C-Suite Conversations

What healthcare leaders need to know now

Laura Kaiser of SSM Health brings courage, conviction to questions around healthcare's future

By | June 8 th,  2017 | Affordable Care Act, chief executive officer, Furst Group, Harvard Business Review, Modern Healthcare, NuBrick Partners, president, SSM Health, Ascension, Blog, costs, Cuba, Intermountain Healthcare, New England Journal of Medicine, Top 25 Women in Healthcare | 4 Comments

 

One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2017. Furst Group and NuBrick Partners, which comprise the companies of MPI, sponsor the awards.

 

U.S. healthcare has more questions than answers right now, but Laura Kaiser doesn’t shy away from them.

 

As the new president and CEO of SSM Health, Kaiser brings an impeccable resume back to her hometown of St. Louis, along with an inquisitive mind and a willingness to eschew the status quo.

 

“We need to think about how we make healthcare sustainable, affordable and accessible,” she says. “There’s always going to be a need for emergency care – acute, critical care, for injuries and illnesses that are unforeseen. But we need to invest in programs and services to minimize chronic conditions that are in fact preventable, because that will help us lower the overall cost of care.”

 

She’s outlined some of her thinking in major periodicals as co-author of articles in the Harvard Business Review and the New England Journal of Medicine. In HBR, she opined on “Turning Value-Based Care Into A Real Business Model.” And, in the medical journal, she and co-author Thomas Lee, MD, were blunt in encouraging big pharma to become full partners in the quest for value-based care: “As payers and providers work together to improve value, will pharmaceutical companies join that effort, or will they acts as vendors that merely maximize short-term profits for shareholders?”

 

“I think any approach to affordable care must have all stakeholders involved and engaged,” she says today. “I actually heard from one of the pharma companies after that was published, and they are interested in having further dialogue.”

 

Kaiser has no problem saying that healthcare is a right, not a privilege, for all humans, a stance her faith-based system supports completely.

 

“I’ve said this to many people without any intended partisan viewpoint,” Kaiser says. “No matter where you sit politically, healthcare isn’t political. For all of its flaws, the Affordable Care Act did three very important things. First, it heightened awareness about the need to provide excellent healthcare to all Americans. Second, it alleviated some financial hardship for people with pre-existing conditions. Last, it extended the availability of healthcare for people up to the age of 26 on their parents’ insurance coverage.”

 

A year and a half ago, Kaiser saw a different approach to healthcare during a fact-finding mission to Cuba, and she has been ruminating on it ever since.

 

“I wanted to see how it is that this small country – and one that has relatively limited resources compared to the U.S. – has better health outcomes than we do,” says Kaiser. “How are they doing that?”

 

Kaiser discovered that physicians, nurses and statisticians are embedded in each community at a rate of about one for every 1,000 to 1,500 residents.

 

“I visited a few of those clinicians,” Kaiser says. “Their medical records are spiral-bound notebooks with pencils. They provide primary care to patients and, if they need a higher level of care, patients are sent to a specialty practice, similar to a federally qualified health center in the U.S. If they end up needing hospitalization, they are simply referred to one of the hospitals across the country. It is a single system.”

 

And medicine is free, including insulin for people with diabetes.

 

“A lot of people in the U.S. have to make the terrible choice between buying medicines or food,” she says. “If we changed our approach, we could create incentives for people to stay healthy, and the overall cost of healthcare in this country would decrease. So, that’s my dream.”

 

At the time of the trip, Kaiser was chief operating officer of Intermountain Healthcare, a Utah-based health system known far and wide for its quality. Earlier in her career, she spent 15 years with St. Louis-based Ascension, another health system with a stellar reputation. Now, in taking the helm as only the third CEO in SSM Health’s history, she has a similarly pristine heritage to draw from – SSM Health was the first health system to be awarded the prestigious Malcolm Baldrige National Quality Award in 2002.

 

“The organization is deeply rooted in continuous quality improvement,” she says. “They have been on the cutting edge since the time of the Baldrige award, so there really is a great foundation on which to build the health system of the future.”

