Em­ploy­ees look for ac­count­abil­ity and in­tegrity from lead­ers

Modern Healthcare - - Q&A -

An­thony Tersigni has been pres­i­dent and CEO of St. Louis-based As­cen­sion since 2004. As­cen­sion was formed in 1999 with the merger of Daugh­ters of Char­ity Na­tional Health Sys­tem and Sis­ters of St. Joseph Health Sys­tem.

It’s the na­tion’s largest pri­vate not-for-profit hos­pi­tal sys­tem, with 131 hos­pi­tals, 1,900 care sites and $17 bil­lion in op­er­at­ing rev­enue for fis­cal 2013. Tersigni pre­vi­ously served as CEO at St. John Health in Detroit and as chair of the Catholic Health As­so­ci­a­tion. He has made Mod­ern Health­care’s 100 Most In­flu­en­tial Peo­ple in Health­care rank­ing nine times. Mod­ern Health­care Man­ag­ing Edi­tor Har­ris Meyer talked with Tersigni about his sys­tem’s re­cent in­te­grated de­liv­ery part­ner­ship with CHE Trin­ity Health, its growth strat­egy, his man­age­ment style, and is­sues re­lated to Catholic health­care doc­trine. This is an edited tran­script.

Mod­ern Health­care: As­cen­sion Health and CHE Trin­ity re­cently an­nounced the for­ma­tion of the To­gether Health Net­work in Michi­gan. What do you hope to ac­com­plish and how is that work­ing out?

An­thony Tersigni: There’s a lot of talk about pop­u­la­tion health, and for us, this no­tion re­ally goes back to our over­ar­ch­ing mis­sion of car­ing for the whole person, body, mind and spirit. We’ve been cre­at­ing clin­i­cally in­te­grated sys­tems of care. These net­works are formed at the lo­cal or re­gional level to fos­ter com­mu­ni­ca­tion, col­lab­o­ra­tion and datashar­ing to en­able our health min­istries to more seam­lessly care for the peo­ple we serve in our com­mu­ni­ties.

We’ve be­gun ef­forts in Detroit with To­gether Health to de­velop these clin­i­cally in­te­grated sys­tems of care, and we’re re­ally ex­cited about the po­ten­tial for us to col­lab­o­rate with another health sys­tem. We have the doc­tors and hos­pi­tal net­work in place, and we have new lead­er­ship in place. So they’re off and run­ning.

MH: You also are in talks to ac­quire a health in­sur­ance com­pany op­er­at­ing in 18 states.

Tersigni: Ac­tu­ally, we have been in the in­sur­ance busi­ness for quite some time. We own six health plans in dif­fer­ent parts of the coun­try. So all our work de­vel­op­ing a con­tin­uum of care is just an ex­ten­sion of the work that we’ve been do­ing for years.

MH: Is As­cen­sion still in the mar­ket to ac­quire more hos­pi­tals, and how are you eval­u­at­ing mar­kets to de­cide where you want to go? And how are you eval­u­at­ing part­ners?

Tersigni: As­cen­sion’s growth strat­egy, if there is such a thing as a growth strat­egy, is about cov­ered lives and pop­u­la­tion health man­age­ment, but not nec­es­sar­ily how many pieces of the con­tin­uum that we have. We have 131 hos­pi­tals but we also have 1,900 dif­fer­ent care sites. So we look at it from a con­tin­uum-of-care per­spec­tive, not nec­es­sar­ily ac­quir­ing hos­pi­tals. We want to talk to those who have seen or bought into the same strate­gic di­rec­tion we’ve de­vel­oped and re­fined over the years. They range from hos­pi­tals to home-care ser­vices, to nurs­ing homes to in­sur­ance com­pa­nies. It’s all driven to­ward pop­u­la­tion health man­age­ment and person-cen­tered care. That’s re­ally our growth strat­egy.

