American Healthcare Leader #11

INSIDE THE ZERO SUICIDE INITIATIVE

applied natural language processing

to build an EHR database

that is keeping patients safe

How Wes Williams

ENABLING CAREGIVERS TO SEE AN ENTIRE PATIENT STORY MATTERS.

Using powerful InterSystems solutions, Netsmart and the Mental Health Center of Denver created a more complete picture of patient health and history, thereby reducing future risks, enabling patient well-being, and creating better, more comprehensive care for over 15,000 children, families, and adults.

Learn more at InterSystems.com/Netsmart

“If you can use machine learning or other techniques to help figure out when it’s important to alert providers, then you help them think a little more clearly about difficult, uncomfortable situations and what steps should be taken to achieve better outcomes.” p. 44

Wes Williams VP, CIO

Cass Davis

Mental Health Center of Denver

Pulse

Focus Life

90 Holistic Healthcare

Health and wellness concerns don’t just extend to the patients getting care at hospitals and clinics. These executives show how focusing on wellness can help ensure an organization’s employees stay healthy and productive.

176

Legal Leaders

The Lifeblood of Today’s Industry Your Stories. Your Lives.

A legal department might not be the first thing that comes to mind when healthcare is brought up. But these executives demonstrate that lawyers are a critical part of delivering medications and treatments to patients in need and keeping their organizations running smoothly. 10

How David Rodriguez crafted TakeCare, Marriott International’s innovative wellness program that helps employees stay healthy and the company feel like a family.

Jay Lichter’s work with COI Pharmaceuticals is on the forefront of bringing some of the most cuttingedge advancements in medical technology to market.

Carmela Castellano-Garcia is grateful for the support her parents and others gave her on her path to becoming president and CEO of California Primary Care Association. Now, she’s determined to inspire a new generation of women and people of color to become leaders.

36

After the large merger between St. Joseph Health and Providence Health & Services, Jim Watson took on the task of getting the newly formed legal department up to speed.

81

How Ann Asbaty’s determination to overcome her breast cancer diagnosis also helped her to become a more effective and empathetic leader at Cigna.

86

After getting her start in healthcare law in 2004, Sharyn Alcaraz developed a passion for the field and wants to help aspiring lawyers with a similar enthusiasm succeed.

K.C. Alfred (COI Pharmaceuticals), Mike Chavez (California Primary Care Association)

Impact Prognosis

Making a Difference in the World

121

Kelli Powers has taken on the task of ensuring every facility in Huntsville Hospital’s network is operating as one unified unit in the wake of the organization’s large expansion.

156

Donna Peters took on the challenge of improving customer service scores at Cincinatti, Ohio-based TriHealth to tremendous results.

Lee Milligan is spearheading efforts to streamline Asante’s IT infrastructure, making it more effective for delivering patient care and easier for employees to use.

Leigh Hickman takes a proactive approach to risk management at CaroMont Health to ensure the organization stays ahead of potential issues.

207

Mike Wood focuses on fostering a culture of learning and development to draw top talent to INTEGRIS Health in Oklahoma City.

220

Donna Lecky enjoys living on the forefront of healthcare, where her work with HealthVenture is helping incubate the next generation of digital healthcare solutions.

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A New Era in Mental Healthcare

When someone gets strep throat, they go to see a doctor. Or when someone has an ear infection, they don’t think twice about taking prescribed antibiotics. It’s been common practice for centuries to seek advice from a physician or take medicine when it’s needed without hesitation. However, when someone can’t shake feelings of hopelessness or sadness, many people still feel the urge to tell themselves to just get over it.

The stigma surrounding mental health issues and individuals struggling with depression, anxiety, or other mental illnesses is still a major barrier for people dealing with these conditions. In many cases, this stigma prevents people from getting life-changing, and in some cases lifesaving, treatment.

That, in addition to the fact that some of the people who would benefit from mental health treatment are uninsured, concerned about the cost of care, or overwhelmed by navigating a complex healthcare industry, makes it no wonder that of the roughly 44 million Americans living with mental illness in 2016, only about 19 million received some sort of mental healthcare treatment, according to the National Institute of Mental Health.

These numbers make it even more vital that, when individuals do decide to pursue treatment, the healthcare system works. And that’s where leaders such as Wes Williams, vice president and CIO at the Mental Health Center of Denver (MHCD) and American Healthcare Leader’s cover story this issue (p. 44), are making all the difference.

After an administrative error led to one of MHCD’s patients dying by suicide, Williams vowed to never let another patient die a preventable death again. To achieve that goal, Williams built an entirely new EHR infrastructure that leverages natural language processing and other state-of-the-art capabilities to ensure that MHCD’s care providers know exactly where patients are in their treatment plans at all times. He also spearheaded the creation of mobile apps that allow caretakers in the field to access EHRs on the go. Because of this, it’s easier for physicians and nurses to administer the appropriate care at the right time for every patient.

Williams’s work, and the work of many other mental healthcare professionals, is inspired by the Zero Suicide Initiative, a national effort to eliminate deaths by suicide in patients receiving treatment in health and behavioral health systems. The initiative lays out a seven-step approach to aid healthcare practitioners in their care of patients with mental illness: lead, train, identify, engage, treat, transition, and improve.

This widespread effort to tackle suicide on a systemic level has the potential to save lives at MHCD and beyond. New technologies such as the ones Williams created for MHCD’s patients point to a hopeful future for the treatment of individuals with mental illness. More importantly, they’re helping healthcare providers keep patients safe. And perhaps one day, they will make the notion that there was ever a stigma attached to mental illness a distant memory.

Joe Dixon Editor

The Lifeblood of Today’s Industry

“Our goal is to have tools in place that recognize clinical risk and facilitate quick responses that prevent suicides from happening.” p. 44

Pulse

TakeCare for Tomorrow

David Rodriguez knows firsthand how Marriott International’s innovative wellness program goes above and beyond to make employees feel like family

By Lior Phillips

Since

starting the business more than ninety years ago, the Marriott family has been passionate about caring for their employees like family. Marriott International executive vice president and global chief HR officer David Rodriguez felt that passion and drive immediately upon joining the organization in 1998. That connection bloomed in 2010 with the development of TakeCare, a revolutionary wellness program that expanded organically thanks to employee champions around the world. Unbeknownst to Rodriguez, he would become one of them.

In 2014, Rodriguez took what was supposed to be a relaxing beach vacation. But his trip was interrupted when his doctor called with grave news: Rodriguez had leukemia, and if he didn’t return home that night and begin immediate treatment, he might not survive. That’s when TakeCare became much more than a program; it became a life-saver.

“I was educated about taking care of myself through TakeCare,” Rodriguez says. “It was one of the reasons why I was able to get through the cancer treatment very well,

and why I’m alive today.” And he’s not alone. Marriott employees have used the program to change their diet, change their exercise habits, quit smoking, and more. One married couple who works at one of Marriott’s hotels used the program to help lose more than one hundred pounds together, Rodriguez says. He believes that TakeCare could only have come from a culture like Marriott’s, one so eager to evolve with the specific needs of its employees.

“The philosophy here is that the best and most sustainable way to deliver exceptional service to customers is to ensure that it starts with taking care of our own associates,” Rodriguez explains. The Marriott family has managed to achieve something that eludes the grasp of most large institutions: maintaining the feeling of a small family business despite being the largest hotel company in the world.

The culture is defined by a set of five core values that guide every decision at Marriott. “The most important value is to put people first in our daily decisions and actions,” Rodriguez says. In addition, Marriott employees

David Rodriguez EVP, Global Chief HR Officer Marriott International

aim to pursue excellence, embrace change, act with integrity, and serve our world. At the company’s core, Rodriguez says, is the belief that everyone wants to live a good life and feel positive about their future, to work in an environment of mutual respect and support, and to be proud of their company’s employees. As chief HR officer, Rodriguez is focused on establishing innovative programs to support the company’s associates and bolster this culture.

The culmination of that culture is TakeCare. At its origin, the program was run exclusively from the company’s headquarters near its Washington, DC, birthplace as an extension of the core value of putting people first. While many companies start wellness programs in the hopes that employees will be healthier (and that medical expenses will go down as a secondary benefit), Marriott was more focused on the cultural value and, as such, focused on holistic well-being. Beyond physical health, the Marriott team developed a cohesive focus on promoting things that make employees feel good about themselves, relationships within the company, and the company’s purpose in society.

While the program was initially only launched in the United States, employees spread TakeCare through word of mouth to colleagues at other Marriott hotels across the world. “Long before we looked to bring it to other hotels or countries, we found it was already there,” Rodriguez says. “There were these informal TakeCare champions, people who got so passionate about wellness and that helped others start their own programs.” But they weren’t merely spreading the same iteration of the program; as TakeCare grew internationally, it melded to the needs and desires of each location. In addition to focusing on good physical health, some hotels focused more on emotional health, while others added in diversity and inclusion programs, and yet others built in more opportunities for community service. The “care” element of TakeCare quickly diversified to care for the community in addition to the employees themselves. “It was at that point that we knew we had something much more powerful than we expected, something that we feel plays a very big part in keeping our company culture healthy and vibrant for the future,” Rodriguez says.

“It was at that point that we knew we had something much more powerful than we expected, something that we feel plays a very big part in keeping our company culture healthy and vibrant for the future.”

The effectiveness of the TakeCare program has garnered Rodriguez recognition from many of his business partners, including health insurance provider Anthem.

“An important measure of any wellness program is how well it engages and excites employees. With TakeCare, David Rodriguez at Marriott has certainly hit the mark,” the company said in a statement. “TakeCare is an inspiring and sustainable program, and Anthem is extremely proud to be his partner.”

As much as the specific developments, Rodriguez is excited by the fact that the employees have felt empowered to make TakeCare their own and express the culture of the company in their own communities. That, of course, exposes individuals who might one day become a Marriott employee themselves to a program and philosophy that differentiates the company from other employers. Globally, the organization gets more than two million applications in a typical year, and then hires about seventy thousand people in that same span. The hundreds of thousands of associates who make up Marriott’s ranks have reported extreme satisfaction and happiness in their work—to the tune of a Legend Award from the Best Place to Work Institute for having been on the 100 Best Places list since the award’s inception. And a large part of that is because employees feel that the organization wants to know them personally and promote their well-being.

KPMG LLP congratulates David Rodriguez on his distinguished career.

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Healing Puerto Rico

Marriott International’s TakeCare wellbeing program works in concert with the company’s social responsibility program, SERVE 360, to empower associates to bring caring and charitable fundraising to local communities. Executive vice president and chief HR officer David Rodriguez has taken pride in the way employees have worked to change the world, and, as a Puerto Rican American, their efforts to provide aid to the island after Hurricane Maria in 2017 hit very close to home.

Rodriguez traveled to Puerto Rico with other members of the leadership team in order to connect with the hotel staffs on the island and to provide whatever assistance they could. “After the storm, I saw photos where Puerto Rico looked quite brown. Upon landing, it was amazing how green it was, how nature had recovered,” he recalls. “It reminded me that nature is able to recover much faster than human beings can.”

That said, Rodriguez and the Marriott team came to Puerto Rico looking to

do anything they could for associates: they launched the company’s TakeCare Relief Fund, ran food banks, and brought electric generators, among other projects. In fact, those efforts extend year-round to anyone in the organization in need. “We delivered millions of dollars in aid to people in Puerto Rico, Texas, Florida, and all of the areas damaged by hurricanes,” Rodriguez explains.

But more importantly, even when Marriott employees were in difficult situations, they came to the assistance of others and put more positivity into the world. Rodriguez was particularly moved by one story of employees at a Puerto Rican Marriott hotel who came to the assistance of a children’s hospital in need of fuel, generators, and supplies. “Although they were not exactly sure how they would solve the problem, our local leaders just stepped in and said, ‘We’re going to make this happen,” Rodriguez says. “There were babies that needed emergency treatment, and they were saved by those efforts. That really is what Marriott is about.”

“We do whatever it takes, we go above and beyond, we innovate and spread the company culture to ensure our company stays healthy.”

And no one knows that as well as Rodriguez. “I could have said nothing about my diagnosis and kept quiet about it, but in a way, I was given a gift,” he says. “I now have a story that I can use to inspire other people.” While going through treatment and chemotherapy, he used his recovery time to think about employee well-being and their sense of purpose to evaluate how he could best bring that to take care of people at Marriott.

After several months of chemotherapy, Rodriguez’s leukemia has been in remission since 2014. Thanks to the organization’s family environment and TakeCare, the healing never stopped. “We’ve created a sense of personal well-being, pride, and ownership in the company. It results in a sense of gratitude and inspiration that leads employees to do the same for their customers and communities,” Rodriguez says. “We do whatever it takes, we go above and beyond, we innovate and spread the company culture to ensure our company stays healthy.” AHL

WE APPLAUD

David Rodriguez

Congratulations to David Rodriguez on the continued success of TakeCare. Embraced at all levels of Marriott, it’s a wellness program that we’re proud to be a part of. We thank David for the opportunity.

Gilead’s

Gilead Sciences’ Gary Tully revamped the company’s contract management system to streamline access to important legal information

By Joe Dixon

Circulatory

In the human

body, the circulatory system transports oxygenated blood and essential nutrients to a person’s vital organs. When it’s not functioning at its full capacity, the rest of the body suffers and struggles to stay healthy.

Although businesses don’t have circulatory systems, Gary Tully sees it as an apt comparison when he thinks about the contract management system at Gilead Sciences, where he serves as the head of legal operations. The company specializes in developing medications for unmet medical needs, such as HIV/AIDS, liver diseases, cancer, inflammatory and respiratory diseases, and cardiovascular conditions.

Tully is responsible for strategic planning of the legal department’s global technology portfolio, managing its outside counsel spend, and providing stakeholders the ability to quickly navigate through the company’s legal contracts in a central repository. Since joining the company in June 2015, the latter issue has been one of Tully’s main priorities.

After arriving at Gilead, Tully realized there was a tremendous opportunity to improve the management of the company’s global contracts. Now a $30 billion company, Gilead had quickly outgrown its existing contract management system, which made it difficult for employees to input, access, and extract critical information from documents it stored; the company’s circulatory system was clogged.

“We found that users were challenged to locate agreements in the system, and we identified two things that made it difficult,” Tully says. “First, the lack of meaningful

metadata describing a contract restricted the ability to search effectively to find a specific contract.

Second, the user interface was not intuitive enough for the average user to understand what type of data needed to be entered, which caused bad data to be put into the system.”

Part of the inaccuracy stemmed from a number of factors that are common during the process of creating a contract. Often, corporations will use email and the track changes features of Microsoft Word to negotiate contracts, sending versions of the agreement back and forth until agreement on terms is met. The side effect of this process is users on both sides are left with several versions of an agreement, and proper record-keeping practices dictate a need to identify a final, fully executed agreement.

Before implementing a solution, Tully spoke with various Gilead stakeholders across commercial contracts, procurement, and other departments to understand what they were looking for in their ideal contract management system. From there, he realized he needed to find technology that fulfilled two goals: the ability to store information for all contracts in a central location and a system that automated as much data entry as possible.

System

Gary Tully Head of Legal Operations Gilead Sciences

“Getting that information was key,” Tully says. “We focused all of our efforts in this first phase toward delivering a solution that would improve upon the challenges we saw in the previous system.”

Armed with information from stakeholders around the company, Tully began his search for a new contract management system. He partnered with his colleagues in various business units, the corporate legal team, and industry experts from Duff & Phelps to help evaluate the market, and together they kick-started a thorough selection process to find the best fit for Gilead. In the end, he opted for a hosted solution primed to vastly expand the company’s capabilities in managing their contracts. Officially rolled out in September 2017, significant efficiency gains have already been realized, including much greater accuracy around contract metadata.

Part of the strategy to improve data quality was to reduce the number of fields that are manually entered by users of the system. Data entry for new contracts has been reduced to only five information fields, and three of those fields are auto-populated by technology. A person entering

the remaining two fields just needs to verify the information is accurate and upload the contract into the system. Rather than performing each of these steps manually, the new process utilizes artificial intelligence to capture another twenty-five fields of information and drastically reduce the possibility of errors.

“It has created more consistent data and a systemic method to correct future data entry errors,” Tully says. “By constantly improving the ability of our data entry, we create a capability to ensure we have high-quality data for use in managing our operations.”

Perhaps most importantly, the new system has freed Tully’s team of the labor-intensive manual data entry required for the numerous contracts that come across their desks every month. This allows the legal team to focus on partnering with Gilead’s executive leadership to help make sound business decisions, something Tully emphasizes as a leader. Having earned his MBA from Pepperdine University, Tully recognizes that having a broader understanding of a company’s business objectives can greatly enhance a lawyer’s ability to do their job.

“It has created more consistent data and a systemic method to correct future data entry errors.”

“Given the talent of Gilead’s legal team, freeing up the lawyers to solve business problems is huge.”

“Given the talent of Gilead’s legal team, freeing up the lawyers to solve business problems is huge,” Tully says. “Our attorneys can be in the conversation to identify risk areas and to provide counsel while balancing business benefits along the way. The value that adds enhances the return on investment from the legal department.”

Although the new contract management system is still in its infancy, Tully says the company is already reaping the benefits of the streamlined system. The benefits will reduce the time needed to create finalized agreements, which will help Gilead serve patients better.

“Our contract management solution isn’t just creating efficiency for the legal department, it’s creating efficiency for the company to deliver the products and services to patients,” Tully says. “Gilead often has patients tell their stories about how the company’s products have improved their lives, and it puts a little more wind in your sails when you get to hear these stories and that you contributed in some way.”

Much like a circulatory system, an effective contract management solution can create efficiencies in a legal department to unclog resources, making them available to enhance their lines of business. In the case of Gilead Sciences, that means advancing therapeutics and improving lives. AHL

Duff & Phelps is proud to congratulate Gary Tully on being recognized by AHL Magazine

As a trusted advisor to Gilead’s legal department, Duff & Phelps values our partnership with Gary Tully. Through his leadership and vision, Gilead is quickly becoming an industry leader in legal operational excellence. We thank Gary for his loyalty and look forward to celebrating his continued success.

A Niche

By Jenny Draper

in Need

How Joe Whalen helps Horizon Pharma tackle patients’ rare diseases

It took

less than a decade for a small start-up to transform into a billion-dollar global enterprise. And now, that biopharmaceutical company is undergoing its latest metamorphosis to seek major gains in narrow spaces. Founded in 2008 with a handful of employees and no office, the precursor to Horizon Pharma began with a big idea: accessible medicines for unmet patient needs. Today, with more than one thousand employees, that means treating rare diseases. And thanks to Joe Whalen, patients on the fringe of medical knowledge take center stage.

“Unless you know someone impacted, you may not have heard about these rare diseases, so we really see the benefit in helping these patients,” Whalen says. “As we grew, we could see that rare diseases had the highest unmet treatment need.”

Less than 5 percent of about seven thousand rare diseases receive one FDA-approved treatment, and Whalen says that those rare diseases, which affect less than 200,000 people, also map the high-growth trajectory for Horizon Pharma. Since its founding in 2008 as a small start-up, Horizon Pharma is continuing to grow as it aims to expand its pipeline of rare disease medicines with the help of Whalen, senior vice president of business development and alliance management.

But before coming to Horizon Pharma, Whalen was earning his BBA in accounting from the University of Notre Dame before earning his MBA in finance at the University of Illinois Urbana-Champaign. He started his career at Searle as a business analyst in 1994 and later supported the strategy for pharmaceutical products in various Europe and US markets. In 2001, he joined Baxter Healthcare as a senior manager of transactions analysis prior to his promotion to director of business development two years later.

He left Baxter to consult for Horizon Therapeutics during its merger with Nitec Pharma in 2010. “We were in survival mode,” Whalen recalls. Three months later, Whalen arrived at the renamed Horizon Pharma and helped take it public a little more than a year later. Specializing in medications for arthritis, pain, and inflammatory diseases, its net sales comprised only two drugs, DUEXIS and RAYOS, by 2013. The risk of stagnation in a crowded market loomed.

So, Horizon Pharma’s leadership team, led by CEO Tim Walbert, envisioned a strategic pivot to not only evolve the company, but also to better serve a new demographic of patients in untapped markets. These diseases include everything from severe fungal infections, such as chronic granulomatous disease (CGD) to urea cycle disorders and more. “We know that drug development is risky, so we feel we need a number of shots on goal to be successful,” Whalen says. Whalen helps lead advances in this new direction through key acquisitions. In the last five years, Horizon Pharma landed eight groundbreaking deals to expand its product pipeline: VIMOVO from AstraZeneca in 2013; Vidara Therapeutics and PENNSAID 2% from Nuvo Research in 2014; Hyperion Therapeutics in 2015; Crealta, Raptor, and the global rights to Imukin in 2016; and River Vision Development Corp. last year.

“Unless you know someone impacted, you may not have heard about these rares diseases, so we really see the benefit in helping these patients.”

Joe Whalen SVP, Business Development and Alliance Management

Horizon Pharma

“It’s motivating to continue to work to find the next solutions for patients.”

“There are a lot of companies that start with one or two products like we did, but then realize the better option for them is to sell and put it in the hands of people like us who have the late-stage clinical experience to get it approved and the commercial experience to get it to patients,” Whalen explains. “And if we have drugs that can benefit patients outside the United States, then we look for partners to distribute those drugs there to maximize the potential for our products to reach patients.”

The results have been staggering, including a 93 percent compound annual growth rate from 2013 to 2017 based on consensus. The first nine months of 2017 comprised eleven medicines, six of which treat rare diseases. According to Whalen, Horizon Pharma will continue to invest in its orphan business unit with the cash flow from its more conventional primary care division. The stability of its osteoarthritis treatments, for example, is supporting Horizon Pharma’s move into uncharted territory.

Dennis Bennett, partner at Global Patent Group, works hand in hand with Whalen when it comes to patent due diligence, and has seen Whalen’s effective leadership firsthand. “Joe is a wizard at leading the disparate group of experts to do the ‘deep dive’ due diligence,” Bennett says.

Nephrology, or kidney health, is one such promising space. About 25–50 percent of patients with chronic kidney disease also suffer from gout—painful inflammation of the joints. Yet mainstream therapies are limited when it comes to treating both diseases together, as needed for about 100,000 patients in the United States. Horizon Pharma’s answer: KRYSTEXXA, the first and only biologic treatment for gout patients.

Another avenue of expansion for the biopharmaceutical company is endocrinology, the field of hormone-related

diseases. When Horizon Pharma acquired teprotumumab last year, it also potentially gained the first FDA-approved therapy for thyroid eye disease (TED) as its first acquisition of a development-stage medicine for rare diseases.

“This is a painful condition,” Whalen says. “The only treatments right now are steroids, which have limited efficacy, or surgery for severe cases.” This move marked the company’s aim to serve more than 15,000 TED patients in the United States as well as a stake in the annual sales potential of more than $250 million.

One product in particular hits close to home for Whalen. ACTIMMUNE, which treats CGD, is also being tested in three clinical trials to study its potential as an immune booster for cancer patients. “My mom is a breast cancer survivor,” he says. “She wouldn’t be here without the US healthcare system.”

Horizon Pharma partners with the Moffitt Cancer Center and Research Institute, Fox Chase Cancer Center, and National Cancer Institute. Whalen adds that the company also invites patients, within or outside the company, to speak at the office. “People leave those meetings with tears in their eyes,” he says. “It’s motivating to continue to work to find the next solutions for patients.”

With each new acquisition and research breakthrough, Horizon Pharma is proving its capacity for high growth in narrow segments. Looking ahead, Whalen says he will continue building long-term value though a collegial approach for Horizon Pharma as it delves further into the identification of undiagnosed patients and unique treatments.

“The pace is fast, and it’s always changing. But we’re making a difference in people’s lives,” Whalen says. “When I look back and see how far we’ve come, it’s been an amazing ride.” AHL

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The Culture of Compliance

Renata J. Matsson ensures that Johns Hopkins Medicine International’s projects around the world comply with US and foreign regulations, as well as local traditions

By Jeff Silver

As the chief

compliance officer of Johns Hopkins Medicine International (JHI), Renata J. Matsson is responsible for meeting an incredibly wide range of best practices, laws, and regulations. That can span from legal consideration and pre-engagement due diligence to ongoing risk assessment, data privacy, and security, as well as business continuity planning. This also extends across global services that include providing healthcare for Saudi Aramco’s roughly 350,000 employees and their families, nursing programs in Brazil, joint university-based medical research in Colombia, as well as consulting, management, training programs, and various other collaborative agreements throughout the Middle East, Asia, South America, and the Caribbean.

Additionally, Matsson manages compliance for patient services, which brings international patients to the United States for medical treatment. In order to manage a variety of different details, she relies on an extensive network of internal JHI specialists, as well as outside legal, consulting, and accounting experts. Her guiding principle to motivate and enable internal personnel and external partners to meet all necessary requirements is to engage in clear and ongoing communication.

“Compliance doesn’t come easily to anyone,” Matsson explains. “That’s why it’s so important to constantly remind everyone to build it into the workflow of every project and to be proactive when there are questions. It’s always harder to fix something after it’s broken than it is to get it right in the beginning.”

After years of experience as a compliance professional, Matsson has learned many lessons. One of the most significant goes beyond simply knowing the applicable regulations. The key is understanding the cultures where they apply. For example, procedures in the United States for obtaining various types of permits or registrations are typically clear and precise. In other regions of the world, however, authoritative sources of information can be vague and diffuse. Even government ministers may not be able to provide complete information, and unwritten rules frequently come into play.

“It’s not uncommon in a foreign jurisdiction to feel as if the application of laws and rules are constantly changing, but it’s important not to appear frustrated, act aggressively, or raise your voice,” Matsson says. “Your success has less to do with the specific law or regulation than it does with the quality of the relationship you develop with the local official.”

Another important aspect of her role is managing expectations. Because of JHI’s reputation, assumptions are often made about the level of expertise and solutions it can provide to overcome any challenges that might stand in the way of a project’s success. In one instance, an international partner expected JHI to implement a working telemedicine program. However, the local technology infrastructure and internal knowledge base were subpar to what was needed to support that goal. Extensive discussions were required to convince the partner that JHI could provide training to move them closer to their objective. But providing a full “telemedicine package” simply wasn’t possible.

Complying with the US Foreign Corrupt Practices Act (FCPA) has become another increasingly challenging task. When working with public universities and health systems, the term “foreign official” becomes more difficult to define when all of the institutions’ staff are, technically, government employees, or “foreign officials” under the law. Additionally, numerous countries have enacted their own anti-bribery legislations that are even more restrictive. For example, while the FCPA permits so-called “facilitating payments” to expedite processing visas and permits, the new laws prohibit such payments.

“We provide extensive training so that everyone knows what’s permissible under the laws,” Matsson says. “The key is to build awareness so that even if someone doesn’t know every detail, they know enough to ask questions.”

Training has also been essential in situations such as when a patient or their family offers expensive gifts as thanks for successful treatment, which staff are generally not permitted to accept. Instead, the gift can only be accepted on behalf of the organization, or in the case of cash, as a donation to Johns Hopkins.

Cultural considerations also enter into working with international patients in the United States. Their customs

Renata J. Matsson Chief Compliance Officer

Johns Hopkins Medicine International

Mike Halstad

Global Compliance Solutions for controlled technologies, OFAC and other research related requirements

“Our previous method for maintaining compliance was much too cumbersome and limiting. Visual Compliance–Research Edition gave us the dynamic tool we needed for our day to day operations.”

“The key is to build awareness so that even if someone doesn’t know every detail, they know enough to ask questions.”

may prohibit being treated by a clinician of the opposite sex or prevent a woman from giving her own consent for a medical procedure (since in many countries, consent must come from a husband or other male family member). In these situations, a great deal of sensitivity is essential.

“We can explain our protocols for their care and safety, but still need to be able to adapt,” Matsson says. “That can mean getting consent from a patient and her husband.”

Adapting may also mean softening the language during an end-of-life situation in order to avoid taboos against directly mentioning death. In some cases, “‘You should be with your family as much as you can’ would be preferable to saying, ‘You have two months to live,’” Matsson explains.

The compliance and risk-management challenges Matsson has to meet are always changing. Terrorism has altered how travel risks are assessed, and growing concerns with national security threats, political changes, and regulatory pressures have also increased the importance of thorough due diligence of foreign parties, which may even include patients.

No matter how issues evolve, Matsson believes JHI will be successful in meeting all its compliance obligations.

“Compliance goes beyond legal considerations,” she says. “It’s intrinsically linked with ethics, the organizational culture, and a commitment to corporate social responsibility. By being sensitive and flexible, we can balance diverging interests and serve the best interests of our stakeholders and the foreign patients and partners we work with.” AHL

Treatment Beyond TwentyEight Days

Frank Severino develops strategic partnerships for RiverMend Health of Atlanta, a multistate behavioral health clinic that’s changing the way addiction is treated

By Russ Klettke

It

took an unfortunate amount of time for the tragedy of the opioid epidemic, which accounted for about three-quarters of the sixty-four thousand deaths from drug overdoses in 2016, to reach widespread attention in the United States. But while public health officials and private care providers searched for answers,

RiverMend Health of Atlanta already had several to offer.

The provider of scientifically driven behavioral health services helps patients who suffer from alcohol and drug dependency, eating disorders, obesity, dual disorders, and chronic pain to begin recovery. The approach is decidedly medical, in partnership with university and hospital affiliations. And yet, no private care provider can exist without a solid business development plan. That’s where Frank Severino comes in.

