← Becker’s Healthcare Podcast
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- [00:00]
A
This is Scott Becker with the Becker Healthcare podcast. We're thrilled today to be joined by one of the nation's best transformative leaders. We're joined today by Mark Clement. Mark is the CEO of the Tri Health System in Cincinnati. In the decade plus that he's ran or led the trial system, they just have had an incredible improvement, incredible acceleration in what they're doing and how they're serving their community. Mark, we're so thrilled to have you with us today. Can you take a moment and introduce yourself and tell us a little bit about the Tri Health system?
- [00:34]
B
Terrific. Well, thank you, Scott, for hosting and thank you for your kind words. Yeah, I've really had the real privilege of being part of Tri Health, leading the organization now for 11 years. I actually returned to Cincinnati, it's my hometown, to lead Tri health again in 2015 following a career that was. It ranged from Chicago to Boston to upstate New York and now back to Cincinnati. And was thrilled to come back to Cincinnati because I was born in one of our hospitals. My dad and brother were both physicians. Within our system, Tri Health is roughly a $3 billion system. Six hospitals, 13 major ambulatory campuses. We employ about 14,000 team members, second largest employer in Cincinnati. And we have really been on a journey to transform healthcare for the better. And that journey started really more than a year ago, 10 years ago, and we've made really remarkable progress and I'm happy to share some of that work with your audience today.
- [01:46]
A
Thank you Mark. And take a moment. I know you've been way out in front and the efforts to provide population health, look at things from population health lens. Talk about why that's been such an important part of the journey at Tri Health and why such a commitment to it.
- [02:04]
B
Yeah, well, you know, when I, when I arrived back in Cincinnati, now now 11 years ago, Cincinnati like, like I think probably a number of major markets across the country had come off of a pretty significant period of consolidation where physicians had left private practice to align with one of the health. It was post Affordable Care act, so physicians were divesting physician owned hospitals. We acquired two and employed really hundreds of previously independent physicians. So the question facing TriHealth 11 years ago was where do we go from here? We had acquired a number of assets, hospitals, ambulatory campuses, new physicians as employed physicians and our board and our physician leadership, our executive team really was facing a choice of doubling down on what we believed was a broken system financed through fee for service, episodic, more reactive than proactive, not well coordinated care in many ways. A sick care system rather than a health care system, double down on that broken fee for service system or go to work on finding a better way. And you know, our board and our physician leaders didn't, didn't flinch. They we realized that there really was a better way. You know, sometimes that's referred to as population health or value based cares. We book care. We believed then and even more so today that there's a moral imperative, if there's a better way to deliver care, more proactive care, more care that's more coordinated, focused on, you know, better managing chronic conditions, early detection intervention, proactive intervention aimed at rising risk, that there really is a better way. And so we've put in place care models and partnered with CMS and commercial insurers to put to put in place innovative value based payment systems that reward us for keeping patients healthy and, and delivering care in the most cost effective setting as well as care models that really are more proactive, focused on improving health. And it's been a great ride the last 11 years. Today our patients are objectively healthier, if you define healthier as better managing chronic conditions, identifying disease earlier through early detection, delivering care in the most cost effective setting, which increasingly is in the outpatient setting and even in the home. So our patients are really objectively healthier, care is more accessible and safer and the services that we deliver are more affordable. We, based upon information provided through one of our commercial insurance companies that we partner with, we provide care at roughly 12 to 15% below the, the, the state average in terms of, in terms of total cost of care. We've been recognized by UnitedHealthcare and Anthem, the two largest commercial insurance companies in the country. We've been recognized as one of the highest performing or top performing accountable care organizations in their networks nationally.
- [05:40]
A
So simply remarkable. Mark, and I've watched it in many systems, feel like they need to own everything they do as part of an integrated delivery system. It's my experience that you take a mixed view of that. You do own a lot of assets, but you're also willing to joint venture and collaborate. Can you talk about that for a moment? Any thoughts there?
- [05:59]
B
Yeah, yeah. Well, you know, I say it pretty regularly. You know, partnerships are in our DNA. Tri Health is the product of a partnership, you know, a partnership between Good Samaritan Hospital, a partnership that came together in the mid-1990s. Good Samaritan Hospital and Bethesda, two academic tertiary care organizations that have served Cincinnati for more than 150 years each. They came together through a joint operating agreement in the mid-1990s. And we've really grown dramatically since that partnership was forged to create Tri Health. And you are right, we partner with a number of organizations. We don't feel like we have to own every asset asset to really carry out our respective missions. For example, we partner with the largest independent orthopedic group in Cincinnati. It's called Beacon Orthopedics. You may recall we did a podcast that probably three or four years ago when we announced that. And it's roughly 60 independent orthopedic surgeons. We have invested in a network of ambulatory orthopedic surgery centers. We've partnered with Select Medical on an acute rehab hospital. We partner with Cincinnati Children's Hospital Medical center on a fetal care center. We deliver babies at meaning trial. Obstetricians and OB nurses deliver babies on the campus of Cincinnati Children's. These are healthy moms carrying sick babies that require immediate intervention, either in utero or post delivery. And up until four or five years ago, we would deliver those babies at Good Samaritan Hospital and then transport them about a mile to Cincinnati Children's. We, we came to the realization that really the best, safest, highest quality care would be to deliver those babies at Cincinnati Children's. So we deliver, you know, two to 300 babies. Healthy moms that are carrying sick babies come to Cincinnati from across the country to deliver Cincinnati Children's and immediately provide that, that intervention that's needed for the newborn or in some cases provide that intervention, you know, before delivery. So, and I could go on with, with a number of other joint ventures that we've engaged in. So, you know, what we, what really guides our development of partnerships and joint ventures is does each of the parties bring something unique to the partnership that, that we can't do independently? Can we forge a true win win partnership from a clinical and financial perspective? And does it enable us to better serve a growing patient population within the greater Cincinnati region? And if the answer to those, if we can hammer out a yes to those, then it really is a win win clinical partnership. And it's a win win win. It's win for the two organizations that are partnering us. And in the case that I just referenced, Cincinnati Children importantly for the community and the patients that we serve.