MH: What are some ini­tia­tives you’ve taken to bet­ter man­age pop­u­la­tion health?

Tersigni: We prob­a­bly have over 30 dif­fer­ent ac­count­able care or­ga­ni­za­tions of some for­mat, and it gives us the op­por­tu­nity to see what works in terms of per­son­cen­tered care, where the ef­fi­cien­cies can come from, and to share those ef­fi­cien­cies and those ideas across the sys­tem. We’re begin­ning to use lessons from the ACOs in im­prov­ing our ef­fi­ciency and out­comes for the peo­ple we’re priv­i­leged to serve.

“There’s a lot of talk about pop­u­la­tion health, and for us, this no­tion re­ally goes back to our over­ar­ch­ing mis­sion of car­ing for the whole person, body, mind and spirit.”

MH: Please talk about As­cen­sion Ven­tures, your ven­ture cap­i­tal arm.

Tersigni: One of our As­cen­sion val­ues is coura­geous in­no­va­tion, so we look for so­lu­tions that will im­prove health­care and the lives of the in­di­vid­u­als and com­mu­ni­ties we serve. It’s part of our larger strat­egy di­ver­si­fy­ing be­yond just the provider space to meet the needs of the pa­tients across the con­tin­uum of care. As­cen­sion Ven­tures was cre­ated to in­vest in mid- to late-stage op­por­tu­ni­ties. It doesn’t in­vest in star­tups. It’s not your typ­i­cal ven­ture fund fo­cused solely on re­turns. We share the health­care prod­ucts from the port­fo­lio com­pa­nies with not only As­cen­sion and our lead­ers, but also some of our lim­ited part­ners. We have ap­prox­i­mately $550 mil­lion in as­sets un­der man­age­ment. As­cen­sion Ven­tures gen­er­ates re­turns that help sup­port our mis­sion to pro­vide care to the poor and vul­ner­a­ble.

MH: Please talk about your man­age­ment style and how you stay in touch with your peo­ple in the trenches.

Tersigni: If I’ve had any suc­cesses in my man­age­ment ca­reer, it’s be­cause I hire peo­ple smarter than me, give them the re­sources nec­es­sary to do their job, and get the heck out of the way. As­cen­sion Ven­tures is a per­fect ex­am­ple. We re­cruited a team of young in­di­vid­u­als from the in­vest­ment man­age­ment world, in­clud­ing a bio­med­i­cal engi­neer. We go out and re­cruit sub­ject mat­ter spe­cial­ists for our sub­sidiaries, and we hope­fully pro­vide the re­sources nec­es­sary so that they can do their job. The way I keep con­nected is through my var­i­ous meet­ings with our se­nior lead­ers across the coun­try and in my vis­its. I’m out of the of­fice al­most ev­ery week vis­it­ing ei­ther one of our min­istries, try­ing to stay in touch with not only what we’re do­ing, but mak­ing sure that we’re true to the mis­sion of As­cen­sion. What I find is that our as­so­ciates are look­ing for some re­ally ba­sic things from our lead­ers, and that’s what I’m hop­ing I and our lead­ers are pro­vid­ing. No. 1 is pre­dictabil­ity. No. 2, they want to un­der­stand what we’re do­ing. They want com­pas­sion and re­spect. Those are part of our val­ues. They want to be able to see where the ac­count­abil­ity falls. They want us to func­tion with in­tegrity. And they are con­cerned about safety and qual­ity of care for the peo­ple we serve.

MH: You just turned 65. Have you talked about any kind of suc­ces­sion plan?

Tersigni: Sev­eral years ago we launched the As­cen­sion Lead­er­ship Academy fo­cused on form­ing not only my suc­ces­sor, but the suc­ces­sors to all 150,000 of our as­so­ciates across the coun­try. We set out to iden­tify tal­ent across the coun­try and nur­ture that tal­ent. I re­view all of the tal­ent across the coun­try twice a year. And we try to give peo­ple the op­por­tu­nity and the skill set nec­es­sary to al­low them to grow.