As vice president of business development, Severino is charged with forming referral relationships that direct people to the organization and its nine sites located in four states. But even though he’s charged with ensuring financial viability of the company, he’s quick to identify with the mission and methodology of the organization.

“Whether it’s substance abuse or eating disorders, we’re dealing with chronic diseases, not moral issues,” Severino says. “We put this in context with medicine and the treatment of chronic illness.”

The difference between RiverMend and many other treatment organizations is that the organization has full-time physicians on staff. For example, although the company was established quite recently, in 2014, it already has incorporated Rosewood Center for Eating Disorders, an established integrative eating disorder program with more than twenty years of excellence serving patients with anorexia, bulimia, and binge eating disorders into its services.

It’s growing collaborative relationships such as these that fills up Severino’s to-do list. RiverMend receives patients referred by other treatment centers, detox facilities, sober living housing organizations, hospitals, employer wellness programs, and physicians. This broad variety underscores something Severino echoes frequently: “Addictions affect all walks of life.”

RiverMend also operates the Positive Sobriety Institute in Chicago, which was originally developed for patients who are medical professionals: physicians and nurses. In marketing lingo, these are the “niche verticals.” Aside

from being the “highly motivated impaired,” as Severino describes it, they are also the patients whose recoveries are closely monitored for the sake of public safety and who risk losing their professional licenses. The verified success rate in these two demographics is about 80 percent; in the general population, drug and alcohol treatment programs achieve about a 20 percent no-relapse success metric. The Joint Commission is currently developing universal protocols for measuring outcomes of such programs.

Learnings from this medically based program—it is affiliated with the Feinberg School of Medicine at Northwestern University, one of RiverMend’s several teaching hospital relationships—now inform the organization’s work with other patients. For example, they know more about the physiology of recovery and its implications for treatment. “We understand how long-term damage to the brain can require as much as two years to heal,” Severino says. “Instead of a prescribed model that incorporates specific days, which is typical in the recovery industry, we build a treatment plan for the individual patient. This includes an after-care continuum, where we encourage patients to live in recovery homes with a group of their peers. That’s where they can learn things such as how to live sober in society—for example, enjoying social events like baseball games without drinking.”

The recovery industry overall faces a headwind of criticism. Severino breaks the critics into two categories: One is the camp that dismisses addiction as poor self-control. The second are families and institutions that had dissatisfying experiences, such as at twenty-eight-day facilities that fail

Frank Severino VP of Business Development RiverMend Health of Atlanta Mac Macdonald

to achieve sobriety (the monthlong program model is based in tradition and insurance schedules, not science).

“Our integrative care model, as well as our medical affiliations with hospitals, is how we distinguish ourselves,” he says. “We can easily make referrals to other medical specialists who identify when other health issues are related to the addiction. Although it’s no magic wand, this approach is complex, innovative, and creative.”

If it seems remarkable that there are few set protocols to addiction treatment, consider the sets of variables and requirements, as well as types of addictions, which define the entire phenomenon of behavioral health. Severino illustrates this by comparing Florida to Illinois in what is required to be a licensed provider: “In Florida, you only need a master’s level therapist and a storefront. In Illinois, the standards are more stringent,” he says. Various new laws, including the Parity Act of 2008 as well as the Affordable Care Act of 2010—have elevated the importance of all mental health care, and yet costs have arguably risen as a result of both. “Patients consequently get less access to quality care,” he says.

But it might be the opioid epidemic itself—including synthetic analogs such as fentanyl—that has had the greatest impact on what RiverMend and all treatment providers are encountering. When Severino started working in recovery programs in 2011, it was after a successful, fifteen-year career in human resources recruiting. He was hired to help the Gateway Foundation transition from a Medicaid-dependent to private pay program, at a time when cocaine and methamphetamines were the predominant scourges.

Severino succeeded there, joined RiverMend in 2014, and is happy to work where he is effectively saves lives. “We put people and families back together,” he says. AHL

Novus knows the hardest step in recovery is the first step. Making this first step as comfortable, safe, and effective as possible, Novus created new protocols, utilizing innovative and clinically successful methodologies in medicine, nutrition and natural integrative remedies, to set our patients on their way to a sustainable sobriety.

Frank Severino’s ability to develop and manage a high performance outside sales team has helped make RiverMend a nationally recognized provider of Behavioral Healthcare. Sunrise Detox Centers has had a working relationship with RiverMend for many years and admires the work that Frank and his team do to fight addiction.

medical technology tailored to the individual patient.

multidisciplinary team of medical professionals available 24/7.

facilities designed to promote therapeutic tranquility, comfort and healing.

in high-dose opiate/opioid cases.

From the Incubator

Jay Lichter details how COI Pharmaceuticals has helped entrepreneurs advance some of most dynamic scientific research into breakthrough medical products in the biopharmaceutical industry

By Danny Ciamprone

to Medical Breakthroughs

Start-up

incubators have become synonymous in the past few years with the thriving scene of innovation taking place in Silicon Valley. From RocketSpace, which produced such notable alumni as Spotify and Leap Motion, to Y Combinator, which helped develop Airbnb and Dropbox, the limits of innovation are only set by the entrepreneurs themselves.

But drive about eight hours south of the Bay Area and you will discover a new kind of incubator. It’s here in San Diego, which is the third-largest biotech hub in the world, where you’ll find Jay Lichter, president and CEO of COI Pharmaceuticals and managing director of Avalon Ventures. Just as Silicon Valley has become synonymous with technology and start-ups, the life science community of San Diego has become renowned as a center of innovation and a destination for entrepreneurs in the life science community.

“We’re really focusing on bringing new companies to San Diego with novel, interesting technologies across both sciences and tech,” Lichter says.

COI, which stands for “community of innovation,” is a fully integrated life science incubator that was established in 2013. As an unconventional entity, it reduces the cost and time to start-up and manages a biotech company by providing streamlined key operational resources. These companies are funded through different mechanisms— Avalon X and XI, Avalon-GSK collaboration, and soon COI Ventures I. COI then provides companies intellectual support by bringing together entrepreneurs, scientists, and industry mentors to collaborate on translating scientific breakthroughs into medical products.

Currently consisting of more than seventy scientists, COI Pharma support staff provide management, finance/

Jay Lichter President & CEO, Managing Director

COI Pharmaceuticals & Avalon Ventures

budgeting, human capital, real estate, and capital equipment to each portfolio company. Lichter, who was originally a scientist, entered the entrepreneurial world in the early 1990s with a company in Avalon’s portfolio. After becoming CEO of several small companies, Lichter found space in San Diego where he could localize these organizations. About ten years ago, that turned into the beginning of what would later become COI.

Lichter soon became a partner, and Avalon added more companies. In 2013, GSK and Avalon entered into the first-of-its kind collaboration, and Lichter says the partnership helped advance the speed in transitioning concepts and ideas from life science entrepreneurs into functioning companies to address unmet medical needs. Each portfolio company rents time, space, and equipment as needed from COI, he explains, to pursue a program or project. There are currently fourteen companies within COI.

“It’s not like a typical incubator where you have six months of cash to pay the rent,” he says. “It has to be part of the Avalon and COI I portfolio. I think that’s really quite different, and because of that, the management oversight by the investor of these companies is very hand in glove. So, it’s operational venture capital: we invest in companies, we run the companies, we keep track of them nearly on a daily basis, and we help the management team partner or sell or finance if necessary.”

Step 1: The Pitch

Before coming to COI with an innovative, scientific proposal, Lichter says the entrepreneur’s concept has to address an unmet medical need, as well as be disruptive technology. “It can’t just be incrementally better. It has to be substantially better,” he says.

The technology and science also must be tractable— meaning COI can see the path from invention to product development. One of the keys for COI is having a clinical and regulatory strategy to get to market. The entrepreneurs themselves must also showcase their drive and commitment for building companies and bettering the community.

“We are in the business of moving fast, and if we want to do something, we decide to do it.”

A major advantage that COI also has in achieving this is its relationships with a variety of academic institutions. These institutions will share a monumental discovery with COI even before the research is published. Other earlystage developments are typically self-funded or co-invested in a build-to-buy partnership.

Step 2: Achieving Buy-in

Once that criteria is met from an entrepreneur, the next step is visiting the COI team and presenting the project. Lichter says the company has a science committee meeting, which is made up of the top dozen scientists in the organization. These scientists hear the pitch and then ask necessary questions. If the committee approves of the concept, then it goes to GSK, which will either agree to collaborate on the concept or state why it isn’t a good fit for the company.

Lichter says the process takes about two months from pitch to development. On average, Lichter and his team review 20–25 projects a month. Over the past five years, they have reviewed more than one thousand proposals.

“We are in the business of moving fast, and if we want to do something, we decide to do it. If we don’t, then we step away, and we typically explain to the entrepreneur why we’re not doing it,” Lichter says.

Wilson Sonsini Goodrich & Rosati

The premier provider of legal services to technology, life sciences, and growth enterprises worldwide

Wilson Sonsini Goodrich & Rosati is proud to work with Jay Lichter in his creation of groundbreaking companies.

Dr. Mike Hostetler, a partner in the SOMA and San Diego offices of Wilson Sonsini Goodrich & Rosati, has been working with COI Pharmaceuticals since its inception. At WSGR, he provides strategic intellectual property counseling to more than 100 growth enterprises in the pharmaceutical and biotechnology, and information technology industries.

“Patent counseling should focus on the stage of the technology and the various exit strategies for the technology. The innovations being created and developed at COI are designed for both venture investments and partnering with pharma. We work with the COI team to craft comprehensive patent estates that have built-in flexibility to facilitate either opportunity. Jay’s experience as a CEO and a venture capitalist has given him the insight to see both the short-term and the long-term components of patent strategy.”

An integral part of WSGR’s interdisciplinary approach to representing life sciences companies is its Patents and Innovations Group. WSGR’s Patents and Innovations Group has more than 150 patent practitioners, including over 80 attorneys, 60 patent agents, 1 European Patent Attorney, 4 Chinese Patent Experts, and several former members of the USPTO’s management. The Patents and Innovations Group files on average 500 patent applications each year, focused on furthering its clients’ strategic business interests.

Step 3: Accomplishing Breakthroughs

Since COI’s founding, eighteen new companies have been formed as a result, including Synthorx, a synthetic biology company that is working to discover and develop novel protein therapeutics.

Synthorx was able to achieve this by introducing a disruptive technology that expanded the genetic alphabet to six base pairs—A, T, G, C, and then X, Y—instead of four. That technology enables the company to make novel protein therapeutics with improved pharmacological properties, such as reduced side effects and better efficacy.

Another medical breakthrough comes from a company Lichter founded, Otonomy, which develops technology for disorders of the ear. The company has developed a treatment for Ménière’s disease, an inner ear disorder that causes vertigo. Treatments for in-ear disorders cannot be administered via traditional medicine because the cochlea is a sensory organ and has barriers in place. Therefore, Otonomy developed an injection across the ear drum into the middle of the ear, which then treats the disorder via osmosis. This has led to a pipeline of products addressing unmet medical needs, such as Ménière’s disease, as well as hearing loss and tinnitus.

Some of these products and companies may not have the name recognition that those coming out of incubators in Silicon Valley might, but it’s the nature of the products themselves that are completely disrupting the science and technology community for the better. Lichter not only credits this to the entrepreneurs and developers, but also to the strong culture at COI and its outstanding partnership with GSK.

“We’ve built an amazing team,” he says. “We have a very large group and work together well. We’re friends, we’re scientists, and we’re businesspeople—it’s a really interesting blend culturally. We’ve had some great successes, getting new investors interested, and making progress on all the programs scientifically.” AHL

“We’re friends, we’re scientists, and we’re businesspeople—it’s a really interesting blend culturally.”

Wilson Sonsini Goodrich & Rosati seeks to provide more than just legal advice to our life sciences clients. We work with our clients to understand their business strategy and to help them successfully execute that strategy. An example of the support that we provide our clients is the Healthcare Innovations Venture Investment Forum, which was last held in Austin in December 2017. Initiated by Patents & Innovation partner Sabrina Poulos, the Austin Forum brought together more than 50 venture and strategic investors for networking and one-on-one meetings with leading life sciences companies and university spin-outs. The next Forum will be held in Fall 2018 in San Francisco.

Contact Mike or Sabrina if your company or fund is interested in participating.

“You can get competent nuts-and-bolts patent work at many firms. WSGR’s Patents & Innovation Group works with our life sciences clients to construct and execute a comprehensive, tailored patent strategy that will enable its clients to dominate and own their commercial space, helping to build value for their ultimate exit.

The craft and care that goes into our unique business-focused approach to patent advice, and the diversity of clients and innovations with which we work, makes this job particularly rewarding. We represent life sciences companies focused on cutting-edge advances in small-molecule therapeutics, biologics, cell-therapies, vaccines, medical devices, diagnostics, tools, and digital health.

Challenging work, exciting innovations, great companies with great people, what else can one ask for?

We are thrilled to highlight the great work that Jay Lichter and COI Pharmaceuticals are doing, and support their mission in the life sciences.”

For more information, contact: Mike Hostetler, mhostetler@wsgr.com, (858) 350-2306

Sabrina Poulos, spoulos@wsgr.com, (512) 338-5441

Wilson Sonsini Goodrich & Rosati

The premier provider of legal services to technology, life sciences, and growth enterprises worldwide

With over 200 legal professionals dedicated to the life sciences, Wilson Sonsini Goodrich & Rosati is the premier legal service provider for life sciences companies. We focus on providing innovative and strategic patent, corporate, and transactional advice, enabling our clients to protect their most valuable assets.

Not a

Moment

Providence St. Joseph Health’s department of legal affairs is unifying and transforming itself so the newly formed organization doesn’t skip a beat

By Jeff Silver

to Lose

When St. Joseph Health and Providence Health & Services came together in the summer of 2016 to create Providence St. Joseph Health (PSJH), the new legal affairs department was faced with a truly daunting task. It was one of the largest healthcare transactions the California Attorney General’s office had ever reviewed. It included 50 hospitals, 829 clinics, and a comprehensive range of additional services across seven states. Complicating matters further, technically speaking, the parties weren’t calling it a “merger.” Instead, they regarded it as a combination of two equal and highly successful organizations.

According to Jim Watson, senior vice president and deputy general counsel, that created both challenges and opportunities. To begin with, the legal team had to help develop an explanation for why the transaction was taking place at all. That led to developing a list of more than twenty aspirational goals that were incorporated into the formal regulatory process, and which had to be duplicated for each of the thirteen California-based hospitals and additional facilities in the other six states. The goals were also added to 385 pages of conditions that the Attorney General’s office placed on the transaction.

“Developing the aspirational goals was a huge undertaking, but once they became part of the official public record, they gave us tangible markers against which to measure and share our accomplishments in the future,” Watson says. “They also helped clarify our vision for the new organization.”

The sheer scope and volume of complying with the various regulatory processes also created the opportunity for—or, perhaps, demanded that—the three legacy legal offices in Irvine, California; Renton, Washington; and Portland, Oregon cooperate and collaborate. The formerly discrete in-house teams varied in their numbers, areas of expertise, and depth of integration with functional and business strategy. However, they helped make the transaction successful by uniting to form a comprehensive unit that tapped the strengths they were each able to provide.

Once the consolidation was officially approved, legal affairs set about integrating its systems, but, otherwise, maintained

the status quo. Watson describes it as tending to the needs of others before looking inward.

“Legal is one of those functions that people start calling immediately to make sure everything stays up and running,” he says.

“Before we started establishing a new operating model and reorganizing the department, we needed to be sure we were able to help keep the lights on for everyone else.”

Now that the dust has settled, legal affairs has set about transforming the department into an integrated team, uniquely qualified to provide PSJH with high-quality, innovative legal services, strategic advice, and mission-focused leadership.

“We want our lawyers to be part of conversations right from the beginning to help craft strategy and to better understand all the elements that impact the mission,” Watson says. “That will ultimately help us more clearly define how we can contribute valued, strategic, and practical counsel in the traditional legal sense, but also as leaders within our ministry.”

To achieve those objectives, the legal department is adopting an approach of solve, shape, and strategize. Watson points out that this will enable staff to address

Jim Watson SVP, Deputy General Counsel Providence St. Joseph Health

“As long as we’re an active partner at every stage, we can offer better advice that benefits every corner of the ministry.”

day-to-day issues, contribute value at operational levels, and be part of conceptualizing longer-term goals.

“PSJH lawyers and legal professionals need to be able to look at every issue and feel empowered to ask the right questions and influence decisions,” he says. “That will help us to have a deeper knowledge of our needs, enable us to provide creative solutions, and anticipate future needs.”

Watson began as an administrative assistant with St. Joseph’s in 1996, so he has been part of the organization in many different functions and witnessed many different organizational perspectives. Leveraging that experience, he believes the new legal department can be most effective by ensuring that it is exceptionally knowledgeable of its ministry and industry, develops collaborative relationships with its leaders, and deepens comprehensive expertise in current and emerging areas of the law.

“From the many vantage points I’ve been able to experience, the legal department’s continuous improvement has helped us remain focused on providing high-quality services while expanding our strategic value to all the different aspects of the industry and our mission,” Watson says.

In one such instance, a senior attorney recently reviewed growth opportunity evaluation approaches that differed between the legacy organizations. This involved partnering with leadership and staff at operational levels to understand the desired new approach, how to best implement it, as well as analyzing how it fit within regulatory and mission frameworks. Ultimately, the appropriate legal advice helped clarify a fresh strategy that was understood and accepted by everyone involved. This has cleared the way for several opportunities to provide excellent service and value for PSJH patients and communities.

One of the benefits the new PSJH legal affairs department provides is an exponentially heightened degree of

trust, experience, and expertise. Watson describes it as a whole that is greater than the sum of its parts.

For example, if an issue arises at a facility in Lubbock, Texas, there is a good chance that someone in California, Oregon, or Washington has seen it before and can offer their insight. As the former legacy offices continue to unify, leveraging that system-wide perspective is an ongoing priority.

In addition to seeing staff from across the organization turn to the legal department as a trusted resource, Watson has also seen the department itself become more cohesive. As PSJH began implementing its earliest strategies as a new ministry, lawyers marshaled their knowledge and insights to deliver strategic value while considering new growth opportunities in Los Angeles and Orange County. They brought in counterparts from labor and employment, regulatory, and transactional groups, as well as experts from other functional areas within the organization to provide additional perspectives on the most advantageous ways to proceed.

“In the past, we might have been more fragmented in our approach,” Watson says. “Now we’re able to start with our regional lead or specialist and then look across the entire system to coordinate and bring together internal services from a variety of legal areas.”

PSJH’s legal affairs department will be preparing for a great many new possibilities—everything from operational enhancements for delivering outstanding affordable healthcare, to an influx of innovations to transform care and improve health outcomes, to diversifying and growing in areas beyond acute care.

“No matter what changes come our way, we want the legal department to be part of the team anticipating needs and devising the creative solutions,” Watson says. “As long as we’re an active partner at every stage, we can offer better advice that benefits every corner of the ministry.” AHL

Naomi Cramer’s Four Steps to Connection

How the chief human resources officer maintains open communication at Banner Health

By Galen Beebe

When

she became chief human resources officer at Banner Health, Naomi Cramer had to find a way to connect with all 550 people in the HR department. Meeting in person wasn’t always an option, so she turned to the next logical approach: email. Every other week, she sends an email she calls Five Bullet Friday. She starts each email with a personal note, then discusses the HR strategy, recognizes her team’s accomplishments, shares an inspirational story or quote, and measures the pulse of what’s happening at Banner.

Early in her career, while working at Target, Cramer was intimated by her senior leaders. In meetings, they often focused on the issues rather than seeking ways better serve their reports and their customers. “I made a vow at that point that if I ever got to a senior-level position, I wanted to be somebody who would be more vulnerable—to share what I was working on, to talk about my personal life a little bit, and also to be a little bit more in the vein of service to others,” she says. Since making that vow, Cramer has focused on this mission and learned four major keys to fostering transparent communication in the workplace.

Share Personal Challenges

Cramer learned the importance of sharing personal challenges with her colleagues the hard way. Early in her career at Target, her first child was born with unforeseen special needs. For eighteen months, Cramer kept her child’s health status private at work.

“I worked really hard, and I did fine at work, but I was struggling so much at home finding the right doctors, finding the right day care, and finding the right support mechanisms,” she says. After attending a leadership development class that discussed transparency and vulnerability, Cramer decided to share what was happening at home.

Her team helped her find doctors and day cares, and many told her about people with special needs in their own lives. “It was like a weight came off of my shoulders because they wanted to support me,” she says. “They always supported me at work, but when someone supports you outside of work, that’s a different feeling. It really it made our bond even stronger.”

Meet in the Middle

Not all team members respond well to these approaches. In some cases, Cramer has had to find other ways to connect with her peers. “In HR, you sometimes have a tough customer—somebody who doesn’t understand the team component,” she says. “They want to do the work at the expense of team engagement and morale.”

She experienced this with a partner in operations at Target. “He didn’t care whether his team was happy or engaged,” she says. “I really started to avoid him because everything we tried to do, he would be the first to say why it couldn’t work.”

But avoiding him only made the issue worse, so Cramer decided to call him every Friday to discuss one operational feature

Naomi Cramer CHRO Banner Health

“The people who are based at corporate build the strategy, and the people in the field have to bring that strategy to life. If it doesn’t work, it’s tough for those field leaders to bring it to life.”

that he was passionate about. “I knew I had to approach him in a different way or we were never going to collaborate together,” she says.

At first, she dreaded the calls, but once she connected with him, he began to ask questions about her team. “This synergy just came together,” she says. “By the end of my Target career, he was one of my best partners.”

Build a Transparent Feedback Culture

Cramer is extending this transparent feedback culture throughout the organization, and her first step is to simplify the feedback process. Previously, it took leaders forty minutes to complete the administrative form that accompanied each performance review. Cramer’s team streamlined the process with customized drop-down boxes and auto-fill information. Leaders can now complete the form in under two minutes, leaving them more time for the conversation that follows. “The conversation’s going to be longer than a minute and twenty-two seconds, but the administrative piece shouldn’t have to be,” Cramer says. “It’s the richness of the conversation that matters.”

Cramer’s goal is to replace the performance review process with quarterly check-ins, thereby creating a consistent feedback culture. Her team has implemented a feedback process they call ARC, which stands for aspiration, results, and capabilities. Following this conversational road map, leaders discuss their reports’ career aspirations, their results, and the path that will get them where they want to go. “You can update every form you want,” Cramer says,

“but if you don’t have a cadence or a routine that helps you do that in a very simple way, then it’s not going to stick.”

Put One Foot in the Field and One Foot in Corporate

To make sure the tools they develop are working, Cramer and her team regularly visit the end users. They alternate between having status meetings in the office and in the field—at hospitals, urgent care settings, and clinics.

After implementing the new review system in the HR portal, Cramer and her leader of HR operations went into the field to see what users thought. “We don’t just go out in rounds to meet people and shake hands and recognize them—we go out to check our work,” Cramer says. They gathered feedback and learned which features were working and which weren’t. Then, they updated the technology to make it more user-friendly.

“The people who are based at corporate build the strategy, and the people in the field have to bring that strategy to life,” she says. “If it doesn’t work, it’s tough for those field leaders to bring it to life.” AHL

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Lockton congratulates Naomi Cramer, Chief Human Resources Officer at Banner Health, for her excellence, innovation, and leadership in the healthcare industry. Lockton is honored to be a part of the Banner Health team, helping serve its mission to make healthcare easier so that life can be better.

Wes Williams VP, CIO

Mental Health Center of Denver

STEMMING

THE TIDE

Wes Williams’ IT efforts are helping

By Jeff Silver | Photos by Cass Davis

Mental Health Center of Denver

reduce suicide

A decade ago,

a Mental Health Center of Denver (MHCD) patient with suicidal ideation in his late twenties

was convinced that he would not live to be thirty years old.

He stabilized and improved through intensive treatment and appeared to be doing well.

Several years later, however, there was turnover among his treatment team, certain details of his initial admission and treatment were either lost or overlooked, and he did, in fact, die by suicide before his thirtieth birthday.

WES WILLIAMS IS DETERMINED TO ENSURE THAT SCENARIO DOES NOT HAPPEN AGAIN.

He’s putting systems and protocols in place that utilize the functionality of a new EHR system and leveraging innovative technologies such as mobile EHR visibility and natural language processing to improve clinical outcomes.

“Our goal is to have tools in place that recognize clinical risk and facilitate quick responses that prevent suicides from happening,” Williams says.

To help make that possible, Williams replaced MHCD’s legacy medical records system, which was struggling to keep pace with a dozen years of patient data. Old information needed to be archived to make room for new input and overall performance had become unreliable. At one point, corrupted data crashed the system for four days.

The severity of the issues prompted Williams to launch a nine-month agile project to replace the entire system. He and his team delivered a minimum viable product (MVP) and met with key stakeholders every month to get feed-

back on what was working, what wasn’t, and what enhancements were needed to continually improve function and performance. Working with its current vendor, MHCD still introduces about a dozen enhancements each month.

“By committing to ongoing improvement, we’ll never really be done enhancing the EHR,” he says. “But now that we’re on a modern platform, we can leverage its web service calls and other APIs to build more of an enterprise solution and integrate the EHR to other key systems, like our HRIS software.”

Once the EHR implementation was stable, Williams moved to migrating to the Microsoft cloud environment, which included implementing Microsoft 365, with the Office suite and Exchange. Azure and its cloud development tools, such as PowerApps for building customized applications within SharePoint and on mobile devices, was also part of the migration.

“Our goal is to have tools in place that recognize clinical risk and facilitate quick responses that prevent suicides from happening.”

“If you can use machine learning or other techniques to help figure out when it’s important to alert providers, then you help them think a little more clearly about difficult, uncomfortable situations and what steps should be taken to achieve better outcomes.”

Two subsequent custom projects demonstrate the flexibility and capabilities the new environment has provided. One is a confidential internal incident reporting system that documents everything from exceptional clinical events, such as suicide attempts and medication errors, to mundane incidents, such as lost staff badges or accidents in the parking lot. The other is a mobile app that gives social workers in the field full access and visibility into patient records. It was custom-built to meet the needs of social workers who ride along with police officers to calls that might involve individuals with mental illness. A laptop was too cumbersome for the “corresponders” who needed fast access to critical information.

“We did more than just streamline operations by eliminating laptops and tablets,” Williams points out. “We were able to create a solution that is secure and supports the requirements of a very specific workflow.”

Williams continually works to leverage the capabilities of such technological improvements to support MHCD’s ongoing suicide and violence prevention initiative. He began by reviewing structured EHR data to determine which information provides meaningful insights into the risk of dangerousness-to-self-or-others designation and flagging people at elevated risk. Then, a monitoring protocol was developed. In addition to alerting care teams, the protocol automatically prompts actions (via the EHR) like background checks through the Colorado Bureau of Investigation and monthly assessments of dynamic risk factors, such as substance use, recently acquired weapons, or significant life stressors, such as divorce or job loss.

Williams’ technology-based harm-reduction efforts are also tied in to an organization-wide quality improvement project that is part of the national Zero Suicide initiative , which highlights clinicians’ responsibilities when working with a person with suicidal ideation. Levels of suicide risk and associated risk factors are entered into the clinical problem list as SNOMED codes, which conform to interoperability requirements. This enables external providers to receive communication around MHCD’s risk assessments.

Two years ago, Williams began working with natural language processing to search unstructured narrative text fields, which make up an estimated 80 percent of information contained in an EHR. That means being able to mine thousands of words that can accumulate over years of treatment to uncover critical information about a patient’s conditions, behavior, or feelings that could be lifesaving in an emergency situation.

“Wes and the Mental Health Center of Denver are pioneers in applying unstructured analytics to the field of psychiatry,” said Dirk Van Hyfte, psychiatrist and creator of the text analytic technology for Cambridge, Massachusetts-based company InterSystems. “By analyzing the word groups in the clinical narratives to assess risk of self-harm, the clinicians are able to spot trends and red flags they might not otherwise see. That has the power to save lives.”

Even though care teams are made up of trained professionals, these tools help them deal with challenging clinical situations.

“If you can use machine learning or other techniques to help figure out when it’s important to alert providers, then you help them think a little more clearly about difficult, uncomfortable situations and what steps should be taken to achieve better outcomes,” he says.

As part of that objective, Williams has created a highlevel EHR dashboard that has been well received by clinicians who use it regularly to input new data.

“So far, our model has been more push than pull, with care teams inputting more than they take from the systems,” he says. “Ultimately, though, our success will be driven by how much they use the information and by directives we can make available to them.”

Williams’ future challenges include developing more mobile applications to help clinicians address the needs of Denver’s homeless population.

“We offer significant community-based services, but you can’t sit in an office and treat people who are homeless,” he says. “That pushes us to come up with innovative solutions to address a diverse range of clinical needs.” AHL

THE ZERO SUICIDE INITIATIVE’S SEVEN ELEMENTS OF SUICIDE CARE

The Zero Suicide initiative emerged after a 2012 US Surgeon General report promoted the goal of zero suicides at healthcare facilities throughout the country. Since then, the Suicide Prevention Resource Center (SPRC) has developed seven essential elements of suicide care that work toward creating a systemic approach to successfully caring for patients at risk for self-harm. The seven elements are:

LEAD

Create a leadership-driven, safety-oriented culture committed to dramatically reducing suicide among people under care. Include survivors of suicide attempts and suicide loss in leadership and planning roles.

TRAIN

Develop a competent, confident, and caring workforce.

