Latest / Becker’s Healthcare Podcast / Transforming Care and Culture at TriHealth with Mark C. Clement

Transcript

Transforming Care and Culture at TriHealth with Mark C. Clement · Becker’s Healthcare Podcast

0:00
This is Scott Becker with the Beckers Healthcare
0:03
Podcast.
0:04
We're thrilled today to be joined by one
0:06
of the nation's best transformative
0:08
leaders.
0:09
We're we're joined today by Mark Clement.
0:12
Mark is the CEO of the TriHealth System
0:14
in Cincinnati.
0:15
In the decade plus that he's ran or
0:17
led the TriHealth system, they just have had
0:20
an incredible improvement, incredible acceleration in what they're
0:23
doing and how they're serving their community.
0:26
Mark, we're so thrilled to have you with
0:28
us today. Can you take a moment and
0:30
introduce yourself and tell us a little bit
0:32
about the TriHealth system?
0:33
Terrific. Well well, thank you, Scott, for, for,
0:36
you know, hosting,
0:38
and and, thank you for your kind words.
0:40
Yeah. I've, I've hit really had the real
0:43
privilege of being a part of TriHealth, leading
0:45
the organization
0:46
now for eleven years.
0:48
I actually, I returned to to Cincinnati. It's
0:51
my hometown to lead TriHealth again in 2015,
0:55
following
0:56
a, you know, career that was,
0:59
it ranged from Chicago to Boston to Upstate
1:01
New York and now back to Cincinnati. And
1:03
and, was was thrilled to come back to
1:05
Cincinnati because I was born in one of
1:07
our hospitals.
1:08
My dad and and brother were both physicians,
1:11
within our system.
1:13
TriHealth is,
1:15
is,
1:16
is roughly a $3,000,000,000
1:17
system, six hospitals, 13 major ambulatory campuses.
1:22
We employ about 14,000
1:23
team members, second largest employer in Cincinnati.
1:27
And, we, we have, really been on a
1:30
journey to transform health care, for the better.
1:34
And that journey started really more than a
1:36
year ago, ten years ago, and we've made
1:39
really remarkable progress, and I'm happy to to
1:41
share some of that work, with your audience
1:44
today.
1:45
Thank you, Mark. And and take a moment.
1:47
I know
1:49
you've been way out in front on the
1:51
the the efforts
1:53
to provide
1:54
population health, to look at things from population
1:56
health lens,
1:57
talk about why that's been such an important
1:59
part of the journey of TriHealth
2:01
and why such commitment to it. Yeah. Well,
2:04
you know, when I when I, arrived back
2:06
in Cincinnati now now eleven years ago,
2:09
Cincinnati,
2:10
like like, I think it probably a number
2:11
of, major markets across the country, had come
2:14
off of a a a pretty,
2:17
significant period of consolidation
2:19
where physicians had had,
2:21
left private practice to align with one of
2:24
the health systems. It was post,
2:27
Affordable Care Act, so physicians were devoting
2:30
physician owned hospitals.
2:32
We acquired two,
2:34
and employed,
2:35
really hundreds of previously independent physicians. So the
2:39
question facing, you know, TriHealth, you know, eleven
2:42
years ago was, where do we go from
2:44
here? You know, we had acquired a number
2:46
of, assets, hospitals, ambulatory campuses,
2:50
new physicians,
2:51
as employed
2:53
physicians. And,
2:54
you know, our board and our our physician
2:56
leadership and our executive team,
2:59
you know, really was was facing a choice
3:01
of doubling down on what we believed was
3:03
a broken,
3:05
system,
3:06
financed through fee for service,
3:09
episodic,
3:10
more reactive than proactive,
3:12
not well coordinated care, in many ways,
3:16
a sick care system rather than a health
3:18
care system, system, double down on that broken
3:20
fee for service system, or go to work
3:22
on,
3:24
finding a better way. And, you know, our
3:27
board and our physician leaders,
3:29
didn't, didn't flinch. They we realized that there
3:31
really was a better way.
