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Hospital chief addresses Obamacare, health care costs

Jared Felkins jfelkins@lebanondemocrat.com • Updated Jul 26, 2013 at 10:06 PM

Matt Caldwell has taken on the challenge of changing the minds of doctors, support staff and patients at University Medical Center, along with adapting to and communicating the ever-changing roles of Medicare, Medicaid and the Affordable Health Care Act, more commonly known as Obamacare.

And that’s just five months into the role of hospital chief executive officer.

Since moving to Lebanon in January, Caldwell said he’s worked to provide quality satisfaction among physicians, associates and patients with regard to the seventh largest hospital in Middle Tennessee and only tax-paying hospital in Wilson County.

“All three were out of kilter here,” said Caldwell, who was most recently CEO of Dallas Regional Medical Center in Texas. “There was a lot of mistrust among the physicians and among the associates, which trickled down to our patients.”

Caldwell said he’s spent a majority of his time working with each group to provide honest information and leadership. He’s also identifying needs in the community, which included speaking Tuesday to the Lebanon Lunch Rotary Club.

“I don’t believe in doing it from the office,” Caldwell said. “I believe in doing it from the front lines.”

Caldwell said he doesn’t support Medicaid expansion among states, which is something Tennessee Gov. Bill Haslam also opted to forego recently with the impending Affordable Health Care Act regulations set to go into effect next year.

“Things have changed drastically, and they continue to every day,” he said. “I think [the impact of the Affordable Health Care Act] has yet to be determined. I think it remains to be seen how if affects states that have expanded Medicaid and those that haven’t. I think we needed something. It remains to be seen how effective that plan will be.”

Caldwell also spent a good deal of time explaining the differences between costs and charges patients see on hospital bills.

“You can pretty much take [charges] and throw them out the window,” Caldwell said. “Charges are really not important. What you have to worry about is the cost.”

Caldwell said Medicaid pays hospitals about 7 cents on the dollar with Medicare in the 12-cent-24-cent range and insurance companies about 32 cents.

“The charges are all over the map,” he said. “It all comes down to three simple words, it’s the law.”

Caldwell said costs are based on patients’ diagnosis, which is something hospitals cannot dictate. That must be done by doctors.

“We have to do what’s right for the patient on the front end and the back end,” he said.

Caldwell said he’s also an advocate of making the billing system more simply explained to patients.

“I don’t understand why we can’t put the details on pages four or five and put the explanation right up front on page one for people,” he said.

Caldwell took over the hospital’s CEO position in January after serving as CEO of Dallas Regional Medical Center, a sister Health Management Associates hospital. During his time with the Dallas hospital, it was ranked No. 1 in patient safety in the competitive Dallas County health care market.

Caldwell has spent 18 years in health care, also working as chief operating officer with Sierra Medical Center in El Paso, Texas, Valley Regional Medical Center in Brownsville, Texas and vice president of patient care services with Baylor Medical Center in Waxahachie, Texas.

Caldwell earned his master of health care administration degree from the University of Texas at Arlington and holds a bachelor of science degree in nursing from Bethel College in North Newton, Kansas.

Caldwell’s parents, natives of Chattanooga, are formerly Baptist missionaries to Brazil, working in the Amazon for 21 years. His wife is also a Brazil native, and the couple has two children.

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