 

The answers that Kaiser and her team come up with should offer some interesting architecture for the future of SSM Health – and American healthcare.

 

 

SIDEBAR: The end of life brings questions, and courage, too

 

Much of the country’s healthcare spending occurs during the final weeks and months of patients’ lives. SSM Health President and CEO Laura Kaiser says that needs to be discussed openly and extensively.

 

“Discussing death and dying is becoming more acceptable thanks to people like Dr. Atul Gawande, who wrote the wonderful book Being Mortal, and Sheryl Sandberg, the author of Option B, a powerfully written book about recovering after suffering the loss of her husband,” says Kaiser, whose parents eventually chose hospice care after battling cancer. “Death and dying can be difficult to discuss, but it is something we need to grapple with as a country and as a society.”

 

She saw great courage in her parents as they made difficult decisions at the end of their lives.

 

“What my dad chose and experienced in hospice was beautiful care. It is what everyone should have if that’s where you find yourself,” Kaiser says. “Many years later, my mom made the same choice and had a similarly extraordinary experience.”

 

Her parents’ bravery flows through Kaiser and gives her confidence while she confronts complex issues as one of the nation’s leading healthcare executives. Kaiser’s dad, a chemical engineer, was her first mentor about leadership. She has fond memories of him from her childhood, listening to classical music in the car while driving to the library together. They shared a love for the “Peanuts” cartoons – especially Lucy, seated in her counseling booth, offering a listening ear for five cents.

 

“I trusted my dad’s counsel and would knock on his home-office door, saying, ‘I have my nickel.’ He would say, ‘Come on in for the consult,’ ” says Kaiser with a chuckle. “I had many 'consults' with him and am the better for it today.”

 

 

2016 Top 25 Minority Executives in Healthcare--Patricia Maryland: Taking risks helps leaders grow

By | December 12 th,  2016 | Affordable Care Act, Patricia Maryland, St. John Providence Health system, Top 25 Minority Executives in Healthcare, C-suite, Modern Healthcare, risks, Ascension, Ascension Health, Blog, CEO, chief operating officer, diversity, leadership, Sinai-Grace | Add A Comment

 

Classic content: One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Patricia Maryland is talking about her role as chief operating officer for the Ascension Health system, but her message seemingly echoes the philosophy of her entire career: to grow, you must take risks.

 

“A major part of my role is leading through change,” she says. “The healthcare industry is going through tremendous transformation which requires leaders to challenge the way we deliver care.”

 

While Maryland has been honored with a number of awards during the four years she has served as COO and president of healthcare operations, she says the arduous role that preceded her promotion stretched her in ways that made her current success possible.

 

In 2007, Ascension asked her to leave St. Vincent Health in Indiana and move to Detroit to become the CEO of St. John Providence Health System and Ministry Market Leader for Michigan. The recession was just getting started; General Motors and Chrysler were restructuring their debt through bankruptcy. The economic pain that Detroit became famous for was just taking shape. As a result, St. John was hurting too.

 

“That was the most difficult time,” she says. “A number of our patients who were formerly employed ended up losing their insurance. We had to close hospitals. We had to consolidate programs and centralize services, and that was very risky. I had to lead through the change of reconfiguring the health system to create long-term sustainability given the external factors impacting the region.”

 

It was a difficult professional time. But on the personal side, Maryland says she was taking a risk there as well. “My daughter was going into senior year of high school; my son was going into eighth grade. My husband was transitioning his career as well. I knew I had to make sure my family was settled and comfortable back in Michigan after having been away for 4-1/2 years.”

 

Looking back, Maryland says the sizable risk proved to be more than worth it.

 

“When I took on the role in Michigan, it was larger and more complex than my previous role, and I was further challenged because it was during the worse of economic times. But I felt like I grew so much from a professional perspective. That role really provided me with the experience I needed to prepare for my current role as chief operating officer. If I didn’t have that kind of experience in leading through change, I don’t think I would be as effective in my role today.”

