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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.”



2016 Top 25 Minority Executives in Healthcare--Tauana McDonald: Leaders remove roadblocks so their people can succeed

By | December 8 th,  2016 | change management, SVP, Top 25 Minority Executives in Healthcare, bundled payments, C-suite, Catholic healthcare, electronic health records, IBM, ICD-10, Modern Healthcare, Rometty, Tauana McDonald, Blog, leadership, Trinity Health | Add A Comment


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


She paved the way for the ICD-10 project at Trinity Health in Michigan. She led the move to electronic health records. She mastered meaningful use. Now, she’s wrapping up bundled payments.


If you need a major project orchestrated correctly at Trinity Health, you inevitably turn to Tauana McDonald, senior vice president of clinical business operations for the Catholic health system.


“I know that I am not a clinician,” she says. “I identify the strategy needs and develop the plans. I lead the work from the corporate office so our clinicians don’t have to focus on operational issues and they can do the work they do best, which is taking care of patients.”


From the standpoint of organizational mission and personal satisfaction, it’s a role that McDonald says is a good fit for her.


“I think some of the projects I lead are making very positive change,” she adds. “That’s how I get to impact both the patients and the caregivers.”


McDonald came close to becoming a physician herself. Both of her mother’s sisters were nurses – one in the operating room and one in pediatrics. She remembers them both as being very nurturing people.


“People in the community looked to them during their most vulnerable times and there was something about that quality that really appealed to me,” she says.



So she completed four years of college as a pre-med, but the doubts about whether it was a good fit for her intensified as she sat down to apply to medical school.


“I called my parents and said, ‘I don’t think I want to be a doctor.’ And they said, ‘That’s fine. You just need to do something that is going to make you happy and contributes to society.’ ”


Giving back is a crucial part of McDonald’s ethics, a trait that she says was instilled by her parents. “In our household, we were always taught to serve because we were blessed and we should use our gifts and talent to help other people,” she says. “I thought healthcare was a great way to do that.”


After deciding to pursue a different future than medicine, she enrolled in the University of Michigan graduate school, where she earned a master’s in health administration. “From the first day in the first class, I knew I had landed in the right spot for me. That’s what got me started on my healthcare journey.”


Her path had several key stops along the way – IBM, where she was hired by future CEO Ginny Rometty; Deloitte, where she spent seven years doing strategy and operations consulting with healthcare organizations around the country; and motherhood – she stayed home for several years after her children were born.


The traveling that came with the Deloitte job was more than she wanted as she balanced family responsibilities, but her former employer Deloitte helped her find a good match at Trinity Health, where she gravitated to the system’s mission that echoed her mother’s advice that “to whom much is given, much is required.”


“A few days after I joined Trinity Health, I was in a meeting and we had to make a tough decision,” McDonald remembers. “The CEO leading the meeting said, ‘Can we bow our heads in prayer? Lord, let us put the patient first and ourselves last. Let us do the best thing for our patients.’ At that moment, I understood what it meant to be part of a faith-based organization. It really resonated with me. It still does.”


She says she also appreciates the diversity of the ministries that Trinity Health offers.


“If there is any kind of work you want to do in healthcare, you should be able to do it at Trinity Health,” she says. “Because we’re so big, there are so many different experiences. If you want to work in a large urban environment or an academic setting, you can work with our Loyola system. If you want to work in a small space, you can do that too. If you are interested in advocacy, we have a huge advocacy team.”


The diversity of the staff is of utmost importance to McDonald as well.


“Developing diverse leaders is really my passion, and I am intentional about it every day, looking at people in our organization who have a lot of talent that other people may not see right away,” she says.


“I believe that having a diverse workforce as well as a diverse leadership team helps us serve our patients better, because we’re bringing those same perspectives. We look like the patients we serve.”
As healthcare continues to evolve, the need for new ideas is critical, and a diversity of experiences can catalyze that, McDonald says.


“I take every opportunity that I can to help people with different perspectives share their voice and get a place at the table that allows them to do that.”


As the leader of so many key initiatives at a major American health system, McDonald is highly sought after as a mentor. Yet she says many of her key takeaways in leadership come not from another healthcare executive but from Florence Ferguson, her 102-year-old grandmother.


One key lesson Ferguson taught her repeatedly was, “You need to begin with the end in mind.”
“She said that a lot,” McDonald recalls. “She said that you need to think about where you want to end up because, as you’re going down that path, you need to be very thoughtful in order to get the results you want.”


Ferguson’s other key concept echoed the best leadership experts in her own less-fancy words.


“We always hear people talk about the shadow of the leader,” she says. “In her words, my grandmother would say, ‘Tauana, your actions are speaking so loudly that I cannot hear your words.’ If you speak things and your actions go in a different way, I don’t think you’re credible as a leader. So I try to have my actions support what I say – and I learned that from my grandmother.”



2016 Top 25 Minority Executives in Healthcare--Trent Haywood: Clinical leaders essential in move to value-based care

By | December 6 th,  2016 | Blue Cross Blue Shield Association, chief medical officer, Community Health Management, population health, Top 25 Minority Executives in Healthcare, Trent Haywood, Modern Healthcare, Blog, Centers for Medicare and Medicaid Services, health disparities, healthcare costs, leadership, physician executive, Lawton, VHA | Add A Comment


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


Trent Haywood has multiple titles after his name – an MD as well as a JD. But to find respect and cohesion among his leadership-team peers as he moved into a role as a physician executive, he says his biggest lesson was to check his degrees at the door.