- [09:20]
A
Just fantastic. And take a second mark. You've had this very traditional leadership career, just like you remind me of this very bright, very young, old school leader where you've really done the work of, started at smaller hospitals, grew into larger hospitals, then became CEO of a great Great system and grew it into a much better system. You've had this tremendous career that I just love and people aspire to, and it reminds me so, so much of generational leadership. Great leadership. Talk for a second, Mark, but what advice you would give to an emerging leader?
- [09:59]
B
Well, first of all, thank you for those, those kind words. You know, I, you know, I talk about it all the time. You know, we, we are any health care is, is really a service industry. And the product that we deliver, we deliver through people and we believe, like Peter Drucker, you know, a half decade, excuse me, a half century ago, said, you know, culture eats strategy for breakfast every day. And my friend Quinn Studer, who's on our board and we've been friends for nearly, you know, 35 years, he worked for me when I was in my first CEO job at Holy Cross in Chicago. Quint went on to say that strategy plus culture wins every day. And I think he's right about that. So the first piece of advice I would give is invest in people and culture because that more than anything will define your success, meaning the success of your organization and how it carries out its mission within its local community. And we do that in many, many ways. You know, we've, we just two weeks ago completed our 34th quarterly leadership development institute where we bring all of our leaders together under one roof a day. And that's physician leaders, administrative leaders, nursing leaders, about a thousand leaders in our organization. We bring them together every three months and we use those to invest in our leaders, to provide updates on our progress in achieving our bold vision of getting health care right, developing skills on the part of those leaders, introducing evidence based leadership, service and care delivery practices, and a number of other things, celebrating our wins. And so, like clockwork, every three months, that's how we create a highly aligned and highly engaged organization, investing in our leaders and investing in our people. And it's paid real dividends. Scott, you know, trials gone in the last 11 years that I've been a part of the organization and I give all the credit to our leadership team and our people. We've gone from, you know, team member and physician engagement in the bottom quartile to we most recently and have consistently been at this level. We are at the 95th percentile in terms of engagement. Engagement really is the degree to which physicians and team members will commit discretionary effort to assisting the organization in achieving its vision and its goals. And that's translated into top decile performance. When we compare our performance in the area of safety and quality Patient experience, engagement, turnover, people growth, market share growth, and then financial performance. We really are performing in the top decile in all of those domains. And I, I really attribute that level of performance to, you know, 14,000 team members and another 2,000 physicians that get up every day and say, this is, you know, this is the right work. And I'm going to, I'm going to commit my discretionary efforts to helping trial get healthcare right.
- [13:01]
A
Mark, it's always a pleasure for me to visit with you. I, of course, love the references to Quit Souter and Peter Trucker, two people I admire tremendously. Someday I'll get a chance to visit with you on a story on quit, which was one of those impressive things I've ever seen a human being do. Just a wonderful, wonderful leader. Congratulations on the success in what you've done at Tri Health. Just give me one more thing. I'll ask you to do two things. Give me a shout out to the, to the, to the team at Tri Health, to, to your entire body of talent there. And then also tell us if Joe Burrow can stay healthy and win titles for Cincinnati.
- [13:43]
B
Well, first of all, I say it all the time. You know, we are blessed with the very best healthcare team anywhere. I know every CEO that does what I do would argue with, would debate that or argue with that. But I feel privileged every day to come to work and work beside this amazing team that really is committed to delivering exceptional service, safety and transforming healthcare for the better. Embracing really more proactive care and delivery, you know, models in second league. What a heck of a game on Thanksgiving. Joe Burrows has shown us why he's a Heisman Trophy winner and why we love having him in Cincinnati. We just hope he can stay healthy.
- [14:25]
A
No, he's an amazing talent. It's fun to watch him. It's excited to see him back. We cheer for him, even though we're not particularly a Bengals fan, but we do love him, I have to tell you. Thank you so much for joining us today, Mark. It's always a pleasure to visit you. Thank you so much for taking the time.
- [14:38]
B
Hey, thank you, Scott.