 

With success comes confidence, and Maryland is utilizing her voice as one of the most powerful healthcare executives in the country to take aim at healthcare disparities. Through a series of op-eds she’s written, she is candidly and forcefully encouraging healthcare organizations and patients to build on the momentum created by the Affordable Care Act and work toward equity of care.

 

“Part of what spurred this outreach is that the African-American community has really embraced the ACA,” she says. “I think we’ve made some great progress to expand healthcare access for many minority populations, but we know that coverage alone is not enough to eliminate healthcare disparities.”
To truly be effective, Maryland says, healthcare organizations need to help patients navigate health systems that can be difficult to utilize.

 

“We must mobilize the newly insured to connect them to preventive care,” she says. “It’s really important that we get them into the appropriate setting right from the beginning. If you can get into a system early enough, see a primary care physician on a routine basis, and comply with your medication requirements, you can have a better outcome.”

 

Maryland is seeing this prescription for good health lived out in her own family. As the oldest of eight children, she was the primary caregiver for her mother, who passed away from diabetes complications at an early age. Three of her siblings are genetically predisposed to diabetes as well, and they and Maryland are determined that their outcomes will be different.

 

“They’re working hard to stave off diabetes,” she says. “They’re exercising, following and complying with their medication regimen, and keeping their weight under control. They’re taking personal responsibility to do what they need to do to stay healthy.”

 

Not every family, of course, has an executive like Maryland to be its advocate. That’s one reason why Maryland also has long been a champion of diversity in the C-suite.

 

“We definitely need to address the pipeline issues of finding more individuals who represent the type of patient we are treating within our organization,” she says. “But it’s also making sure that those who are in leadership roles have the cultural competency to be able to manage populations to which they are providing care.”

 

Such leaders, though, need to have the attributes of servant leadership, Maryland adds.

 

“The nature of our work requires humility,” she says. “The fact that we are taking care of people at their most vulnerable state, when they are entrusting their lives to us, requires a different kind of leader.”

 

Maryland says her mentors Tony Tersigni (President and CEO of Ascension) and Bob Henkel (President and CEO of Ascension Health) have been her role models for servant leadership. In fact, it was Tersigni who identified her as a potential CEO leader within Ascension after observing her leadership style at DMC Sinai-Grace Hospital. Sinai-Grace also was where she’d unknowingly caught the attention of authors James Kouzes and Barry Posner, who ultimately featured her in their book “The Leadership Challenge” because of the work she did in transforming Sinai-Grace by challenging the process of how care is delivered. During this time, she was able to effectively garner the support from the Jewish community to assist in the transformation.

 

“You never know who’s paying attention to you,” Maryland says. “So always do your best – and do it with grace.”

 

 

Patricia Maryland: Taking risks helps leaders grow

By | July 8 th,  2016 | Affordable Care Act, Patricia Maryland, St. John Providence Health system, Top 25 Minority Executives in Healthcare, C-suite, Modern Healthcare, risks, Ascension, Ascension Health, Blog, CEO, chief operating officer, diversity, leadership, Sinai-Grace | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Patricia Maryland is talking about her role as chief operating officer for the Ascension Health system, but her message seemingly echoes the philosophy of her entire career: to grow, you must take risks.

 

“A major part of my role is leading through change,” she says. “The healthcare industry is going through tremendous transformation which requires leaders to challenge the way we deliver care.”

 

While Maryland has been honored with a number of awards during the four years she has served as COO and president of healthcare operations, she says the arduous role that preceded her promotion stretched her in ways that made her current success possible.

 

In 2007, Ascension asked her to leave St. Vincent Health in Indiana and move to Detroit to become the CEO of St. John Providence Health System and Ministry Market Leader for Michigan. The recession was just getting started; General Motors and Chrysler were restructuring their debt through bankruptcy. The economic pain that Detroit became famous for was just taking shape. As a result, St. John was hurting too.

 

“That was the most difficult time,” she says. “A number of our patients who were formerly employed ended up losing their insurance. We had to close hospitals. We had to consolidate programs and centralize services, and that was very risky. I had to lead through the change of reconfiguring the health system to create long-term sustainability given the external factors impacting the region.”