“Someone gave me advice early on that, if you’re going to transition away from the bedside, you have to become comfortable no longer being called ‘Dr. Haywood’ but just ‘Trent,’ ” says the chief medical officer of the Blue Cross Blue Shield Association. “Being viewed as ‘the doctor’ has great social capital, but it prevents other executives from really getting to know you and sharing with you as a peer.”


But make no mistake – Haywood says he believes that more clinician executives are needed precisely because of their unique qualifications to bring the value to value-based care and to balance patients’ needs and concerns with healthcare finances.


“The business is evolving,” he says. “The model used to be ‘the suits and the scrubs.’ The suits did their thing, and the rest of us in scrubs did our thing. It was very siloed, and as long as you stayed on your side of the fence, it worked well.


“The model is changing. You have a new generation of clinicians who are going back and getting additional degrees. I think it’s going to continue to be the norm where you’re going to have many more clinicians in leadership roles.”



Haywood says his experience was easier than a lot of physician executives because he was able to wear both hats on a weekly basis for a seven-year period while he worked at the Centers for Medicare and Medicaid Services.


“On the weekends, all I was doing was focusing on individual patients as they came through the door of the ER. Then, during the week, I would be back at CMS flying all around the country trying to make a difference on a national level. My situation was unique; I was fortunate.”


Haywood’s own influences in leadership included his parents. His father Stanley, who recently passed away, had the longest tenure on the Lawton, Okla., city council in history. His mother Charlotte led the young people’s program for many years at the church the family attended.


“I learned early on from my mother that if you want maximum output, you have to take the time to invest in people,” he says. “You also have to delineate which people you are going to invest your time in.”


Haywood’s father coached him in athletics and impressed upon him the importance of teamwork over individual accolades. “If everyone showed up for practice, they were going to get into the ballgame, regardless of ability,” he remembers. “He put the onus on the team to think beyond ourselves and how we were going to approach the game in a team-based manner.”


In the same way, Haywood notes, payers and providers are going to need to work together as a team to help renovate the U.S. healthcare system. As someone who has worked as the deputy chief medical officer for the government (CMS), and chief medical officer for a major provider association (VHA) before coming to BCBSA, he thinks the convergence can’t happen soon enough.


“You’re going to see more and more collaboration across the board within a population-based framework,” Haywood says. “If I want to manage a population, then I need to understand more acutely where that population is going in terms of specialists and which ones are performing better for my population.”


But the talk between payers and providers needs to evolve beyond healthcare delivery, he says. Affordability is critical when many families live paycheck to paycheck with little savings, and that is reflected in BCBSA’s push for transparency in healthcare costs, Haywood adds.


“We don’t want families paying for waste in the system, and so that’s led to the issue of transparency. And the purpose is affordability – how can we make healthcare affordable for a family?”
Haywood has been using BCBSA’s new Community Health Management hub tool to take a deep dive into the data that affects healthcare consumers at the ZIP code level. For example, he recently dug into the statistics to show how something that many people take for granted – access to a car – affects population health, with many people in struggling neighborhoods unable to maintain nutritional health because they lack transportation.


“We need to get into the communities and do a better job of population health at the community level,” he says. “We need to find answers to questions like: What are the characteristics of a population? What are the environments in which we find those populations? And what are the behavior patterns of those communities?”


Like his father, the city councilman, Haywood hopes to make a difference on the local level – by guiding BCBSA policy on a national scale.


“Most healthcare decisions happen outside the four walls of a clinical setting,” Haywood says. “I’m excited that we’re going to transition to more of a preventive healthcare model instead of a disease-based model.”



2016 Top 25 Minority Executives in Healthcare--Pamela Sutton-Wallace: Leaders need to challenge themselves to grow

By | December 1 st,  2016 | academic medical center, Pamela Sutton-Wallace, Top 25 Minority Executives in Healthcare, University of Virginia, Lean, Modern Healthcare, Blog, CEO, Duke University, safety, quality | Add A Comment


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


Pamela Sutton-Wallace earned many accolades while serving 17 years in the Duke University Health System and easily could have spent many more years there. But she wanted to prove she could excel in leading a healthcare institution, and that led her to University of Virginia Medical Center, where she was named CEO in 2014.


“I grew up in the Duke system and was afforded many opportunities to develop skills, knowledge and relationships to be successful in healthcare leadership,” she says. “In accepting the role of CEO at UVA, I wanted to challenge myself by applying these skills in a new environment where I believed I could bring value.”


Given her Duke pedigree, where she rose to senior vice president of hospital operations, it’s no surprise that her goals for UVA are high: to make it one of the top 10 health systems in the country. She inherited a strong structure, one with little to no debt on the books. But as she assessed UVA, she came away feeling it was a well-respected organization that nonetheless wasn’t getting enough attention for all of its accomplishments.


“UVA had this great reputation, but you didn’t see it referenced anywhere,” Sutton-Wallace says. “It wasn’t on Leapfrog and U.S. News & World Report. You didn’t see it on NIH listings. But I felt very aspirational, because all the underpinnings are here. We have some of the best faculty, some of the most innovative physicians, nurses and professionals I’ve ever met.”