3:34
You know, sometimes that's referred to as population
3:36
health or value based care. We book care.
3:38
We we believed then and and even more
3:40
so today
3:41
that there's a moral imperative if there's a
3:43
better way to deliver care, more proactive care,
3:46
more care that's
3:48
more coordinated, focused on,
3:51
you know, better managing chronic conditions, early detection,
3:55
intervention, proactive intervention,
3:58
aimed at,
4:00
rising
4:01
risk,
4:02
that, that that there really, is a better
4:04
way. And so we've put in place,
4:06
care models and partnered with, CMS and commercial,
4:11
insurers,
4:12
to put to, to to, put in place,
4:15
innovative
4:16
value based payment,
4:18
systems, that reward us for keeping patients healthy,
4:22
healthy and and delivering care in in, the
4:24
most cost effective setting,
4:26
as well as care models that really are
4:28
more proactive,
4:29
focused on improving health.
4:32
And, it's been a great ride,
4:33
the the last eleven years. Today, our patients
4:36
are objectively,
4:37
healthier. If you if you define healthier as
4:40
better managing chronic conditions,
4:42
identifying disease earlier through early detection,
4:46
delivering care in the most cost effective setting,
4:48
which increasingly is in the outpatient setting and
4:51
and even in the home. So our patients
4:53
are are really objectively healthier.
4:56
Care is,
4:58
more accessible and safer,
5:00
and the services that we deliver are more
5:02
affordable.
5:03
We
5:04
based upon,
5:06
information provided
5:07
through, one of our commercial,
5:09
insurance companies that we partner with, we, we
5:12
we we provide care,
5:14
at roughly, you know, 12 to 15%
5:17
below,
5:19
the the, the state average in terms of
5:21
in terms of total cost of care. We've
5:23
been recognized by UnitedHealthcare
5:25
and, Anthem, the two largest
5:28
commercial insurance
5:29
companies in the country. We've been recognized as
5:32
one of the the highest performing or top
5:33
performing
5:34
accountable care organizations
5:36
in in their networks nationally.
5:39
So simply remarkable, Mark, and I've watched it.
5:42
And and many systems feel like
5:44
they need to own everything they do as
5:46
part of an integrated delivery system.
5:49
It's been my experience that you take a
5:51
a mixed view of that. You do own
5:52
a lot of assets, but you're also willing
5:54
to joint venture and collaborate.
5:56
Can you talk about that for a moment?
5:58
Any thoughts there? Yeah. Yeah. Well, you know,
6:00
I'd I'd I'd say it pretty regularly.
6:02
You know,
6:03
partnerships are in our DNA.
6:06
TriHealth is the product
6:07
of a partnership.
6:09
You know, a partnership between Good Samaritan Hospital,
6:11
a partnership that came together in the mid
6:13
nineteen nineties,
6:15
Good Samaritan Hospital and Bethesda,
6:18
two,
6:19
academic tertiary care,
6:21
organizations,
6:22
that have served Cincinnati for more than a
6:25
150
6:26
each. They came together,
6:28
through a a joint operating agreement in the
6:30
mid nineteen nineties,
6:33
and we've really grown,
6:35
dramatically since, that partnership was forged forged
6:38
to create TriHealth. We and and you are
6:41
right. We partner with a number of organizations.
6:44
We don't feel like, we we have to
6:46
own,
6:48
every asset to to really, carry out our
6:51
respective missions. For example, we we partner with
6:53
the the largest,
6:55
independent orthopedic group, in Cincinnati. It's called Beacon
6:59
Orthopedics.
7:00
You may recall we did a podcast on
7:02
that probably three or four years ago,
7:04
when we announced that, and,
7:06
it's, it's roughly 60 independent orthopedic surgeons. We've,
7:11
we we have invested in a network
7:14
of ambulatory
7:15
orthopedic surgery
7:18
centers. We've partnered with select medicals,
7:21
on a, on a an acute rehab
7:24
hospital. We partner with the,
7:26
Cincinnati Children's Hospital Medical Center on a fetal,
7:30
fetal care center. We deliver babies
7:33
at, meaning TriHealth, obstetricians
7:35
and,
7:36
OB, nurses
7:38
deliver babies on the campus of Cincinnati Children's.