IDENTIFY

Systematically identify and assess suicide risk among people receiving care.

ENGAGE

Ensure every individual has a pathway to care that is both timely and adequate to meet his or her needs. Include collaborative safety planning and restriction of lethal means.

TREAT

Use effective, evidence-based treatments that directly target suicidal thoughts and behaviors.

TRANSITION

Provide continuous contact and support, especially after acute care.

IMPROVE

Apply a data-driven quality improvement approach to inform system changes that will lead to improved patient outcomes and better care for those at risk.

*All information from The Zero Suicide Initiative/Suicide Prevention Resource Center

Your Stories. Your Lives.

Life

“At some point in their life, everybody is going to need healthcare. Not everybody is going to need a Cartier watch. Not everybody is going to need an X-Box. But everyone is going to need healthcare.” p.86

Looking Back,

Carmela Castellano-Garcia President, CEO California Primary Care Association

Mike Chavez

Carmela Castellano-Garcia reflects on twenty years of leadership and the potential she sees in the next generation of leaders

By Danny Ciamprone

Charging Ahead

Carmela Castellano-Garcia made her way around the boardroom table in the conference room of San Jose City College. At just eleven years old, she was decades away from having her own seat at the table, let alone a full-time job. Instead, her role on this day was to collate and staple roughly fifty documents. Following the guidance of her mother, who was the executive secretary for the college at the time, Castellano-Garcia had to ensure the stack was in the right order and stapled properly, or she would have to start over.

“I remember being really frustrated by the tedium of that but also really learning about the importance of things having to be right,” Castellano-Garcia recalls.

It was that day as well that would lay the foundation for some of Castellano-Garcia’s most formative years. With the laps around the boardroom complete and the massive document in hand, it was ready to be handed over for review to Leo Chavez, the faculty senate president and a leader her mother greatly admired. Chavez would go on to become the chancellor of the Foothill-De Anza Community College District, the president of San Jose City College, and later president of the Sierra Community College District. It was then that Castellano-Garcia knew she was “going to be like Leo” when she grew up.

Today, Castellano-Garcia is the president and CEO of the California Primary Care Association (CPCA), which represents more than 1,300 nonprofit community health centers and regional clinic associations that provide care for those who may not have access to healthcare. She’s also been in plenty of boardrooms since those days helping her mom, Carmen, at San Jose City College years ago. But it was the intangible qualities such as leadership, determination, and a tireless work ethic that stayed with her at an early age with help from her parents.

“Looking back on my past—on becoming a CEO, becoming an attorney, all the investment that I made in my higher education—it comes back to the tremendous support that I had along the way, and it really starts fundamentally with my parents,” she says. “As a child, I was instilled with a confidence and a wherewithal to believe that I could do anything I set my mind to.”

It’s that same inspiration she invokes in others, particularly for women and people of color, who may not see the C-suite as a destination in their future. Having served for twenty-five years in the nonprofit sector and in various leadership roles, Castellano-Garcia says there are few women today in these same types of positions, and far fewer women of color. As a result, she stresses how important it is for women in leadership to invest time and effort in helping other women advance their careers.

“I believe I can help do that by simply being out there and showing them that it’s possible,” Castellano-Garcia says. “I have learned that young women—particularly coming from low-income backgrounds, immigrant families, or if they’re the first in their family to go to college—haven’t been exposed within their family or environment to women of color in the C-suite.”

Inspiring women at an early age is essential for Castellano-Garcia to help accomplish this, and part of

“As a child, I was instilled with a confidence and a wherewithal to believe that I could do anything I set my mind to.”

Mike Chavez

Leadership Runs in the Family

Carmela Castellano-Garcia credits much of her success to her parents, and she says it was her mother, Carmen, who also instilled in her a tireless work ethic and leadership mentality. After graduating from UC Berkeley, Castellano-Garcia worked alongside her mother at San Jose City College as the special assistant to the president. “I learned so much by working side by side with my mom in the president’s office for a year,” she says. “I was on my way to law school, but I also knew that when I became the executive that I was going to need someone like my mom to support me so that I could be successful.”

Years later, Castellano-Garcia worked again with her mom when they served together on the board of the Chicana/Latina Foundation, a nonprofit organization that promotes professional and leadership development of Latinas. The organization not only provides scholarships, but it also encourages young women to pursue leadership roles through its Leadership Institute.

Castellano-Garcia continues to follow the lead of her mother, Carmen. Carmen and her husband, Alcario, started the Castellano Family Foundation (CFF) after winning the California State Lottery in 2001. The CFF was created as a way to give back to the community and to support organizations in Santa Clara County that were involved in Latino arts and culture, as well as education.

Carmen was the primary trustee, serving as president of the foundation and running the day-to-day operations until Castellano-Garcia took over as the president of CFF in 2015. In this role, Castellano-Garcia works to carry on the legacy and example that her parents have set for their family and the community. It’s that example that inspires Castellano-Garcia to continue the tireless work that her parents set out to do fifteen years ago.

that is sharing her personal stories. As the only MexicanAmerican woman in her graduating class at Yale Law School, Castellano-Garcia says even if the odds seem stacked against you, simply use that as motivation.

In fact, when she speaks with young women today, one of the first questions Castellano-Garcia asks is how many in the room were told by their high school counselor not to consider a prestigious school and instead go to community college. “It’s always one-third of the room,” CastellanoGarcia says. She then follows up by asking how many were discouraged to leave home to attend college. Again, the amount of hands that raise in the air is staggering. “That’s still happening to young women,” she continues. “There are a lot of challenges that young women face in trying to pursue their education.”

Castellano-Garcia faced those same obstacles when she was pursuing her education. She recalls vividly her high school counselor telling her that she belonged at San Jose State University, even though she dreamed of going to UC Berkeley. She did go to San Jose State, but ignored her counselor’s advice and ultimately transferred to and graduated from UC Berkeley before being accepted into Yale Law School.

At CPCA, Castellano-Garcia furthered that message of pursuing one’s dreams when she introduced an internship program to cultivate future leaders. The program offers real-world experience for students interested in careers in public health or healthcare delivery. About twenty-five people have experienced the benefits of the internship program to date.

“I’m often the first person of color they’ve ever met as a CEO and the first person who’s ever suggested that they have the same potential. No wonder they don’t see those possibilities for themselves.”

“We have to do more to make women and people of color think about the possibilities of roles in the C-suite,” she says. “I’m often the first person of color they’ve ever met as a CEO and the first person who’s ever suggested that they have the same potential. No wonder they don’t see those possibilities for themselves.”

Castellano-Garcia and CPCA also recently created the director of human and organizational development position in order to help develop and train leaders of the future. “I have a lot of young people working for me at CPCA. These are future leaders in healthcare,” she says. “With this new position, we’re going to invest more time and effort in their human development, and that is something I am really excited about.”

Much has changed for Castellano-Garcia since her days helping to staple papers at San Jose City College. But what hasn’t changed are those lessons instilled in her at a young age by her parents: to push harder, go further, be bolder, and do better. These qualities have only grown stronger since she was that eleven-year-old girl circling the boardroom table, dreaming of being in the C-suite herself one day.

“The entire time I was growing up and seeing my mother in action professionally during my youth was critical for me in terms of understanding the importance of professionalism, commitment, and high standards, because my mom is the epitome of that,” Castellano-Garcia says. AHL

At Anthem, we’re committed to being a valued health care partner and working together to transform health care with trusted and caring solutions. We’re developing the technology, solutions and programs that give members greater access to care and working with providers to ensure a quality health care experience for members.

www.anthem.com/ca/medi-cal

No Challenge

Gregory S. Moss’s proactive and willing approach brought early success to his US legal career at Kadmon Holdings, Inc.

By Jeff Silver

Is Too Big

SVP, Deputy General Counsel

Gregory S. Moss, Esq.

Kadmon Holdings, Inc.

LLike many kids growing up in Australia, Gregory S. Moss spent most of his time watching television and playing sports. The fact that one of his favorite shows was The Practice foreshadowed his future legal career, which eventually brought him to the US, where he is now a senior vice president and deputy general counsel at Kadmon Holdings, Inc. The fully integrated biopharmaceutical company engages in the discovery, development, and commercialization of small molecules and biologics to address disease and therapeutic areas of significant unmet medical need.

After law school in Australia, Moss decided to follow his future wife—whom he met in school—to New York City. When a position fell through at a large law firm there just before he was to depart for the US, he decided to make the trip anyway. As luck would have it, a referral from a family friend led to a brief meeting with Steven N. Gordon, Esq., and his first job as an associate at Gordon’s law office. It also positioned Moss to do work for start-up Silhouette Capital, a hedge fund Gordon was developing that used highly detailed information from legal proceedings to help direct its investments.

“I had no idea what I was getting into in that first job. I ended up traveling around the country doing everything from annotating and studying trial process and jury questionnaires, to eventually analyzing court jurisdictions and types of evidence,” Moss says. “I just said ‘yes’ to everything thrown at me and figured it out as I went along.”

After a short stint back in Australia, where Moss worked at Gadens Lawyers (which has since been acquired by Dentons Australia), Gordon asked him return to New York to work in his new company, Kadmon Holdings. Moss jumped at the opportunity.

Moss brought a highly proactive and aggressive approach with him to Kadmon that he had honed while working at Gadens. Whereas his previous New York responsibilities had required “jumping into action” to effectively handle various issues and circumstances, the model at Gadens, like most large law firms, had been much more conservative and controlled. Moss excelled, however, by acting decisively and quickly built a strong reputation in the world of Australian corporate risk.

“I found that just billing hours and doing what was expected wasn’t personally satisfying and didn’t do anything to differentiate me,” he says. “Instead, I never hesitated to tackle new challenges and come up with specific solutions to address them.”

Using that same approach at Kadmon resulted in several early, high-profile successes. First, Moss identified inefficiencies and potential regulatory risks within the company’s promotional review process. He then took responsibility for developing a new process just prior to receiving FDA notice of regulatory action against the company. Because remedial action was already underway, however, the issue was quickly resolved.

Moss also helped handle a major licensing deal for a Kadmon product with AbbVie Pharmaceuticals as well as major debt and equity financing transactions. In addition to providing some of his first experiences working on complex scenarios with pharmaceutical companies, lenders, and banks, he recognized how emotionally invested he was in the outcomes for the company.

“Australians are typically conservative and formal in business dealings, so I was surprised at how emotionally involved I got in the transactions I handled,” Moss says. “It felt like I was being kicked in the stomach when things didn’t go as planned, and then tremendous pride and excitement when everything wrapped up successfully.”

The positive outcomes of those and other issues led to Moss gaining more seniority and responsibility than he expected within his first three years at the company. Since then, he has helped Kadmon through a successful IPO in 2016 and he handled major portions of complex international issues related to the spin-off of MeiraGTX, a UK-based gene therapy research business. Following the completion of that transaction, Moss served on the board of a MeiraGTx-collaborator and acted as counsel to the new company in its early years.

“I just said ‘yes’ to everything thrown at me and figured it out as I went along.”

A Winning Education

Gregory S. Moss’s first passion was sports. He played cricket, rugby, swam, ran cross-country, and played right mid-fielder at professional and semiprofessional soccer clubs while on a soccer scholarship in college. He credits those athletic experiences with teaching him about dedication, commitment, time management, teamwork, and leadership.

“By nature, I’m not one to sit back and let others do the work,” Moss says. “Participating in sports from a young age taught me how to use my passion and energy productively.”

He believes that sports also helped develop his leadership and communication abilities, a strong work ethic, and understanding the dynamics of group effort.

“I love working in this industry, first, because we’re addressing a noble cause that improves patients’ lives when we succeed,” Moss says. “But it’s also invigorating to get to work on something different and challenging every day and to work with people that inspire me. I’m very lucky to have friends and mentors in my workplace.”

One new initiative requiring his attention is the company’s development of KD025, a potential treatment for chronic graft-versus-host disease. If approved, it will be the first novel drug that Kadmon has developed and delivered to market through its own pipeline.

When asked if there were any other specific strategies that were key to his success at the company, Moss reveals that from the very start, he approached his time in New York as if he were putting down roots to stay. He’s also continued to say “yes” to new work—everything from corporate governance and labor and employment matters to SEC reporting and a wide range of other business, legal, and compliance issues.

“As soon as I arrived in the US, I took a long-term perspective so that I would have the tools in place to take advantage of the amazing opportunities here,” he says. “I opened bank accounts, got new phone service—even started citizenship paperwork—so that I could hit the ground running. Nothing is forever, but I planned as if it was.” AHL

Guided by

How caring about the end goal of an organization has been the driving force behind Steve Bertram's career in healthcare

By Chris Rathje

the Mission

At a young age, Steve Bertram lost his father to a sudden, unknown illness. Later on in childhood, Bertram would read about a local Michigan company called Upjohn and how the company’s medical innovations helped people. The ability to help others strongly appealed to Bertram and continued to stick with him as he grew professionally with several jobs in the healthcare industry. This also set Bertram on

a

path

to a

mission-driven career at an early age, eventually landing him at his current position as senior vice president of global human resources at Atara Biotherapeutics.

After obtaining his MBA from Michigan State University, Bertram started working at Upjohn full time. While there, he contributed to their work to fight ALS. After several years at Upjohn, he felt it was time to move on after Coca-Cola had been trying to recruit him for more than a year.

At the time Bertram made the move, Coca-Cola’s human resources program was held in high regard, and he felt like it was a great opportunity for him to put his MBA experience to use, he says. He was also immediately impressed by the company’s strong culture. Coca-Cola was very successful, in part, because of its core principle to “compete intensely and win,” Bertram says.

After working for the soft drink juggernaut for a couple of years, Bertram was ready for another change. His time at Coca-Cola made him realize how important a company’s mission was to him, and he kept this in mind as he moved on to other opportunities.

He chose to go to biopharmaceutical company Amgen, despite the fact that it required a cross-country move, was in the middle of the pack of the offers he had received financially, and couldn’t offer him a grand title. But Bertram didn’t care about any of that; he cared about what the company was doing to help patients.

After working outside of the industry for a few years, Bertram had a strong desire to get back to the mission-driven nature of the healthcare industry, he says, because doing impactful work “helps you get through the hard days.”

The move to Amgen made sense to him on both a professional and personal level because Amgen was also working on treatments for ALS, a disease Bertram is passionate about. His college roommate “succumbed to this insidious condition at too early an age,” Bertram says.

He uses his roommate’s story as an example of how it doesn’t matter what background a person comes from or what kind of character a person displays; anyone can become unlucky in his or her health. His roommate’s health issues also underscored why Bertram has such a passion for working in healthcare. “Every day you wait, it might be a lost life,” he says.

Steve Bertram SVP, Global Human Resources

Atara Biotherapeutics, Inc.

Focus on the Present

Between Steve Bertram’s time at Amgen and Atara, he took six months to train for a Mount Everest base camp trek. Despite setbacks caused by an earthquake in Nepal and a knee injury that required surgery two months before he left, Bertram accomplished his goal alongside his climbing partners after a nineteen-day trek.

“Every day I wanted to get on the trail,” Bertram says. He was excited for every day’s challenges, and accomplishing this feat helped teach him how to focus on his breathing, be in the moment, and accomplish the task at hand, a skill he regularly uses while working for Atara.

Bertram’s leadership style is steeped in mission-driven values. “I want to enable the 95 percent of employees who are doing the right thing in every way, every day,” Bertram says. He strongly believes that the 5 percent of employees who do not fit a company’s mission usually have everything they need to thrive, and the reason they are not successful is because they are “value felons” who consistently live outside of the values of their unit or company.

Now, after many successful years at Amgen, Bertram is putting his expertise toward his new role at Atara Biotherapeutics. The company works in the immunooncology space where it develops treatments to combat serious cancers that occur after transplants and could have fatal consequences.

Atara has offices in four locations, with its corporate headquarters in San Francisco; a major hub for research and development in southern California; another lab set up in Denver; and a fourth location in New York. Creating a unified culture between the four locations has been a challenge, but Bertram relishes it. Bertram says being present at the early stages of Atara’s lifespan has been incredible,

Michael Haring

Striving for Balance

Outside of the office, the focus of Steve Bertram’s life is his family. He has been married to his wife Rebecca for twenty-four years, and the couple has three children. Their son Ian is a senior at the University of California-San Diego studying nanoengineering, their son Logan is a freshman at Colorado State studying business, and their daughter, Jensen, is a sophomore at Newbury Park High School, where she plays soccer and lacrosse.

and he hopes he can help set the framework for what it will be for decades to come.

In order to begin creating a unified culture between the four offices, Bertram is implementing technology such as video conferencing in addition to emphasizing the importance of in-person gatherings. Making sure that the locations have celebrations such as holiday parties, recognition of milestones, and other bonding activities, he says, has also contributed to a united culture.

Bertram is also focused on increasing collaboration and camaraderie among employees within the same office. To help foster this culture, the company is currently constructing a T Cell Manufacturing Facility in Thousand Oaks, California. The facility will have a mezzanine level where offices and huddle areas will be built to meet the needs of the different units located in southern California.

“Getting great talent is not the problem, getting them what they need to unleash the most of their talents is the challenge,” Bertram says. “We want to become more than a work unit, more than colleagues. We want people to like one another, trust one another, and like where they work.” AHL

More Than Just Money

Lauren Zink leads compensation, benefits, and HR shared services at Indiana University Health, but she is also instrumental in developing innovative strategies for the growing healthcare system

By Jeff Silver

IIndiana University Health (IUH) has grown tremendously over the past decade to include fifteen hospitals, nearly three thousand beds, and more than thirty-five thousand team members. In the past two-and-a-half years alone, it has acquired hospitals and physician practices in five regions throughout the state.

This growth has provided tremendous benefits to the more than one million residents who receive care through the system. However, it has also presented internal challenges related to uniting discrete cultures, operating processes, and legacy systems.

Lauren Zink is IUH’s vice president of human resources and total rewards. Her responsibilities put her in the center of finding solutions that will effectively integrate these many different factors.

“Many of the groups that are now part of IUH have been connected to their local communities for more than thirty years,” Zink says. “We have to find ways to respect their professional legacies and simultaneously integrate them to serve the interests of the larger organization.”

One way she helps individuals open up to new ideas and address the uncertainty that accompanies all acquisitions is through her “Newco” exercise. Participants are asked to imagine their first day at a new company with no existing systems in place. That gives them a blank slate to design processes and procedures to accomplish a specific objective without preexisting restraints or limitations.

“It takes a minute for people to let go of what they know and what’s familiar,” she says. “But eventually, they free their minds, stop worrying about failing, and tap into a level of creativity that often surprises them. That’s how mind-sets shift and innovation occurs.”

Zink also focuses on changing the atmosphere surrounding compensation. She points out that while salaries alone are rarely the most significant reason employees leave an organization, the way in which compensation decisions are made contribute tremendously to how engaged and committed they feel.

She believes that much more transparency is needed around data on competitive market rates and how they

Lauren Zink VP of HR and Total

Chris Bergin

Taking the Right Risks

After twenty-five years as a consultant and HR leader, Lauren Zink is writing a book to share her insights and advice. She is combining existing research with her own experiences to help leaders learn how to take the right risks.

“Team members and colleagues have their own styles and motivators, so leaders need to be flexible,” Zink says. “That often means interacting in ways that don’t feel familiar.”

She contends that success comes from personal engagement and being willing to fail. “If you’re willing to be vulnerable, then you can truly inspire people,” she says. “That’s how you lead a team.”

impact the wide range of roles in healthcare. Practically speaking, this means clarifying methodologies and processes used to reach compensation decisions. It also requires acknowledging perceptions about the value of various positions. For example, nurses fulfill critically important responsibilities in delivering quality patient care, but market-based guidelines and limitations determine what they are paid.

“Being up-front about what market-based decisionmaking processes look like shows respect for the individual and instills trust and confidence,” Zink points out. “If you’re honest, team members will accept the information, even if they don’t like what they’re hearing. If they feel you’re trying to hide something, you can’t expect a positive reaction.”

Zink and the HR team work hard to engage with IUH senior leadership. They diligently provide communication cascades that include face-to-face two-way dialogues and larger group-focused educational events. These efforts ensure that leaders absorb and process ongoing changes and can share them accurately and openly with their own teams. By offering a consistent message in a variety of formats, Zink finds that resistance to change is gradually overcome.

Chris Bergin

“Clear job descriptions that are accurately priced to the market and associated with well-defined career options are very important details that help engage and retain the workforce.”

“The most common reaction to any kind of change is fear,” she explains. “We have to constantly remind everyone of the risks associated with not making the changes, and keep them focused on the progress we’re making toward getting to where we need to be.”

One new effort underway to nurture a culture of trust and transparency is a timekeeping pilot program in the HR department. Instead of managing vacation, personal leave, shift changes, and other time-related administrative activities through IUH’s centralized timekeepers, participants in the program will personally manage—and be held accountable for—all schedule-related details.

Zink and her teams are also working on creating a simplified organizational structure with uniform job descriptions and compensation practices. This will eliminate different names for the same jobs in different locations and help clarify opportunities for career development.

“Clear job descriptions that are accurately priced to the market and associated with well-defined career options are very important details that help engage and retain the workforce,” she says.

Healthcare has to contend with a huge number of external factors that are outside its control. Zink points out that those factors add to naturally conflicting priorities that exist between departments. For example, financial teams focus on maintaining fiscally responsible practices at the same time that clinical teams are committed to offering life-saving care, much of which is exorbitantly expensive and, in many cases, is not fully reimbursed.

Zink believes her greatest contribution in that environment is facilitating engagement at all levels to help find solutions to move forward, no matter what the external factors might be.

“There is nothing more inspiring or motivating than seeing someone experience a breakthrough by contributing to a creative, innovative solution that couldn’t have been developed without them,” she says. “It’s a privilege to help make that happen.” AHL

Reach for

By Clint Worthington

the Stars

How Philips’s Chris Whaley went from a young sci-fi fan to a healthcare innovator

In many respects, Chris Whaley has Star Wars to thank for his career in healthcare.

Long before becoming vice president and head of human resources for monitoring and analytics and therapeutic care at Philips, Whaley was a young child with an ardent love of science fiction. And seeing the original Star Wars in 1977—perhaps the most iconic science fiction movie ever produced—was a turning point for him. “From an early age, I was very interested in what the future would hold,” Whaley recalls.

With stars in his eyes and a dream of working for NASA, Whaley worked in several different sectors before eventually joining Philips, a leading health technology company. Now, as a major voice in Philips’s healthcare initiatives, Whaley’s science fiction visions of the future are becoming a reality.

But Whaley’s journey from prospective NASA engineer to an HR role in healthcare for Philips is a long and storied one. He earned his bachelor degree in aerospace engineering just in time for the market to consolidate. Later, he achieved his master’s degree in industrial engineering. After some time at trucking firms and furniture manufacturers, Whaley was drawn to a role as a crime analyst at the Knoxville Police Department, using analytical and mapping software to examine crime trends for prevention.

“This was when I started to realize how I could take skills from one field to apply to really different areas,” he says. Eventually, Whaley found himself at Philips, working as a knowledge engineer, which he felt was an opportunity to rekindle his sense of childlike wonder and desire to help others. “I saw this could be a place where I could grow and work in different industries, functions, and even locations over time,” he says.

With his wide array of experience rooted in engineering, Whaley finds many different applications of that work history at Philips. For example, his engineering training

Chris Whaley VP, Head of HR, Monitoring & Analytics and Therapeutic Care Philips

“We are making the science fiction visions of the future a reality. The kid inside me has come full circle.”

helped him acquire his Project Management Professional certification and become a Six Sigma Black Belt. Following some changes in Philips’s business model in his sector, Whaley moved from business transformation into HR, where he found his current home.

“Some of the skills I had were not typically found in HR at the time, which was a benefit for the company,” Whaley says.

In keeping with his science fiction idealism, Whaley is constantly drawn to Philips’s mission of making life better—particularly in healthcare. With aging populations and the rise of chronic conditions and cost of care, Whaley says, individuals are becoming more active in monitoring their health. “That contributes to a desire for connected care, anywhere, at any time,” he says. Additionally, the rise in data from multiple sources–in addition to advances in analytics, artificial intelligence, and predictive modeling— provides Whaley and his team with greater chances to improve healthcare access and outcomes.

One initiative that Whaley and his team are currently working on is the IntelliVue Guardian, a patient monitoring analysis system which, when paired with their new wearable medical grade biosensors, facilitates the continuous monitoring of heart rate, respiration rate, and posture in low-acuity patients. According to Whaley, the system “allows the detection of deterioration of a patient as much as twelve hours before an adverse event takes place.” It then notifies the care team before any problems occur. A pilot program of the Guardian system at Augusta University Medical Center reported an 88 percent reduction in predictable codes and an overall improved ability to prevent instances of cardiac arrest. Whaley views this initiative as an exciting example of the healthcare innovations that Philips specializes in.

While much of Whaley’s job entails supporting these types of initiatives, he also strives to revitalize the leadership and technical capabilities of the related teams at Philips. During its annual strategy review process, the

company looks at its existing business operations and see where it plans to grow. Through strategic workforce planning, technology road maps, and more, Whaley and his colleagues look at the capabilities and competencies of their people, processes, and systems to see where they can improve. They then create detailed action plans to address any gaps in these capabilities, including hiring specific talent, updating IT systems, or utilizing training to foster professional development in their staff. The goal, says Whaley, is to help ensure Philips has the workforce to fit the future.

In order to accomplish that goal, Whaley and the team place a premium on employee engagement. According to Whaley, one major breakthrough for Philips was realizing the disparity between increased employee pride and retention and actual performance. “It’s not enough for people to feel engaged, but they also have to act engaged,” he explains.

The IntelliVue Guardian is a wearable device that automatically monitors a patient’s vitals such as pulse, temperature, and respiratory signs to help nurses detect health issues sooner. According to Philips, 40 percent of unanticipated hospital deaths happen on the general ward.

Philips’s management is taking this expanded view to heart in finding ways to simplify processes and remain competitive in the market. These include lean techniques such as daily management, as well as other traditional engagement activities. For many, the intrinsic value of their contributions to public health is a key driver. “We also see our employees excited to be part of shaping the future of health and well-being and the billions of people we touch,” Whaley says.

Whaley may not have become an astronaut, but he feels his work at Philips helps fulfill his boyhood dreams of ushering in a better future for humanity. “The most satisfying part of my job now is that I am working in healthcare and am part of a company whose goal is to improve the lives of three billion people a year by 2025,” Whaley says. “We are making the science fiction visions of the future a reality. The kid inside me has come full circle.”

Think you’re done with digital transformation? New challenges are headed your way as the future of work becomes a reality. Time to get ready for what’s next. www.deloitte.com/

Leading by Learning

Christine Aucreman’s leadership style requires both teaching her team and learning from them

By Galen Beebe

Like many leaders, Christine Aucreman found inspiration for her leadership philosophy through a combination of life experiences, observation, and a passion for reading. Her professional journey has provided numerous opportunities to stretch her perception of what’s possible as she’s consistently worked to overcome one hurdle after another.

Aucreman first entered the healthcare arena ten years into her career, after four years in public accounting and six years in the corporate office of an international, publicly traded manufacturing firm. Her debut into healthcare was as a director of internal audit for a health system that was in a difficult market. A few months after Aucreman joined, the board hired a turnaround firm to help the system return to profitability. Because of her previous experience, Aucreman was tapped to work with the consulting firm to measure, validate, and communicate the cost-saving efforts.

Within a year of this assignment, Aucreman became the finance leader for one of the hospitals in this system. This was a pivotal moment in her career, she says. Her fluency in the language of business had made her stand out, but she was still learning the acronym-dense language of healthcare. “I’ll never forget it: I was told on a Friday that they would like me to report to administration on Monday,” she says. “I knew right then if I was going to assume this responsibility, I would have to study, build relationships, and connect with subject matter experts to help get me ramped up quickly.”

Christine Aucreman VP, Financial Planning and Operations

Aucreman’s team included experienced subject matter experts, most of whom were more tenured than she was within the healthcare field. She was tasked with the dual challenge of gaining her team’s trust while learning from their expertise. To establish herself as both a learner and a leader, she studied and earned her Certified Healthcare Financial Professional (CHFP) designation from the Healthcare Financial Management Association within a year of taking the position, and she quickly demonstrated that she would use these new skills to advocate for her team.

“Had I approached that role from a point of insecurity, where I felt as though I needed to pretend that I was an expert in a particular area or to fake my way through it, I would have been dead in the water,” she says. “Sometimes you have to be comfortable saying, ‘Okay, educate me. Help me learn everything I can about your subject area.’”

“I knew right then if I was going to assume this responsibility, I would have to study, build relationships, and connect with subject matter experts.”

Courtesy of Mount Carmel Health System

Mount Carmel Health System

Her efforts paid off. Despite a drop in high-acuity patient volume, her team dramatically increased net revenue thanks to its work within revenue cycle, predominantly around denial prevention, clinical documentation, pointof-service collections, and Medicaid conversions. Although she had no experience in revenue cycle when she took the position, and acknowledged this was the part of the role she most feared, within two years she was appointed senior vice president of revenue cycle and financial operations for the system because of her success in this arena.

