Charles T. Frock
Chief Executive Officer
FirstHealth of the Carolinas
Almost everyone agrees with the
principles of full health care
coverage, affordable cost and high
quality, but the devil is inevitably in
How do we extend coverage to all? How do
we pay for it? How do we balance priorities
with non-health obligations? The debate is
playing out in Congress and will probably
come to a head this fall. How it will turn out is
anybody’s guess, but I am not overly concerned.
Let me explain.
Using three elements of health policy (access,
cost and quality) is a useful format in assessing
the efforts of FirstHealth of the Carolinas and
its physicians in addressing these issues.
Access: FirstHealth already provides
emergency care to all, regardless of ability to
pay. Our charity care policy provides a sliding
payment scale suited to individual financial
capabilities. We support existing physician
practices and clinics in recruiting additional
physicians to the area. We have established
Family Care Centers in less-populated areas
and have transitioned several to free-standing
status to provide better access.
Our non-profit health insurance subsidiary,
FirstCarolinaCare, has focused on the small
business community with significant incentives
to cover the previously uninsured. Our
Community Health Services division takes
screening and other preventive services to
schools, businesses, churches and community
agencies. We work with other organizations,
such as the Moore Free Clinic, to make
primary care more accessible.
Costs: We strive to be as efficient and
as cost-effective as possible. Our managers
and staff have enabled us to remain a lowcost
provider compared to other hospitals
offering the same services. In fact, within
our peer group of 10 similar hospitals across
the Carolinas, we are consistently the first
or second least expensive. We use industry
techniques to reduce costs and eliminate errors.
We encourage our physicians to find and
use high-value drugs, implants and medical
supplies without compromising quality. We
have negotiated fair reimbursements from
managed-care organizations to ensure our
Our community generously supports our
Foundation, allowing us to maintain cuttingedge
technology, facilities and services. This
is vital since more than two-thirds of our
reimbursement is set by public programs
(Medicare and Medicaid) that don’t cover the
full cost of care
Quality: We and our physicians have
been recognized for our results, and we
remain committed to providing the best in
medical care. We compare very favorably on a
Consumer Reports Web site using Medicare
data to compare hospital quality, tying with
Duke for eighth out of 100 N.C. hospitals.
So why am I optimistic about our future and
whatever health reform brings?
- FirstHealth and its physicians are committed
to addressing the goals of health reform.
We expect to keep our quality high, costs
reasonable and care accessible.
- Any major change out of Washington will
likely be phased in or piloted, giving us time
to plan accordingly.
- Our experience is that the federal
government will address unacceptable
consequences from passed legislation with
either technical adjustments or major
One caveat: There has been no
discussion in Congress about tort reform or
medical malpractice. Until there is meaningful
reform in this area, and an end to the need
for doctors to practice defensive medicine,
we will never achieve the cost efficiencies our
physicians and hospitals can provide.
The debate over health care reform rages.
Whatever happens (and I believe significant
reform legislation will eventually be passed),
rest assured that FirstHealth’s physicians
and staff are committed to delivering what
you expect from us: high-quality care at an
affordable cost available to all.