 

It was a difficult professional time. But on the personal side, Maryland says she was taking a risk there as well. “My daughter was going into senior year of high school; my son was going into eighth grade. My husband was transitioning his career as well. I knew I had to make sure my family was settled and comfortable back in Michigan after having been away for 4-1/2 years.”

 

Looking back, Maryland says the sizable risk proved to be more than worth it.

 

“When I took on the role in Michigan, it was larger and more complex than my previous role, and I was further challenged because it was during the worse of economic times. But I felt like I grew so much from a professional perspective. That role really provided me with the experience I needed to prepare for my current role as chief operating officer. If I didn’t have that kind of experience in leading through change, I don’t think I would be as effective in my role today.”

 

With success comes confidence, and Maryland is utilizing her voice as one of the most powerful healthcare executives in the country to take aim at healthcare disparities. Through a series of op-eds she’s written, she is candidly and forcefully encouraging healthcare organizations and patients to build on the momentum created by the Affordable Care Act and work toward equity of care.

 

“Part of what spurred this outreach is that the African-American community has really embraced the ACA,” she says. “I think we’ve made some great progress to expand healthcare access for many minority populations, but we know that coverage alone is not enough to eliminate healthcare disparities.”
To truly be effective, Maryland says, healthcare organizations need to help patients navigate health systems that can be difficult to utilize.

 

“We must mobilize the newly insured to connect them to preventive care,” she says. “It’s really important that we get them into the appropriate setting right from the beginning. If you can get into a system early enough, see a primary care physician on a routine basis, and comply with your medication requirements, you can have a better outcome.”

 

Maryland is seeing this prescription for good health lived out in her own family. As the oldest of eight children, she was the primary caregiver for her mother, who passed away from diabetes complications at an early age. Three of her siblings are genetically predisposed to diabetes as well, and they and Maryland are determined that their outcomes will be different.

 

“They’re working hard to stave off diabetes,” she says. “They’re exercising, following and complying with their medication regimen, and keeping their weight under control. They’re taking personal responsibility to do what they need to do to stay healthy.”

 

Not every family, of course, has an executive like Maryland to be its advocate. That’s one reason why Maryland also has long been a champion of diversity in the C-suite.

 

“We definitely need to address the pipeline issues of finding more individuals who represent the type of patient we are treating within our organization,” she says. “But it’s also making sure that those who are in leadership roles have the cultural competency to be able to manage populations to which they are providing care.”

 

Such leaders, though, need to have the attributes of servant leadership, Maryland adds.

 

“The nature of our work requires humility,” she says. “The fact that we are taking care of people at their most vulnerable state, when they are entrusting their lives to us, requires a different kind of leader.”

 

Maryland says her mentors Tony Tersigni (President and CEO of Ascension) and Bob Henkel (President and CEO of Ascension Health) have been her role models for servant leadership. In fact, it was Tersigni who identified her as a potential CEO leader within Ascension after observing her leadership style at DMC Sinai-Grace Hospital. Sinai-Grace also was where she’d unknowingly caught the attention of authors James Kouzes and Barry Posner, who ultimately featured her in their book “The Leadership Challenge” because of the work she did in transforming Sinai-Grace by challenging the process of how care is delivered. During this time, she was able to effectively garner the support from the Jewish community to assist in the transformation.

 

“You never know who’s paying attention to you,” Maryland says. “So always do your best – and do it with grace.”

 

 

At Ascension, Patricia Maryland’s patient-centered focus aligns with a passion for analytics

By | September 25 th,  2015 | Healthcare, Patricia Maryland, executive, Modern Healthcare, patient-centered care, president, analytics, Ascension, Blog, leadership, Top 25 Women in Healthcare | 1 Comments

 

One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2015.

 

As the oldest daughter in a large family, Patricia Maryland, Dr.PH, was often left in charge when her mother was hospitalized during a years-long struggle with Type 2 diabetes. Her mother eventually died of complications from the condition, and Maryland recalls her frustration with the fragmented healthcare system in which they found themselves.

