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Big challenges face the Dayton area's health-care industry, says Tom Breitenbach, founding president and CEO of Premier Health Partners, the parent operating company for Good Samaritan, Miami Valley and Middletown Regional hospitals.

Chief among them:

• Attracting top medical professionals to the Dayton area and keeping them here.

• Covering the costs of providing free health care to the poor and uninsured.

• Controlling the rising cost of health care in general so local businesses can stay competitive.

Premier's battle two years ago with Anthem Blue Cross and Blue Shield, the area's largest health insurer, essentially revolved around those issues, Breitenbach said last week in an interview with the Dayton Daily News.

For more than a year the two could not come to terms over reimbursement rates, and they went without a contract for all of 2005, severing access for Anthem's 317,000 enrollees to Premier's hospitals, the 100 physicians of Premier HealthNet and other affiliated services.

The two came to terms in late 2005 and entered a contract that's good through 2009.

Breitenbach talked to the Dayton Daily News about the dispute and the underlying issues facing the industry and Dayton community. He began with the challenge of recruiting top medical talent:

Breitenbach Ohio is suffering a brain drain. The really bright people are going to Chicago or New York or Dallas or someplace and we really need to create an environment in Dayton where, at least for medical professionals, they view this as a really great place.

Now, fortunately, we've got two very strong health-care systems (Premier and Kettering Medical Center Network) and a wonderful, blue-chip medical school (Wright State University Boonshoft School of Medicine). So we have the infrastructure in place, I think, to be successful, but we just have to be sure that we have a consensus, especially given the relatively weak economy that Dayton's had the last five or 10 years, that we retain the resources to be able to attract these talented young people.

When a physician is looking around, the first thing he or she wants to know is, "What kind of facility am I going to practice in? Does it appear to be of high quality? I'm 32 years old now, I want to stay here until I'm 60. Will the hospital still be here?" Those are very important questions that these young people are looking at.

Looking for talent

That's why Premier continues to invest hundreds of millions of dollars in high-tech medical equipment and new capital projects, such as the Miami Valley South Health Center in Centerville (due to open this fall), Breitenbach said. And this year, the company's bringing Greene Health Partners in Greene County into the fold. Part of that deal includes helping Greene build a new hospital.

'DDN' So how's the recruitment effort going?

Breitenbach It's going pretty good. It's not easy. We're recruiting nationally, we're holding our own. I'm more concerned not necessarily with today, which is a concern, but more so with five or 10 years down the road.

Recovering from the confrontation

The break with Anthem ravaged Premier's bottom line in 2005. The combined net income for its three hospitals fell to $805,000, a hundred times less than 2004's $80.5 million.

But Premier has recovered, Breitenbach said, and expects 2006 to be its best ever. (The final numbers aren't in yet.)

'DDN' Are there lessons to be learned from the Anthem dispute?

Breitenbach The lesson to be learned is you can't solve national problems locally. Your paper stated that editorially. These discussions are going on all over the country, disputes between doctors and hospitals, insurance companies and employers.

But I think the good news is there's a silver lining, there's a national consensus emerging that something has to be done about this.

The system is broken, everyone would acknowledge that. Massachusetts and California are looking at state initiatives to care for the indigent. I think (Ohio) Gov. (Ted) Strickland is committed to looking at the issue, as is (Ohio House) Speaker Jon Husted.

Trying to find a solution on the local level

On a local level, Breitenbach pointed to the Greater Dayton Area Hospital Association's Hospital Cost Council, a consortium of hospitals, insurance companies, businesses and public officials exploring ways to contain health-care costs.

There's also the Montgomery County SafetyNet, a similar group studying ways to better deliver health care to the poor and uninsured, he said.

Breitenbach I think it's best to have these discussions in a low-key fashion, not in the cauldron of contract negotiations. So I guess if there's a lesson to be learned it's best to anticipate these problems and have reasonable discussions outside the scope of contract negotiations, and I think we're doing that and that's a positive.

Tom Breitenbach

Job: President and CEO of Premier Health Partners, the parent operating company for Good Samaritan, Miami Valley and Middletown Regional hospitals.

Born: July 5, 1947, in Cincinnati

Education: Bachelor's degree, University of Notre Dame; master's degree, Xavier University; graduate of the professional accounting program at Northwestern University.

Other current roles: Chairman of CareSource USA, the parent company of the largest Medicaid HMO in Ohio; board member of the Dayton Foundation.

Contact this reporter at (937) 225-7408 or agottschlich@DaytonDailyNews.com.