discuss health care policy in context to the goals of the Revolution. And Gov. Scott was ready for us like no other, to hear how the Revolution was playing out back where I grew up.
I remember when every health care organization bolted from Florida, less than two decades ago because they had the same problems we had today. No one was left when we first started to grab the mailed-in keys, saying, “we left town so good luck!”
I met Gov. Scott a few times over the years related to health care, but he knows the Signature Revolution left the state just six years ago because Gov. Crist and Sen. Atwater thought we were bluffing. So, we moved to the Bluegrass State after much deliberation and a great opportunity. We believe the spirit-led call was the right call, but the painful struggle to help bring about inches of change is beyond any vortex I have ever seen.
This recent meeting with Gov. Scott was much different, though, because I wanted to thank him for the great progress from my limited point of view. I see the change Florida has made since we left, and I don’t love it all, but I love 80% of it. He made hard calls early, helped people anticipate the pain, and then managed like a great CEO would. There is no pension time bomb, there has been a return to prosperity for many, and great discussions are taking place at the health care policy level, led daily by the FHCA team that makes the complicated process work.
I watch Kentucky struggle and be discussed at national conferences in a negative light – at least in my long-term care and post-acute industry – like never before because the data screams for change. It is beyond a crisis, if not an epidemic! Kentucky is now scoring near the bottom in nearly every post-acute category as we struggle through another mud-slinging campaign for governor, awaiting one to emerge and lead us out of health care darkness. The recent ads are definitely the opposite of the Lincoln-Douglas debates that we crave as engaged voters; I wonder if we will ever get it right, here.
Since we left Florida six years ago, I have kept my finger on the pulse of both states’ ability to build consensus and modify policy that yields opposite results. For example…

  • Florida has improved oversight to a culture of performance improvement linked to QAPI goals; Kentucky ranks second to worst in the nation in provider fines, at 10 times the national average.
  • Florida made significant steps to address out-of-control litigation; Kentucky dropped to the worst place in America with out-of-town law firms because of our health care economic engine for growth.
  • Florida is considering rebasing their Medicaid system to a ‘quality outcomes approach’ as we speak; Kentucky sits idle, celebrating the fact that we were one of the first case mix states from the Patton administration.

Florida modified their Certificate of Need (CON) laws and process, providing a hybrid solution that protects legacy providers but creates more flexibility for new capital and new construction; Kentucky has the oldest physical plants in the country, and keeps the tightest CON constraints anywhere in the country.
I watch our governor’s race with great hope for real change. I pray for a more bipartisan approach to unify the Commonwealth, finally, but the health care debate has been impossible to set up, even as board chair of Health Enterprises Network.
Do not take me wrong, we love our team. We love the people’s passion, spirit and commitment to excellence here in the Commonwealth. We have upgraded our senior team to world class here in Kentucky, but we just need the government to finally get things done that take us out of the bottom five quickly, or no other health care organizations will be here long term.
We need the next governor to not be afraid of being a one-timer. Someone needs to pull the Band-Aid off because, as I speak in D.C. this week, my peers laugh at our expanding Kentucky portfolio, thinking we are delusional based upon every meaningful statistic my industry tracks.
No one can argue that we need cabinet change for oversight and punitive tactics during the next administration. We need a plan for medical reform immediately. We need reasonable tort reform, and we need better educational and workforce plans because we cannot find the skilled workforce we need to compete in many rural markets where we try to serve our elders.
Our peers are bolting as we speak, my mailbox is full of medical records requests for the next 50 lawsuits from out-of-state law firms, and we fight through survey wars that are really unnecessary to improve quality in the state.
I still believe something great can happen here, and I pray for every political leaders to pull down the info from these web sites and tell me why we want to be ranked there! Let’s get unified, all share some pain, realize who the real enemy is, and bring it full circle so we become the beacon light that we know we can!
I told Gov. Scott I would see him on my next family vacation or at our new grand openings, where we won a few CONs, but our hearts and minds are in Kentucky – where we can make a real difference.
With that, we strongly urge all our Kentucky stakeholders to go out and make your voice heard!

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