From the moment she began talks with her supervisor at the University of Virginia, Executive Vice President Rick Shannon, who is known for his work in quality and safety, she was determined that quality, safety and service would be “the hallmark of care.”


Thus, UVA uses the Lean method and real-time, root-cause problem solving to address six areas of concern in its Be Safe Initiative. If an issue is reported in any of those areas, from a pressure ulcer to an infection to a staff injury, Sutton-Wallace and her leadership team visit the unit/department in question to ask what happened, whether the team faced barriers that led to the issue, and whether it was preventable.


“In two very short years, we have been able to achieve demonstrated improvements,” she says. “That’s exciting to me. That’s why we do what we do.”


Sutton-Wallace took a circuitous path to end up doing what she does. Although she was a candy striper as a youth – her mom worked as a medical transcriptionist for close to 40 years in a small Baltimore community hospital – her initial interest was in politics.


“I was three years into working on a Ph.D. in political science,” she says, “and I realized I didn’t want to teach and do research in the political space for the rest of my life.”



She took a job working in underwriting at Blue Cross Blue Shield of North Carolina. It was during that time that Hillary Clinton was attempting to create a model for universal healthcare during her husband’s administration. Sutton-Wallace became inspired by that and went back to school, earning a master’s in public health at Yale, a curriculum that still pays dividends to this day, she says.


“At Yale, I had to take just as many epidemiology and biostatistics research method courses as health policy and management courses,” Sutton-Wallace notes. “I was in a classroom setting that taught clinical aptitude. The majority of students weren’t clinicians, but you came to understand disease pathology and the whole notion of population health.”


Her background has afforded her good conversations with clinicians, she says, because she doesn’t approach situations from a strictly financial angle.


“I’m very invested in what the quality is, and what are the outcomes associated with care,” she says. “Public health has always been about population health.”


Of course, finances are always one facet of the picture, and that is quite clear at academic medical centers, including UVA, which will face unprecedented financial challenges given the changing climate for healthcare providers.


“How are academic medical centers, which have often relied on very slim margins, going to continue to invest in research and education?” she says. “That’s really challenging, because we still have an insatiable appetite for new technology and new discoveries, and we still want to train the best and the brightest new clinicians. But we don’t necessarily have the income streams in those missions to cover those costs.”


It’s a dilemma that CEOs nationwide are trying to solve, even those like Sutton-Wallace who didn’t initially aspire to a healthcare career. Because of that, Sutton-Wallace says she enjoys speaking to students and young professionals about her journey, including that interrupted path to a political-science doctorate.


“My best lessons came from making mistakes,” she says. “You learn a lot about yourself. You learn resilience, you learn the power of mentors to encourage you, and you learn how to integrate those learnings into improved performance.


“You also learn not to be discouraged if things don’t work out exactly as you’ve planned. Half the battle is figuring out what it is that you don’t want to do.”



2016 Top 25 Minority Executives in Healthcare: After a complex merger, Ruth Brinkley works to build a new culture at KentuckyOne Health

By | November 28 th,  2016 | merger, Top 25 Minority Executives in Healthcare, Modern Healthcare, Ruth Brinkley, Blog, Catholic Health Initiatives, CEO, CHI, diversity, leadership, Louisville | Add A Comment


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


Mergers and acquisitions are complicated equations when just two organizations are involved. But three? That’s a daunting challenge for anyone. Small wonder that Catholic Health Initiatives turned to a veteran CEO like Ruth Brinkley to choreograph the complicated venture and lead the new KentuckyOne Health system.


Brinkley, who revamped the sprawling organization to survive and thrive under reform, says the bumps in the road are beginning to get fewer and farther between. “I’m a big believer in culture and the impact of culture on strategy and on building excellence,” she says. “One of the things we have consciously worked on since the very beginning was to shape a desired culture. I would say we’re 60 to 70 percent of the way there.”


KentuckyOne Health is comprised of the former Saint Joseph Health System, the former Jewish Hospital & St. Mary’s HealthCare, and the University of Louisville Hospital and James Graham Brown Cancer Center. It is a complicated arrangement. Catholic Health Initiatives is a majority owner of KentuckyOne. The other owner is Louisville-based Jewish Heritage Fund for Excellence. But the individual hospitals that were Jewish hospitals are still Jewish; the Catholic ones are still Catholic; and the university hospital remains secular. The partnership with the university was held up by former Kentucky Gov. Steve Beshear, who initially challenged a full three-way merger over concern that the public university hospital would be required to follow the Ethical and Religious Directives of the U.S. Conference of Catholic Bishops. And that, in turn, slowed down the process and the culture work by about a year.


Daunting? Absolutely. But Brinkley’s eyes were wide open from the beginning.


“I did expect this to be a big job, a big bite, so to speak,” says Brinkley, who left Carondelet Health in Tucson, Ariz., to return to Louisville and CHI. “I believe in the merger, in the vision of what we set out to do. When the days or the issues get tough, I go back to the belief in that vision.”


Brinkley had already achieved much in her career as a CEO and a lauded leader in Catholic healthcare for many years. Her resume was full. But the prospect of the merger energized her, moved her geographically closer to her children and grandchildren, and brought her back to her what she calls her extended family at CHI.