We have done for­mal suc­ces­sion plan­ning for me. We know who would step in if I got hit by a truck to­day. And then we have a for­mal process that is on­go­ing where we iden­tify a pool of can­di­dates, both in­ter­nally and ex­ter­nally, for the board to con­tinue to re­view as we move into the fu­ture. We’re look­ing at suc­ces­sion plan­ning across all of the se­nior po­si­tions all the time. Our min­istry is 200 years old and we have an obli­ga­tion to make sure that it sur­vives another 200 years.

MH: Please talk about Health City Cay­man Is­lands, a large hos­pi­tal in the Cay­man Is­lands in which As­cen­sion is part­ner­ing with an In­dian com­pany. What’s the pur­pose and how might that tie into your U.S. op­er­a­tions?

Tersigni: Health City Cay­man Is­lands is a 2,000-bed ter­tiary-care hos­pi­tal, the first of its kind in the Caribbean, and its open­ing in March marked the begin­ning of a new health­care de­liv­ery sys­tem, not only for the Caribbean, but also South Amer­ica. It’s a long-term vi­sion to bring en­hanced health­care to the peo­ple liv­ing in the Cay­man Is­lands, the Caribbean re­gion and the Amer­i­cas.

The op­por­tu­nity for As­cen­sion was to learn from Dr. Devi Shetty, the chair­man and founder of Na­yarana Health in Ban­ga­lore, In­dia, about his meth­ods of pro­vid­ing high-qual­ity health­care that is ac­ces­si­ble and af­ford­able to all, in­clud­ing those who are poor. We rec­og­nize the tremen­dous op­por­tu­nity this part­ner­ship pro­vides us to learn new ways in car­ing for peo­ple we serve.

Dr. Shetty has come up with a num­ber of in­no­va­tive ideas that have worked in Ban­ga­lore. We’re try­ing to take what worked in Ban­ga­lore and see how many of those tech­niques and ideas are ap­pli­ca­ble there in the Cay­man Is­lands. We hope to learn from that and bring some of those ef­fi­cien­cies back to As­cen­sion fa­cil­i­ties in this coun­try. It’s a grand ex­per­i­ment of learn­ing and work­ing with three dif­fer­ent cul­tures.

MH: In seek­ing part­ner­ships and ac­qui­si­tions around the coun­try, some Catholic sys­tems have en­coun­tered oc­ca­sional con­flicts in­volv­ing the U.S. Con­fer­ence of Catholic Bish­ops’ Eth­i­cal and Re­li­gious Di­rec­tives. As­cen­sion re­cently faced some is­sues in Bartlesville, Okla., with the Jane Phillips Med­i­cal Cen­ter and the med­i­cal staff there re­gard­ing doc­tors pre­scrib­ing birth con­trol se­vices. Has this been an is­sue for your sys­tem, how do you re­solve it, and how do you per­suade com­mu­ni­ties that the di­rec­tives won’t get in the way of med­i­cally nec­es­sary ser­vices?


Oc­ca­sion­ally we find that con­fu­sion can arise about what we can and can’t do as a faith-based Catholic in­sti­tu­tion. We work hard to avoid that kind of con­fu­sion. We’ve worked with our col­leagues in Tulsa to en­sure that there’s clar­ity in this par­tic­u­lar case, and we re­gret that com­mu­ni­ca­tion prob­a­bly wasn’t more clear at the out­set. We have con­tin­ued to work on clar­i­fi­ca­tion of what we can and can’t do there.

MH: So the physi­cians in Bartlesville are not un­der any con­straints in or­der­ing birth-con­trol ser­vices for their pa­tients?

Tersigni: I think it’s fair to say for us that we don’t be­lieve in the cor­po­rate prac­tice of medicine, and so we rely on our physi­cians to do what’s in the best in­ter­est of the pa­tients that they serve.

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