BY: JOSEPH BARCIE, MD, MBA
Because of the growing Latino population in the U.S., the increasing need for nurses from nursing schools in Mexico, the proximity of several CHRISTUS Health markets to the U.S./Mexico border and the international nature of our sponsoring congregations, there were compelling reasons in 2001 to enter into sincere conversations with the owners of Mexico's Muguerza hospitals about leading and growing two hospitals there.
In those days, the international ministry made up 2 or 3 percent of the CHRISTUS portfolio, but that number is approaching 30 percent with CHRISTUS' entrance into Chile and Colombia. CHRISTUS Health is now the third largest private health care provider in Mexico and the second largest private health care provider in Santiago de Chile.
In Texas and New Mexico, two states where CHRISTUS ministries are located, a recent U.S. Census report shows Hispanics make up almost 30 percent of the population in Texas and close to 50 percent in New Mexico. CHRISTUS believes that, despite some cultural differences, its operations in Latin America help instruct the ministry on ways to better serve the Hispanic population in the U.S.
However, the expansion of CHRISTUS' healing ministry in Latin America is in response to needs more critical than those seen in the U.S. There are not enough hospitals or physicians to serve the critical health care needs in Latin America, and CHRISTUS' expansion in key Latin American countries provides the opportunity to utilize its business and clinical expertise and infrastructure to quickly improve the access and affordability of health care. The Latin America strategy is central to who CHRISTUS is as a health system, but it also makes good business sense in the long term. CHRISTUS works with the most prestigious academic medical center in Chile and a hospital in Colombia that is known across Latin America for its innovative technology, high quality care and fully automated laboratory. Through a partnership with General Electric, CHRISTUS Muguerza in Mexico often receives the newest technology before it is available for sale in the U.S.
During 15 years as an international health care organization, CHRISTUS has learned some important lessons about health care at home and abroad:
- People are people. Regardless of where someone lives or the culture of the country or region, when someone is sick or a loved one is sick, they want to receive the best care delivered in a compassionate way, and they need support during such an uncertain and fearful time. This is common across the globe.
- Insurance doesn't always mean access. The international markets where CHRISTUS operates — Mexico, Chile and Colombia — have near-universal health care. But CHRISTUS found it could make improvements in effectiveness; for example, in one of the hospitals that is part of a partnership in Chile, approximately 18,000 patients left the emergency department in 2014 without being seen and treated. That means almost 50 patients a day — patients who had insurance — couldn't access the care they needed. CHRISTUS saw that by improving the hospital's patient flow processes and capacity, it could have a dramatic impact on access to care with a reasonably small investment of people and resources.
- Consumerism. The U.S. health care industry has been talking about a swiftly approaching rush of consumerism for the last 10 years. Latin American countries saw consumerism arrive long ago, and working with strong international partners who have been operating in consumer-driven markets gives CHRISTUS experience and familiarity with best practices.
For example, in Mexico, Botox treatment is available at shopping malls. Ambulatory centers display prices prominently outside the buildings. In Chile, Mexico and Colombia, the major insurance companies have offices and self-serve digital kiosks located in hospitals.
In Colombia, insurance companies offer subscription ambulance services and home care, which treats thousands of people a month. Members who call with a medical issue are triaged over the phone, and a doctor will be dispatched to the patient's home for concerns that don't require a visit to the emergency department. The service will send a dentist to treat urgent dental needs, setting up his or her dental chair in the patient's living room.
- New models of care. A strategic partnership with Coomeva Cooperativa Medica in Colombia is an important one for CHRISTUS as it shifts its focuses from an emphasis on sick care to wellness care. The beneficiaries of Coomeva's insurance products are offered incentive programs to manage their chronic diseases such as diabetes, obesity and hypertension. They also have incentive programs for parents to use prenatal care, ensure their children receive vaccines and use available dental hygiene services. The services are coordinated through 100 ambulatory centers nationwide, making it easy for beneficiaries to gain access to the care they need.
When deciding to forge a partnership in a new country, CHRISTUS considers a variety of elements, including:
- Mission is foremost. Would the proposed partnership allow CHRISTUS to further the healing ministry of Jesus Christ? Does the potential partner have a vision and core values similar to those of CHRISTUS?
- Country risk. What's the level of political and economic stability? What's the legal and regulatory environment like?
- Market size and local market dynamics. Are the overall economic factors positive and steadily increasing? Is the size sufficient to justify financial and human capital investment? Does the potential partner have a sufficient presence to improve health care in the country and support the mission?
- Long-term trends. Are the forecasted growth trends positive for the country and company?
CHRISTUS knows that potential partners in Latin America have different expectations of how partnerships are formed. The health care business in Latin America has more to do with building trust and fellowship while possible business partners get to know each other.
In fact, that's what all of CHRISTUS' international ministries are focused on — building local operations that our community members can trust. The system's international operations represent partnerships and investments in these markets that include charity or community benefit, but don't stop there. They extend beyond to supportive employment relationships, ensuring the availability of high quality health care and a commitment to sharing best practices on both sides of the border.
That trust is easy to see in the 100 ambulatory centers we now collaborate on in Colombia, or the prestigious awards won by our hospitals in Chile or our community benefit partnerships in Mexico.
Through one of those partnerships with Operation Smile, an international charity that provides free surgery to repair cleft lips and cleft palates for patients in 60 countries, we met "Virgilio," a 22-year-old living in a rural area of Mexico. He could not read, write or speak properly because of his severe cleft lip. This June, 160 CHRISTUS Muguerza Associates volunteered to act as Operation Smile patients' postoperative caregivers, providing medical, psychological and speech therapy to ensure patients' full recovery and help them to reintegrate into their communities.
The team at CHRISTUS Muguerza in Mexico treated Virgilio at one of the region's Cleft Lip and Palate Medical Brigades, and it changed his life. He wanted to learn to read, to write, to get a job and leave home. It gave him hope.
The leaders of CHRISTUS Health did not know when they started our international journey in 2001 that we would meet Virgilio. They didn't know that we would expand from two hospitals in Mexico to nine, as well as expand into Chile or Colombia. They didn't know that we would employ 15,000 associates in our international operations, or build an international supply chain.
I like to think, though, that the CHRISTUS leaders who established our international ministry for strong reasons supported by our mission, vision and values and a robust business case, had faith that it would become what it is today — a beacon of hope, as it has been for Virgilio, providing much-needed quality care to thousands of people close to home.
JOSEPH BARCIE is senior vice president of international services for CHRISTUS Health, based in Irving, Texas.
Copyright © 2016 by the Catholic Health Association of the United States
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