“The real draw was the excitement of the vision for this merger and what it was to accomplish. And it felt familiar. It felt good coming back to CHI. It’s always been a wonderful place to work. You see the mission come alive, and you see the values in people’s hearts.”


While the work of the merger more than filled her days, and many of her evenings, it was a temporary diversion from a personal tragedy.


“I had experienced a big loss in my life; my husband passed away when I was in Arizona,” she says. “Time is a great healer and work is a great healer, if you use it correctly. But I will also tell you that we all eventually have to pay the debt of grief. I like to say that grief can be delayed, but it won’t be denied. The work gave me something to focus on, but we each have to go back and deal with the issues we need to deal with, and I did that as well.”


Brinkley’s career has taken her from rural Georgia, where her grandparents raised her, to urban Chicago as a student and a nursing leader, to a number of other settings. So she is well-versed in the many types of populations that KentuckyOne serves, from Appalachia to Louisville. “The needs are very different across the state,” Brinkley says. “We try our very best to represent and reflect the communities we serve.


“We know that healthcare does not begin and end inside the walls of a hospital, so we’ve developed outreach programs to decrease the use of the emergency room for routine care, and to decrease readmissions. We’re starting to focus more on the social determinants of health.”


Brinkley says she learned many key lessons on leadership from her grandmother, who encouraged her to become a nurse, as she was growing up in Georgia – in fact, in 2009, she wrote a children’s book called “Grandma Said” to honor the woman who shaped her early life. But in Georgia, Brinkley also saw the sad results of those aforementioned social determinants, as family and friends dealt with suffering brought on by health disparities. Thus, she makes it a key priority to move her organizations upstream into the communities whenever possible.


“We know that a hospital only impacts 20 or 25 percent of health status,” she says. “The rest are social determinants. So, for example, at our St. Mary’s facility in west Louisville, we are starting a community garden. It’s a somewhat challenged area with a lot of immigrants. The city is leasing us 4 or 5 acres of land. We are going to engage the community and staff and hopefully be able to help people grow their own vegetables, because we had found through our community health assessment that this was a real need.”


Another need that Brinkley has been talking about for a number of years is the push to increase diverse leadership at the highest levels of healthcare organizations. Patients, she says, benefit greatly from diversity.


“It’s where our greatest opportunity is to serve the community,” she says. “It’s so important for our patients to have people in leadership who look like them and can relate to them. We have a lot more work to do, but we’ve made a good start at KentuckyOne.


“You have to let people know through word and deed that you understand their experience.”
With a wealth of experiences to draw from, Brinkley is trying to do just that.



2016 Top 25 Minority Executives in Healthcare: Nicholas Tejeda responds to healthcare's need for younger leaders

By | November 21 st,  2016 | academic medical center, El Paso, Top 25 Minority Executives in Healthcare, C-suite, Modern Healthcare, Tenet, Blog, CEO, leadership, the Hospitals of Providence, Transmountain | Add A Comment


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


When Nicholas Tejeda got his first CEO post at the ripe old age of 32, he made a running bet with his assistant.


“Every time someone new would come into my office and meet me for the first time, our bet was, ‘How long will it take for the person to make a comment about my youth?’ Almost inevitably, it would be seconds, not minutes,” Tejeda remembers.


Now, two promotions later within the Tenet organization, the 36-year-old Tejeda is the CEO of a hospital that hasn’t even opened yet, the Transmountain Campus of The Hospitals of Providence in El Paso, Texas. The comments keep coming, albeit less frequently, and he sees it primarily as a function of working in healthcare.


“Certainly, no one is commenting in the Bay Area on anyone in technology being young when they’re 36,” says Tejeda, a student of history. “Quite the opposite – they’re considered quite aged for the industry at 36. But if you look back in time at what Thomas Jefferson was able to accomplish by the time he was in his early 30s, or Albert Einstein and his miracle year that he had well before his 30s, you realize that it’s a unique function of hospitals to look at youth that way.”


Tejeda says he finds that large health systems are more open to younger leaders than community hospitals or small systems.


“I find that independent hospitals and smaller systems don’t appear to have the luxury or the comfort with taking a risk on people who might be younger,” he says, “and it’s for a couple legitimate reasons. One is that they question the experience relative to the other people who are willing to come there. The other thing that the hospitals question is the young executive’s willingness to remain in the organization for a sustained period of time.”



Some in the industry have questioned whether the changes engendered by the Affordable Care Act have deterred organizations from hiring or promoting young C-suite leaders, but Tejeda doesn’t see that as an impediment.


“I don’t think the ACA has been at all harmful to younger leaders,” he says. “In fact, I believe it has reinforced the need and the recognition by boards of trustees that a different talent set and a new sense of energy and curiosity is needed in leadership to adapt and understand the ACA. What has worked in the past might not work going forward, and so that’s given those in governance a reason to look at new types of leaders.”


A new approach is certainly what Tenet has in mind with the Transmountain Campus which, when finished in 2017, will be the fourth acute care hospital in The Hospitals of Providence health system in El Paso. The new facility is a teaching hospital developed through an academic affiliation agreement with the Texas Tech University Health Sciences Center. El Paso is sorely lacking physicians and the new venture will play a major role in solving this challenge.


