DEVENS -- Healthcare is big business. Three hospital executives talked about the business of providing health care in the region.

Providing care, collecting payment and providing employee benefits were all under discussion at the Nashoba Valley Chamber of Commerce Breakfast with the Boss on Nov. 1.

Two CEOs of general hospitals weighed in: Sal Perla from Nashoba Valley Medical Center, part of for-profit Steward Health Care and Deborah Weymouth from UMass Memorial Health Alliance Hospital Clinton, part of the nonprofit UMass medical system.

Michael Krupa talked about TaraVista Behavioral Hospital in Devens. The newest hospital in the area is a for-profit acute-care psychiatric institution.


Both Health Alliance and Nashoba provide community care and specialized services. Both can rely on other hospitals in their networks and elsewhere when patients need treatment not offered on site, Perla and Weymouth said.

If a patient and family is willing to travel, perhaps to Cape Cod or the North Shore, mental health beds can usually be found in the Steward system, Perla said.

Those in need of psychiatric in-patient treatment often have to wait longer in the emergency rooms at Health Alliance although Clinton has a geriatric psych ward, Weymouth said.

That type of wait is the reason for TaraVista, Krupa said. The licensed 108-bed psychiatric hospital was needed in a state that had insurance coverage for patients but not enough beds.


Instead of a retrofitted area in an existing hospital, he was able to build what "truly looks like a very fine hotel," Krupa said. The patients arrive from area emergency rooms. Many have a dual diagnosis: a mental health illness and substance abuse disorder.

Massachusetts has the lowest uninsured coverage in the country, Krupa said. "If this was not the case, (TaraVista) would not have been built."

The healthcare providers must get the insurance payments, though.


"It detracts from patient time," Weymouth said. Medical providers spend an inordinate amount of time and energy on paperwork and follow-up.

Steward doctors are trained in how to write everything down, Perla said. The group also provides insurance reimbursement services to doctors in its medical groups and extended network.

Like other businesses, these hospitals offer health insurance for their employees.

As a nationwide employer, Steward negotiates excellent rates for health insurance, Perla said. Employee contributions are scaled so that the lowest-paid people might have no premium at all. In-network care has a zero deductible.

As the newest kid on the block with the smallest number of employees, TaraVista provides a high-deductible plan through a private insurer, Krupa said. The company contributes $750 for an individual deductible and $1,500 for a family plan.

Health Alliance self-funds, Weymouth said. The program allows the company to see how their own employees respond to wellness initiatives.

The high rates of opioid abuse is on the minds of these administrators.

Between 50 to 80 percent of TaraVista's patients have a co-occurring addiction, Krupa said.

Prevention needs to start with primary care, Perla said. Nashoba is also seeing more dual-diagnoses patients and has a pain clinic to help wean patients off opioid medications. , Nashoba also has two addiction medicine physician and holds clinics. Body:

Unlike the AIDS epidemic, "this one's not invisible," Weymouth said. Addiction affects both employees and patients. In addition to a number of clinics, Health Alliance holds support groups.

"It can't be done alone," she said. "We're just a cog in that wheel."

Follow Anne O'Connor on Twitter @a1oconnor.