Aucreman’s greatest weakness became one of her greatest strengths, propelling her to later go on to serve as a chief revenue cycle officer for another health system before ultimately joining Mount Carmel Health System as the vice president, financial planning and operations. When she first joined the Ohio-based health system, her focus was predominately tactical; one of her first tasks was assembling a strong team. “I had to focus an enormous amount of energy on recruitment during the first few years,” she says. Crediting insight gained earlier in her career, she knew it was imperative

“Had I approached that role from a point of insecurity, where I felt as though I needed to pretend that I was an expert in a particular area or to fake my way through it, I would have been dead in the water.”

to get the right people on the right seat of the bus and that the key to this approach was not only recruiting employees who have the right skill, capacity, and drive to learn what they don’t know, but also demonstrating the same.

Once she has the right people in the right positions, Aucreman believes it’s equally important to create an organizational structure that supports them, while also assessing technology needs and enhancing workflow. Using the Tableau overlay software, her team has created business intelligence tools that allow finance and operations leaders to more easily isolate and analyze data. With the lengthof-stay dashboard, for example, leaders can identify opportunities to reduce the length of stay for Mount Carmel’s patients by comparing actual length of stay to the Medicare geometric mean and note variances. To date, her team has created several drillable dashboards that are accessed and used by leaders ranging from front-line managers to the CEO of the system.

“These tools allow us to provide our leaders with business intelligence that equips them to quickly analyze information

and in turn make better, more informed decisions aimed at driving operating results,” Aucreman says. With the right talent, structure, and tools, her team was able to make substantial improvements in the value of information provided to the operating leaders, improve customer service, and significantly increase colleague engagement, while at the same time reducing labor cost.

Now that Aucreman has a strong foundation in place at Mount Carmel, she has shifted her focus to strategy, leadership development, and succession planning. In October 2017, her leadership team completed a facilitated leadership strategy deployment exercise where they created specific breakthrough goals, organized priorities, and ultimately created a vision statement for their team.

Aucreman oversaw this process, but this time she let them drive the bus. Meanwhile, she developed her own personal “where do we go from here” vision, which consists of five key challenges: focus on the details, they matter; begin each day with a beginner’s mind; embrace above-the-line behavior; open the door to discomfort; and give relentless effort every day.

For five weeks, her team reflected on these challenges, sharing their personal strategies to embrace these behaviors with the group. “It was incredible. Every single one of them contributed to this exercise,” Aucreman says. “It has been really cool to see what happens when I am willing to be vulnerable, share my story, equip them with a framework, and then step aside.” AHL

Claro

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At the Top

Edward Angelini thrives under pressure after more than fourteen years at Purdue Pharma L.P.

By Sarah Breeden

EEdward Angelini believes that coaching basketball can offer lessons for effective legal leadership. In fact, he points to former Chicago Bulls coach Phil Jackson. Jackson molded his Bulls championship teams not only by coaching star players like Michael Jordan but also by mentoring supporting players like Steve Kerr.

“Kerr was a great three-point shooter,” Angelini explains. “He knocked down three-point shots when defenses collapsed on Jordan. Even though it was a more limited role than Kerr might have enjoyed on another team, part of Jackson’s success relied on instilling in Kerr the understanding that it was better for him to fulfill that role on a highly successful team.”

Phil Jackson knew what was good for the Bulls was ultimately good for all the individual players. It is not surprising that today Kerr is the head coach of the NBA’s reigning champion and best team, the Golden State Warriors. Likewise, an effective manager must persuade his team that successfully fulfilling roles will improve results

for everyone involved. “That to me is leadership—getting someone to see how doing the best for the organization aligns with their individual goals and interests,” he says. This team-centered management philosophy—combined with technical expertise, creative problem solving, and trust of clients—drives Angelini’s success.

As the head of the corporate transactional group, associate general counsel, for Purdue Pharma L.P., Angelini optimizes business results and advises executive management on strategic corporate transactions. In fact, about 95 percent of all contracts are negotiated through Angelini’s group, and Angelini and his team counsel on all of Purdue’s transactional activity, which includes licensing, mergers and acquisitions, finance, and general corporate transactions. He and his team are intimately involved in the commercial aspects of the company, advising on evaluating prospective business deals, negotiating and executing those deals through the closing, and helping integrate new acquisitions into the existing organizational structure.

of His Game

Edward

Angelini Head of Corporate Transactional Group, Associate General Counsel Purdue Pharma L.P.

Henry Veloso

Before his career as an in-house lawyer, Angelini was first drawn to the idea of becoming a lawyer while he was attending Amherst College. The practice of law, as a discipline, seemed like a natural continuation and an ideal intersection of his academic interests—English, political science, history, and philosophy—and it fit his aptitude for analytical and creative problem solving. So he decided to pursue a JD at Boston University, and after graduation, he worked at law firms for almost nine years. “It was an excellent experience and excellent training, but I was often getting a term sheet that was fully negotiated,” he says. “No matter how close you were to a client, you were often one or two steps removed from the real strategic decision making driving business development opportunities.”

Instead, Angelini wanted to work with clients from the beginning to the end of a transaction and help them incorporate acquisitions into their business. Working as in-house counsel allowed Angelini the opportunity to do exactly that. His first in-house role came at Transamerica Technology Finance Corporation before he moved to Purdue. Although he didn’t have much direct experience in the pharmaceutical industry at the beginning of his transition to an in-house counsel role, he liked that healthcare was a dynamic, evolving industry where he could learn the business and acquire marketable skills. He was impressed, in particular, by the strength of Purdue Pharma’s law department, the critical role that the department played in key strategic business initiatives, and the opportunity to make an impact.

Now, more than fourteen years later, Angelini is still fascinated with the complexity of his work. The role enables him to provide counsel on sophisticated transactions where potentially hundreds of millions of dollars are at stake. The transactions Angelini works on are highly sophisticated and involve a lot of moving parts. He says he succeeds by finding solutions to unanticipated problems and avoiding the inflexible role of an attorney who simply recites rules and tells people no. And much like a professional athlete, Angelini finds the intense pressure stimulating. “The job gives me the opportunity to practice at a very high end of my profession,” Angelini says. “Not every lawyer gets the opportunity to work on multimillion-dollar deals or work on transactions that are critically and strategically important.”

“Not every lawyer gets the opportunity to work on multimilliondollar deals or work on transactions that are critically and strategically important.”

Throughout his career, Angelini has worked with a wide array of management styles and personalities. The key to building effective working relationships with anyone, he says, is trust. One component of that is having a strong work ethic. “Clients want to see that you are working hard for them—that you are plugging away on a daily basis,” he says. “They want to know that you’ll get it done in a timely manner. That, along with demonstrating good judgment over a period of time, is all part of building trust.”

Another component that helps Angelini build trust is being approachable and easy to work with. He recommends that attorneys be relatable to their clients. “Be a person people enjoy working with and talking with,” he says. Someone with an approachable demeanor is far more likely to gain a client’s trust and, therefore, create more effective working relationships.

In addition to the exciting work, Angelini credits his longevity with Purdue Pharma to being able to coach such an excellent team of lawyers and paralegals. And like all good coaches, Angelini keeps the long-term outcomes of his team in the forefront of his mind. It is, perhaps, the most rewarding aspect of his job. “It’s been great to be part of a professional, motivated team that’s working on delivering strategic, important results for the organization,” he explains. “Most of the real rewards come from being part of that team. I am fortunate to report into a great general counsel and to have excellent and talented colleagues on my team.” AHL

Triumph over Complacency

From her experiences as both a patient and an executive, Ann Asbaty champions Cigna’s ability to thrive through change

By Jenny Draper

Few people knew Ann Asbaty was battling breast cancer, but that’s how she wanted it. She felt her diagnosis would be true only if she said it aloud and it was visible to others.

“This was my way to survive,” she says.

Asbaty’s journey with cancer was a lesson of compassion. It was also a lesson that would ultimately strengthen her ability to lead Cigna through the perpetual metamorphosis of the health marketplace. “It made me a better, more empathetic leader,” she says. “I now understand that everyone is dealing with something; it might be invisible to others, but it’s real. This perspective serves me well in my role of challenging our best and brightest leaders to motivate their teams to give their best self at work.” And after twenty-seven years with Cigna, she’s more capable than ever to empower others and lead the global health services organization into the future.

With more than 95 million customers across thirty countries, Cigna must constantly adapt to stay at the forefront of the health insurance industry. “The world is awake while you sleep,” Asbaty says. “The pace is exciting and exhausting, but I love it.” As the CEO of the Americas, her impact spans more than two hundred jurisdictions, more than thirty licenses, and international regulators. The cultural nuances in healthcare consumption also mean that her team’s purview is not only extensive, but it’s also far from uniform. “Change is energizing,” she adds. “It forces a fresh way of advancing the business. I’ve always seen it as an accelerator if done right.”

Asbaty’s own career path reflects her embrace of change. After graduating from Middlebury College, Asbaty interviewed for the role of product director of a cracker manufacturer, but decided to pivot her career path instead. “I realized that I needed to do something that was more meaningful,” she says. So Asbaty spent her first three years in the workforce at Blue Cross Blue Shield of New Jersey, but it wasn’t until she joined Cigna in 1990 that she found a home for her energy, appetite for change, and vision.

Starting as a national account executive in the US business, she moved through the management ranks of Cigna to market leader, chief operating officer of national

accounts, senior vice president of key global accounts, global health and wellness officer, and president of North America Global Health Benefits. She assumed her current role, CEO of the Americas - International Markets, in late 2017. “I was able to reinvent myself through different parts of our business, which is also constantly in flux,” she says. “The pace of change is so fast that we must invent products and innovate continually to stay relevant.” For example, Cigna recently launched a mobile wellness app that provides customers with 24/7 access to a vast global health network of medical professionals wherever they are in the world. A tool such as this and access to 24/7 multilingual customer service accommodate increasingly mobile and global customers.

“Cancer, diabetes, and heart attacks don’t need a passport,” she adds, citing the 150 clinicians available to Cigna customers outside of the United States. This unique and very personal view, shared by few, has not only shaped Asbaty’s leadership style but also her company’s coverage offerings. As a leader within the organization, Asbaty brings to the boardroom her extensive background in US business, which built on a foundation of leading through change. At the same time, she brings the lessons she’s learned from receiving Cigna’s health and wellness solutions.

Asbaty’s own biopsy results arrived in February 2012. She was participating in a large group employers’ workshop at an annual client forum when her cell phone rang. “There’s a time when I would have judged someone who took that call, as I did,” she says. “I know better now.”

Leaving the workshop to answer the phone, her doctor delivered a devastating diagnosis—one that would take her on a grueling journey and include a mastectomy, chemotherapy, and radiation. “It’s not an overstatement to say that this call forever changed me,” she says. “It was a moment of learning; a lesson in compassion. You just never know what someone is dealing with. No one in that room had a clue that my life was about to change.”

Maura McConnell

“Trust who you are, and tomorrow is another chance. I’ve always believed that you can breathe your future into existence.”

Ann Asbaty CEO of the AmericasInternational Markets Cigna

As Asbaty highlights the breadth of resources that Cigna provides, she recounts how deeply she depended on the organization’s oncology case managers. Her breast cancer specialist not only expedited everything from handling claims to working with a pharmacy to deliver medications to her doorstep, but she also provided an additional support system. “She checked in with me all the time,” Asbaty says. “I could have ended up in the hospital or missed a treatment if not for her. One day, she insisted I eat a meatloaf; my oncologist wasn’t going to tell me that!”

When Hurricane Sandy hit and severely damaged her home on the same day her father died—leaving Asbaty without power for a week and grieving—her oncology case manager found her. “She made sure I was okay. I would have paid money for all the help she gave me and amazing service she provided if it hadn’t already been included with my Cigna medical coverage,” Asbaty says. “Our company really has a soul. Health and wellness is the heart of who we are.”

As a patient with Cigna healthcare coverage, Asbaty experienced personally the value that Cigna delivers to its customers—and a few areas of opportunity that she was sure to address. “When I began losing my hair as a result of the treatment I was receiving, I realized our coverage for wigs could be enhanced and slight improvements made to our processes,” Asbaty explains. She pursued these matters, and she’s proud that her advocacy resulted in modifications to Cigna employee coverage.

Now five years cancer-free, Asbaty continues to champion preventative care initiatives in her global role. For Asbaty, the mission is personal. She points to Cigna’s recent campaign—Go, Know, and Take Control—which promotes screenings and check-ups across social media platforms. The campaign’s popular 2016 advertisement, “TV Doctors of America,” featured actors from popular television shows like Grey’s Anatomy, Scrubs, House, and ER, including Patrick Dempsey.

Maura McConnell

“As we have more dialogues to understand each other and to connect and lift each other up, our workforce can go from engaged to truly inspired.”

Her experience with cancer is not the only thing that enlightened her leadership, though. Mentors shaped her journey along the way. Mentors provided guidance that reinforced some very important lessons. “Trust who you are, and tomorrow is another chance,” she says, citing this as advice she received from mentors. “ I’ve always believed that you can breathe your future into existence.”

Today, Asbaty’s helping the next generation of leaders by offering one-on-one mentoring and support for women. In fact, she created the first North America, International Markets’ Women’s Network. This forum unites people around the globe to facilitate individual growth through its quarterly collective conversations. “Some of it may be gender-based, but we include men because they have a vested interest in women reaching their human potential, too. Many have female managers, partners, relatives, and friends,” Asbaty says. “As we have more dialogues to understand each other and to connect and lift each other up, our workforce can go from engaged to truly inspired.”

These events showcase Asbaty’s most significant piece of advice: find your voice. Asbaty found her own voice amid the constant change in the industry and her personal health; it required the courage and determination she aims to develop in others. Her journey is one of triumph over complacency, and thriving through change—a stance she believes will continue to transform the company. “You must do what you think you cannot do, because that’s how you go to the next level of being your best, truest self,” she says. Changing marketplaces require adaptable and dynamic leaders—and Asbaty is both. AHL

More Engaged, More Effective, More Productive Employees

Wellbeing support for 53+ million employees across 78,000+ organizations in 200+ countries and territories.

Learn More at www.workplaceoptions.com.

Living Happily Ever After in Healthcare

Sharyn Alcaraz did not intend to practice healthcare law. But after nearly fourteen years in the industry, she’s encouraging young lawyers to follow in her footsteps.

By Galen Beebe

SSharyn Alcaraz didn’t intend to become a healthcare lawyer. She began her in-house career working in digital media, but in 2004, she took a position as general counsel at Alta Healthcare System. It was a jarring transition—it was her first general counsel position, her first time at a turnaround company, and her first experience practicing healthcare law. Looking back, there was another concern to deal with: a lack of new lawyers entering the field.

At the time, most of the leaders Alcaraz worked with, including lawyers and senior counsel, had spent their careers in the healthcare industry. “You never saw new thought leaders coming in,” she says. “If you are going to innovate and modernize healthcare, you need new thoughts.”

Alcaraz is now vice president, legal at Peregrine Pharmaceuticals, a biopharmaceutical company. Although she has seen more lawyers pursuing careers in healthcare law in the past decade, the need for young, innovative attorneys is as great as ever.

Healthcare is an industry with endless demand. “At some point in their life, everybody’s going to need healthcare,” Alcaraz says. “Not everybody’s going to need a Cartier watch. Not everybody’s going to need an Xbox. But everybody’s going to need healthcare.”

Alcaraz wants to ensure that there is a robust pipeline of young healthcare lawyers ready to step into the everchanging field. She reflected with American Healthcare Leader on what it takes to have success in the field today.

Look Through the Regulations

As a corporate generalist, Alcaraz entered the healthcare industry with a broad knowledge of the law, but the industry regulations added another aspect to each transaction. “In healthcare you have a full, vast, second body of law that you have to take into consideration,” she says.

Healthcare is one of the most regulated industries in the United States, and these regulations affect every aspect of the industry, from leasing transactions to corporate governance. “Healthcare law is an added set of laws through which everything must be viewed when you’re practicing your particular practice area,” she says. “I had to look at everything through a completely different lens.”

Sharyn Alcaraz VP, Legal Peregrine Pharmaceuticals

Incorporate Your Interests

The healthcare industry interacts with almost every other industry, and it requires practitioners of almost every type of law. “Every single aspect of what is normally practiced in the legal field is practiced in healthcare institutions and industries,” Alcaraz says.

Becoming a successful healthcare lawyer requires understanding the industry’s many regulations, but it also requires a broader understanding of law. Healthcare law is a lens to look through, but an attorney also needs to understand what they are looking at. “Find the area that you really like to practice and perfect the technical aspects of your craft,” Alcaraz says. “Then, layering on the regulations of healthcare won’t seem so overwhelming.”

Healthcare Is a Business

Before joining Alta Health System, Alcaraz didn’t think of healthcare organizations, such as hospitals, as businesses. “We think of healthcare law as a charitable pillar. It’s the healing, caretaking institution of our society,” she says. “It’s nevertheless a service business.”

Like any business, healthcare institutions must be self-sufficient, and the legal team plays a vital role in maintaining a company’s financial health. “You must be able to sustain yourself, even if you are not-for-profit,” she says. “You cannot lose money every year if you want to be an ongoing service to your community.”

A lawyer’s role is the same, regardless of whether the business they serve is providing cancer treatments or computer software: to help a client to be compliant and to structure and litigate deals correctly and efficiently, while achieving their overall mission and annual financial goals.

Be Open to Exploration

After two years at Alta Health System, Alcaraz returned to the field of digital media. “I was pretty certain that I didn’t want to do healthcare,” she says. “That wasn’t the place for me.” But despite these initial doubts, Alcaraz joined a specialty pharmaceutical company a year after leaving Alta, and she has been in healthcare ever since. It is important, she says, for young lawyers to explore the industry before deciding to pursue another path. “Take a look at what the industry as a whole can offer you,” she says. “If you’re interested, say, in real estate, why not look at real estate in the healthcare industry? If you’re interested in intellectual property, why not look at life sciences?”

As the healthcare industry continues to evolve, new sectors will grow more important. With the rise of telemedicine and the use of EHRs, cybersecuring becomes an increasing concern. “People look at healthcare as a dinosaur, prehistoric service. It’s not,” Alcaraz says. “There’s a lot of disruption that’s still happening now in the healthcare sector as a whole.”

Remember the Mission

Healthcare may be a business, but it’s a business with an essential mission at its core. “It’s a business about people,” Alcaraz says. “I can’t think of a service industry that’s more about people than this one.”

In addition to helping the company to compliantly achieve its goals, healthcare lawyers have an added responsibility to the patient. Doing the best thing for the patient means being a good corporate citizen and following the rules that are put in place to protect them. “It’s always about the patient,” Alcaraz says. “That’s the best advice I’ve ever been given, and it’s really guided my helping my organizations to implement the regulations.”

It was this mission that drew Alcaraz back to healthcare law. “When I come home every day, I realize that I helped my employer either keep people alive, take care of them, or make their quality of life better,” she says. “I’m helping people every day.” AHL

Holistic Healthcare Holistic Healthcare

Employees coming to work don’t leave their outside lives at the door while on the job.

To acknowledge that, these industry-leading executives have developed well-rounded health programs that assist individuals with a range of well-being needs, from physical to financial health.

Ahead of the Wellness Curve Ahead of

by Sheila Barabad

Erik A. Sossa addresses PepsiCo employees’ wellness concerns before they become bigger problems

By Joe Dixon

Photos

Erik Sossa • VP, Global Benefits & Wellness

In an iconic I Love Lucy episode, Lucy and Ethel go to work at a chocolate factory. After getting kicked out of several departments, they are placed on an assembly line where they are responsible for wrapping chocolates before they go to the packing room.

At first, everything is going well. But as the conveyor belt speeds up, Lucy and Ethel struggle to keep up the pace. So they start shoveling candy into their mouths to make sure no chocolates get past them.

Erik A. Sossa, vice president, global benefits and wellness at PepsiCo, Inc., thinks about this scene when he approaches his role at the multinational food, snack, and beverage corporation.

“I believe the challenge we face with employee engagement is meeting people where they are: at the right time, in the right place, and in the right way,

rather than overwhelming them with information all at once and in the same form,” Sossa says.

His goal is to engage each of PepsiCo’s employees so they see the opportunities and benefits of the company’s wellness programs that have relevance for them, that can help them stay healthy, or assist them in their time of need, before they have undergone ineffective or unnecessary treatments.

“For many companies, 5 percent or less of their population drive about 40–60 percent of their healthcare spend,” Sossa says. “While it is essential to focus on those folks who are driving most of the spend, it is equally important to help the other 95 percent stay healthy, so that our programs are sustainable.”

Sossa’s role encompasses three aspects. First, he acts as a center of expertise for the organization, with Sossa

and his team leading the global strategy for all benefits and wellness programs.

The second is ensuring that the health and wellness strategy supports Performance with Purpose, PepsiCo’s fundamental belief that the company’s success is inextricably linked to the sustainability of the world around us. PepsiCo’s Performance with Purpose goals focus on improving the products it sells, operating responsibly to protect the planet, and empowering people around the world.

Lastly, he and his team are responsible for making sure programs benefit employees and are executed in a cost-effective and efficient way for the company. This challenge is one Sossa takes quite seriously. To help keep employees happy and healthy, PepsiCo has crafted a holistic wellness strategy that goes far beyond the traditional interpretation of employee wellness. In addition to improving employees’ physical health, PepsiCo’s programs focus on mental, emotional, social, and financial well-being. These resources are available as part of the company’s Healthy Living program.

“Erik Sossa has expanded the scope of PepsiCo’s employee health initiative to address elements of wellness that are traditionally overlooked,” the team at health insurance provider Anthem said in a statement. “This whole-person approach, combined with the ‘Health ACE’ advocacy solution developed in partnership with Anthem, has driven engagement and achieved the kind of results any company would be thrilled to see.”

To engage employees physically, the company has implemented a variety of programs meant to foster friendly competition and get employees up and moving. One program—Ready, Step, Move, Give!— encourages employees to be more physically active. Using a team competition format as well as enabling individual participation, it measures employees’ physical activity by converting it into an equivalent number of steps. The number of steps taken is then translated into a dollar amount, which the PepsiCo Foundation donates to charity to benefit communities where PepsiCo does business.

In addition to a focus on physical well-being, Sossa has also worked to provide PepsiCo employees with an abundance of mental health services. For example, PepsiCo employees have access to an online resilience

“I believe the challenge we face with employee engagement is meeting people where they are: at the right time, in the right place, and in the right way.”

coaching platform that gives individuals tips and tools to manage stress more effectively. Sossa is also working on training managers so they are better equipped to identify when one of their team members is stressed, either in their personal or professional life, and to give them tools to help them cope.

Sossa has also helped develop wellness programs to address one of the most important, yet often overlooked areas: financial health.

Nearly one-third of employees reported that financial stress was a distraction at work in 2017, according to PricewaterhouseCoopers’ 2017 Employee Financial Wellness Survey. Additionally, 46 percent of respondents said they spend at least three hours at work thinking about personal financial matters.

Addressing this issue, Sossa’s team has created PepsiCo’s Healthy Money initiative, curating several resources employees can use to assess their financial health and develop strategies to improve it.

The company offers a variety of webinars and on-site workshops dedicated to issues such as preparing for retirement, refinancing debt, and debt management, among others. PepsiCo employees may also speak with a financial advisor through a third-party vendor to discuss any financial matters that are causing distress.

Having all of these resources available for employees is a great start, but Sossa says his main focus now is making sure the right employees are engaging with the right programs at the right time.

“That’s the million dollar question I believe every employer is looking at,” Sossa says. “I haven’t met a benefits leader who has felt like they’ve completely cracked the code of employee engagement, but we always strive to lead in this area.”

“I haven’t met a benefits leader who has felt like they’ve completely cracked the code of employee engagement, but we always strive to lead in this area.”

To improve employee engagement in health and wellness programs, Sossa has partnered with a thirdparty service that helps analyze employee health and wellness data. The third-party service puts together medical data, prescription drug information, wellness screening data, and wellness questionnaire data to create a holistic picture of each employee’s current state of wellbeing and needs, and then identifies which of PepsiCo’s benefits programs may be of most value to them.

Through this third party, employees are sent targeted messages to inform them about certain health and wellness programs that might be useful at a particular time, depending on their current medical activity. These targeted messages are helping to improve employee engagement in Pepsi’s healthcare programs, Sossa says.

The company has also tried to improve employee engagement through its Health ACE team, which stands for: assist, connect, and educate. It’s another way to spread awareness about the multitude of health and wellness resources available to employees and their families.

“What we’re trying to do is give employees one place to go and to bring the resources directly relevant to them,” Sossa says. “This team spends most time on the highest-acuity cases, but it is designed

In honor of healthy leadership.

We recognize Erik Sossa with PepsiCo for his dedication in leading the way to workplace wellness.

Mercer is proud of our partnership with PepsiCo.

We support PepsiCo’s mission to help employees and their families live better – physically, financially and socially. Together, we are driven to innovate. We commend Erik Sossa as a creative force for positive change in the health care industry.

“It is such a great story because it reminds us how we can have a positive impact on the lives of our employees and their families.”

to help employees whatever their needs are. It aims to communicate all of the programs available to individuals, whether they are employees or family members, dealing with health conditions.”

While there is still work to be done to increase employee engagement in wellness programs, Sossa is proud of the impact he’s already seen. One story in particular stands out for him.

In the early days of PepsiCo’s Healthy Living program, a local television program covered one of the company’s wellness events in New Jersey. When the reporter asked one employee about the Healthy Living Program, the employee ripped off his belt and pointed to some of the worn, original belt notches and said, “This was me before Healthy Living.” He then pointed to three new holes further in on his belt and said, “This is me now.”

“That visual showed me how someone had embraced the program and valued it,” Sossa says. “It is such a great story because it reminds us how we can have a positive impact on the lives of our employees and their families.” AHL

Erik Sossa

IS MAKING A DIFFERENCE BY CHANGING HOW THINGS ARE DONE.

We are proud to support him and PepsiCo as they take a whole-person approach to employee health. They have helped their employees take control of their health in a way that exemplifies the values of PepsiCo.

Thank you, Erik, for your continued innovation and partnership.

By

Make Health the Default Option Make Health the

How Anita

Shaughnessy

is putting Wells Fargo’s health and well-being program in the context of the culture

Anita Shaughnessy has been in corporate wellness for nearly as long as the field has existed. In fact, it was during some of her first tenures at General Foods and Citi where she led fitness classes and organized employee volleyball games. At the time, her focus may have been on fitness, but there was an unexpected benefit to the programs she was developing.

“When I look back, I realize that some of those activities are really the core foundation of driving culture and engagement with team members,” Shaughnessy says.

Now, as vice president, well-being benefits manager, at Wells Fargo, she is bringing that same culture and engagement to employees firsthand. When she joined the company in 2013, the wellness program was only available to employees who were covered through the company’s healthcare plans. Shaughnessy knew that health issues affect business results as much as healthcare claims do, so she expanded the program to the entire population and renamed it to well-being. “You need to have the programs within the context of the culture,” she says.

Next, Shaughnessy partnered with the sustainability, philanthropy, and corporate properties groups to create a view of well-being that extends beyond physical health. Her team worked with the sustainability group to create a bike-to-work campaign, which encourages physical activity, lowers carbon emissions, and reduces the need for additional parking spaces. “There’s a lot of shared messaging and shared agendas that you can capitalize on,” she says. “When you have this messaging, it continues to reinforce that to team members across the spectrum.”

To engage team members in developing well-being programs, she created a network of champion teams. These teams form walking clubs, raise awareness around healthy eating, and plan events, which creates a healthy community and healthy habits.

In 2016, Shaughnessy’s team partnered with Rally Health to offer Rally, a digital health platform that members can use to compete in individualized challenges, as well as set and track personal health goals and earn rewards along the way. To launch Rally, Shaughnessy’s

Anita Shaughnessy • VP, Well-Being Benefits Manager • Wells Fargo Shawn Photography Group

team worked with the champion team in Charlotte, North Carolina, to organize a daylong celebration. They hosted NFL running back Jonathan Stewart as their health ambassador for the day. About two thousand team members attended the event, thanks, in part, to the champion team’s organizational efforts.

“Wells Fargo stands out among large employers for its commitment and efforts— led by Anita’s amazing team—to seamlessly integrate well-being into all corners of the enterprise and to provide employees with a digital platform that empowers them to adopt healthy behaviors,” says Rhett Woods, chief creative officer at Rally Health.

Along with digital tools such as Rally, Shaughnessy has refined physical amenities that make choosing healthy options easier. The well-being group partnered with the corporate properties group to modify the built environment through initiatives such as indoor and outdoor walking trails. “If you think about the workplace environment, it’s a natural place to build in the opportunity to make health the default option,” she says.

Then in 2017, the wellness team completed a pilot test of walking treadmill workstations at four locations. The treadmills, which are in private conference rooms and have adjustable desk attachments, are programmed to operate at a maximum of two miles per hour. “The idea is not that you’re going to be burning massive numbers of calories,” Shaughnessy says. “The idea is just to keep your body in motion while at work.”

Employees had been asking for treadmill workstations since Shaughnessy joined Wells Fargo. In addition to improving health and well-being, the visual presence of the walking treadmills also helped reinforce the company’s commitment to the team.

Along with employee feedback, the well-being team uses anonymized health data to inform their strategy. In 2018, they are scheduled to roll out a digital weight management program called Real Appeal, which is aimed at those who are at risk of developing chronic health conditions due to their weight. “Without having that health claims data to look at the rate of diabetes and metabolic syndrome within our population, we would not have the wherewithal to consider that as an intervention,” Shaughnessy explains.