“This hospital is a large step in helping address that shortage,” he says. “Studies have shown that physicians are more likely to remain where they train. The relationship between Tenet and Texas Tech is very strong, and I’m intrigued by what we can do in this market.”


Although he left a non-profit system (Catholic Health West, now Dignity) to join for-profit Tenet, he says the differences between the two types of organizations are exaggerated.


“Both want to strengthen clinical quality and safety, improve the patient experience, and remain a financially viable partner for the community. At the end of the day, healthcare is a physician or nurse taking care of a patient, and they don’t care if the parent company has bondholders or shareholders.”


Tejeda has only been in El Paso for about a year. He has moved several times in response to career opportunities.


“I often get asked by early careerists, ‘How have you had such success?’ ” Tejeda says. “There is no shortcut to hard work, diligence, risk-taking and luck. But one thing I can’t overemphasize is mobility, and for me, mobility comes with a strong supporting partner, my wife. We have moved several times.


“We just moved from California, where we lived next to her parents – and we have their only grandchildren. Yet she supported the move to a community that we didn’t know, where we’d never been, and where we didn’t have any family because she knew this was a wonderful opportunity for us.”


As to hard work and luck, Tejeda grew up in Wichita, Kan., and he and his siblings worked in his father’s pharmacy from a young age.


“It was my dad’s expectation that my sisters and I would know the customers’ names by the third time they came in. He’d remind us that the customers never wanted to be in the pharmacy, because they were sick and sometimes grumpy. But he said, ‘Imagine what you’ve won if they leave the pharmacy with a smile because of how you’ve treated them.’ I’ve never forgotten that.”


Luck intervened when the college-age Tejeda found a university and a part-time job close to his girlfriend Elena, who is now his wife. He stumbled into a job working in patient registration at St. Rose Hospital in Hayward, Calif. It was there that he had a chance encounter with the hospital CEO, Michael Mahoney. The two had an instant connection, as St. Rose was owned by a parent company in Wichita, Tejeda’s home town. They spent an hour talking, with Mahoney telling him to look him up after college if he wanted a job. Tejeda did.


The rest, of course, is history, albeit a short history. He is, after all, just 36.



2016 Top 25 Minority Executives in Healthcare: Wright Lassiter: In healthcare's new order, no time to bask in past success

By | November 8 th,  2016 | Allegiance Health, Baldrige, merger, Top 25 Minority Executives in Healthcare, Health Alliance Plan, Modern Healthcare, president, succession, succession planning, transformation, Alameda County Medical Center, Blog, CEO, HealthPlus of Michigan, Henry Ford Health System, Nancy Schlichting, Wright Lassiter III | Add A Comment


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


Wright Lassiter earned kudos as a CEO for engineering a huge turnaround of the troubled Alameda County Health System in California. Now, as he succeeds Nancy Schlichting as the leader of the prestigious and celebrated Henry Ford Health System in Michigan, you might think he could take a deep breath and relax a bit.


But that’s not how he sees it at all.


“As we look at the next 5 to 10 years, the way that quality and safety outcomes will be measured will be different,” he says. “We’re clearly moving even more from volume to value and risk, so I think the measures for success for Henry Ford in the future will be different than they have been for the last 10 or 15 years. I strongly believe that there is transformation required for our organization. We need to focus differently than we have in the past.”


Henry Ford won the coveted Malcolm Baldrige Award for quality in 2011, just one of a series of major accomplishments in its long history of stellar healthcare. Lassiter says one of his tasks in seeking to propel Ford to even greater heights is to remind his staff that past glories are no guarantee of future results.


“In a rapidly changing industry that may require different things of us, some days I worry about the complacency that could spring from so many years of excellence,” he says.
In particular, notes Lassiter, the future success of Henry Ford may not be as closely tied to the success of hospitals as it has been in the past.


“For the next five or 10 years, we’re going to have to leverage our large medical group, community medical staff and our insurance company much more effectively than we have in the past,” he says. “That will require both executional and cultural shifts to do even more of what we call integrated care and coverage, this notion of a more narrow network. And I think we’re perfectly situated to do that.”



To grow, Henry Ford is stretching out beyond its traditional home of Wayne, Macomb and Oakland counties, where it has provided care for the past century. In recent months, the health system has merged HealthPlus of Michigan, an insurance company 75 miles north of Detroit, into Health Alliance Plan and merged Allegiance Health, a system 90 miles west of Detroit, into the system. They’re also partnering on the Aldara Hospital and Medical Center, a hospital in Riyadh, Saudi Arabia, that will open later this year.


“These are the kinds of things we’ll be doing more of in the next five-plus years and that will require some transformation,” Lassiter says.


The announcement of Lassiter’s appointment as Schlichting’s successor struck some as unusual in the healthcare world simply because of the length of the handoff was two years. But, as Lassiter notes, there were some unusual circumstances.


“If it was a planned succession within the organization, two years is not necessarily that unusual,” he says. “But for us, the board thought it made sense because they had agreed on Nancy’s retirement date, and there was a lot of strategic work that they wanted to happen. The board was very clear that they wanted the new CEO to be fully engaged in the strategic work to reduce the risk of transition derailment or midstream change.”


