Interview: Ravi Chari

Ravi Chari, MD

President & CEO HCA Healthcare-West Florida Division

What did HCA West Florida learn from COVID-19?

What we learned from COVID-19 can be broken down into three areas. First, care like family. Our people are our greatest asset and we had to make sure we protected them through this by creating a pandemic pay model, not furloughing anyone and guaranteeing we had the appropriate PPE available. Second, unlocked possibilities. One of the things we did early on was analyze how we use PPE and then we created a better process around preservation and distribution of these valuable resources. We accelerated our implementation of telemedicine throughout the organization and also expanded access to care, with the opening of two new free-standing emergency rooms in south Lakeland and Wesley Chapel. We initiated a heart transplant program and advanced extracorporeal membrane oxygenation (ECMO) at Largo. We started a ventricular assist device program there as well. We also started new programs in MitraClip for advanced heart care and launched a lung nodule program. In spite of the COVID-19 overlay, we moved forward with clinical program advancements to ensure we are improving how we deliver care. Third, raise the bar. In a lot of ways, what COVID-19 caused us to do is question everything. Things we thought were tried and true now are not so much. In our organization, we challenged our team to live our common purposes, making a difference by providing compassionate care to those we are privileged to serve.

What partnerships with local higher education institutions have you established?

We have the Galen College of Nursing on campus at Northside. We’re going to expand with them to other campuses in our footprint across the West Florida division. We continue to work closely with all of the colleges and educational institutions, from Fort Myers all the way up to Inverness. That continues to be a high priority for us across all specialties, not only nursing but also other areas, including respiratory therapy and radiology technologists.

In Tampa Bay, healthcare and social assistance account for 13.7% of the total workforce

( ) health coverage, according to DataUSA statistics, leaving 12.1% without coverage, slightly higher than the 10.9% nationally (2019 numbers), according to the PolicyAdvice website. Of the number of insured, 43% receive it from employee plans, 19.7% from Medicaid, 8.52% from Medicare, 14.4% from nongroup plans, and 2.4% from military or VA plans. The number of uninsured people appears to be on the rise: between 2016 and 2017, the percentage of uninsured grew by 4.38%, from 11.6% to 12.1%.

In terms of approving its citizens for social security disability, Florida is slightly below the national average: 12.2% are approved in the state against 13.7% nationally. These rates have improved slightly in recent years. The total per capita spending on healthcare was $8,076; per enrollee with private insurance, it is $4,606; and per enrollee using Medicaid, it is $5,175. These numbers, too, are on the rise.

Healthcare is big business in the Tampa Bay region. By number of employees, healthcare and social assistance is the most common industry (26,224 people, or 13.7%), followed by retail and technical services. It is also the highest paid sector when seen by median earnings: people working in health diagnosing, as treating practitioners, or other technical occupations earn, on average $86,881 per year. And these workers are kept busy, in no small part the result of a large number of retirees who live in the area: in 2018, the ratio of primary care physicians to patients in Hillsborough County was 1 to 1,189, an .834% decrease over the previous year. The ratio for dentists is 1 to 1,769 patients a year, and for mental health specialists, 1 to 613 patients.

The COVID-19 pandemic laid bare some of the longsimmering fault lines in the aforementioned statistics. With the onslaught of the health emergency, followed by massive unemployment and economic dislocation, ( )