Early on, Shaughnessy met with stakeholders to learn what barriers their teams faced in utilizing the well-being tools. Tellers, for example, didn’t take the health assessment because it was only available on a PC, and tellers service their customers using a different computer. Now, the assessment is delivered as an app. “Things like that really helped me to understand how to tailor our efforts,” she says. “I can’t sit here in a tower and design programs and expect them to be successful without understanding the needs and interests of our total population.”

By completing the health assessment or watching a video about navigating healthcare, team members can learn about their health status, and they can earn dollars toward their healthcare costs. In 2016, Wells Fargo awarded roughly $80 million in health and wellness dollars. In 2017, the company expects to exceed about $89.5 million.

Changing the culture surrounding well-being requires more than simply providing tools. Shaughnessy works with leaders to give team members permission to move and stretch when they need to, especially in long meetings. “It’s those cues coming from leaders and managers that really help to reinforce the messaging and

Champion team members exercise in one of Wells Fargo’s on-site fitness centers.

the success of what we’re trying to do dayto-day,” she says. With those norms established, it’s not uncommon to see people stretching at their workspaces or raising their adjustable desks to standing height.

Corporate wellness programs have come a long way since Shaughnessy’s career began, and healthcare claims have moved from the centerpiece of corporate wellness to merely one factor. “If you just look at healthcare claims, you’re really being shortsighted, because while it does have an impact on cost, it’s a very long tail,” she says. “Wellbeing has a broader impact on the overall value proposition of what it feels like to work for a company like Wells Fargo.” AHL

Shawn Photography Group

Driven by a passion for improving the employee benefits experience, Kim Johns spearheaded the creation of a comprehensive care network for Mohawk Industries

Creating a New Path in Employee Well-Being Creating a New

By Joe Dixon

In healthcare, there are two key ways to approach benefits: as a necessary, yet cumbersome, part of running an organization, or as an exciting opportunity to enhance the employee experience and well-being. At Mohawk Industries, a flooring manufacturing company headquartered in Georgia, Kim Johns and her team take the latter approach.

“At Mohawk, there is a lot of passion around benefits,” says Johns, Mohawk’s director, employee benefits. “In a lot of places, benefits are one of those things that you have to have. Everyone here has tremendous energy around how we can do better, how we can help our employees and their families, and how we can spend our money better and wiser, so it becomes more real.”

That energy has translated into the creation of a new, robust care coordination and employee benefits program, which culminated in a cutting-edge network of healthcare providers throughout the United States and an on-site care team that Mohawk employees are able to access easily and efficiently. Additionally, the

“At Mohawk, there is a lot of passion around benefits . . . Everyone here has tremendous energy about how we can do better.”

care providers in Mohawk’s network are able to share information with one another, which helps ensure patients receive the most comprehensive and wellinformed care possible, Johns says.

The first layer of this new program begins with Mohawk’s on-site care teams. These individuals work in on-site clinics at many of Mohawk’s manufacturing facilities and are dedicated to educating employees about their healthcare options; they assist employees while they navigate the complex healthcare industry.

“We’re starting with some of the basics,” Johns says. “Let’s make sure everybody is getting their preventive screenings that are appropriate for their age and gender. Let’s make sure everyone gets their flu shot. Let’s make sure that, if you have multiple conditions and you’re on multiple medications, that you’re taking all of your prescriptions correctly.”

As part of this initiative, Johns and her team are also encouraging employees to access telehealth services. To start, Johns and her team would like to migrate patients

who have acute care concerns to these platforms, as a way to make care more accessible and less intimidating than going to a physician’s office.

But for employees who might need more comprehensive care than preventive screenings and regular check-ups, Johns and her team also spearheaded the creation of a sweeping network of healthcare providers that offer an array of services for individuals facing any health issue.

Johns and her team worked on bringing this plan to fruition for more than a year before rolling it out for employees on January 1. In total, the network is composed of about 1,900 physicians and six on-site clinics in Northwest Georgia—where about half of the company’s US workforce resides—with eighteen more spread out across the country. Together, those clinics serve about 32,000 members in Mohawk’s health plan. But the network took years of exhaustive planning by Johns and her team to make it to its successful rollout in 2018.

Johns’s strategic vision for the network was simple: create a resource for employees that can aid in the treatment of as many diseases as possible, in an affordable and accessible way for Mohawk employees and their families. Ultimately, she and her team wanted to have the safest and healthiest population of workers in the industry. To achieve that grand vision, Johns had to balance her larger vision while keeping track of all the minuscule details that go into an initiative of this size, she says. It also meant getting the right partners in the room to help make the process go as smoothly as possible.

“One of the things that Mohawk takes pride in, organizationally, is that we’re innovative,” Johns says. “So, we had to have partners that were willing to be innovative and take risks. Everybody had to get comfortable to really drive different thinking and different processes for what we’re doing here.”

A major risk that Johns and her team took throughout this process was to get the largest healthcare system in Northwest Georgia to participate in the network. A significant portion of the network’s ability to provide a wide array of services to patients in the region hinged on this health system participating in their initiative, so it was critical that Johns and her team explained their goals and processes in a way that helped the system see the value of partnering with Mohawk.

It also required Johns to effectively convey her vision to the health system’s stakeholders, assure them that the project would be completed as envisioned, and that it would be a mutually beneficial partnership for the system and the patients they serve. That meant coming up with a solution to ensure that the health system

Telehealth is just one of many options available to Mohawk employees in the new care coordination network.

could treat Mohawk patients through the network without disrupting physicians’ normal workflow.

“They might only have fifty Mohawk patients out of the two thousand they care for, so they’re not going to change their whole workflow for us,” Johns says. “But if we can give them tools and resources that they could make available to all of their patients, then that’s a really big win for us and for them.”

In the end, Johns’s pitch was successful, and the health system is now an integral part of Mohawk’s clinically integrated network, she says.

Looking ahead, Johns is excited to start seeing network providers share information and to begin gathering data about which programs and services within the network are most popular with Mohawk employees. As this information comes in, Johns will continue to refine the network’s offerings and work to provide new services as needs arise. She also wants to see this initiative make an impact even beyond the lives of the members of the company’s health care plan.

“We have no intention that this is going to be a Mohawk-exclusive network,” Johns says. “We really want it to be available for other employers in Northwest Georgia who want to take advantage of this tremendous opportunity to interface with the provider community, while managing costs and managing the health of their employees in a better, different way.” AHL

Employers Health Network o ers a fully transparent and functionally integrated healthcare benefits solution for self-funded employers.

The solutions are customized on an employer specific basis, and are designed to reflect the employers benefit design strategy, e ectively control cost, and insure that the best quality care is available to all employees and their family members.

Orlo Dietrich Chief Executive O cer Orlo.dietrich@ehnhllc.com

Cary Smith President Cary.smith@ehnllc.com

By Joe Dixon

You’re Now Free to Learn About Wellness You’re Now Free

Kembre Roberts knows that education is the key to a first-class benefits program at Southwest Airlines

Since 2011, Kembre Roberts has sharpened her expertise in health and wellness working at Southwest Airlines. Now, she’s ready to take on yet another new challenge to help improve and educate others about employee well-being at the company.

Roberts began her tenure at Southwest as a health and wellness program manager, a role she enjoyed for two-and-a-half years. Then, she transitioned to people manager, keeping her focus on wellness initiatives. For nearly four years, Roberts dove into the highly specific details of Southwest’s health and wellness programs that encompass physical, mental, emotional, and financial aspects of employee well-being.

But in December 2017, Roberts decided to change course to another role at the company: people manager, benefits and labor strategy. Whereas Roberts had been used to knowing the smallest details of the wellness programs Southwest offered its employees, her new role would allow her to steer the overall strategy and vision for these programs from a more holistic perspective.

“This is really challenging me to step out of the wellness zone and to really think about how our employees value their overall healthcare spend compared to their wellness, compared to their 401(k),” Roberts says. “And how do all of these finances matter to them for a total rewards package? So, it’s definitely stepping outside the wellness box to make sure that our employees are valuing the total rewards package they have today.”

To help employees get the most out of their total rewards packages, Roberts is focusing on employee education. Her goal is to educate individuals on how to navigate a complex healthcare system and how to maximize their dollars when they need to utilize medical services.

A major focus of this effort is making individuals aware of alternatives to emergency room visits, which are some of the costliest healthcare expenditures for individuals and companies, Roberts says. Since 2016, she has been coordinating with Southwest’s healthcare vendors to have them come on-site to discuss employees’ various options when they need to see a doctor.

Kembre Roberts • People Manager, Benefits and Labor Strategy • Southwest Airlines

Stephen M. Keller

“Data definitely drives decisions for

us.”

These vendors educate employees about services such as the benefits of urgent care facilities, the difference between in-network and out-of-network providers, as well as help for individuals with chronic medical conditions who might be concerned about how to best manage an illness. Roberts has also partnered with healthcare providers to come on-site and help employees connect with a primary care physician if they don’t have one already.

“When you think about the corporate space and combining more of a population health model, that is pretty new to an employer environment,” Roberts explains. “We want to create more of a population health mind-set, create opportunities for individuals based on their disease conditions, create a way for people to utilize the community resources available to them, and then partner with local hospital systems or vendors to help employees make the best decisions, rather than communication just coming from a corporate environment.”

Roberts and her team initially helped roll out this partnership at Southwest’s call center locations, and

in 2018 she is helping to expand it to airport locations in eight markets throughout the United States. But this expansion isn’t a matter of simply copying the approach used at Southwest’s call center locations. The company’s airport locations are vastly different from the call centers, which means Roberts needs to carefully tailor her approach to this project, she points out.

There are several differences between Southwest’s call center locations and its airports. For example, the call centers typically have employees all working in the same space on the same schedule. This makes it easier to ensure every employee receives the same information when vendors come in to educate employees about their healthcare options, because it’s easier to gather every employee together.

The airport locations, however, usually have more than one break room and a variety of work spaces and schedules, which creates challenges for communicating the same information to every worker, Roberts says. In addition to the human resources challenge, physical accessibility is another obstacle Roberts and her team face at Southwest’s airports that isn’t present at its call centers.

For instance, in the past, Roberts has led teams that coordinated with local vendors to bring a mobile mammogram unit to some of Southwest’s call center locations. In these settings, it’s easy to roll the machine into the parking lot, where it’s simple for employees to find if they would like to use that service. At airports, however, it’s difficult to find a spot to park that unit, and it’s also hard to find a place that is easily accessible to the most people possible, Roberts says.

Despite these challenges, Roberts is going to continue to strive to implement programs that will make the most impact for Southwest’s employees in its call centers and at its airports. To assess the impact of a particular wellness program, Roberts has spearheaded focus groups and created customer satisfaction surveys as a way for Southwest employees and vendors to provide feedback on the usefulness of the company’s programs.

“Data definitely drives decisions for us,” Roberts says. “We spend a lot of time with our medical carrier and our pharmacy benefits manager making sure that we’re selecting programs that can make a difference for our employees, make their overall healthcare experience better, and have it be something that they are going to enjoy and not become a burden for them to manage.” AHL As part of a global health and wellness healthcare company, our mission at UnitedHealthcare is to help people live healthier lives and help make the health system work better for everyone. Our solution combines the resources of our health benefits and services businesses. Visit www.uhc.com to

Keeping the Public Interest in Mind Keeping the

Kathleen Harris, vice president of benefits and global employee services at Time Warner Inc., oversees the health and wellness programs that help 23,000 employees stay well

By David Levine

Kathleen Harris had her eye on public health from the very beginning of her adult life. What she didn’t know, however, was that her interest in public health would lead her to helping keep Time Warner’s approximately 23,000 employees healthy. As vice president of benefits and global employee services, Harris is responsible for defining the benefits strategy for the company’s employees all over the world. Perhaps the greatest benefit comes from the programs she develops that contribute to those employees’ health and well-being.

Harris, who grew up near Hartford, Connecticut, holds a bachelor of science degree from the School of Public and Environmental Affairs at Indiana University–Bloomington and a masters in public health from Yale University. “During my graduate program, I had an internship in benefits consulting, and

from there I never really left,” she says. Harris worked as a health and welfare consultant at Towers Perrin, and then spent four years as a senior consultant and client delivery lead of the Group and Healthcare Practice at the benefits consulting firm Watson Wyatt. During her time there, she was responsible for identifying consulting opportunities for Fortune 500 clients and building strategic HR solutions that met both their business and human capital needs.

She joined Time Warner in 2006. “As a consultant, I had always been an outsider,” Harris says. “Sure, you provide information on the newest and greatest ideas, but you rarely see a project finished. I wanted a better understanding of the corporate stakeholders’ perspective.” She expected to work on the corporate side for a few years and then go back to consulting.

“But that never happened,” she laughs. “It is too fascinating working with a company like Time Warner that has such an amazing presence and so many recognizable brands. It can be really hard to get projects across the finish line, but it is also super rewarding. It was too hard to give that up.”

Harris was hired as a strategic benefits consultant to manage enterprise-wide programs, and from there, she was given additional responsibilities in other areas. “I now have responsibility for everything that falls under benefits, including wellness, health and welfare, and retirement benefits,” she says. She was promoted into her current role in 2011. Time Warner’s health-related benefits cover everything from wellness and prevention to stateof-the-art health and care management programs that provide support to Time Warner employees with complex, acute, and chronic conditions.

Health and wellness initiatives are front and center at Time Warner, she says. “We think it is important to keep employees

healthy and happy,” Harris says. “We also realize the healthcare system is complicated and hard to navigate, and we don’t want employees worrying about that. Our focus is on ensuring that our workforce can easily access the healthcare system when needed.”

She and her team work with several different health and wellness vendors. Harris and her team take a concierge approach to help Time Warner’s employees navigate the healthcare system. They provide access to expert medical opinions, healthcare pricing information, and help understanding their explanation of benefits (EOB).

Among her biggest accomplishments is establishing the company’s Fit Nation program. Harris saw the great success CNN—one of Time Warner’s subsidiaries— had with its program of the same name. CNN Chief Medical Correspondent Dr. Sanjay Gupta recruited viewers, many with health challenges, and spent months training them to complete a triathlon. “Gupta’s producer said, ‘We did this for seven people. Wouldn’t it be cool to do it

Kathleen Harris • VP of Benefits and Global Employee Services • Time Warner Inc.

Time Warner employees get ready for the swimming leg of the 2017 Westchester Olympic distance Triathlon.

“I still can’t get over the number of people who really get excited about the rewards. People like to show off that they got to a certain rewards level.”

for all of Time Warner?’” Harris remembers. “I said, ‘That is the most awesome thing I’ve ever heard.’” She worked with CNN to roll out the program enterprise-wide. Now, hundreds of employees across Time Warner participate in runs and triathlons worldwide.

“It has become one of the most successful programs that we have rolled out,” she says. Participants can train for a triathlon or something shorter, such as a 5K or 10K run. They can also learn to run, bike, or swim. Time Warner provides the coaches, the facilities, the uniforms, and the entry fees. The program, which is now in its sixth year, achieves about 25 percent employee engagement, which she says is a large number for this type of offering. “What we have learned over the past six years is people of all backgrounds, from athletes to people literally getting off the couch or who have health challenges—the idea of camaraderie has been huge for us. They feel they are accomplishing something as a team,” Harris says.

One of the ways Harris has made it easier for employees to get involved with Fit Nation or any of the company’s other health benefits is through the use of the Virgin Pulse platform that Time Warner implemented in 2016. Virgin Pulse, a

leading provider of employee-centric solutions that drive well-being, culture, and productivity across organizations around the world, launched the Virgin Pulse app for Apple Watch. “We had all these programs but no centralized home,” Harris says. “Where do we put this information, where people who want to can go back for it, if not today, then two weeks from now?” The platform acts as the central hub to find that information, and it even includes ways to track progress, earn points, and cash them in for rewards for participation. “I still can’t get over the number of people who really get excited about the rewards,” she says. “You see the boxes of rewards being delivered in the hallways. People like to show off that they got to a certain rewards level.”

Though these health initiatives are certainly a team effort, Harris acts as the quarterback for these projects, because she serves as the point of contact for all of Time Warner’s employees and executives globally. Harris, however, prefers to share the credit. “The proudest part for me is that this idea came from within our company,” she says. “It really is homegrown. Across the US and in the United Kingdom, all the people who make it happen are really fantastic.” AHL

WE APPLAUD

Kathleen Harris

Her commitment to the well-being of Time Warner employees and their families is at the heart of the company’s employee wellness efforts.

We are proud to support her and Time Warner as they act proactively to improve the health of their employees and their families.

Thank you, Kathleen, for your continued dedication and partnership.

Making a difference in the world.

Impact

“I always felt I should work for a cause that is bigger than me.” p.128

Revenue Cycle Revolution

Mike Simms revamped Cone Health’s billing and collections process to improve the organization’s bottom line—and its relationships with patients

By Joe Dixon

Rapid consolidation

in the healthcare industry, coupled with reductions in Medicare and Medicaid reimbursements, is forcing healthcare providers to get creative.

More than ever, it’s become critical for care providers to find ways to make themselves stand out as exceptional customer service representatives if they want to have positive patient experiences. For Cone Health, a nonprofit health system headquartered in Greensboro, North Carolina, the answer to that mandate is coming from an unlikely department: finance.

According to Mike Simms, hospitals are having a difficult time with increased patient-responsible balances. “The increase in these balances is due to the Affordable Care Act and employers making employees more responsible for cost-sharing,” says Simms, Cone Health’s vice president of revenue cycle. “It’s important for revenue cycle teams to develop technology and processes to handle this increase in patient-responsible balances.”

Often, care providers prioritize their first impressions with patients, making sure experiences with front-desk personnel, nurses, and physicians are satisfactory. But collections and billing, which is often one of the last touchpoints a patient has, is a just-as-important, yet often forgotten, aspect of patient care, Simms says.

“If we don’t do a good job explaining to our patients what they owe and if we don’t give them a web portal that allows for easy access of information and an easy way to communicate with us, then they’re going to have a bad experience,” he says.

Simms knows from experience the power of clear, concise billing and a user-friendly web portal for a patient’s experience, as he and his team recently led the revitalization of Cone Health’s billing and collections process.

Simms oversees Cone’s patient registration and back-end patient accounting processes, including claim submissions, refunds, denials management, and more. Over time, he saw that these processes were not meeting patient expectations and created difficulties for patients and the organization when it was time for individuals to pay their bills.

He identified two main issues: confusing billing statements and a rigid collections process that didn’t provide patients with enough options to pay their accounts. This frustrated patients who wanted to make payments and led to more accounts going to a collection agency. Simms and his team first set out to revamp the billing statements.

Before the revitalization, the bills sent to Cone Health’s patients were bland and uninformative, and patients often called the organization’s customer service line for clarification on their statements, Simms says.

To address this concern, Simms and his team spearheaded a request-for-proposal process, where he and the team asked third-party vendors for their ideas about how Cone Health could improve its web portal and online billing statements. The team prioritized vendors who could provide state-ofthe-art technology and patient-friendly deliverables, as well as capabilities such as an online messaging system and ways for patients to set up and manage their own payment plans without having to pick up the phone. After reviewing proposals and scoring each vendor, the team selected one and began implementing the new solution with Cone Health’s IT department.

Now, Cone Health’s statements are colorful and easy to read, providing a quick summary of a patient’s accounts as well as a more detailed breakdown of the charges from their visit. Whereas before Cone Health’s system left patients waiting to speak to customer service representatives, now the system is receiving a 95 percent satisfaction score from patients who are using the new and improved web portal and billing statements.

“We don’t get as many calls to our customer service department about not understanding statements,” Simms says. “Our employees enjoy it because there’s some other added functionality, such as cash posting, which makes it easier for them. Our customer service reps process credit card payments through this vendor as well. So, from a patient satisfaction standpoint and an employee satisfaction standpoint, it’s helped us.”

While working on upgrading the company’s web portal, the team also worked to implement new billing and collections tools and procedures. At the time, patients had six months to pay the balance on their medical bills before the account would be handed over to a third-party vendor to handle collections. But Simms found that this structure didn’t allow patients enough time to pay, which resulted in individuals getting upset about the billing process.

To remedy these issues, the team decided to bring certain aspects of the collections process in-house instead of using an outside vendor. Although the third-party vendor calling patients about their bills was acting on behalf of Cone Health, Simms often heard complaints from customers who thought that it was a collections agency, which hurt the organization’s relationship with patients.

As part of the effort to improve the organization’s relationship during this process, the team implemented a predictive dialer within the customer service department, which automatically calls patients to remind them that an upcoming payment is due. This not only frees up Cone employees to perform other tasks, it also improves the

Mike Simms VP of Revenue Cycle Cone Health

William Jarrett

BOTTOM LINE RESULTS AND EXCEPTIONAL SERVICE

CMRE has been providing revenue cycle management solutions to healthcare clients for more than 40 years. We drive financial results and exceptional service by maximizing our people, processes and technology. CMRE’s highly skilled and professional team members are all US based.

Our core philosophy is that the needs of our clients and their patients must be placed above our own. We conduct business with integrity, honesty, confidentiality and legal compliance.

CMRE Service Solutions:

“The revenue cycle team and the IT team worked well together, knowing that this was the best thing for our patients.”

institution’s relationship with patients because it’s clearly identifiable as a call from Cone Health, with whom the patient already has a relationship.

Additionally, the team spearheaded an effort to make the payment process more flexible for patients, such as by increasing the time that patients had to pay their bills to twelve months. The team also routed patients who could not pay within twelve months to a third-party loan vendor, which allowed them to pay over a longer period of time at a low monthly interest rate.

At the same time, this vendor provides cash funding minus a service fee of the account balance to Cone Health based on the patient’s propensity-to-pay scoring. Without this assistance, the established payment plans could remain on Cone’s accounts receivable for years, Simms says. There is always the possibility that the patient will stop paying the vendor, in which case the account would be returned to Cone and the organization would have to pay back the advanced funds. Known as the recourse rate, this scenario has only applied to about 3 percent of Cone Health’s accounts since the switch. More healthcare organizations are looking to implement these loan programs to help solve some of the issues with the high out-of-pocket costs that patients are experiencing, Simms says.

“I’m very proud of these projects,” Simms says. “The revenue cycle team and the IT team worked together great, knowing that this was the best thing for our patients.” AHL

The continuous and dramatic changes in the healthcare industry demand attention. CMRE has responded by providing customized receivables solutions that optimize cash flow and provide a superior patient experience. Hospitals, healthcare systems, and physician billing companies across the nation have partnered with CMRE for over four decades to maximize cash flow and ensure their patients are treated with compassion and dignity when resolving their financial obligation. CMRE continues to invest and focus on people, processes, and technology to ensure our clients and their patients are afforded the results and experience they require and deserve.

The Power of Working Together

As Huntsville Hospital expanded, CFO Kelli Powers made it her mission to preserve and support employees through the transition

By Randall Colburn

Kelli Powers

knew right away that she would enjoy working for Huntsville Hospital after making one simple observation: CEO David Spillers knew his employees’ names.

Powers, who was the CEO of a different hospital at the time, describes herself as an “employee advocate.” So when a CEO position opened up at Athens-Limestone Hospital, one of Huntsville’s affiliates, she applied and got the job.

As the expansion of Huntsville’s network continued— now encompassing nine different hospitals across northern Alabama—Powers also found herself in a state of transition. Spillers invited her to serve as the CFO for Huntsville Hospital itself. While the shift wasn’t an unprecedented one—Powers began her career in finance—it did pose several daunting challenges, as well as the question of how she could best serve employees in this role.

One of her major responsibilities, after all, is consolidation while creating the system—an initiative that’s bound to make employees nervous. Huntsville’s network has grown large enough that it makes operational and financial sense to ensure that all of its affiliates’ processes are aligned with those of Huntsville Hospital. As such, a majority of Powers’ work as CFO is uniting each hospital’s business offices under one roof, which is a push that began just last year.

Powers got started by shepherding each hospital onto the same payroll system, a process that serves as a prologue to the larger effort of boiling down the four different computer systems being used by Huntsville’s affiliates to just one— with one hospital’s payroll left to transition. Changes such as these can be worrisome for employees because it often necessitates changes in location or management. There’s also the possibility that one’s job may be lost in the consolidation.

But Powers and her team met these fears with a commitment to clear communication and transparency, as well as a solution that demonstrated just how much Powers and Huntsville value their employees.

“With the Congressional Budget Office consolidation, we gave all of those people an opportunity to work at our business office,” Powers explains. “If that didn’t work out, then they could find a job at the hospital doing something a little different.” It was a reasonable compromise, one designed with employees in mind. As such, Powers says the only jobs lost in the transition were through attrition.

Losing employees is the last situation Powers and her team want, and she is constantly working toward creative ways to streamline operations that don’t involve staff reductions.

“I’m always looking for cost-saving ideas that do not impact people financially,” she says. “One thing that leads to good patient care is creating a work environment where people want to come to work.”

Just like Spillers, Powers works to know the names of all of her employees, a formidable challenge considering they surpass four hundred in number. She provides herself plenty of opportunities, however, by throwing a healthy amount of celebrations. In the past, she’s even gone “undercover.” Early on in her tenure at Huntsville, before she got to know everyone, she presented herself as an accountant when working alongside employees to help with inventory at one of Huntsville’s affiliates.

“There were a lot of things I found out that day,” she recalls, as it was through this exercise that she learned of broken equipment in one of the hospital’s operating rooms and a lack of funds to fix it. Employees, she says, might be hesitant to push certain issues when there are larger concerns at hand, but it’s helpful for Powers to know of any and all ways she can improve conditions for her team.

Powers values all of her employees, and she has a particularly strong devotion to nurses. “In our business, it’s all about the care you receive, and a lot of that comes through nurses,” Powers says. “Obviously, there are other people involved in care, but the nurse is with the patient all day long. And it’s a tough job taking care of people when they’re sick. They’re not happy, and it can be hard to make them happy.”

With that in mind, Powers is often asking herself how she can, through her position as CFO, “bring savings to the system that we can in turn put back into nurses’ pay.” But it’s not just pay that Powers wants to provide. It’s also a better work environment. For a nurse, that means

Kelli Powers CFO Huntsville Hospital

Courtesy of Huntsville Hospital

“Obviously, there are other people involved in care, but the nurse is with the patient all day long. And it’s a tough job taking care of people when they’re sick. They’re not happy, and it can be hard to make them happy.”

supplies and resources. “When I worked at Athens, we had one bladder scanner for two floors,” she says. “Here, I’m always thinking about how can we work to give nurses the tools that make their jobs easier.”

Powers often returns to a lesson she learned from a former boss: with any decision, think about how it affects the people that make the least amount of money. Because she keeps that in mind, Powers has learned how to find alternative avenues when it comes to cost-cutting and streamlining.

In addition to being an employee advocate, she also describes herself as a “change advocate.” Change, she says, can be difficult for anyone to process, but it’s change that often allows Powers to create an environment where employees are most valued.

That’s crucial when Huntsville is in the midst of so much transition. As daunting as the expansion may be, though, Powers knows it’s what’s best for Huntsville. “I’m not afraid to take on some more,” she says.

And as Huntsville better equips itself to take care of the local community, Powers will do everything in her power to ensure a fruitful future for those giving that care. AHL

Hayes is proud to partner with Huntsville Hospital to drive revenue cycle improvement. We are grateful for Kelli Powers’ leadership and her team’s talent and drive to deliver bottom line results. We applaud the entire Huntsville team for the work they do to continue to improve healthcare for their patients every day.

Our Comprehensive Revenue Integrity Support Program (CRISP) combines the financial acumen of our revenue cycle experts with our industry leading revenue integrity software, MDauditTM to ensure you collect, find, recover and retain each dollar you worked so hard to earn. Learn more CRISP@hayesmangement.com

www.hayesmanagement.com

Compliance

In Action

Deborah Penza started her career in the first healthcare consulting firm focused on compliance. More than twenty years later, she’s still at the forefront of the business.

By John Sadler

Compliance wasn’t Deborah Penza’s first career choice.

The Florida Atlantic University political science major went to George Washington University to continue her studies. She envisioned a job at the CIA or FBI in her future. In Penza’s second year of study, however, she took a job temping for several lobbying firms that shared an office space in the Washington, DC, area—a choice that set her on a career path in an emerging new industry.

“I took a combined role at one of the lobbying firms as an administrative assistant and legislative analyst,” she says. “Two months after I took that job, Richard Kusserow retired as the inspector general of the US Department of Health and Human Services and joined the firm, which was quickly split into two companies: Strategic Management Associates Inc. and Strategic Management Systems Inc. I was fortunate enough to be the first employee of Strategic Management Systems.”

After decades working for the CIA, FBI, and HHS, Kusserow developed a deep knowledge of the healthcare industry and its compliance-related risks. Compliance was a rapidly growing field, a byproduct of 1980s government procurement scandals and the newly adopted Federal Sentencing Guidelines. As a result, Strategic Management Systems quickly emerged as one of the first healthcare consulting firms that focused on corporate compliance.

“I think the wide implementation of compliance programs was the natural progression of things,” Penza says. “If you look back at the period of time in the 1980s, there were a significant number of scandals involving defense industry contractors fraudulently billing the federal government. Compliance programs as we know them today evolved from the defense industry’s efforts to institute controls to minimize the likelihood of such events. They were really the pioneers of modern-day compliance.”

Penza says that the firm’s early years weren’t the most well planned out. “True to Dick Kusserow form, we just kind of winged it,” she says. “No one had really ever created a compliance program for the healthcare industry. We were developing compliance programs from scratch that were designed to meet the minimum requirements set forth in a footnote in the sentencing guidelines.” Although it started with less than twenty-five employees, Strategic Management Systems emerged as one of the most wellregarded firms in the field. “The running joke was that if you were under federal investigation, you came to us for your corporate compliance program,” she says.