7:41
These are healthy moms carrying sick babies
7:44
that require immediate,
7:46
intervention either,
7:48
in utero or
7:51
post delivery.
7:53
And, up until
7:54
four or five years ago, we would deliver
7:56
those babies at Good Samaritan Hospital and then
7:58
transport them about a mile,
8:00
to Cincinnati Children's.
8:02
We we came to the realization that the
8:04
really the best, safest, highest quality care would
8:07
be to deliver those babies
8:08
at Cincinnati Children's. So we deliver, you know,
8:11
two to 300 babies,
8:12
healthy moms that are carrying sick babies,
8:15
come to Cincinnati from across the country to
8:17
deliver at Cincinnati Children's
8:20
and immediately provide that, that intervention
8:22
that's needed for the newborn,
8:24
or in some cases, provide that intervention,
8:27
you know,
8:28
before delivery. So and I could go on
8:30
with with a number of other joint ventures
8:32
that we've, engaged in. So, you know, what
8:35
we what what really guides our development of
8:37
of partnerships and joint ventures is,
8:40
does each of the parties bring something unique
8:42
to the partnership,
8:43
that that that we can't do independently?
8:46
Can we forge a true win win,
8:49
partnership from a clinical and financial perspective?
8:53
And and does it enable us to better
8:55
serve a a growing, patient population within the
8:59
Greater Cincinnati region? And if the answer to
9:02
those,
9:02
if we can hammer out a yes to
9:04
those,
9:05
then it really is a win win clinical
9:07
partnership, and it's a win win win. It's
9:09
win for the two organizations that are partnering,
9:11
us and and and this in in the
9:13
case that I just referenced Cincinnati Children's,
9:16
most importantly for the community and the patients
9:18
that we serve.
9:19
Just fantastic. And and and take a second,
9:22
Mark. You you've had this very traditional leadership
9:26
career, you know, just like it it's you
9:28
remind me of this very bright, very young,
9:30
old school leader
9:32
where you've really
9:34
done the the work of started at smaller
9:37
hospitals, grew to larger hospitals, then became CEO
9:40
of a of a great great system and
9:41
grew it into a much better system. I
9:43
mean, you've had this tremendous career that I
9:45
just love and and people aspire to. It
9:48
it reminds me so so much
9:50
of of of generational leadership, great leadership.
9:53
Talk for a second, Mark, but what advice
9:55
you would give to an emerging leader?
9:58
Well,
9:59
first of all, thank thank you for those
10:01
those kind words.
10:03
You know, I,
10:04
you know, I I talk about it all
10:05
the time. You know, we we are
10:08
any health care, is is really a a
10:10
service industry, and and the product that we
10:12
deliver,
10:13
we deliver through people.
10:15
And,
10:16
we believe, like Peter Drucker,
10:18
you know, a half decade or excuse me,
10:20
a half century
10:22
ago said, you know, culture
10:24
eats strategy for breakfast every day. And my
10:27
friend, Quench Studer, who's on our board and
10:29
and we've been friends for nearly, you know,
10:32
thirty five years, he he he, worked for
10:34
me when I was,
10:35
my in my first CEO job at Holy
10:38
Cross in Chicago.
