Wayne UNC Health Care CEO and President Janie Jaberg says no one truly knows what is going to happen in health care.

And she told those attending a Tuesday luncheon on health care that she, too, has no clue what will happen, but that she does know that health care costs will continue to increase.

Also, many organizations are going to high deductible health insurance plans, she said.

"Medicaid has grown in our state budget by 30 percent," she said. "Health care, not only is it costly, but it is changing every day. You still go to the doctor, you pay for the visit. You come to the hospital, you pay for it. So it is by episode.

"What we are transitioning to is a value-based model. So it is going to be based on quality. It is going to be based on your health. It is not going to be on your episodic care -- a whole change in the way health care is being managed and paid for. We are right in the middle of it. So most of it is still fee for service, but a little bit it is the alternative payment models."

However, Mrs. Jaberg spent most of her time Tuesday as keynote speaker for the Wayne County Chamber of Commerce's Health Care Hot Topics luncheon at Lane Tree Conference Center talking about the hospital and its efforts to stay abreast of the changes while ensuring the best patient care possible.

"Putting patients first is my motto," said Mrs. Jaberg, who began her career as an operating room nurse. "It has kind of been adopted by the rest of the organization, which you would expect, and we are going through some cultural change. Our patients first, it sounds easy. It sounds simple. Sometimes it is not so easy and so simple because you have some tough decisions to make.

"But when I have those tough decisions, I always go back to what is best for our patients, and what is patients first? It should help guide every decision that we make. It does take the whole team."

Communications is the key -- people have to talk and work together to solve things and sometimes have to agree to disagree, she said.

Those who work in the organization are not employees, they are teammates, she said.

"We made that transition as part of our cultural change back in January," Mrs. Jaberg said. "They are as equally important as any of the executives who just stood up and you met. I don't care whether they are environmental services and they are coming to make sure your room is perfectly clean and meets all of the expectations.

"Whether it is somebody answering the phone when you call the hospital. Whether it is our campus police. Whether is a nurse who is caring for you. A therapist who gives you a lot of support, a lot of help. It takes every single person to make this work."

Mrs. Jaberg said she and the hospital's leadership make rounds and visit with patients.

"We do that to make sure that we are exceeding their expectation, to make sure that there is nothing that's out there that we might not be able to help them with," she said. "But the other reason that we do it that it gets us out where we need to be."

She also talked about the hospital's partnering with UNC Health Care under a management service agreement. The hospital board selected UNC Health Care more than a year ago to manage the organization.

"What does that mean?" she said. "It means we, your hospital, have access to everything that UNC Health Care does -- research, policies and procedures, physicians, education. You name it, we have access to it. They also give us guidance and support."

The relationship continues to grow, she said.

Wayne UNC Health Care currently has a hospitalist program in which a person's primary care provide does not come to the hospital, another of the transitions in health care, she said.

All a hospitalist does is see patients in a hospital, she said.

UNC Rex Health Care will take over Wayne's hospitalist program at 7 p.m. on June 30. The majority of the same providers will stay with Wayne she said.

Also, four more have been added and more are being recruited.

"The other thing that we are working very closely with is an organization that manages the (system's) physician practices," Mrs. Jaberg said. "We are transitioning our physicians to UNC PN (Physician Network). All that means to you is that when you go in there may be a different sign and if you get a bill, the invoice may look a little different.

"They are still our organization, but they will have a close relationship with UNC which will give our medical staff access to much more specialists and a lot of the research that is going on at UNC."

Wayne UNC Health Care is a good hospital and is working to be a great one, she said

"So how do we get from good to great?" she said. "Change culture -- we are working on that."

It will take years, and the hospital leadership realizes that and has accepted the challenge, she said.

"We are changing what we do and how we do it so that we can be better," she said. "As we go through this challenge the way to get there is through communications.

Mrs. Jaberg said she is out in the community talking to businesses and holding community town hall meetings where she will talk but then ask what is working well and what is not working well and where do residents want to see the hospital go.

She asks for ideas and suggestions.

The only way to find out is to ask, said.

Mrs. Jaberg said she realizes that Wayne UNC Health Care will not be all things to all people because it is not a big enough system to do that.

However, it is part of a system that can, she said.