When Lassiter came aboard, Schlichting quickly moved many of her key executives into a structure that reported to Lassiter. A number of those leaders, who had been contemplating their own retirements, warmed to Lassiter quickly and agreed to stick around as part of the transition team. And then came one of those unexpected circumstances that upped the ante – in June 2015, President Obama asked Schlichting to become the chairperson of the Commission on Care, which Congress established to find the best way to provide healthcare to military veterans.


“Nancy has acknowledged from day one that there was no way she could have served the nation in this role unless she and the Henry Ford board had agreed on an overlapping transition period,” Lassiter says. “The commission requires her to travel quite a bit, and that has actually accelerated the transition process as well.”


As Lassiter puts his own stamp on Henry Ford over the next decade, what will constitute success? He lists four items:


• HFHS will leverage its Baldrige award to become a high-reliability organization, one that can put its safety record up against the aviation and nuclear industries;


• It will be seen as the leading value-based healthcare system in the country;


• It will have developed a comprehensive statewide delivery system across Michigan – and beyond;


• It will be in the top 10 percent in metrics for employee engagement, physician engagement, customer service and safety scores.


“If I could look back 10 years and we had achieved these things, I’d say we had been wildly successful,” he says.



Top 25 Minority Executives in Healthcare: Sumit Nagpal's technological innovations at LumiraDx take aim at overhauling care for people with chronic conditions

By | October 19 th,  2016 | Steve Jobs, Top 25 Minority Executives in Healthcare, Alere, LumiraDx, Modern Healthcare, NeXT, Richard Branson, software, Blog, CEO, EHR, interoperability, leadership, National Health service, Sumit Nagpal | Add A Comment


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


The challenges facing patient care go far beyond issues of EHR interoperability. Patients eat, drink, exercise, do home testing, take prescriptions and talk with friends and family in a plethora of ways that have nothing to do with doctors – so can all those everyday moments that don’t happen in a clinical setting be collated to keep chronic conditions in check?


Sumit Nagpal and his co-founders have been thinking and working on those questions for, oh, about 25 years now. Thus, LumiraDx, the latest iteration of their ideas, could be thought of as an overnight success that’s been two decades in the making, as customers are rapidly coalescing in their recognition of the transformation of patients’ lives that is possible with this new firm.


“We think of ourselves as an outcomes company,” Nagpal says. “Our approach is to coexist and make use of all of the existing infrastructure that’s already in place, including EHRs, and amplify it to find out more about individuals at risk, always safely, and always with their consent – identify them, risk-stratify them, and then help them achieve better outcomes through very targeted programs.”


Nagpal, Chief Architect of U.K.-based LumiraDx Holdings, and CEO of its U.S. unit located in suburban Boston, says to think of their offering as an “overlay” on top of existing systems that address needs inside the four walls of hospitals and physician practices, but currently in a siloed way. LumiraDx uses data from these systems, and joins it up with information from point of care and home-based diagnostic devices, social care systems, personal-activity trackers including wearables, and even social media to personalize and customize care solutions.


Are patients adhering to their medication schedules? Are they getting depressed and unable to do the things that will improve their well-being? Do they feel positive about their health? “All of that can provide context and inform us as we then work to help these individuals slow and perhaps turn back the progression of disease,” Nagpal says.


The successes are adding up quickly. Richard Branson’s Virgin Care rewarded LumiraDx with a national contract in England to help the company manage and improve outcomes across the high-risk populations it serves. That’s on top of LumiraDx’s contract with the National Health Service, the national payer for England, to join up health and social care data for the entire population of greater Manchester, affecting 2.9 million lives. Another contract with a major corporation will soon bring LumiraDx into 12 more countries in Western Europe and Scandinavia. And other agreements are in the works, including in the U.S. market.


“We’re a grown-up startup,” Nagpal asserts. “I hope we never stop thinking of ourselves as a startup in many ways, because that mindset gives us the agility, speed, innovation and creativity that I value so much. But our software platform is now in its fifth generation and it’s been proven and tried in the market with real customers pushing its boundaries to the point where its flexibility, usability, and scalability are market-defining. And our credentials around precision diagnostics are second to none.”


So who exactly is LumiraDx’s market? Nagpal outlines three categories of buyers for their population-health offering:


• Providers that have figured out that a focus on improving outcomes is the only path to surviving and thriving in the new emergent models of care.


• Payers, both private and public, that have taken on an active role helping their members create those kinds of outcomes.


• Employers who might be self-insured, acting as payers with a vested interest in helping their employees live healthier lifestyles and achieve better productivity and outcomes because of that.


LumiraDx, Nagpal says, aims to go beyond, say, a simple glucose test at home.


“We are taking point-of-care and home testing to levels that have not been seen in the industry yet. We’re able to measure more advanced and actionable indicators of chronic disease. We’re able to reach deeper into a patient’s health status and therefore provide more targeted interventions, proactively, before higher acuity arises.”


And clinicians are deeply involved in every aspect. “We’re doing this with patient consent, under the supervision of their physicians, collaborating with them so that there’s a joined-up care plan,” Nagpal says. “We’re breaking the silos down, rather than creating yet another one.”


The importance of physicians and caregivers in Nagpal’s world comes from his father, who is an MD. “If I go back in time, my interest in healthcare really did arise from being fascinated with what my dad does,” he says. “He evolved from being a doctor to managing hospitals to being involved with the public health status of large populations. I grew up in these organizations.


