Jim Hinton leaves Presbyterian for new challenge in Texas
Jim Hinton recently stepped down as president and CEO of Presbyterian Healthcare Services. He took over the helm of the state’s largest health system and one of its biggest private employers in 1995, gaining recognition for his work in system integration and bolstering population health initiatives.
After more than three decades with the organization, Hinton is leaving to take the top slot at Baylor Scott & White in Dallas — the largest not-for-profit health care system in Texas and one of the largest in the country.
Hinton, 57, grew up in Albuquerque and began his career with Presbyterian a month shy of his 24th birthday. He was only the sixth executive to lead Presbyterian since its founding in 1908.
Hinton, who was also heavily involved with Albuquerque civic organizations, recently sat down to reflect on his time working in health care in New Mexico and what the future may hold.
Q: Why are you leaving Presbyterian now?
A: The phone rang seven months ago. A recruiter was calling to gauge my interest in the job at Baylor, a system I’m quite familiar with and admire. I thought this is what I would love to do in the next phase of my career, five to eight years out. I’ll miss Pres. I’ve been here for 34 years, and I’ve loved it. But I just couldn’t let it go. It felt like the opportunity of a lifetime.
Q: What accomplishment at Presbyterian gives you the most pride?
A: There are several things. Getting better outcomes for patients, managing the cost of care more efficiently and developing innovative approaches to delivering care. I’m proud that, as a state, we’ve been able to expand medical coverage so that thousands of previously uninsured now have a card in their wallet that looks like mine. In the end, working in health care is a team sport. From our security guard Marty out front greeting people to a heart surgeon working to heal a neonatal patient — everyone here takes pride in making a difference.
Q: What have been the biggest challenges?
A: Just the changes in health care that have occurred. My career spanned the inception of managed care. That was a challenge, so strategically we had to position ourselves for that. And growth, taking an organization to about 11,000 dedicated employees wasn’t easy. Building a new hospital in Rio Rancho, planning a new one in Santa Fe, expanding our network of clinics, growing our medical group and insurance lines have also taken a lot of time, energy and resources. Pres is a bit of a hybrid: a hospital system, a medical group and a for-profit health plan. But we also partner with a lot of other insurers and our members go to other hospitals and providers. Approximately 30 percent of our health-plan members have used Presbyterian facilities in the last year. We rely a lot on Blue Cross-covered patients. A large number of our plan members go to UNM doctors and clinics. Health care in New Mexico is not as monolithic as people make it out to be.
Q: What do you think of the Affordable Care Act?
A: My sense is that there are parts of the ACA that have broad bipartisan appeal that I don’t think anyone wants to see go away, such as not denying coverage for pre-existing conditions. But you have go back to the fundamental issue of how we finance care: Will more
funding be coming from employers, individuals or government? It’s clearly time for new answers. Exchanges are struggling all over the country. Premiums are inadequate to fund the cost of care. When you look at the Affordable Care Act, there’s a portion of it that is obviously focused on extending coverage to the uninsured. That’s been the most controversial part. But there’s another focus in the ACA related to delivery system reform and the movement from fee-for-service to feefor-value. I don’t see that movement being curtailed. I don’t see that being repealed.
Q: Is your successor in place yet?
A: That’ll be the board’s decision; not mine. Dale Maxwell has been appointed as interim CEO, and my sense is that the board will develop a process in January to assess Dale against other (potential) national candidates. It doesn’t have to be a search, but an assessment process. That’s how I got the job. You want to give any candidate the gift of being nationally vetted. Dale’s a super-strong guy. He’d be a great successor.
Q: The organization you’ve just joined is a huge, sophisticated integrated system. As a practical matter, how do you go about doing
your homework and making the personal connections that are necessary to get started?
A: You know, technical knowledge is one thing, but it’s really about relationships and culture that allow people to be successful. Cultures are not good or bad. They are just different. The role of a new leader is to help emphasize the parts that are most critical to future success. That said, it’s both daunting and exciting. I’ve made a lot of site visits and know some of the key players already. I have three bankers’ boxes full of material, and that doesn’t even include the things they’ve sent electronically. I’m trying to get up to speed: This is a very large system — 48 hospitals, 47,000 employees and 1,000 care sites spread over North and Central Texas.
Q: As an outsider, is there anything you’ve identified that you can help Baylor improve?
A: Yes, but I think it’s really sort of degrees of improvement. The overall strategy and direction of Baylor — making sure that we provide high-value care, that we understand and continue to learn how to manage population health — these are very contemporary and, I think, directionally, absolutely correct. The Baylor Scott & White system came together three years ago, so the work culture still has to be anchored. In addition, there is this evolution from pay-for-volume to pay-for-value in a state that doesn’t have a tradition of capitated managed care. There are some specifics that we can work on, but I don’t have 34 years to do that. I don’t have that much runway left, so this is where technology and the larger team can play a role. I’ll still be out and about, but with technology, you can reach a lot of people.
Q: How is the Presbyterian plan to provide Medicaid managed care services to a group of 11 health systems in North Carolina going? Are you still looking to possibly bring as many as 600 jobs to Albuquerque?
A: It’s going very well. We are working very diligently to launch a health plan with the partners, but it’s still about 18 months before we enroll the first members. As you can see from the construction from my window, an 87,000-squarefoot addition to Presbyterian’s corporate headquarters is going up that will house new employees doing Medicaid management services for the future North Carolina venture. Presbyterian wanted an equity position in the new venture and will be a minority owner. We wanted to have a voice rather than just pay claims.
And yes: There may be similar initiatives beyond the one in North Carolina.