Deborah

Penza SVP, Chief Compliance Officer Impax Laboratories

“The running joke was that if you were under federal investigation, you came to us for your corporate compliance program. ”

Kusserow was instrumental in keeping Penza in her current career path. “I was scheduled to sit for the FBI exam, and I think that one of my colleagues leaked it to Dick,” she says. “A few days before the exam, he called me in and gave me a raise. I never looked back.”

Penza’s decision to stay at Strategic Management Systems set her on a path that would take her to multiple countries and large pharmaceutical companies.

During her nearly ten years at Strategic Management Systems, Penza helped construct the compliance program from the ground up, training thousands of employees across multiple sectors of the healthcare industry—and ultimately becoming the only employee with a noncompete agreement. Elan Corporation contacted Strategic Management Systems to help implement a compliance program ahead of a pending FDA consent decree. The company mentioned that it was also looking to staff its program, which was appealing to Penza because the company was international. So in 2001, she left Strategic Management Systems with Kusserow’s blessing and full support.

Around half a year after Penza joined Elan, Art Falk took over as chief compliance officer. “We were a perfect fit because his background was in pharmaceutical quality,” she says. “Together, we set up a compliance program. It was actually Art that made it possible for me to attend law school.”

In the early 2000s, law degrees were rapidly becoming a prerequisite for compliance. “By the time I was at Elan, the field had evolved to the point where companies were looking for lawyers to fill the compliance officer role,” Penza says. “To stay there and be a compliance officer, I really thought I needed that credential.”

So in 2002, Penza enrolled in law school. At the time, she was traveling more than one hundred thousand miles a year to multiple countries for Elan. “In hindsight, I don’t know how I did it,” she says.

Penza’s experience traveling gave her a strong sensitivity to other cultures. She says that it’s important for visiting workers not to presume too much understanding of other countries’ cultures.

“If anyone ever tries to tell you that pharma is not a small world, they don’t know what they’re talking about.”

Once, in Israel, Penza was training employees in a medical device manufacturing plant. A colleague recommended that she cut out a case study on sexual harassment because it would not be relevant to the workforce. At the end of the training, Penza asked the workers if there was a topic they would have liked to discuss. “And don’t you know that the subject that came up was sexual harassment,” she says. “There was a case in Israel at the time that involved a rabbi who had been accused of sexual harassment. Shortly after the announcement that he won the court case, a number of other women came forward to describe what he’d done to them. It was big news at the time and employees were curious about the topic.”

Penza left Elan before its merger with Perrigo to take a job with Watson Pharmaceuticals, which had recently acquired the Arrow Group—a purchase that took the company’s commercial sales and marketing activities international.

“Up to that point, they did not have a full-time compliance officer,” Penza says. “One of the company’s attorneys was trying to manage compliance on a parttime basis in addition to her other responsibilities. It was a fantastic opportunity for me to come in and take the program to the next level while obtaining a significant amount of M&A experience.”

During her time at Watson the company completed a number of high-profile acquisitions, including Actavis in 2012, at which time Watson assumed the Actavis name. At that time, Penza had traveled to countries as diverse as China, Bulgaria, and Serbia. However, she learned her lesson from past experience at Elan to accept when it was time to move on to a new position.

A past colleague had become the CEO of Impax Laboratories. Penza told him that she was looking for a new position. “It turned out that he was looking for a compliance officer,” she says. “If anyone ever tries to tell you that pharma is not a small world, they don’t know what they’re talking about.”

Penza is now senior vice present and chief compliance officer at Impax. She reports to the CEO, is a member of the executive committee, and oversees the compliance program and related activities. In addition, she was recently assumed responsibility for the company’s pharmacovigilance team, which monitors drug safety.

One of the things that has stuck out to Penza over the years is the continuous changes compliance undertakes due to technological advancement.

“The one that keeps me awake at night is cybersecurity,” Penza says. “Beyond cybersecurity is this whole idea of artificial intelligence and the Internet of Things. What does that mean for our industry and what does that mean for compliance?”

She says new technology should always be a consideration for compliance officers. “For compliance officers, staying on top of the evolution of technology and identifying and understanding the risks and benefits that it potentially creates for the business is going to be our biggest challenge in the next decade,” she says. AHL

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“A Cause That Is Bigger Than Me”

Jim Schindler, senior vice president, assistant general counsel at Masimo, helps lead a medical technology company more interested in saving lives than earning huge profits

By David Levine

Schindler SVP, Assistant General Counsel Masimo

Jim

Soon after

leaving law school, Jim Schindler discovered that he didn’t like the traditional practice of law. So he spent the early part of his career at a financial counseling firm advising clients on their investments. Then, when he moved into private practice, Schindler mostly advised clients in contract disputes and that wasn’t satisfying either. “In private practice, I felt like a mercenary, doing things on request with not much significance in the broad scheme of things,” he says. The financial industry and private practice were just about making money, he felt, and that was not something that he could get passionate about. “I always felt I should work for a cause that is bigger than me,” he says.

That cause, he found, was healthcare. Now, as a senior vice president and assistant general counsel at Masimo, a global medical technology company based in Irvine, California, Schindler believes wholeheartedly in the company’s mission and in his work helping save lives.

Most important to Schindler, he says Masimo genuinely cares about patients. “That comes from Joe Kiani, its founder,” he says. Kiani founded Masimo in 1989 as a “garage” start-up. Kiani built a device that improved the measurement of the oxygen saturation of arterial blood. Today, Masimo is publicly traded and employs more than four thousand people worldwide. Not only does Masimo sell its own patient monitors, it also licenses its technology to work inside other monitoring devices from a host of manufacturers—including GE, Philips, Zoll, and many more—to ensure its life-saving technology gets to as many patients as possible.

“Joe turned down lucrative offers for his technology early on because of his concern that the technology would be buried by the buyer and not see its way to patients. I admire that passion,” Schindler says. Kiani is opening up Masimo’s technology platform to other device companies so patients can benefit from increased connectivity and the sharing of data between medical devices—in essence, sharing some of its intellectual property freely with its competitors.

“In private practice, I felt like a mercenary, doing things on request with not much significance in the broad scheme of things.”

Since Schindler joined the company in 2011, revenues have almost doubled from around $400 million to 2018’s projection of around $760 million. Schindler believes he has helped with the growth because he and his department understand that just informing Masimo’s executive team about the law is marginally helpful. Instead, he says his department is involved in the business, understanding its products, business model, and goals so his team can provide pragmatic advice that Masimo can use right away. Sometimes, the proposed path to the business goal is not the legally less risky path. “Masimo trusts us to think creatively and suggest other paths that can be taken to achieve business goals with less risk,” he says.

Currently, the biggest project on his team’s plate is preparing Masimo to be compliant with the European Union’s General Data Protection Regulation requirements. The EU law goes into effect May 2018 and requires companies to give an individual much more control over the collection, processing, use, transmission, and storage of their personal information. He says this affects every aspect of the company’s business, including its products, IT systems, website, HR systems, entity management systems, customer and vendor contracts, marketing, and even facilities. “With no one functional owner of the data protection function or any department that clearly would own such a project, our

legal department has owned this project,” he says. The legal team is learning about the requirements of the regulations, how data comes into the company, what it’s used for, where it’s stored, and how the company’s systems work in order to recommend changes, processes, and procedures that comply with the law. “And the advice has to be practical so that the business isn’t left wondering what must be done, and actionable in that our recommendations can be used right away by the business,” he says. “We view this as a critical project for the continued growth of the company, not just because the fines are quite high for noncompliance but also because Masimo’s customers are going to require—in fact, some are already requiring—that Masimo’s products help them comply with the requirements.”

As a leader, Schindler tries to help his team members reach their potential by bringing each individual’s strengths to the forefront. “I tell my team that they need to tackle a project from their own perspectives,” he says. “I don’t want them trying to complete a project from my perspective or how I would do it because that’s a recipe for failure. They aren’t me, and their perspectives are valid and valuable.”

His job, he says, is to guide them to a stronger result. When a team member brings a project to him or asks questions along the way, he challenges them. “I ask them whether they thought of this or that issue,” he says. “I ask them the assumptions underlying their work product so that we can discuss whether they are the right ones based on our collective experience or knowledge.”

Ultimately, that results in team members who feel empowered to make decisions on their own and to become confident advisers to the business, he says. “It’s much more efficient in getting things done,” he says. “This allows the legal department to provide quality support to a rapidly growing and expanding company in a highly regulated industry using a legal team that is smaller than that of many companies our size in this industry.”

Schindler is especially proud of Masimo’s support for the Patient Safety Movement Foundation, which has the goal

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of ending preventable deaths in hospitals around the world. Masimo has embraced the challenge and is doing its part to help and work with other medical device companies to resolve the inability of medical devices to talk to each other, share the valuable data all these devices generate, and have the devices work together to give a clinician a true and better picture of a patient’s health. “When Joe began hearing stories of people who were dying from preventable causes, he and Masimo set out to do something about it and get other entities, like medical devices companies, hospitals, and governments around the world, to work together to end this problem,” Schindler says. “Masimo’s mission is bigger than just making money. Its mission is to help patients. I see it every day, and it lets me work for a bigger cause than me.” AHL

Specializing in real estate and employment law, Stuart Kane LLP is proud to work with healthcare industry clients like AccentCare, Cognizant TriZetto, Crossover Health, DexCom, InTouch Health, and St. John’s Health.  Real estate partner Josh Grushkin is grateful to Jim Schindler and the Masimo team for the opportunity to be of service.

Yulchon is a full-service international law firm headquartered in Seoul, Korea, with a broad client base comprised of major domestic and foreign companies, including many Fortune 500 companies. By delivering innovative solutions to complex challenges that face today’s businesses, Yulchon continues to be on the cutting edge of legal practice.

The Race to Seven Billion Patients

Paul Campbell reflects on Mylan’s staggering growth and the perfect combination of acquisitions and internal development that has led to increased access to high-quality medicines around the world

By Will Grant

Mylan has been in the pharmaceuticals business since 1961, but it’s fairly evident that Paul Campbell’s fifteen years at the company have transpired during truly inspired times.

to buy a majority stake in an Indian-domiciled company. “I got an opportunity to spend time understanding and working through not only the culture, but also the business practices within India, which can be very different than what we’re used to in the US,” Campbell says. “That was very challenging.”

Matrix provided Mylan with world-class manufacturing capabilities. It also provided the company with an opportunity for a vertical integration strategy, which Campbell thinks was visionary at the time.

Mylan’s staggering exponential growth saw a company with $1 billion in revenue in the United States transform into one of the largest generic and specialty pharmaceuticals companies in the world. Campbell, who serves as Mylan’s senior vice president, controller, and chief accounting officer, says that the company’s success comes in large part from striking the right balance between external acquisitions and internal opportunities. He sees Mylan’s business model as the one to beat at present and is intent on aiding growth with world-class information systems and upgraded reporting capabilities.

During his time at Mylan, Campbell has served in a wide variety of progressively more complex positions, including vice president of global operations finance; director of internal audit; and vice president and assistant controller. The variety of roles, Campbell says, reflects the culture at Mylan. “I think it is unique and innovative that Mylan provides people opportunities to get involved in certain activities that their titles may not exactly say would be related to their job description,” he says.

One opportunity for growth came starting in 2006, when Mylan made two landmark acquisitions that repositioned the company as a giant in its field. First, by gaining a controlling interest in India-based Matrix Laboratories, Mylan became one of the first pharmaceutical companies

Just a year later, Mylan announced that it would acquire the generics branch of Merck KGaA, a German chemical and pharmaceutical company. The acquisition was a carveout of the larger business, and the company was twice the size of Mylan at the time. The acquisition also yielded a much-needed global footprint for Mylan to accomplish its mission statement to deliver medicine to the world’s seven billion people.

Campbell says that Mylan’s relatively short list of acquisitions prior to 2006 made the complexities of those two deals all the more pronounced from both an accounting and integration perspective. In fact, Campbell counts figuring out the complex accounting around those transactions and learning what it takes to integrate businesses together as some of the milestones of his career. Such extreme growth has provided unique challenges for Campbell and his team. He cites system integration and accelerating reporting of information to the speed of business as areas he’s anxious to address. “Obviously, from a statutory reporting perspective, we have systems to report our numbers, but providing the right information to business leaders really requires us to have a world-class management reporting system and processes supporting that effort,” Campbell says. Campbell and his team will be looking to upgrade and integrate those systems over the course of the next 12–18 months.

Paul Campbell SVP, Controller & Chief Accounting Officer

“I got an opportunity to spend time understanding and working through not only the culture, but also the business practices within India, which can be very different than what we’re used to in the US.”

Mylan

Inspiration, innovation and leadership

This is what Paul Campbell brings to business and the industry. We congratulate him on being profiled in American Healthcare Leader and commend him for being a voice in the healthcare industry.

“We sell in more than 165 countries and territories and offer more than 7,500 products now.”

www.pwc.com

During that time, Mylan will continue to evolve, especially when it comes to its product offerings. The company has worked to complement the external acquisitions by developing a significant pipeline of products in both the biologics and respiratory spaces, and that pipeline—whether strictly internal or as part of a partnership—has been a great source of research and investment for the company.

Like the opportunities he’s been afforded that may not have expressly reflected his job title, Campbell works to get his team members as involved as possible. “I think it really prepares people better for when we actually make a decision to take on an acquisition,” Campbell says. “If you’ve involved in the process for a period of time, you can have a better understanding of what we are buying and why we’re buying.”

Moving forward, Campbell says his personal goal is to provide a guiding hand and supportive role for his team.

“We have a saying here at Mylan that your attitude equals your altitude,” Campbell says. He places a high priority on making sure his team feels empowered and emboldened just as he has throughout his career at Mylan. In fact, over the course of his fifteen years with the company, Campbell is proud to have been part of such exceptional growth, growth in which he played an integral role. “We sell in more than 165 countries and territories and offer more than 7,500 products now,” Campbell says. “In 2016 we were around $11 billion dollars in global revenues. We’ve got a workforce of around 35,000 people, so it’s been just unbelievable what we have become from where we were.” AHL

From financial impact to wellness, Pam Mortenson shares how she helps Health Advocate develop customized solutions that address customers’ goals

By Jeff Silver

TheHolistic Perspective

For decades,

West Corporation has been a leading technology-enabled company that connects people all around the world and makes companies more efficient. It provides innovative solutions to companies ranging from telecommunications and entertainment providers to financial services firms. But in 2014, a new opportunity arose when the company acquired Health Advocate, a national health concierge and benefits solutions company. The acquisition merged West’s communication technologies with Health Advocate’s expertise at supporting employer health benefits. As a result, Health Advocate now offers even more valuable insights and services to employers and their employees who face ongoing health- and benefits-related challenges.

“We offer an integrated approach that addresses the many different factors impacting claims costs and overall employee health,” explains Pam Mortenson, Health Advocate’s executive vice president, product strategy. “Many start-up companies in the wellness space only focus on solving one isolated area and miss the holistic perspective that’s needed to produce meaningful results.”

Mortenson says that Health Advocate’s clients and members face four main challenges. First, employees encounter risks associated with high-deductible health plans. Second, companies struggle to increase user engagement with their health programs at the same time that they want to see quick returns on their investments. Simultaneously, their claims costs continue to rise without a clear understanding as to the reasons why. And finally, employers often offer so many different programs that employees may not realize what is available or how separate services are all connected.

Health Advocate addresses these issues by simplifying and clarifying healthcare for its members. A consultative approach is used to garner information from members through health risk-assessment questionnaires and, in some cases, biometric screenings. Claims data analysis is also used to help spot gaps in care, such as missed physicals or inconsistent diabetes care management, as well as pinpoint sources of care costs and identify chronic conditions that may need to be addressed.

“We work with our clients to understand their goals and issues, and then we recommend services and programs that will help meet the needs of the employee population,” Mortenson says. “Otherwise, you’re throwing a lot of darts and hoping one or two of them actually hit something that produces the value you’re looking for.”

Once those issues and priorities have been assessed, Health Advocate helps employers connect appropriate programs and services to the right employees. This is accomplished through both print and digital communications, as well as person-to-person interactions. Employees can call a single number that connects them with a Personal Health Advocate. From this single point of contact, they can then get answers to questions about their health plan options or referrals for second opinions, among other types of assistance.

In addition to these interactions, personalized digital programs have also proven to be effective. The Smart Goals program, which recently completed its pilot phase, sends text messages about personal goals, such as daily diet and exercise reminders. The results have been staggering, as a reported 95 percent of participants completed the pilot program, 68 percent agreed to continue their participation, and a majority felt that the program helped them achieve their health goals.

In the spring of 2017, a major upgrade of Health Advocate’s member portal and mobile app was also rolled out. Improvements increased the ease of use as well as the value of the available information. Although available services vary by employer, members can find health plan information, health and wellness advice, health procedure cost estimates, information about various incentive programs and fitness challenges, and tools to help track their levels of participation in the programs.

Since the launch, member visits to the online portal increased by roughly 55 percent, and first-time downloads of the mobile app jumped by 129 percent. There have also been more than two million actions tracked indicating that members took specific steps to improve their health.

“The combination of so much information developed for specific users who can access it through so many different channels is what makes our approach successful,” Mortenson explains. “Having digital solutions in addition to live coaches and nurses enables us to address everyone’s preferences and a variety of needs.”

Mortenson often focuses with her clients on transitioning from traditional wellness programs that highlight physical

Pam Mortenson EVP, Product Strategy Health Advocate

Kyle O'Reilly/West Corporation

“Overall physical fitness is obviously important, but we have to be sure to meet the needs of the entire person.”

fitness to well-being initiatives that emphasize a broader view of holistic health. In addition to physical conditioning and healthy eating, for example, the well-being approach could include support and advice for chronic illnesses, education on planning for retirement, guidance on finding a physician, and referrals for substance abuse.

“Overall physical fitness is obviously important, but we have to be sure to meet the needs of the entire person,” Mortenson says. “That means going beyond traditional exercise and medical visits.”

Mortenson speaks from experience. As an avid runner, she rediscovered the sport when her late husband was fighting a terminal illness. In addition to strengthening her cardiovascular system, running relieved some of her stress and gave her extra energy to care for him and her family.

“Running was a huge part of how I got through a very difficult time in my life,” Mortenson says. “I wouldn’t have been able to care for my husband the way I did without the benefits I got from taking care of myself by getting out on the road every morning.”

As a firm believer in a healthy lifestyle, she welcomes the opportunity to deliver that message to Health Advocate’s customers as often as possible. AHL

Husch Blackwell Understands.

Healthcare leaders need legal partners who understand their complex challenges. Our healthcare team includes nearly ninety skilled attorneys—all with experience in your business. By collaborating across disciplines, we offer comprehensive counsel that addresses industry pressures, compliance constraints, and your unique business goals.

Husch Blackwell law firm applauds Pam Mortenson and West Corporation for their innovative work with Health Advocate, which improves the wellness of thousands of employees nationwide.

When Procurement Changes Meet

Measurable Results

Gary Foster explains how he helped dramatically improve Highmark Health’s procurement process and discusses innovations making a meaningful impact in healthcare purchasing

By Danny Ciamprone

Gary

VP of Procurement

The origin

of the phrase “may you live in interesting times” has been passed down for generations.

Perhaps no other industry today is better associated with that phrase than healthcare, and in particular the procurement process within the industry. In recent years, the number of new suppliers entering the healthcare industry has been substantial. According to the Centers for Medicare and Medicaid Services, healthcare spending in the United States reached roughly $3 trillion in 2016. Additionally, major technology companies such as Google, Apple, Amazon, IBM, Microsoft, and countless startups are looking to become part of the healthcare market accounting for record spending compared to years past.

So, to say it has been an interesting time for Gary Foster is putting it lightly. His years of expertise in procurement span a multitude of industries, including energy, technology, entertainment, and food and beverage, including AnheuserBusch—the largest brewer in the world.

“Gary has been a successful leader of change, transforming procurement methods through process optimization, datadriven decisions, and automation,” says Chris Simchick, founder and CEO of SDLC Partners, L.P. “Through our work as a business partner, we’ve seen how he propelled and enhanced business relationships, Highmark’s culture, and business results through collaboration and strategy.”

From his perspective as vice president of procurement at Highmark Health, Foster says the procurement process has some universal similarities across industries, but the rapid evolution of healthcare in the past few years has created

Foster

Highmark Health

complex processes. Contributing factors include multiple layers of regulations at both the state and federal level that are constantly changing along with growing concerns over data security and privacy. Further complications include new and major companies wanting to enter the market, as well as a lack of standards for categorization of expenditures in the healthcare industry.

“If you like to create new solutions and solve problems, then this is a great industry and a great profession to be in because there’s so much change and there’s so much volatility,” Foster says. “But at the same time, there are tremendous opportunities to introduce some new approaches that may not have been done before and to create partnerships with suppliers that haven’t been forged before. The adage in the healthcare industry that ‘We won’t solve tomorrow’s problems with yesterday’s solutions’ is probably truer today than ever.

It’s a mantra that Foster takes to heart, and that his peers are also recognizing.

“Highmark Health has consistently been on the leading edge of improving health outcomes and payer-provider collaboration, and Gary has played a crucial role in this effort by establishing strong, valuable business relationships that improve quality and enhance patient care,” says Dr. Emad Rizk, president and CEO of Verscend Technologies. “Verscend is honored to partner with Highmark Health to continuously improve healthcare.”

Foster spoke with American Healthcare Leader to discuss some of the key strategies he implemented, the improvements he’s observed, and the future of procurement in the healthcare industry.

“If you like to create new solutions and solve problems, then this a great industry and a great profession to be in because there’s so much change and so much volatility.”

One of the reasons you were recruited to Highmark Health a little more than a year ago was specifically to improve the procurement process. How did you go about doing that?

Having moved here from Texas, I can say this is not my first rodeo. My assessment of the department’s current state was informed by my experience in various industries. One of the first steps you have to take is a solid accounting of what the current process is, gather data on it, examine where the problems are, remove emotions and opinions, and look at the facts. You have to identify where the business is going to benefit from doing things differently. If you’re really going to try to implement wide-reaching change, then you have to have a clear understanding of what the cause for action is and how it’s going to help the business, particularly if you’re talking about something that addresses procurement processes. It’s one of the few internal business processes that connects with nearly the full spectrum of the enterprise. It spans the strategic business planning, marketing, technology, compliance, legal, and financial functions, among others.

Another thing that we introduced was Lean Six Sigma improvement concepts borrowed from the manufacturing industry. We applied them to the healthcare procurement processes. I’m not aware that this is common practice in healthcare, but I can tell you that the results are very enlightening to everyone involved.

The third piece of the puzzle is that it’s hard to change internal processes. I met with senior leaders regularly to explain the vision and how the new model would align with their business strategies.

Did you recognize any areas in the process that could be immediately addressed?

There were a lot of problems in role clarity—who’s supposed to do what at what point in the process. The way things were happening evolved over time, and people were interjecting themselves into the process without any planned rigor. There was valid perception of bureaucracy and lack of clarity in procurement. We hadn’t done a good job of laying out a streamlined approach, nor educating employees and reinforcing it.

One of those strategies you implemented involved category management, which is fairly unique to the healthcare industry. What was the result of that?

Using category management is a very successful approach for procurement in other industries I’ve been in. The concept is built around a thorough analysis of the annual spend across the enterprise. You take all of the third-party expenditures, and you put them into logical subgroups—not by business unit and not by supplier. That’s important, particularly in complex organizations, because you could have multiple business areas that are buying similar products or similar services and from the same or similar suppliers. That’s where you are looking to try and find the opportunity to achieve synergies and to manage spend at the enterprise level. Then, individual procurement professionals are assigned to one or two categories of spend to study and immerse themselves into that specific market. They also study the company’s expenditure patterns, as well as the drivers and trends, because we ultimately want these sourcing category experts to begin formulating a view of how can we optimize our spend across the company in each specific category. For example, marketing, IT security, and risk revenue

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services. These are multiyear perspectives that have to be communicated and bought into by the key executives of the business.

What has been the effect of these new procurement strategies?

The recommended changes were implemented faster than I had originally anticipated. One factor that helped accelerate this was collaborating with a unique internal team at Highmark Health that specializes in internal organization optimization, formed through hiring consultants from major firms and insourcing that expertise in the company. So, when we combined my vision for the target state of procurement with those consulting methodologies, we were able to quickly create a solid business case. That really became a tremendous catalyst for pursuing implementation and getting buy-in all the way up to the C-suite.

Another major factor was the excellent reception that I received from Highmark Health business leaders and executives. They were genuinely eager for us to raise our level of sourcing expertise, which in turn increased support for their teams and helped them execute their business strategies.

And I can tell you that it’s working. It’s our first year of operations utilizing the new model, and we exceeded the historical financial performance of the procurement function by nearly 50 percent. Our plan for our second year is to deliver another 33 percent improvement on top of the first year’s progress. We’re proud of that, and I’m extremely grateful for the willingness of my team to fully embrace and implement our new business model. They’re an outstanding group, and I’m really proud to work with them.

The Future of Procurement in Healthcare

Over the past few years, the city of Pittsburgh has become a hub for robotics and technology. But there’s another area of robotics that Gary Foster, vice president of procurement at Highmark Health, has observed that will be particularly important for the future of procurement: digital transformation tools and techniques including robotic process automation (RPA), blockchain, machine learning, and artificial intelligence.

There are a few RPA pilots underway at Highmark Health, but Foster believes nearly every transactional process will be revamped with some variety of digital transformational technologies and techniques over the next several years. That includes purchase order conversions, invoice and purchase order reconciliations, entry processing, and similar data review and entry processes.

“Imagine taking business requirements for a product or service and electronically pushing them into an auction tool, and then connecting up prequalified suppliers with their ordering processing computers and enabling this group of technologies to communicate with each other,” Foster says. “This isn't science fiction. I also think that there's opportunity for artificial intelligence and big data to do procurement contract document optimization. It’s an exciting time.”

Another factor in successfully improving procurement was aligning several different functions of Highmark Health. How did you go about breaking down those silos?

Throughout this implementation, we continually met face-to-face with business leaders and said, “Here’s what we see in the current state. Here’s where the problems are. Here’s a vision of where we want to go. Here’s how this is going to benefit you.” We were always focused on what’s in it for them because they are our clients.

And timing is everything. Just as we were creating the business case and preparing for the implementation, Highmark Health was adopting a new set of core behaviors to drive an enterprise-wide culture change built on four areas: customer-first, purposeful execution, trust in working together, and transformational leadership. The target state of the new Highmark Health procurement function was aligned perfectly with these new four core behaviors. AHL

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Navigating the Ins and Outs of Tax Compliance

NYU Langone Health’s Ed Berkovitz guards the institution’s nonprofit status and finds ways to save the organization money

By Peter Fabris

of healthcare industry consolidation shows no sign of slowing down. And today, decisions about joining forces with another healthcare organization and how to integrate the entities afterward are some of the toughest tests for leaders.

Indeed, mergers and acquisitions present many challenges for executives of institutions across the country, but one sometimes overlooked issue—tax compliance— should get more scrutiny, explains Ed Berkovitz, director of tax reporting and compliance for NYU Langone Health. Tax compliance is particularly important when a nonprofit organization affiliates or merges with other healthcare organizations.

Ensuring that a nonprofit hospital system, for example, maintains its tax-exempt status when it merges with other healthcare organizations can take considerably more effort than many leaders suspect. The consequences of failing to comply with tax regulations in such a case could put the organization at a risk of challenges to its tax-exempt status by various federal, state, and local regulators.

Berkovitz focuses on tax compliance matters for NYU Langone Health, a nonprofit health system that

operates more than two hundred locations in the New York metropolitan area. The organization has grown rapidly in the past decade through affiliation and merger and acquisitions, and that has been a major area of focus in Berkovitz’s seven-plus years with the organization.

While he can turn to others inside the institution and to outside consultants for help with accounting and legal questions, as a one-person department he bears the primary responsibility for tax compliance.

Though preparing annual tax compliance is a major responsibility, Berkovitz sets his sights on several other issues, including property and sales tax, post-issuance tax-exempt bond compliance, opportunities for tax credits, and reporting of charitable care. All of these matters impact tax reporting and compliance, and this wide scope of issues justifies having an executive dedicated to them, he says.

“The key reason for having a dedicated tax staff is to understand the issues better,” Berkovitz says. “Consultants may not be at the table when some of these issues arise.”

For example, when considering an acquisition or new venture, several tax issues have to be addressed immediately after a deal is finalized. Property, income, and sales tax

Ed Berkovitz Director of Tax Reporting and Compliance

“The key reason for having a dedicated tax staff is to understand the issues better. Consultants may not be at the table when some of these issues arise.”

implications must be considered, as well as possibilities for the application of potential tax credits and incentives. “We would have to work with our suppliers and vendors to make sure that the sales tax exemptions were applied to our activities where applicable,” Berkovitz says about the process following a merger.

Contracts for major ticket items would undergo particular scrutiny. Additionally, acquisition of property requires additional scrutiny to determine the applicability of property tax exemptions. Berkovitz would look carefully at the terms of the acquisitions, leases, and property uses to determine the necessary steps to seek property tax exemptions.

Tax considerations also crop up as nonprofits use tax-exempt bond financing. The terms of these bonds permit certain uses for the funds. For instance, the bond might be earmarked for renovation of a space in an office park for a specific use, such as an outpatient clinic, or to buy equipment such as an MRI machine or computers.