“I’ve seen a similar evolution in my career along the way. If I weren’t doing what I’m doing today, I actually would love being a doctor.”


As an entrepreneur, Nagpal bears the influence of another leader, Steve Jobs, for whom he consulted when Jobs was creating NeXT in between his stints at Apple. Nagpal is perhaps more low-key than Jobs but earnestly wants his products to become nothing less than an omnipresent strand in the fabric of healthcare.


Nagpal says the value he brings to LumiraDx is a vision for giving patients and their caregivers “a seamless user experience” that isn’t tethered to the boundaries of a health system and simply lets them go about their daily lives as LumiraDx works unobtrusively in the background. “I’m helping create products that just blend into the woodwork of daily life, into routine clinical practice, even though there’s tremendous change that these things are causing, and massive complexity that we are masking.”


The path from a driven, college-age CEO to his current role has been a journey in leadership, Nagpal says.


“Leadership is both about leading and but also massively about enabling people you work with to also lead,” he says. “It’s not a cult of personality; it’s a team sport. If I had to make a choice between trying to do it all myself or doing it with people who have an incredible pool of knowledge, experience, talent and leadership, it’s a very simple choice.


“We are able to go much further as a team of leaders than I could ever have possibly imagined doing myself.”



U.S. healthcare is broken. Sachin Jain and colleagues want to help transform it

By | October 12 th,  2016 | CMS, Sachin Jain, Top 25 Minority Executives in Healthcare, Modern Healthcare, readmissions, Anthem, Blog, CareMore Health System, extensivists, Harvard, physician leadership | Add A Comment


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


In his mid-30s, the laundry list of accomplishments that Sachin Jain, MD, MBA, has already achieved stretches like the curriculum vitae of an executive twice his age. As a medical student at Harvard, he and some friends started a medical clinic for the homeless. He eventually became a lecturer for Harvard Medical School and was a physician for Brigham and Women’s Hospital and the Veterans Affairs Boston Healthcare System. He and a friend founded a new medical journal that is growing by leaps and bounds.


He was a senior advisor to Don Berwick at CMS and has been a leading advocate for quality and safety. He was the chief medical information and innovation officer at Merck, the pharmaceutical giant. Now, he’s the president of CareMore Health System, an innovative blend of payer and provider that’s owned by Anthem.


So what exactly drives this guy?


“On some levels, it’s outrage,” Jain says candidly. “Healthcare could be better and should be better. I’ve always been drawn to problems related to our failure to effectively apply the knowledge that we already have. Healthcare is full of those problems.”


The mission aspect of healthcare comes naturally to Jain. His father, Subhash Jain, MD, founded the pain management service at Memorial Sloan Kettering Cancer Center. One of his aunts, Shanti Jain, MD, went against the grain in her native India by opting not to marry. She devoted her life to rural healthcare in India, going places other clinicians were loathe to go.


“She was somebody who saw problems in the world and came up with solutions,” says Jain of the woman who was an early pen pal of his as he grew up in New Jersey. “It wasn’t just about healthcare. She went to one community and saw the kids didn’t have a good education, so she built a school. She saw that the sanitation system was an obstacle to good healthcare so she started fixing the tatters of the sanitation system there.”


When Jain’s aunt died of ovarian cancer, her sister, Kanti Jain, MD, who was a diabetes researcher at Cornell University, moved to India to take over the work. Jain says he himself toyed with the idea of moving to Asia as well but decided against it, although he has volunteered with the medical mission there.


“Somewhere along the way, as the first person in my family to be born in the U.S., I became American and decided that America was my home,” he says with a chuckle. “And, frankly, I also had this realization that there are lots of people suffering from healthcare injustices right in our own back yard.”


With a background that includes mentors like Berwick, David Blumenthal (now head of the Commonwealth Fund) and Michael Porter (author and economist at Harvard Business School), Jain says he feels he has found an ideal outlet at CareMore for his passion around quality and safety. The organization actually was founded as a physician group by California gastroenterologist Sheldon Zinberg, MD, who created an innovative way to care for chronically ill elderly patients.



The idea is to be omnipresent via extensivists, who provide continuity of care, as well as home care to help prevent readmissions, whether that means supplying car rides to the doctor’s office or even delivering a refrigerator to keep insulin cold. It morphed into a health plan, focused on Medicare patients, and is now is a $1.2 billion enterprise that has more than 100,000 members in eight states and manages care for Medicaid patients in Memphis and Des Moines as well.


The results have been impressive:


• CareMore’s patients are hospitalized 20 percent less than the industry average, even though its population tends to be sicker than the average Medicare patient. (If one adjusts for the health of the patients, the admission rate is 40 percent less.)
• Its Congestive Heart Failure program participants on average experience 43 percent fewer hospital admissions than the average Medicare patient with CHF.
• For patients with end stage renal disease, there are 45 percent fewer admissions.


And its members pay lower costs as well.


Jain admits that the CareMore model won’t fit every situation. “The CareMore model is disruptive and transformative, so we have to be very thoughtful about how and where we integrate and pilot it,” he says. “But I do think there are a number of opportunities to take the work that we’ve done successfully serving Medicare patients to serve similar patients in commercial and Medicaid populations.”


