Samuel E. Moskowitz often cites the following quote when discussing our current health care system: “It’s not the strongest of species that survives, not the most intelligent that survives. It’s the one that’s most adaptable to change.”
“Change is what’s needed today,” he says. “It’s not just size and scale of institutions. We have a lot of incredibly smart people, but the organizations that are going to survive will be the ones that respond to change and transform themselves. Berkeley Research Group wants to partner with the institutions and work together to help enable that change.”
Founded in 2011, BRG is a global consulting firm that “helps leading organizations advance in three key areas: disputes and investigations, corporate finance, and performance improvement and advisory.”
Moskowitz serves as a managing director in BRG’s Clinical Economics practice based in Hunt Valley. With more than three decades of experience in health care administration — working at the University of Maryland Medical Systems, as chief operating officer of Mercy Health Services, and as president of MedStar Franklin Square Medical Center from 2012 to last April — Moskowitz works on strategies with hospitals in Maryland and around the country.
“Eventually, you learn there is a systematic issue in treating symptoms and episodes,” he says. “You start to look at the root of the cause and the strategy side. At BRG, we take the expertise we have with the regulatory environment and create this strategy focus.”
A Pikesville resident and Chizuk Amuno congregant, Moskowitz serves as a senior advisor to the Maryland Department of Health COVID-19 Surge Planning Task Force, where he works closely with such leaders as Gov. Larry Hogan and Dennis R. Schrader, acting secretary of the state’s Department of Health.
Jmore recently spoke with Moskowitz about BRG and what the firm is doing with the state regarding the pandemic.
Jmore: What does BRG do?
Moskowitz: Berkeley Research Group is a leader in the Maryland hospital industry with its special regulatory environment. The environment is unique [in that Maryland is] one of the only states with a unique reimbursement environment. BRG is an expert is this reimbursement system and the development of what we call alternative payment models. We are now working with other states on variations of the Maryland model.
What does that mean?
Maryland’s model is ahead of the game in terms of the transformation of hospitals and the health care industry. It’s no longer about how many patients are in beds. Instead, we are looking at how well we are keeping patients out of beds. That change really turns you inside-out as a health care provider, and BRG helps institutions make some of those strategic choices. The reimbursement model of the ‘60s was all about billable events and transactions, and now we are moving away from that.
Everyone who knows about health care financing knows health care has become less affordable for both the patients and for businesses. What BRG is doing for health systems is trying to develop an incentive-based model where it’s not about just the transactions — for example, going to doctors’ offices or getting a lab test done — but instead it’s about how to take of people in a more proactive way so they end up in expensive care settings, if possible. The system is climbing out of this episodic fee-for-service model to a new model that rewards people for less episodic care. The term used is from-volume-to-value.
How does the pandemic play into this?
Covid-19 has taught us the importance of ‘systemness,’ a word that’s not yet in the dictionary but should be one day. This crisis is forcing hospital to use their entire systems and all their resources to tackle the Covid-19 crisis. For example, MedStar is using their transportation system to move patients through their 10 hospitals. Another example is if one hospital is short of personal protective gear, they can use the access from one of their other hospitals. Something else we’ve noticed is patients are now learning hospitals aren’t always a requirement for certain services. Emergency department visits are down 15-20 percent because patients are seeking care elsewhere, whether it’s doctors’ offices, urgent cares or telemedicine.
What role is BRG playing when it comes to fighting the pandemic?
BRG serves as an advisor to the Maryland Department of Health on COVID surge planning. We are trying to stay ahead of the curve where we have enough capacity in the hospital system to manage the number of people who need to be in hospitals.
You read in the paper about some of the other states having real problems with hospital beds and I give credit to the state and to Gov. Hogan for staying ahead of the curve and being fully transparent. As a result of that, I think we are able to feel as comfortable as we can trying to keep hospitals open to serve Covid-19 and non-Covid-19 patients.
I think what sets Maryland apart is our leaders’ willingness to work together. It’s not somebody’s issue to be left in Silo A, it’s everyone working together across silos. The governor is surrounding himself with people who have expertise in this and is listening. That sends an incredible message to the people in the health industry that we are all going to work together to confront this big problem that happens once every 100 years.
How does Judaism inform your professional and personal lives?
My father and mother were strong believers in the three pillars of Judaism: Torah, avodah [service] and gemilut hasadim [loving kindness]. It started with my father and his father, who was very involved in a town that had two synagogues. One was Conservative and the other was Reform.
You compare that to Baltimore, and we live in Pikesville, imagine how many synagogues we drive by. The social service component, married to the business component, [means] looking at the three pillars in a different light.
The Torah is sacred to us, and the big piece of what I was brought up in, and my wife and I are very committed to, is service and tzedakah [righteousness]. We do it with different agencies, and we are very big with Krieger Schechter Day School. My wife just finished as the board chair. For us, it’s about education here. Both our kids are graduates of Schechter.
All private schools, for the last four or five years, have been struggling — whether it’s Park or Beth Tfiloh, Schechter – trying to figure out the value proposition. I will tell you my wife worked hard on strategic planning for KSDS, recognizing the environment.
We are also very involved at Chizuk Amuno. My father’s father was a Zionist like the word is defined — Israel has always been front and center for the Moskowitz family. When he would write me letters, he would always include yisroel chai. I didn’t understand how important that was to him until later in life.