To comply with the terms of the bond, the organization would have to maintain regular records demonstrating that the space and equipment were being used as per the bond covenants. Recordkeeping may include the site’s floor plans and an accounting of how areas within are being used. A historical analysis of properties financed by tax-exempt bonds covering the life of the bond and any refinancings must be maintained, which may require going back to the original transfer deed, Berkovitz explains.

Keeping many types of documentation up to date is crucial to maintaining nonprofit status. With for-profit organizations now having a significant presence in the healthcare industry, regulators are looking closely at whether nonprofits deserve tax exemptions. “They are asking, ‘How is a nonprofit hospital different from a for-profit hospital?’” Berkovitz says. As a result, nonprofits have to be diligent in making the case for their continued tax-exempt status by scrupulously documenting items such as

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“We were able to use energy credits for a natural gas cogeneration plant that has made us more resilient in the face of a natural disaster.”

the level of charity care that they provide and any research and educational activity they conduct.

Another significant compliance area involves the unclaimed property reporting. Despite not being specific to tax-exempt organizations, it does garner Berkovitz’s attention. When vendors or patients fail to cash checks for payments or refunds, after a specified holding period the payments are considered unclaimed property by state governments. This can happen, for example, if a patient is issued a refund for an overpayment but does not cash the check. “The potential in terms of dollar amounts is significant,” Berkovitz says.

Healthcare organizations are required to account for this unclaimed property and try to contact the property owner. If they are unable to locate the property owner, then they are required to report and remit the unclaimed property to the appropriate state agencies. The state is then responsible for holding those funds in trust for the rightful owners. States may seek accounting records related to unclaimed property going back a couple of decades, Berkovitz says, and if the records aren’t available, then they use various extrapolation methods to determine the amount due. “I call it a tax on sloppy record keeping,” Berkovitz says.

Berkovitz also has opportunities to save the organization money by identifying eligible tax credits and applying for them. For example, when considering a new project, they seek to understand whether any tax credits or incentives would be applicable. The organization has also benefited from clean energy credits by switching to alternative energy sources. “We were able to use energy credits for a natural gas cogeneration plant that has made us more resilient in the face of a natural disaster,” he says.

It’s clear that Berkovitz’s efforts go well beyond oversight of annual tax filings. His sharp focus on tax issues benefits the organization by protecting its nonprofit status and even generating ways to offset expenses through tax credits and incentives. Given the current healthcare business environment, any large institution would be prudent to have somebody keeping watch over this key financial terrain. AHL

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From the Sunshine State

After discovering a passion for supply chain management while on vacation, Matt McGraw is now bringing an abundance of innovation to OSF HealthCare System

By Will Grant

to Improving the Supply Chain

Matt McGraw has a funny way of relaxing. “I’m probably one of the only people in the country that fell into my healthcare career while vacationing in Naples, Florida,” McGraw says with a laugh.

It is true, though. The now-vice president of supply chain integration for Peoria, Illinois-based OSF HealthCare System had to take some time off a few years ago, and he decided to accompany his father—an engineering and construction professional for a large healthcare organization—who had a new hospital to build in the Sunshine State. That vacation would ultimately showcase McGraw’s more salient qualities and jumpstart a career in supply chain, where McGraw’s passion and willingness to get dirty has been anything but relaxing.

While most people heading to Florida would have seen fit to set up shop on a beachfront for days on end, McGraw quickly found himself looking for something to do. He asked to head in to work with his father and volunteered to work for free. As he was helping the supply chain group haul equipment into the new hospital, McGraw had a chance encounter with the senior vice president of support services, who asked him if he had given any thought to getting involved in healthcare.

Matt McGraw VP, Supply Chain Integration OSF HealthCare System

“He didn’t know anything about me other than I was willing to come in and work without being compensated,” McGraw says. “Based on that, he was willing to take a chance.” McGraw soon moved to Naples to begin learning the industry.

McGraw believes that slowly working his way into new roles provided him not only a fundamental set of skills on the way up, but also incentivized him to continue his education. “Every position a person holds needs to be a stepping stone,” he says. “Whatever direction you’re going—up, laterally, or changing all together—you have to continue to learn.”

And McGraw’s interest and passion for supply chain couldn’t have come at a better time. “Supply chain is really coming into its golden age,” he says. “It’s definitely at the forefront of a lot of conversations right now.” In the wake of declining reimbursement models, fast-paced consolidation, and the search for a sustainable cost structure, McGraw sees supply chain in prime position to bear the weight and continue to find solutions for constant financial challenges in healthcare on the whole. “Financial challenges have created a burning platform for supply chain,” McGraw says. “Declining revenues mean you get a captive audience when you’re searching out supplyrelated savings.” Supply chain has found itself in the C-suite, and McGraw seems primed for the challenge.

As one of Healthcare Purchasing News ’ Elite 8, a distinction recognizing supply chain operations worth watching, McGraw has reasons to be energized. Along with more traditional functions, OSF is continually seeking innovative methods to make supply chain a revenue center. That includes managing a supply chain collaborative of 20–30 healthcare entities not actually owned by OSF. Through a partnership with OSF’s purchasing organization, Premier Inc., OSF is able to secure those independent healthcare entities at discounted costs that it would not be able to obtain on its own.

The partnership with Premier has further-reaching revenue implications as well. OSF will act as a licensed implementer for Premier’s enterprise resource planning (ERP) system. OSF’s partnership with Premier and successful implementation of the ERP software has helped net savings of about $32 million since January 2016, and McGraw sees the success as one to leverage. “Because we have operational knowledge of that software and we’re supply chain and finance people, it makes for better implementation of the product,” he says.

A New Kind of Revenue Center

OSF is still in the early stages of developing a consolidated services center on the north side of Peoria, Illinois, but regardless of the specifics, Matt McGraw says it’s going to dramatically change the supply chain.

The fifty-acre campus “will allow OSF HealthCare to consolidate administrative operations teams that work closely with each other, including human resources, accounts payable, finance, facilities management and construction, pharmacy, and supply chain,” according to OSF. Additional services being considered include internal self-distribution, pharmacological distribution, sterile processing operations for surgical instruments, custom pack building for surgical packs, and food preparation and distribution services.

“Because we have operational knowledge of that software and we’re supply chain and finance people, it makes for better implementation of the product.”

The implementation of the new Premier ERP system is part of OSF’s system-wide functional transformation. The ERP has enabled McGraw’s team to condense the system implementation time from nearly six months to between forty-five and sixty days and on-site deployment support to fewer than two weeks. McGraw sees the benefits as multifaceted. It doesn’t wrap up resources. Instead, it’s its own advertisement for OSF’s implementation services, and as OSF continues to acquire new hospitals, it has standardized a process that is now easily repeatable. Its ease of access to data serves to further enhance Premier’s benefits.

“The system is bringing visibility to our data and putting it at the fingertips of users,” McGraw says.

OSF’s plans to open a consolidated services center in Peoria will only further reinforce supply chain’s continued and expanding role in generating revenue. The 75,000 square feet of office space and 270,000 square feet of warehouse space will include consolidated administrative operations teams and more. It’s yet another project that may not have concerned supply chain in the past, but now has the department's full attention.

McGraw says the potential seems limitless, and those prospects seem to carry extra weight coming from someone who discovered his livelihood while he was supposed to be vacationing. AHL

The Truth Is in the Data

TriHealth’s Donna Peters on cultivating servant leadership and a customer-focused response through numbers

By Will Grant

Donna Peters

loves math. In fact, the IT director of Applications Solution Center at Cincinnati, Ohio-based TriHealth says being able to find a definitive answer fits her personality perfectly. But its simplicity often only exists in the theoretical. “I’m a blackand-white person who lives in a world of gray,” Peters says with a laugh.

The complexities of managing a team of 105, most of whom work remotely, seem to blur colors immediately. But when Peters and her team reviewed their customer service and employee engagement surveys, the data didn’t lie, and Peters knew a change was necessary. Since then, TriHealth has undergone a radical transformation, emphasizing servant leadership and employee engagement—factors that have provided Peters with numbers to smile about.

The spark for TriHealth’s radical IT overhaul was initially the result of a few high-level retirements in 2016. Rather than simply fill vacant staff positions, Peters and the executive director of IT operations, Cathy French, decided to take a step back and reflect on the way that TriHealth’s IT team conducted business.

French, who Peters credits not only as her greatest mentor but also as one of the main reasons that she has been at TriHealth for two decades, challenged Peters to imagine a completely new way of organizing her team. Peters’s pragmatic approach meant, in her own words, “reorganizing a lot of boxes” on a page. It wasn’t until French literally crossed out all of those boxes and instead drew a circle that Peters really understood the magnitude of the project she was taking on. The way her team interacted needed to transform.

Peters saw good reason for the transformation. After pulling customer service satisfaction numbers, she began to see a theme: too many calls were being transferred, and it was taking too long, sometimes days, to provide the assistance necessary to close those tickets. In addition, employee engagement numbers seemed to indicate that a considerable portion of team members didn’t feel engaged or valued in their positions. It was too much for Peters, who assumed her role in December 2015 and is, admittedly, “crazy competitive.”

“Every competitive bone in my body went into overdrive,” Peters says. “If the data isn’t the strongest burning

Peters IT Director of Applications

Center

platform for why we need to make a change, then I don’t know what is.”

Encircling that page of boxes suddenly seemed to make sense. It was time to tear down walls that, while emphasizing specification and singular expertise, were leading to no single individual feeling responsible for the overall customer experience. “The doctor who calls us doesn’t care what the product is. If the experience isn’t working, then they don’t want to hear about our problems,” Peters says. “They just want help as quickly as possible.”

The goal, then, would be to train team members to take ownership of the entire customer experience, not just their specific purview. “The ‘that’s not mine’ mentality no longer existed,” Peters says. “That was world-rocking.”

The widening of responsibility and scope was not one that Peters or French took lightly. The night before they would meet their entire team with the restructuring news and after attending a conference, the two sat up until the early hours of the morning in a hotel room in Las Vegas trying to understand the plan’s implications for every single member of their team. “That was our big Vegas experience,” Peters says with a laugh. “Eating junk food in a hotel room and trying to see this from every possible person’s chair.”

While realizing that shift might be difficult, Peters says she wasn’t quite ready for the magnitude of the transition. Within three months, 13 percent of the Applications Solution Center’s team left, including colleagues that Peters had come up with through the company. The emotional strain was severe, but Peters says it also paved the way for new hires who were prepared to be more experiencefocused. The infusion of new ideas and talent provided a

“Every competitive bone in my body went into overdrive. If the data isn’t the strongest burning platform for why we need to make a change, then I don’t know what is.”

Donna

Solutions

TriHealth

Quality Staffing & Consulting Services

“People take pride in knowing that they’re part of our story and journey.”

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new foundation rooted in servant leadership. “It was some of the hardest work I have ever done,” Peters says. “But we’re now measuring our ticket closes in hours instead of days.” Customer service scores currently measure at about 93 percent, as well.

Meanwhile, leadership at TriHealth sought to better engage its workforce and build a culture of employee engagement, which focuses on team member recognition. More time at meetings was devoted to recognizing team members’ efforts and accomplishments. “People take pride in knowing that they’re part of our story and journey,” Peters says. “We make sure we keep that front and center every single team meeting.” As service numbers began to increase, Peters says the team took over leadership’s motivational push. Encouraging that positive momentum has become part of the overall culture at TriHealth. Employee engagement scores currently measure at about 92 percent.

Peters says that while pushing ahead, she’s working to ensure that all team members are able to increase their breadth of knowledge so as to be as effective as possible in all aspects of the customer experience. Initially, as team members transitioned to more responsibilities, no employees were sent for additional training outside of TriHealth. The effectiveness of that cross-training and education in-house is a success that Peters hopes to leverage to its fullest capacity as team members continue to broaden their base.

While such a radical transformation meant many long nights and some serious growing pains, Peters is pleased to say the data doesn’t lie. “We’re providing better service to our patients and caregivers, and our team members feel that what they’re doing is meaningful,” she says. Those numbers, at least, are pretty black-and-white. AHL

In proud support of Donna Peters, our valued partner at TriHealth.

Policeman, Fireman, Medicare Biller?

It might not be on a short list of dream jobs for many, but Kraig Couture has put his finance skills to use to give patients an ideal billing experience and drive revenue for Vibra Healthcare—finding a dream job along the way

By Lior Phillips

“Nobody grows up saying, ‘I want to be a Medicare biller,’” says Kraig Couture, vice president of revenue cycle at Vibra Healthcare. Despite that fact, the healthcare industry continues to see more and more patients each passing year, which means more and more bills need to be filed, processed, and collected. The increasing complications of the insurance industry only make those demands more pressing.

Couture might not have grown up wanting to be in the healthcare industry—or a revenue cycle expert for that matter—but after high-level accounting stints at major organizations like 20th Century Fox and ITT Sheraton, he found a new home at Vibra. Couture was hired initially as chief financial officer for two of the system’s hospitals, though he didn’t expect to get an offer. “I honestly didn’t think I would get the job, but I thought my strong accounting and finance background would be beneficial,” he says. “I realized in the interview process that knowing healthcare wasn’t the sole concern. As long as you had a strong, diverse background, you would do very well.”

There was a learning curve, to be sure—even in terms of language. The healthcare-specific vocabulary and acronyms added a layer of difficulty to the already complex financial work. But Couture had already worked in many different fields, each with its own methodology and mission. In fact, his first job as a teenager working in fast food actually proved to be a recurring source of inspiration. “A lot of the customer service-focused work at McDonald’s has been useful for my whole career,” he says. “McDonald’s biggest thing is customers. When I started in healthcare, others would laugh when I called people customers in meetings. But though they might be our patients, they’re really our customers, and we want to leave them with the best impression of our company.”

One of the best ways to leave that lasting impression is by providing patients with a positive billing experience. Early in his tenure, Couture wrote a white paper that proposed consolidating billing operations across the company—a move that would make a major impact on the

growing organization. “In previous roles, I saw why standardization works and how consistent documentation procedures, training, and streamlined processes saved money,” he says. Eventually, the grouping of hospitals grew from six to more than fifty, the team that had been bringing in $1 million a month was bringing in $80 million, and Couture rose to the position of vice president of revenue cycle.

Couture, however, still gets hands-on with every step of the process. He designed the structure of the office. In fact, he stays up-to-date on all the necessary details to keep things functioning smoothly. “Unless you are in the departments with the staff helping out when needed, you won’t know what’s going on,” he says. “Every position in the business office is equally important as the other, and you have to be willing to jump in and help whenever and wherever help is needed. Leading by example is so important to the staff, along with having a strong management team to support you and your vision. I have to have the pulse of what’s going on because healthcare is always changing.”

Even after providing the best care possible, an incorrect or mishandled bill will leave the patient with a bad reaction. Vibra Healthcare focuses on providing the best possible experience. But on the rare occasion someone

Kraig Couture VP of Revenue Cycle

Vibra Healthcare

“Unless you are in the departments with the staff helping out when needed, you won’t know what’s going on.”

isn’t happy with their experience, Couture and the team have committed themselves to going above and beyond to connect the patient with the right office to find an answer. Essentially, Couture wants every person who gets off the phone with the billing department to come away ready to recommend Vibra to a friend in need.

But, of course, proper billing is essential to the organization, too. In order to keep the hospital running, the team needs to not only bill patients, but also collect on payments. Learning that element of the business and how best to work with payers and insurance companies provided a major challenge early in Couture’s career. However, by this point, it’s become an area of strength. By working with technology and billing vendors, Couture has helped Vibra further automate, streamline, and bolster processes to continue to drive growth. By billing out over 75,000 claims a year and accepting over 145,000 payments, Couture and his team continue to look for ways to streamline the revenue cycle.

And though there might not yet be many kids growing up dreaming of a career as a Medicare biller, Couture knows firsthand there’s plenty of opportunity for an individual with a strong accounting skill set to make a real impact on the health of others. “We have some employees who have absolutely no healthcare experience who have done very well because they come in like a sponge, wanting to learn,” he says. “I didn’t have a healthcare background, and I’ve done pretty well.” AHL

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CaptureNet’s software and service hybrid solution combines intuitive software, intelligent analytics and premium service to improve net collections of patient responsibility receivables by an average of 26% and doubling operational efficiency historically delivered by outdated in-house methods and third party letter service, outsource, EBO, and early-out tools.

Risk

Warrior

Leigh Hickman is CaroMont Health’s top legal warrior and, one might argue, its top worrier. She’s taken risk management under her wing so that the rest of the organization can attend to its mission of healing.

By Russ Klettke

Throughout history,

healthcare’s guiding principle has been “do no harm.” That adage, of course, suggests an avoidance of risk. But it’s Leigh Hickman’s job to seek out risk and stare it in the face.

Hickman is the chief legal officer at CaroMont Health, a regional health system with a large network of physician practices, urgent care, hospice, emergency facilities, and a 435-bed regional medical center. She took on the job of creating an enterprise risk management program in 2017 for the nonprofit hospital with one clear objective: provide the best care for patients.

In this day and age, risk management in healthcare organizations has to go beyond clinical care. Hospitals, physician practices, pharmacies, and other allied healthcare providers are businesses as well, even if they’re operating as nonprofits. Considerations such as market share, governance, and human resources have to work properly and add value, not detract from it. And lest anyone assume risk management

is a theoretical construct, Hickman can relate from firsthand experience that it’s really something much more pragmatic.

“A restructuring of the organization in early 2017 relegated risk management to me,” says the attorney, whose career began in medical malpractice litigation. “We thought we were doing pretty well managing clinical and related legal risks, but there were other operational roles to consider.”

As she evaluated the risk program, Hickman noted that risks were being assessed in silos, and that there were big unknowns. “I wondered if we were effectively managing them or if we had just been lucky,” she says.

Those unknowns included business concerns such as market share. Based in Gastonia, North Carolina, which is in the greater Charlotte metro area, CaroMont is surrounded by major hospital systems. As a communitybased system, factors such as the distribution of CaroMont’s providers can make a major difference in how resources are utilized and how they can impact the hospital system’s overall financial health.

Dodie Huffman

Hickman Chief Legal Officer

Hickman’s enterprise risk management steering committee followed a process that first assessed where there might be things to worry about. They surveyed CaroMont’s leadership and key managers to create a list of vulnerabilities that they could take action on in a 12–18-month time frame.

Making this work required leadership and support from the board of directors, Hickman says. The board restructured some director committees and incorporated risk management into committee and staff accountabilities. With risk being treated as a priority, staff at all levels gained a clearer understanding of how to identify and manage risk.

This comprehensive approach has already yielded cost-saving efficiencies. For example, they discovered four different departments were addressing employee safety issues in their own silos. “Just bringing people together helped us figure this out and allowed the departments to work together more efficiently and effectively,” she says.

However, it’s not always a cutand-dried matter. EMRs are a perfect example of this concern at CaroMont. The organization is moving ahead with improvements to its EMR database, but in doing so Hickman and the company must also begin to think about cybersecurity threats.

These cybersecurity threats are a catch-22 for healthcare providers. Modernization of EMRs is necessary and incentivized in the ACA. Yet this digitization of information is then vulnerable to privacy breaches, financial exposure, and possibly even operational shutdowns. For example, a ransomware

Leigh

CaroMont Health

virus in July 2017 called Petya infected computers in several American hospital systems to such an extent that at least one system operating in three states disabled its entire IT system, causing the operation to revert to paper records for a time.

But rather than panic about these issues, Hickman says they go about managing risks like this methodically. “We look at industry best practices,” she says. “Everyone is concerned about cybersecurity concerns such as ransomware. We engage technology to assess risks and to put safeguards in place.” But as with other organizations on guard against this, she says their best weapon is education. “The biggest risks are with employees. We teach them to be smart when it comes to suspicious email.”

Hickman’s measured approach to risk management has established her as a trusted partner and leader within the industry.

“Leigh is an outstanding professional and a true asset to CaroMont,” the medical malpractice team at Shumaker, Loop & Kendrick LLP said in a statement. “She is an innovative, efficient, confident, and bold leader. It is a pleasure to work with her.”

Hickman and her team at CaroMont know that being risk averse does not equate to an avoidance of innovation and progressive approaches to healthcare delivery. In fact, CaroMont was an early adopter in the ACA’s accountable care organization (ACO) program, which simultaneously seeks to reduce the costs of caregiving while improving patient outcomes. The savings from this program, shared with Medicare, totaled more than $11.5 million in its first three years of implementation. Quality-of-care performance results in 2016 were at or above the national mean in almost every measure. And Hickman believes that by managing risks effectively, CaroMont can continue to devote financial and staff resources to innovative programs like the ACO, which improves the care provided to patients.

Hickman says the enterprise risk management program is new enough that there isn’t an established measurement formula to gauge its success. “But I look forward to seeing how this impacts the board’s strategic thinking going forward,” she says. AHL

“We thought we were doing pretty well managing clinical and related legal risks . . . but I wondered if we were effectively managing them or if we had just been lucky.”

Our female healthcare attorneys are thrilled to congratulate

on her outstanding leadership contributions as Chief Legal Officer of CaroMont Health. It is a privilege to be a friend and trusted partner throughout her continued succes s. slk-law.com | Shumaker is a 260 strong, full-service law firm.

Lisa Hoffman

Karen Stiles Brooke Loucks

Stacy Stevenson

Jeffrey A. Flaks President, COO Hartford HealthCare

Chris Rakoczy

Healthcare

Without Borders

Although Hartford HealthCare has been making an impact for patients for more than one hundred years, Jeffrey A. Flaks explains why it’s the healthcare system’s mission to make a difference in Connecticut’s communities and beyond

By Danny Ciamprone

He was

just sixteen and behind the wheel of his local pharmacy’s delivery car. Jeffrey A. Flaks was driving through New Haven, Connecticut, dropping supplies at nursing homes, assisted living facilities, physician offices, surgical centers, and community hospitals. It was his first job in high school, and he was already developing relationships with caregivers in a variety of settings, seeing empathy and compassion firsthand.

Perhaps the values he learned along that route led him to Hartford HealthCare. Or, perhaps the notion of giving back and caring for others was simply ingrained in him for as long as he can remember. Growing up, Flaks’s grandfather taught him that he had an obligation to make the world a better place.

“There was this notion, in many ways, of having the willingness to dream, to think big, and to appreciate that we have a great opportunity to contribute, to make a difference, and that we have an obligation to do the very best that we could,” says Flaks, president and chief operating officer of Hartford HealthCare.

His parents were public school teachers, and, along with his grandfather’s words of wisdom, they taught him the importance of integrity, caring, excellence, and trust—all of which he has brought with him to Hartford HealthCare, Connecticut’s most comprehensive healthcare network. It’s not only the renowned specialists that are viewed in the highest regard, but also the entire organization’s commitment to give back to others. It’s a tradition that dates back more than a century.

“We have a very strong focus within our health system on that tradition of really understanding our responsibility to contribute to the health and well-being of our community,” Flaks says. “It’s the area of my own work that gives me the greatest personal fulfillment, the greatest satisfaction and pride to know that I have this opportunity to be part of an organization that values community like we do and substantially makes a difference.”

There are three programs in particular that stand out for Flaks that demonstrate the substantial difference the hospital system is making in the Hartford area.

“We have a very strong focus within our health system on that tradition of really understanding our responsibility to contribute to the health and well-being of our community.”

Hartford Promise

Several years ago, Hartford HealthCare made a commitment to help at-risk youth in the state’s capital enroll in college. Hartford Hospital is the region’s Level 1 trauma center. Flaks and the leadership team recognized that healthcare and socioeconomics go hand in hand when it comes to well-being.

Through the Hartford Promise program, students can qualify for a full scholarship to a four-year college. To be eligible, students must maintain a 3.0 GPA, have a 93 percent attendance record, and be a resident of Hartford throughout their high school careers, and they must have attended a Hartford public high school since ninth grade.

“We are really committed to the Hartford Promise,” Flaks says. “It makes a generational difference in people’s lives and the future of different families.”

Home Ownership Incentive Program

Proving that socioeconomics and healthcare directly tie together, Flaks and his team also helped launch Hartford HealthCare’s Home Ownership Incentive Program (HIP), which created a loan that covers the closing costs of a home purchase for employees. Through the program, Hartford HealthCare provides a structured forgivable loan with debt that can shrink over a number of years. It assists staff members in buying their first home in designated areas of the capital city.

“I personally attended the closings for a number of these homeowners, and it’s watching people realize the American Dream,” Flaks says. “In many instances, these are people who have never lived in a house that they’ve owned in terms of their upbringing or family, and when they go and sign those documents, and are given the keys

“We have a great opportunity to contribute, to make a difference, and an obligation to do the very best that we can.”

Chris Rakoczy

and walk through their own front door—to witness it is really overwhelming.”

For Hartford HealthCare and its staff, investing in neighbors and communities is creating vitality. “We’re reinventing the strength and sustainability of the city of Hartford, and we’re helping staff members of our organization begin to create that pathway to their future and get equity. That’s a special thing,” Flaks says.

Take Charge of Your Health

In 2012, Hartford HealthCare officially launched Take Charge of Your Health, a program designed to help communities most affected by health and healthcare disparities to address health issues and improve their well-being. Having reached more than three thousand people in the Hartford area, Flaks says the program brings mobile screenings—such as mobile mammography, prostate screenings, and blood draws—directly to people in culturally sensitive ways.

“We connect people to healthcare,” Flaks says. “There have been so many examples of people through these screenings and through these processes where we’ve identified their life-saving health circumstances.”

Just as Flaks recalls the route he drove as a sixteenyear-old, these programs are creating an avenue to connect people in the community with the same values his grandfather taught him years ago. Now he’s seeing those same values imbedded every day in the culture of Hartford HealthCare.

As Flaks explains, everyone in the hospital system is encouraged to make a difference. The team starts with a daily huddle, focusing on recognition, communication, innovative ideas, and quality improvement. It’s referred to as H3W, or How Hartford HealthCare Works.

“Our staff understands that they can make a contribution to make a difference,” he says. “They are expected to contribute ideas, they are expected to be part of quality improvement initiatives, they recognize each other in this process, and they communicate together.”

Giving Back from Connecticut to Puerto Rico

Hartford HealthCare has been giving back to the community for decades. So it’s no surprise that when Hurricane Maria struck Puerto Rico in 2017, staff members came together to launch Hartford HealthCares to raise funding for a generator in Hartford HealthCare’s sister hospital, Hospital General Castañer.

Jeffrey A. Flaks says the hospital system has recognized the impact it can make in the Hartford community, and now that same impact is being felt outside of the city’s borders.

“It’s really a way that we can galvanize the strength and resources and commitment of our organization when anything like that would occur, whether it's local, national, or otherwise,” Flaks says.

And that culture resonates throughout the organization, starting with leadership, as Flaks and CEO Elliot Joseph lead with a coach’s mentality. With a strong relationship that dates back more than twenty years, Flaks says they have a willingness to take calculated risks, and the notion of giving back and paying it forward is a passion they’ve transcended throughout the organization.

“When you see the way that we’ve created boundary-less healthcare and the capacity to improve quality, it’s absolutely phenomenal,” Flaks says. “We’ve really become a health system through integration that has the capacity to provide personalized, coordinated care in a way that adds tremendous value to our individual patients and to our community.” AHL

Management is about persuading people to do things they do not want to do, while leadership is about inspiring people to do things they never thought they could.

~ Steve Jobs

Hartford HealthCare offers gratitude and congratulations to our president and chief operating officer, Jeffrey Flaks.

You represent everything a leader should be. And more.

Thank you for bringing our values to life and helping us create healthier communities. Thank you for your vision, commitment and inspiration.

A Look Through the

Caring Lens

Faiyaz Bhojani’s approach to well-being isn’t a project. It’s a philosophy.

By Jeff Silver

As a member of Royal Dutch Shell’s health global leadership team, as well as leading the health function in the Americas, Faiyaz Bhojani works tirelessly with a cadre of professionals to address the health and well-being, occupational and environmental health, and safety of employees and the communities they work in.

Bhojani says that the health leadership team has developed an innovative approach to create what he calls a Culture of Health philosophy. Culture of Health is transforming the boundaries of traditional corporate health and wellness by creating an ecosystem at work, which emphasizes basic drivers of human behavior such as economic, social, and psychological well-being, and then combining those with efforts to nurture individual optimism, resilience, hope, and self-efficacy. The goal is to help employees be the best they can be in all facets of life.

“Today’s work environment is filled with change and uncertainty, which the brain perceives as threats. That negatively impacts decision-making and problem solving,” Bhojani explains. “If we create an environment that fosters positivity, then our brain perceives it as a reward, which helps increase engagement, collaboration, creativity, and innovation.”

Shell assists in this approach through creating an enabling work environment supported by tools, activities, and policies. That includes healthy cafeteria food choices, healthy cooking demonstrations, collaborative workspaces, fitness centers, walking trails, smoking cessation, and fatigue management. Collaborative, individual, and team contests—such as a Fitbit step challenge—as well as standing and walking meetings, encourage physical activity. These all contribute to creating a supportive environment that fosters healthy behaviors.

Sessions focused on building resilience have also replaced stress management and are among the more unique aspects of performance. These voluntary groups address topics such as building a positive culture, maintaining a hopeful outlook, nurturing a positive selfimage, and accepting change. Organizational surveys have consistently shown a positive correlation between session participants and increased engagement that lasts more than two years after participating.

“We need to look at everything that we do through a lens of care,” Bhojani explains. “In the same way that we look after our children, we need to do the best for our employees. If they feel that we’re truly caring for them and helping to make them the best they can be, then they will give their best efforts in return.”