It’s also making its presence felt in academic medicine circles. Leaders at Emory Healthcare in Atlanta recently chose CareMore to help them transform their care model for Medicare Advantage patients. It’s a provider-payer relationship that Jain says he is excited about.


“The leaders at Emory were visionary in their thinking that a California-based managed-care company could be a transformation partner,” Jain says. “They were able to think beyond the stereotypes of the payer industry and get into the guts of what CareMore actually does – and how it might be relevant in their setting.”


A year after joining CareMore as chief operating officer and chief medical officer, Jain was promoted to president in April 2016. With that distinction, he joins a growing list of physicians who are at the helm of healthcare organizations. He continues to see patients on a limited basis, and says he knows why physicians are willing to take on a bigger role.


“For the first time, you have a generation of physicians who are seeing that the system is broken,” Jain says. “They believe they can and should lead change, and that their insights as physicians can drive better care.


“We want to deliver better healthcare. We want to bring back the joy of work to actually delivering healthcare. There are few better jobs in the world than being a physician or a nurse where you get to take care of patients and be a part of their lives in that intimate way. There’s nothing quite like it.”



Revisiting the Top 25: Georges Benjamin says apathy and political agendas are threatening to roll back progress on public health

By | October 6 th,  2016 | climate change, payers, population health, Top 25 Minority Executives in Healthcare, clean air, clean water, Flint, gun violence, lead, Modern Healthcare, providers, Blog, American Public Health Association, APHA, zika | Add A Comment


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


Georges Benjamin has led the American Public Health Association as executive director since 2002, but he has never been busier or more vocal.


“I think we’re in an environment where the forces doing things that are opposed to the public’s health are more active, and so we’re more active,” he says.


The issues are numerous, from climate change to gun violence -– and a few things that didn’t used to be controversial at all.


“When you look at clean water and clean air, there’s an effort to push back on a lot of the things that public health has done over the years to make the environment safer for us and to make us healthier,” he adds. “We’re having to weigh in on things that, in our minds, were settled.”


Some threats he sees as audacious.


“The misinformation around the Affordable Care Act continues to be a concern and the lack of national recognition of the prevention aspects of the law are absolutely amazing,” Benjamin says.


Others, he says, are the result of apathy and inattention.


“We lost 40,000 public health workers across the country through the last recession and they haven’t been replaced,” he notes. “We’re losing programs because the funding has been cut. And then there’s public health preparedness. We spent a lot of money getting ourselves prepared after 9/11. Not only have there been reductions in funding for the preparedness of our nation to deal with biological attack, but our preparedness for everyday emergencies is not as good as it used to be.”


Benjamin's words may be finding an audience. On April 19, President Obama appointed Benjamin to the National Infrastructure Advisory Council.


The water crisis of Flint, Mich., is one example of the decay of public health, Benjamin says. So is a lack of funding to deal with mosquito-borne disease – not just zika, but dengue and chikungunya. Give him 10 minutes and he can tick off a variety of issues that need addressing, particularly in the corridors of Washington, D.C., where APHA is based. And, yes, he’d like to see hospitals and health systems get a little more vocal and visible on these issues too.


“The healthcare delivery side of the house needs to weigh in on a range of things that historically they have not weighed in on,” Benjamin says. “They always show up for the Medicaid hearing or the healthcare financing hearing. But we need them to show up at the hearing for the public health budget on lead, we need them to show up for the hearing on clean water. We need them to spend their healthcare dollars in a more objective way to address climate change.”


In many communities, hospitals are one of the biggest employers and have a large footprint. While some have made moves to address their carbon-dioxide emissions, it’s often done from a business perspective to get better energy rates, Benjamin says. “They also need to do it from a health perspective because it makes their community healthier. And they need to see it through that lens.”


If providers can become more public-health-conscious, he says, then they can begin to make a difference via population health.


“We have to make sure ‘population health’ isn’t just a buzzword and people don’t take what they’re already doing and rename it ‘population health,’ ” Benjamin says. “We want to make sure it doesn’t go the way of ‘managed care’ – the idea of the moment that, when it doesn’t achieve its goals because it wasn’t done right, people call it a failure.”


APHA works with payers as well, including partnerships with the UnitedHealth Foundation and the Aetna Foundation, and isn’t shy about criticizing insurers and providers alike. “When we think they’re off-track, we scream and yell and holler at them -– but we generally have the same goals around health and the well-being of our communities.”


With that community health in mind, Benjamin says he is glad to see more of his fellow clinicians stepping up to accept the mantle of leading administratively as well. “Having made decisions around patients gives you a unique perspective that you bring to the table. When you’re the COO or the CEO, the buck stops with you and you get to use those skills differently than you would if you were the medical director and in a more advisory role.”


But physician executives need to learn that leadership “is not giving people an order and expecting them to follow,” says Benjamin, himself a former military leader. “It’s setting goals, getting people aligned to go in a particular direction, and then giving them freedom.”


It’s a far different role than simply being a clinician, he says.


“One of the reasons I enjoyed being in an emergency position was that, most of the time, you saw results of your work right away. But in management, things are like a big battleship and they don’t turn very quickly. And so the gratification is much more delayed, much more subtle, and you’ve got to really understand what a win is.


“Sometimes a win is not what you would like. You have to accept progress and be comfortable with that. And then, realize you have to come back another day and try to move the boat a little further along.”