Transcript: How A NYC Hospital System Reconstructed Itself to Better Deliver Value

As light music plays, the Manhattan skyline near the Queensboro Bridge sweeps by. People and cars cast long shadows outside a building labeled Mount Sinai.

ON SCREEN TEXT:          New York City, New York

Employees work at their computers, and one wears a headset. Niyum speaks in voiceover.

NIYUM: There isn't a straight road. It starts with a commitment.

He interviews.

ON SCREEN TEXT:   Niyum Gandhi

                                    Mount Sinai Health System, Executive VP

NIYUM: I think it's not possible to do unless you're willing to jump all in. And I think it requires commitment from the absolute top of the organization.

A man holds a phone to his ear at his desk.


NIYUM: What we're realizing now or have realized maybe years ago is that the industry actually isn't configured as a system for health care. It was designed to treat illness and prevent death, not to treat the person and prevent illness.

JEREMY: I think it's--it's terrifying for, you know, for a few reasons.

Jeremy interviews by a glass wall.

ON SCREEN TEXT:   Dr. Jeremy Boal

                                    Mount Sinai Health System, Chief Clinical Officer

JEREMY: You know, some of it has to do with the fact that we've been doing business a certain way for decades. And this is what we know how to do, and so, you know, we are challenging ourselves to learn a whole new set of competencies, and there's no evidence that we will be successful.

As workers focus on their computers, the screen partially fades and white text appears.

ON SCREEN TEXT:   In New York, Mount Sinai Health System

                                    created a new model dedicated to

                                    delivering value-based care.

                                    In the first year, ER visits decreased

                                    by one-third.

JEREMY: They've got case managers, and they've got better IT and analytics, and they've got resources that are available to them to check on their patients even when the patient's not in the office.

Doctors and nurses converse in the halls. The scene fades partially, and white text appears.

ON SCREEN TEXT:   Mount Sinai has 7,200 physicians

                                    who provide care at more than

                                    4.1 million patient visits a year.

JEREMY: They've got scorecards that tell them which of their patients need certain surfaces.

NIYUM: And the way we look at it at Mount Sinai is that if we aren't part of the solution right now of figuring out the right way to improve value, we're going to be on the back end of somebody else figuring out a less-than-ideal way of improving value.

A doctor approaches the nurses station counter and points something out.

JEREMY: But being able to say, "You know what?"

Two nurses discuss a chart as they walk through a corridor. Two others stand at a computer together. Two surgeons in full scrubs operate on a patient's head.

JEREMY: "We have to do this. It's going to be hard. It's gonna be painful. We're gonna make mistakes along the way. But at the end of the day, it's the right thing for the health system."

NIYUM: Re-architecting the kind of nature of the relationship between those who are paying for care and those who are providing care is necessary so that we can all be part of the solution together rather than being at odds with one another and continuing to see increasing cost year over year.

A doctor wears a protective smock and gloves as she talks to a patient lying in bed. A woman slides through a scanning machine, red lights shining on her face.

JEREMY: So if we design it right, I think physicians and extenders and staff can go home at the end of the day and put that their head on the pillow and actually feel really good about the care that they've provided, because it's part of an integrated system.

Four doctors walk and talk. A nurse inserts a thermometer into a patient's mouth.

NIYUM: It's actually okay if we take a near-term financial hit, because we're here to serve the community. And this is a higher-value way of serving the community. And that return will come in the future. But we'll invest right now to get there.

A reflective skyscraper stands out in an aerial shot of Mount Sinai Hospital. The UnitedHealthcare logo fades in against a white background.

ON SCREEN TEXT:          UnitedHealthcare®