10:39
Quint Quint went on to say that
10:41
strategy plus culture,
10:44
wins every day. And, I think he's right
10:46
about that. So I so the first piece
10:48
of advice I would give is
10:50
invest in people and culture because that, more
10:53
than anything, will define your success, meaning the
10:55
success of your organization and how it carries
10:59
out its mission
11:00
within its local community. And we do that
11:03
in many, many ways. You know, we've we've,
11:05
just two weeks ago, completed our thirty fourth
11:08
quarterly leadership development institute where we bring all
11:11
of our leaders together under one roof for,
11:15
a day, and that's physician leaders,
11:17
administrative leaders, nursing leaders, about a thousand leaders
11:20
in our organization. We bring them together,
11:23
every three months, and and we use those
11:25
to invest in our leaders,
11:27
to provide,
11:28
updates on our progress in achieving our bold
11:31
vision of getting health care right,
11:33
developing skills on the part of those leaders,
11:36
introducing
11:36
evidence based leadership service and care delivery practices,
11:40
and a number of other things celebrating our
11:42
wins. And so, like clockwork, every three months,
11:45
that's how we create a highly aligned and
11:47
highly engaged organization,
11:50
investing in our leaders and investing in our
11:52
people. And it's paid real dividends, Scott.
11:54
So, you know, trial's gone, in the last
11:57
eleven years that I've been a part of
11:58
the organization, and I give all the credit
12:00
to our leadership team and our people. We've
12:02
gone from, you know, team member and and
12:04
physician engagement in the bottom quartile to we,
12:08
most recently, and have consistently been,
12:11
at this level. We we are at the
12:12
ninety fifth percentile in terms of engagement. Engagement
12:15
really is the degree to which,
12:17
physicians and team members will commit their discretionary
12:19
effort to assisting the organization in achieving its
12:23
vision and its goals.
12:24
And that's translated
12:26
into top decile performance
12:28
when we compare our performance,
12:30
in the area of safety and quality, patient
12:32
experience,
12:34
engagement, turnover,
12:35
people
12:36
growth, market share growth, and then financial performance.
12:39
We we really are performing
12:41
in the top decile in in all of
12:43
those domains. And and I, I really attribute
12:46
that level of performance
12:48
to, you know, 14,000
12:49
team members and another 2,000 physicians that get
12:52
up every day and say, this is, you
12:54
know, this is the right work, and I'm
12:55
gonna I'm gonna commit my discretionary
12:57
efforts to helping TriHealth get health care right.
13:01
Mark, it's always a pleasure for me to
13:02
visit with you. I, of course, love the
13:05
references to Quit Suter and Peter Drucker,
13:08
Two people I admire tremendously.
13:12
Someday I'll get a chance to visit with
13:13
you on a story on Quitt, which is
13:15
one of those impressive things I've ever seen
13:17
a human being do. Just a wonderful, wonderful
13:19
leader.
13:20
Congratulations
13:21
on the success and what you've done at
13:23
TriHealth.
13:24
Just give me one more thing. I'll ask
13:26
you to do two things.
13:28
Give me a shout out to the to
13:30
the to the team at TriHealth, to to
13:32
your entire
13:34
body of talent there. And then also,
13:37
tell us if Joe Burrow can stay healthy
13:40
and win titles for Cincinnati.
13:43
Well, first of all, I say it all
13:44
the time. You know, we are blessed with
13:46
the very best health care team anywhere. I
13:48
I know every CEO,
13:50
that does what I do would would argue
13:51
with would debate that or argue with that,
13:53
but, I I I feel privileged every day
13:56
to come to work and and work beside
13:58
this amazing team that really is committed to
14:02
delivering exceptional service,
14:04
safety, and transforming health care for the better,
14:07
embracing,
14:08
really more proactive care and delivery, you know,
14:11
models.
14:12
In second league, what what a heck of
14:14
a game on Thanksgiving.
14:16
Joe Burrows
14:17
has shown us why he's a Heisman trophy
14:19
winner and, why we love having him in
14:21
Cincinnati. We just hope he can stay healthy.
14:24
No. He's an amazing talent. It's fun to
14:27
watch him. It's exciting to see him back.
14:28
We cheer for him even though we're not
14:30
particularly a Bengals fan, but we do love
14:32
him. I I have to tell you, thank
14:33
you so much for joining us today, Mark.
14:35
It's always a pleasure to visit you. Thank
14:36
you so much for taking the time. Hey.
14:38
Thank you, Scott.