Troubled MLK Toddles Toward Rebirth
As it nears the end of what will be nearly a decade-long exile from providing inpatient care, Martin Luther King Medical Center has appointed the top physician at the nation’s largest public health plan to oversee its reemergence as a full-fledged hospital in 2014.
Elaine Batchlor, M.D., chief medical officer at L.A. Care Health Plan, was named as MLK’s new chief executive officer earlier this week. She will begin work on Oct. 15.
Although Batchlor has not had any prior experience as a hospital administrator – most of her career has been on the payer side of the equation – she has long been a fixture in local and regional public health circles. She has overseen the treatment of nearly 1 million Medi-Cal and Healthy Family enrollees during her tenure at L.A. Care. Prior to that, she oversaw healthcare finance efforts at the California Health Care Foundation, one of the state’s biggest public policy think tanks.
Many political and healthcare leaders praised her selection this week, citing her thoroughness as a manager and even-keeled demeanor.
“I am delighted with Dr. Batchlor’s appointment to helm the new MLK Hospital,” said Los Angeles County Supervisor Mark Ridley-Thomas, whose district includes the facility. “She has the experience, expertise and leadership skills required.”
Batchlor will assume what could be the single most scrutinized hospital leadership position in California. Originally opened in the early 1970s in Willowbrook, an unincorporated portion of South Los Angeles, MLK was considered part of the rebuilding of the community after the 1965 riots.
But the previous incarnation of the hospital – infamously dubbed “killer King” by many locals – failed on virtually every level. Tales of negligence regarding its patients began drawing widespread media coverage not long after it opened, and became more harrowing over the decades.
The most recent string of horrific care-related mishaps – including a patient left to die on the floor of a waiting room as staff walked by, drew stiff penalties from the California Department of Public Health. That and a series of Pulitzer Prize-winning articles by the Los Angeles Times that chronicled epic episodes of mismanagement left the County Board of Supervisors with little choice but to finally shutter the hospital in 2007.
MLK reopened as a county-operated outpatient facility not long after its initial closure, but plans have been in the works for years to reintroduce its inpatient services.
“This is a chance at a new start (for the hospital),” Batchlor said in a phone interview on Wednesday. “South L.A. is one of the most underserved areas in the entire region in terms of healthcare. This is an opportunity to bring the community a new state-of-the-art hospital.”
Inpatient operations will be run by a private corporation that received public funding to refurbish and reopen the hospital. A medical “village” of offices and related structures is also being built at the hospital site as part of a community redevelopment effort.
Batchlor said the new facility would work closely with the L.A. County Department of Health Services to care for that system’s patients.
And despite her lack of hospital experience, Batchlor asserted the work in some ways would be similar to her duties at L.A. Care.
“I will be working with much of the same population in the new position as I have in my years at L.A. Care,” she said.
Nevertheless, the expectations of MLK’s new CEO are expected to be colossal.
“It is going to be under a huge microscope when it reopens as a hospital,” said Jim Lott, executive vice president of the Hospital Association of Southern California. “There is an expectation on the part of many that it is going to fail, and there will be a lot of pressure on Elaine to disprove that, that the hospital can serve the community effectively.” In addition to his duties with HASC, Lott chairs the Charles Drew University board of regents, which had a prior teaching affiliation with MLK but is now affiliated with the University of California’s healthcare system.
Others familiar with the reopening of the hospital who asked not to speak on the record concur with Lott. They note that as long as the hospital carries the MLK name, the residents will consider it a dubious enterprise until it proves otherwise. However, there is one plus: MLK’s new employees will not have the civil service protections enjoyed by workers at the old county-operated hospital, making it far easier to avoid an entrenched culture many claimed had systematically endangered patients.
Lott does not see Batchlor’s lack of hospital experience as a shortfall. “She’ll have the resources and in regards to all the technical aspects, a strong management team,” he said, adding that Batchlor also brings strong skills as a clinician. A rheumatologist by training, Batchlor obtained a medical degree from Case Western Reserve University and performed her residency at Harbor-UCLA Medical Center. She also earned a master’s in public health from UCLA.
However, other sources have suggested that two c-suite level members of Batchlor’s staff will also have little hospital experience, although that will be mitigated by their having worked closely with her in the past.
Moreover, the hospital will face a daunting patient mix. Despite an upcoming large expansion of the Medi-Cal program as part of the Affordable Care Act, many South L.A. residents are undocumented, and therefore will be unable to enroll in Medi-Cal or purchase subsidized insurance through the California Health Benefits Exchange.
As a result, industry observers believe as many as 25% of the patients who enter the hospital will have no insurance or way to pay their bills. As many as half of the patients will be Medi-Cal enrollees, meaning the hospital would receive a fraction of the compensation expected from commercial payers.
“The hospital will lack many traditional revenue streams while operating in a very competitive environment,” Lott said.