 

“We didn’t understand at that time she needed more than general primary care,” she says. “Someone should have been helping us navigate her care to the appropriate subspecialist and other support systems as her condition continued to worsen.”

 

Unfortunately, similar stories have played out within hospitals and health systems across the United States.

 

As president of healthcare operations and chief operating officer of Ascension Health, a subsidiary of Ascension, Maryland is committed to leading change – knowing from experience the great need for personalized, coordinated care in this ever-changing healthcare environment.

 

“I think we can do a better job in healthcare,” says Maryland. “The time has come for us to turn the process upside down – or should I say right-side up – organizing the providers around the needs of the patients, not expecting the patients to figure where to go in our complicated health systems to get the care they need at the convenience of the providers.”

 

As the world’s largest Catholic health system, Ascension’s mission is steeped in delivering spiritually-centered, holistic care to all with special attention to those who are poor and vulnerable. Maryland makes a point of saying that all healthcare leadership should approach the business of healthcare from a similar perspective.

 

“Without passion for why we are here and what we are trying to do, we will not be able to be the transformational leaders that healthcare needs today.”

 

That passion has not dampened her business objectivity, however. Quite the contrary. Maryland’s passion is paralleled only by her dedication to analytics, cultivated through her master’s degree in biostatistics and doctorate in public health.

 

 

Maryland explained that biostatisticians tend to work in pharmaceutical industries or medical research areas, with a focus is on efficacy, research, precision and statistical analysis. However, she believes that in today’s health industry, metrics are essential for all healthcare leaders.

 

“Data analysis is the lifeline of any business, particularly a healthcare organization,” she says. “It is vital that we maintain clear and measurable data so that we can address opportunities for improvement that would not be realized otherwise. By tracking trends, Ascension analyzes where we need to go and what decisions we need to make on any given initiative.”

 

Maryland says statistics are especially crucial as the roles of payers and providers overlap and converge.

 

“As we think about population health management and the direction that the health industry is moving, analytics and the ability to predict outcomes using data is so important,” she says. “Predictive analytics have helped us manage risk.”

 

Her background has come in handy as Ascension has moved boldly into this new era of providers taking on risk. She was one of the architects of Together Health Network (THN), formed by partnering with Trinity Health, another Catholic system, to create a physician-led, clinically integrated network in the state of Michigan. THN worked with Blue Cross Blue Shield of Michigan to create Connected Care, a Medicare Advantage product that rolled out in January 2015 and already has surpassed enrollment projections.

 

“We are especially attractive to payers because our organizations – both Trinity and Ascension – have some of the best metrics in the state,” Maryland says. “We are able to offer the value combination of high quality and low cost to major payers, and to take on and manage their members with a level of consistency.”

 

With Ascension operating in 23 states as well as the District of Columbia, the THN experience has been a strong test run to for the organization in developing comprehensive, integrated systems of care. It’s also working to round out other parts of the care continuum – including senior care and home care – so it can better serve its communities.

 

Ascension also has taken the plunge into insurance. The system acquired U.S. Health and Life Insurance Co. last December and is using that platform as well as MissionPoint Health Partners, its population-health management company, to develop benefits and gain experience by managing the quality and cost of care for Ascension’s own associates and their dependents. In essence, it has become its own incubator for development of an insurance product for self-insured employers.

 

“We are going to pilot it first with our own employees,” Maryland says. “Once we have a proven track record with our associates, we’ll take it to market. How do we go anywhere else and offer the product unless we ourselves can say, ‘Look at our results.’ This is also why data is so important. We believe we have the best practices, and with this data we will be able to demonstrate it.”

 

From new partners to new products, healthcare’s future looks a lot different than it did just a few short years ago. Yet despite the changes in how her system and the industry operate, she says the fundamentals are the same. After all, as Maryland knows, healthcare is deeply personal.

 

“Considering Ascension’s scale and scope, we asked ourselves, ‘If not us, then who?’ We are committed to leading change in the healthcare arena,” she says. “Through standardizing and connecting once disparate systems, we remain true to our Mission of delivering compassionate, personalized care to those who need it the most.”

 

 

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