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Mile-High Health Reform

Dr. Patricia Gabow molds Denver's public health system into a national model.

Patricia Gabow
David Kidd
Twelve years ago, Denver's public hospital was in a clinical condition that could only be described as critical, with faltering public support and a $39 million deficit. Today Denver Health is widely regarded as a model public health system, thanks in large part to its CEO, Dr. Patricia Gabow.

A native Pennsylvanian, Gabow grew up in a family of teachers. At 12, however, she formulated a different goal for herself: becoming a doctor. After studying to become a nephrologist or kidney specialist at the University of Pennsylvania School of Medicine, Gabow moved to Denver in 1973 to establish a nephrology program at its public hospital. In 1997, she took over as CEO.

Gabow's first step was reconstituting the public hospital as a stand-alone hospital authority. She used her new autonomy to build a network of clinics that could serve needy residents before they reached the emergency room. Using process improvement techniques pioneered by Toyota, she strengthened operations while making huge investments in electronic health records and health IT. In the process, Gabow put Denver Health in the black-and made the city a national model of integrated care.

Recently appointed to a new federal commission on Medicaid and the Children's Health Insurance Program, her new focus is on Medicaid challenges post-health-care reform. One, Gabow says, is, "How does one create a reasonable floor for access coverage and quality across all the states?" Another challenge is the fee-for-service nature of Medicaid, "which is a problem not just for Medicaid," she says. "It's a problem with our whole delivery model."

John is a Governing correspondent covering health care, public safety and urban affairs.
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