Faiyaz Bhojani Regional Health Manager, North and South America Shell

“By not just talking the talk, but walking the walk, we create an inspiring and empowering environment. It’s leadership by example and through commitment.”

Since implementing this approach, leaders at Shell are asking important questions such as, “How did you perform when you worked for an uncaring supervisor,” and, “How was your performance impacted when you worked for a supportive supervisor?” Using recent developments in topics such as neuroscience and brain functioning, Bhojani says the company has built a case for the approach that senior executives are starting to model. For example, they go to the fitness center during business hours and have implemented a new maternity policy that provides 120 days of paid leave globally, which is above and beyond the legal requirement, Bhojani says.

“By not just talking the talk, but walking the walk, we create an inspiring and empowering environment,” Bhojani says. “It’s leadership by example and through commitment.”

Bhojani characterizes all the progress that’s been made in creating a culture of health and care as a team effort by a group of sincerely passionate, committed, and visionary people. And the results of this cultural change journey have been noticed externally. Shell Health has been recognized by the American Heart Association, the US Chamber of Commerce, Houston Business Coalition on Health, and the Health Enhancement Research Organization. Bhojani says he is proud and humbled by the recognition, but there is still a long way to go.

In fact, throughout this journey, Bhojani has been influenced by his father’s advice: “Nothing is impossible.” In

one notable instance, Bhojani persevered through four levels of establishment at the University of Texas School of Public Health even after multiple administrators insisted on enforcing their requirement for GRE and the Test of English as a Foreign Language scores. This was in spite of the fact that he had already completed medical school in Pakistan—in English. Ultimately, he met with the school’s dean, whom he convinced to waive the requirements.

Bhojani imparts that same persistence and willingness to question authority to his own team.

“When something is proposed, I always encourage my team to ask, ‘Why are we doing this, and how does this help our people?’” he says. “On the other hand, when we’re told we cannot do something, I always ask, ‘Why not?’ It’s how I empower and inspire my team.”

As he looks to the future, Bhojani sees a work environment that will be drastically different from today’s. He believes automation, robotics, artificial intelligence, machine interfaces, and remote employment will create an entirely new landscape with continual change and uncertainty that companies need to start planning for now.

“I am surprised that so many large organizations still look at developing and rewarding people, performance, and health and wellness with a twentieth-century perspective,” Bhojani says. “How we work will completely change in the next 10–20 years, so I trust we can help organizations now to start adapting to and coping with what’s coming.” AHL

www.huronconsultinggroup.com

LE

Healthcare is one of the most complex industries for practicing law.

To succeed in their roles, these executives have learned to balance a risk-taking attitude with surehanded guidance so their teams and companies may thrive.

Jason Marks assumed the challenge of putting Valeant Pharmaceuticals’ legal issues in the past. Now he’s working to secure its future.

By Joe Dixon | Photos by Gillian Fry

JASON MARKS SVP, Head of Litigation and Government Investigations

Imagine a line of passengers waiting to board a plane. The gate agent gets on the intercom to let everyone know that boarding is about to begin. The agent also has one other announcement: engineers will be finishing construction of the plane during the flight.

Most people would run the other way, demand refunds, or book another flight. But Jason Marks, senior vice president and head of litigation and government investigations at Valeant Pharmaceuticals International, Inc. would be the first person to board the plane. By takeoff, Marks would be helping complete construction, as well as piloting the plane to its destination.

This is indicative of Marks’s approach to life: he sees complex challenges that others might fear as exciting opportunities, and he relishes the opportunity to tackle them. So, in November 2016, when he was offered a position to join Valeant and create a litigation and investigation function from scratch, he says he couldn’t resist the chance to oversee some of the highest-profile and complex litigation and investigations in the life sciences industry.

“The company was in the middle of a storm, and I pride myself on being able to build something sustainable in the middle of a hurricane,” Marks recalls. “Valeant needed someone to take control and right the plane, and I knew I could help steer the company out of harm’s way.”

It was an undertaking that few have experienced. When Marks started, Valeant was facing multiple government investigations and three securities class actions, including one of the largest securities class action lawsuits in United States history. In his first year with the company, he resolved two of these class actions, in addition to multiple government investigations, and he cleared the docket of dozens of preexisting litigation matters.

While he was tackling these major legacy litigation and government investigations matters, Marks also needed to devise a strategic plan to ensure these successes were sus-

tainable. To do that, he worked with other legal partners, many of whom are quick to praise his ability to undertake large-scale initiatives like this one.

“As outside counsel, I have had the pleasure of working closely with Jason,” says Paul Curnin, cochair of Simpson Thacher & Bartlett LLP’s litigation department. “He is an excellent leader, savvy and strategic, deeply committed, and always up for a challenge.”

While facing this particular challenge, it became apparent to Marks how Valeant could significantly improve its future. To meet this goal, he created the legal operations function at the company and established its enterprise risk management office. Neither had previously existed at the company.

Marks knew that creating a legal operations function would be essential to building a legal infrastructure that would address the needs of the company. To complete this task, core tools had to be implemented in order for Valeant’s legal team to conduct its day-to-day work, while dealing with the legal challenges that were necessary for the company’s survival.

“We cannot run a multibillion dollar organization’s legal function without various enterprise legal management systems,” Marks explains.

We congratulate our friend Jason Marks of Valeant Pharmaceuticals on his continuing leadership and accomplishments. It is our pleasure to work with Jason Marks and Valeant Pharmaceuticals.

We are 725+ lawyers serving clients from 13 offices located in the leading financial and business centers in North and South America, Europe and Asia. The world’s leading organizations, companies and corporations choose us to be their representatives in their most critical situations. But more, they consider Proskauer a strategic partner to drive their business forward. We work with Fortune 500 companies, asset managers, major sports leagues, entertainment industry legends and other industryredefining companies which are changing how business is conducted today as well as tomorrow.

“None of these things existed prior to my arrival at the organization, and lawyers were reviewing stacks of paper bills that accounted for millions of dollars.”

Within his first three months at Valeant, Marks developed a legal billing and matter management system. Since then, he has implemented an electronic contract management system and an electronic document hold system. He also has explored other tools, including artificial intelligence programs, to optimize and improve the team’s efficiency. Additionally, he’s ramped up hiring in the legal operations department, including bringing on a director of legal operations.

“None of these things existed prior to my arrival at the organization, and lawyers were reviewing stacks of paper bills that accounted for millions of dollars,” Marks adds.

“Jason strives to improve everything he touches, and he has been doing so for years,” says George Apostolides, partner at Saul Ewing Arnstein & Lehr, one of Marks’ outside legal partners. “He is the kind of in-house counsel who we at Saul Ewing Arnstein & Lehr like to work for: passionate, driven, and relentlessly pushing for excellence.”

The presence of the legal operations team made an immediate impact on the company. In less than one year, Valeant saved more than $4 million simply by reviewing and cutting legal bills. The company also saved more than $20 million in 2017 by driving discounts with firms and vendors, Marks notes.

The benefits of the legal operations department go well beyond improving the company’s ledgers. The newly implemented electronic management systems provide Marks and his team a central repository to manage the company’s ongoing litigation, investigations, and other legal matters. Marks is also working on making this repository accessible to Valeant’s outside counsel so that they can manage case dockets on their own. This will enable his in-house attorneys and paralegals to be more efficient, he says.

Simpson Thacher Proudly Supports the Work of Jason Marks

Senior Vice President, Head of Litigation and Government Investigations at Valeant Pharmaceuticals

We Applaud Jason on His Vision and Industry Leadership

“I only want to bring in the best and the brightest. I want to bring in people who will help make a difference.”

Eventually, Marks anticipates that the system will be used to house drafts of legal documents, which will allow people to make and track revisions to documents in real time. System enhancements also have provided consistency and transparency when preparing for internal audits and public disclosures. Marks’ team can now easily create customizable lists and flag matters that could cause reputational harm, meet certain materiality thresholds, or require public disclosure.

Although creating the legal operations department to help manage litigation cases was an immediate task, Marks also realized there were no mechanisms in place to assess the total risk the business was taking at a given time or to establish risk tolerance. So, to ensure the company is able to properly address risk moving forward, Marks spearheaded the creation of Valeant’s enterprise risk management office.

“Every company does a risk assessment, but we’re taking that risk assessment to the next level by embedding it directly within senior leadership,” Marks says. “We don’t just want to know what the risks are; we want to know what’s driving the risks. Then, we can put action plans in place to address and mitigate the risks.”

Even with Marks’ willingness to jump into the fray, the ability to gain traction required the support and collaboration of a dedicated legal team. The key to the success of these initiatives so far has been hiring the right people and leading authentically, Marks explains.

Arnold & Porter Kaye Scholer LLP proudly congratulates

Jason M. Marks Senior Executive and Global Life Sciences General Counsel

Valeant Pharmaceuticals on being named an American Healthcare Leader.

apks.com

“People can be nervous to hire good people, because they are afraid that their talents might outshine them,” Marks says. “I’ve never been concerned about that. I only want to bring in the best and the brightest. I want to bring in people who will help make a difference.”

The other aspect driving the success of these projects is leading in a way that engenders respect, loyalty, and teamwork. To accomplish this, Marks always supports his team, even through mistakes, and provides employees with continual and constructive feedback about their performance. Letting his team know that it is OK to fail is critical for developing a trusting relationship, he says.

His success also stems from Marks’ philosophy about his own work. Whether it’s leading legal functions of a major pharmaceutical company or guiding a plane through turbulent weather, he wants to inspire his team to perform their jobs with the same passion he does.

“Throughout my career, my mentality has been that if there’s a problem that needs fixing, I volunteer to do it,” Marks says. “It’s what has propelled me through my career: to never shy away from responsibility, never fear failure, and always look for things that will help me learn, grow, and improve.” AHL

Jackson Lewis P.C. is a law firm with more than eight hundred attorneys in major cities nationwide serving clients across a wide range of practices and industries. The firm’s commitment to client service, depth of expertise and innovation draws clients to Jackson Lewis for excellent value-driven legal advice.

Greenberg Traurig, LLP:

“Jason Marks is a strong leader with intense loyalty and dedication to his in-house team and his outside counsel. He is incredibly smart, strategic, decisive and innovative. His dynamic leadership and unparalleled focus make him a tremendous asset to his internal clients. We are proud to have him as a client and friend.”

–Lori Cohen, Shareholder

Jackson Lewis P.C. Proudly Supports

Jason Marks and Valeant Pharmaceuticals

“THE JUDGE GOES TO THE GROCERY STORE”

Gina Knox pays it forward by helping younger attorneys take the mystery out of a legal career

By Megan Bungeroth | Photos by Guerrero

GINA KNOX General Counsel Little Company of Mary Hospital

NEVER STOP LEARNING.

Pay it forward. Hold your ground. Be comfortable in your own skin. These are just a few of the theories that Gina Knox puts into practice each day as the general counsel (GC) for Little Company of Mary Hospital in Chicago.

For both herself and her team, Knox promotes the importance of continuous education and learning. In fact, she completes the continuing legal education (CLE) credits required for attorneys every other year—and in the off years, she completes the credits needed to keep her nursing license active as well. Although she hasn’t worked as a nurse since completing law school in 1991, Knox believes that her ability to stay up to date on nursing practices and training helps her communicate with the medical staff at the hospital.

Plus, her ingrained familiarity with medical terminology, abbreviations, and lingo allows her to be an especially effective GC. “When I’m reviewing medical issues that happen on a daily basis, I can access those medical records, ask the right questions: Were the right people consulted? What was the outcome? Is it foreseeable?” Knox says. “I’m grateful that I worked as a nurse. I understand the demands, the caseload, the medications, and the difficulty in documenting. I know the reality versus just the theory, and I think that’s really important.”

Knox takes that same approach to mentoring and promoting experience- and knowledge-sharing among colleagues. She firmly believes in a pay-it-forward model for not only helping younger, less-experienced professionals, but also for building a network she herself can rely on when she runs into complicated legal issues.

“Paying it forward is not just the theory of putting the energy out there; it’s actually walking the walk,” Knox says. “I had a call with a less experienced insurance attorney last year. She did not understand certain aspects of insurance jargon. I tried to help her. I told her, ‘When you deal with somebody, try to pay it forward. Take the time to explain it.’”

When Knox graduated from law school, she felt that the culture surrounding lawyers encouraged everyone to keep their knowledge and expertise closely held, rather than openly shared. Attorneys—especially female attorneys, who were in the vast minority at the time—felt pitted against one another, she says. Today, Knox tries to actively dispel that feeling by encouraging young women to see each other as resources rather than competition.

“You have to be educated in what you’re negotiating and take a stand.

Being firm and taking a stand are

not mutually exclusive with being

When she needs advice or a different perspective, Knox turns to her own circle of fellow attorneys; most of them are women who have supported one another for years. Knox acknowledges that women can face particular challenges in the legal profession, especially in courtroom settings where they are most seriously outnumbered by male colleagues. According to the American Bar Association, female attorneys made up 35 percent of active attorneys in the United States in 2017—only a 5 percent increase since 2007.

Knox knows firsthand that feeling outnumbered as a woman can be intimidating. That’s one of the reasons she mentors young women even as they’re considering a career in law. “I tell my kids all the time, ‘If you take the mystery out of life, it’s not that scary,’” Knox says. “Everybody has their first day as an attorney or their first day in law school. It’s scary to walk into court for the first time. It’s as silly as reminding yourself, ‘You know what, the judge goes to the grocery store. We’re just people.’”

Knox also makes sure to pass on the kinds of practical advice she wishes she had heard when she was just starting out, like the value of taking an LSAT prep course or how to approach law school applications to make yours stand out. She advises young people to use as many networking

avenues, both online and in person, as possible. Continuing to learn and be open to new experiences will also open up career opportunities, she says.

For women especially, Knox also advises to focus on standing firm, especially in negotiations, whether they’re trying to settle a claim/lawsuit or contract terms, without taking things too personally.

“If you’re negotiating, you have to be educated in what you’re negotiating and take a stand. Being firm and taking a stand are not mutually exclusive with being a nice person or professional,” Knox says. “I think that is a very hard concept for younger people, particularly women, to understand. I think that comes with time, you have to be comfortable in your own skin. You have to be educated in what you’re negotiating or discussing.”

With all that said, one piece of wisdom that Knox would pass on to her younger self would be not to worry too much.

“That does not mean that you don’t run after what is important to you,” she says. “You need to look for opportunities, but don’t worry so much because if you have those basic components, and you continue to nurture those— being hardworking, having foresight, being open—things will fall into place.” AHL

Lowis & Gellen LLP

Leaders in health care litigation and solutions, Recognizes Gina Knox General Counsel at Little Company Of Mary Hospital

For her leadership dedication, and compassion in providing legal counsel so that healers can heal.

a nice person or professional.”

RELISH THE UNEXPECTED

Stephanie Westermeier went from private practice to general counsel at Saint Alphonsus Health System and managing counsel at Trinity Health by finding new challenges and welcoming surprise opportunities

By Galen Beebe

ONE THING

that has been consistent for Stephanie Westermeier throughout her legal career has been unexpected situations.

“Despite your best-laid plans, you don’t know what is going to pop up each day or how a situation you are working with is going to evolve factually or legally,” Westermeier says. “A philosophy that I’ve developed over time is to try to remain undaunted and look at unexpected, and at times, frustrating circumstances as problem-solving opportunities.”

Westermeier has worked on a multitude of matters and had many opportunities to flex her problem-solving skills as general counsel for Saint Alphonsus Health System, a four-hospital nonprofit system with locations in Idaho and Oregon. She also serves as a managing counsel for Trinity Health, which operates Saint Alphonsus Health System and numerous other facilities in healthcare markets across the United States.

Courtesy of Saint Alphonsus Health System

STEPHANIE WESTERMEIER General Counsel, Managing Counsel

Saint Alphonsus Health System

Trinity Health

But Westermeier didn’t originally plan to go in-house. Instead, she began her legal career while still in college, when she worked on medical liability defense cases as a paralegal at a large law firm. After law school, she continued medical liability defense litigation work, as well as working in the employment and class action litigation arena at Givens Pursley, LLP. Then, after spending several years in private practice, she began receiving a number of assignments from a partner there who focused on business and healthcare law, which she found complex and interesting. As a part of this work, she started working closely with the hospital risk manager and other members of the leadership team at Saint Alphonsus.

“I began to focus almost exclusively on advice and counsel work, both in health law and in employment law,” Westermeier says. “I moved away from litigation and realized my sweet spot in practice was on problem-solving rather than litigating disputes. Advice and counsel work had me at hello.”

Despite her passion for advice and counsel, Westermeier was reluctant at first to go in-house. She was a partner in her firm, and she enjoyed private practice, as well as the combination of healthcare and employment work for numerous different types of clients in a variety of different industries. But Saint Alphonsus’ mission and the opportunity to deploy and grow her legal skills led her in-house.

“The chance to use, focus, and increase my legal skills on a single client with a very laudable mission focused on healing the community ultimately made me say yes to the opportunity,” she says.

Westermeier was the first in-house counsel to join Saint Alphonsus, where she organized a new legal department. During her first several years at the hospital, she was asked to oversee the risk management and organizational integrity compliance functions, as well as serve as general counsel. Although challenging, this experience proved valuable as she transitioned from private practice to in-house.

“It gave me a good foundation and perspective,” Westermeier says. “You can’t advise as well if you don’t understand the operational side, as well as the strategic and business side of an organizational client.”

“The chance to use, focus, on a single client and increase my legal skills

In 2010, Trinity Health acquired three Catholic Health Initiative hospitals—two in Idaho and two in Oregon— and formed the Saint Alphonsus Health System. After the acquisition, Westermeier helped to establish the board’s regional governance structure. She analyzed the possible structures with outside counsel Bob Schuchard of Davis Wright Tremaine. She and her colleagues, including the board chairs of the existing hospitals and Sally Jeffcoat— then president and CEO and now executive vice president, growth, strategy, and innovation at Trinity Health—chose to form mirrored boards for each of the hospital corporations and for the health system.

ultimately made me say yes to the opportunity.”

“If you don’t like managing people then you don’t want to be heading down the path to a general counsel position.” and developing their talent,

In the mirrored board structure, the same members sit on the boards of the health system and each of the four hospitals. This structure centralizes important strategic and operational decision-making for the health system, which leads to a more efficient, effective process. The legacy hospital board members remained as members of the community hospital boards. These boards are then delegated the critical role of overseeing areas that include medical staff credentialing, quality, and community benefit issues.

“Each community hospital board chair or other designated member sits on the regional board,” Westermeier says. “That integrates the community’s issues, and they have an ability to provide local input on issues in front of the health system board.”

Westermeier has spent a considerable amount of time determining the structures that will best suit the

GIVING BACK ON AND OFF THE CLOCK

In 2013, Stephanie Westermeier’s years of tireless work and ability to effectively problem-solve were recognized when she was awarded the Outstanding Corporate Counsel award from the Association of Corporate Counsel, Mountain West Chapter. The award recognizes a corporate attorney who demonstrates significant leadership contributions and a commitment to professionalism.

“I was greatly honored,” Westermeier says. “There’s something about being acknowledged for your work and your role by people that you respect that fuels you to be better at what you do.”

Westermeier is also making contributions outside of the office, as she volunteers on the board of the Women’s and Children’s Alliance (WCA), a nonprofit organization that provides services to individuals who are victims of domestic abuse and sexual assault.

“In general, I like to be part of organizations that are educators and problemsolvers, and the WCA has a great mission of freedom from the societal problem of abuse and violence,” she says.

organization, prioritizing legal work and counseling and otherwise leading her legal team. “There’s more to being a general counsel than knowledge of the law and advising the organization,” she says. “If you don’t like managing people and developing their talent, then you don’t want to be heading down the path to a general counsel position.”

Westermeier notes she has been fortunate to work with eminently talented and dedicated lawyers both at Saint Alphonsus and in California. Westermeier also says that being a general counsel requires continuous learning and that her best mentor —her current boss, Paul Neumann, general counsel at Trinity Health—came along later in her career. “Paul is brilliant, and he has the ability to sprinkle wisdom on a thorny issue or on life in every interaction,” Westermeier says.

Westermeier advises those who want to pursue a career in healthcare law to find a practicing mentor and learn the fundamentals of the heavily regulated industry. She says you need to invest the time to develop and maintain the competency and the expertise. It’s something that you can’t just “dabble in.”

“You don’t have credibility or ability if you don’t have a good knowledge of the law, which is constantly changing,” she says.

Even with her decades of experience, Westermeier not only welcomes new challenges, but says part of one’s personal growth is also how they handle the unexpected. “The problem is not going away,” she says. “It has to be solved. And it’s kind of fun if you can figure it out.” AHL

Joining Forces for The Future

Davis Wright Tremaine’s team of award winning healthcare attorneys spans the full range of healthcare services.

Our clients include healthcare providers, hospitals, academic medical centers, joint ventures and long-term care facilities.

CONGRATULATING EXCELLENCE

We are proud to have worked with STEPHANIE WESTERMEIER and her colleagues at SAINT ALPHONSUS HEALTH SYSTEM to obtain the groundbreaking antitrust decision in Saint Alphonsus v. St. Luke’s. Stephanie’s tenacity, commitment and intelligence have helped make us better lawyers.

Robert Homchick | Ingrid Brydolf

Jason Farber | Adam Romney

Adam Greene | Kathy Drummy

Davis Wright Tremaine congratulates Stephanie Westermeier on her 16-year tenure as General Counsel for Saint Alphonsus. Her intelligence, compassion and dedication are among the reasons she is well deserving of such recognition. DWT is proud to work with Stephanie and St. Alphonsus – they are truly leading by example.

After diving into healthcare law at a private practice Hawaii, Allison Griffiths is bringing her unique skill set to senior care service provider Avalon Health Care Group

By Jonas Weir

IN

FROM ALOHA TO AVALON 1974,

Hawaii became the first state to require minimum standards of healthcare benefits by law when it adopted the Hawaii Prepaid Health Care Act—which required businesses to offer health insurance to employees who work more than twenty hours per week for four or more consecutive weeks in the state. It was a landmark law that foreshadowed the ACA in 2010. It was a law that helped healthcare lawyers like Allison Griffiths, deputy general counsel of Avalon Health Care Group, have a leg up on lawyers who hadn’t experienced navigating such regulations before the ACA.

“Healthcare is a highly regulated industry, which makes it interesting,” she says. “Hawaii was particularly interesting. They were kind of a pioneer in healthcare legislation. They had their own set of regulations that had interesting implications with federal law. So, navigating those was challenging.”

Today, Griffiths is back on the mainland, where she serves as a jack-of-all-trades legal advisor at Avalon Health Care Group. Based in Salt Lake City, the company provides senior care services—including skilled nursing, assisted living, senior living, and rehabilitation therapy—in Arizona, California, Hawaii, Idaho, Oregon, Utah, and Washington. It’s a great fit for Griffiths because she connects with Avalon’s mission-driven work.

“Our company culture is all based around the people that we serve. Our patients are at the heart of our entire company culture,” she says. “Our company slogan is, ‘We embrace a reverence for life and a heart for healing.’ It resonates with who I am as a person.”

But Griffiths was not always on a path to become a healthcare lawyer. In fact, she wasn’t even sure she wanted to be a lawyer.

Deputy General Counsel

Health Care Group

ALLISON GRIFFITHS

Avalon

I’M GOING TO RUN A MARATHON, AND RUN IT FASTER

Just as she didn’t grow up determined to be a lawyer, Allison Griffiths didn’t grow up with the goal of being a marathon runner and Ironman triathlete. But inspiration comes from unlikely places.

Back in 2000, Griffith’s boyfriend had just broken up with her, but she still attended the Chicago Marathon to watch and cheer him on. That’s when she made an important resolution.

“I made a promise to myself on that day that I was going run the marathon the next year, and run it faster than him,” she says. “And I delivered on that promise.”

Running marathons, however, led to injuries. So, she did what anyone with extreme determination would and transitioned into biking and swimming, too. And when she watched that same ex-boyfriend complete the Chicago Triathlon, she made herself the same promise.

“I told myself again on that day that I was going do that Chicago Triathlon and do it faster than him, and I delivered on that as well,” she says.

To this day, Griffith is still a triathlete. In fact, even as someone who balances parenthood with a hectic legal career, she is also an avid skier.

“To get to live in Park City, so close to the ski mountain, is a really special place,” she says. “But it’s also some place that I get to run and bike. It is a huge outlet for me, in terms of helping balance my crazy hectic career. It’s truly a mountain playground that I live in.”

“It

was the work that I liked the most.

It

was just the most mentally challenging work I had,

After growing up in Southeast Missouri, Griffiths earned a scholarship to the University of Missouri. She chose political science as a major—not because she had a clear direction of future career but because the course material just interested her most. But when graduation time came in 1998, she had to decide what her next steps were.

“Well, it was by happenstance, not having a clear path in life, and saying ‘What the heck am I going do?’” she says. “So, I can’t say that it was always my life’s passion to be a lawyer.”

Still, Griffiths was drawn to a legal path. After earning her JD from Chicago-Kent College of Law at the Illinois Institute of Technology in 2003, she practiced law in Chicago for a few years before moving to Hawaii, passing the bar there, and joining the fifty-person firm Alston Hunt Floyd & Ing.

During her second year as an associate at the firm, she started doing some work for the firm’s healthcare group.

And that’s when she found her passion.

“I knew pretty quickly that was the path for me,” Griffiths says. “It was the work that I liked the most. It was just the most mentally challenging work I had, and it was also a combination of transactional and litigation.”

The complexity of the work was not the only thing that attracted her to the company, though. The healthcare group was also led by two women who served as mentors to the young lawyer: Dianne Brookins and Ellen Carson.

“They were absolutely mentors to me,” Griffiths says. “I really credit them with getting me into this field. They cared about my development, and my progress, and my career trajectory. They taught me all that they could. They invested in me.”

and it was also a combination of transactional and litigation.”

The mentorship Brookins and Carson provided was invaluable, especially considering the attrition rate among female law associates, Griffiths says. A 2017 study by the National Association of Women Lawyers showed that, despite being hired in nearly equal numbers as men at the associate level, women are the minority of both equity (19 percent) and nonequity partners (30 percent). In fact, the study showed that the likelihood that women will become equity partners has only marginally improved in the past ten years: 16 percent in 2007 and 19 percent in 2017.

“I feel like I was lucky to have those strong female role models that showed me how to establish work/life balance: having children but still having a career, and also just navigating being a woman lawyer, which presents its own challenges,” Griffith says.

Griffiths, in fact, stayed at Alston Hunt Floyd & Ing for more than eight years, even continuing to work for the firm after she and her husband decided to relocate to Utah in 2010. After leaving the firm in 2012, Griffiths worked for a few private practices before taking her first in-house counsel position at Avalon in 2016. Aside from identifying with the mission of the organization, the opportunity to transition to in an in-house position was attractive for its own reasons.

“One thing that obviously interested me was not having to bill your entire day in six-minute increments—not being a slave to the billable hour,” she says. “More importantly, when you’re outside counsel, you only get to see just a small slice of what the business does on a day-to-day basis. But when you’re inside, your guidance and advice is much dearer to the business goals.”

And the transition has provided Griffiths with work that’s been just as exciting as what interested her in healthcare law in the first place. The highly regulated nature of providing senior care keeps her on her toes, and the freedom to work with everyone from clinical staff to human resources has her even more embedded in her work than ever.

“It’s been extremely challenging but extremely rewarding, too,” she says. “Now, I get to more directly see the fruits of my labor, so to speak, because I see the business consequences of my work every day.” AHL

“At the end of the day, we need to consistently deliver practical capabilities and actionable, reliable information.” p. 202

Prognosis

Mending the Technological Divide

Lee Milligan and his team are building a powerful digital foundation at Asante to improve the patient experience

By Jeff Silver

ighly advanced, integrated computer systems are an essential part of the contemporary healthcare environment. Lee Milligan was well aware of this throughout medical school and his residency. In fact, he maintained a keen interest in the intersection of medicine and the digital world well into his first job as a physician in the emergency department at Medford, Oregon-based healthcare provider Asante.

His interest was so strong that he started taking computer science classes at a local community college at about the same time the hospital began searching for a new enterprise EHR system. Over time, Milligan became so involved in the implementation of the application that he changed careers, ultimately becoming Asante’s vice president and chief medical information officer. He has been helping lead the transformation of the health system’s IT environment ever since.

When he came to work at Asante, Milligan discovered that its existing system was not interactive, was mainly populated by scanned PDFs, and offered no computerized physician order entry, and only minimal QA functionality. In addition, with value-based care on the horizon, the system could not fulfill most of its reporting requirements.

“Becoming part of the team that implemented our Epic EHR system confirmed how much I like integrating healthcare and computers,” Milligan says. “It gives me the chance to have an impact that goes far beyond the one-on-one clinician/patient experience.”

His new position enabled him to address what he views as some of the inherent weaknesses of even the best digital systems. Although vendors are IT experts, they are not nearly as strong when it comes to understanding clinician workflows and developing the most effective solutions to support them.

Lee Milligan VP & CMIO Asante

Leah Nash Photography

“We used to build reports, give them to requesters, and then let them figure out what to do with them. Results are much more beneficial if we take time to show how to use the product we’re delivering.”

In response, Milligan launched the Asante-Epic Physician Builder program, which offered analyst-level training to a group of ten physicians. Since being certified, they have leveraged their insights into procedures and clinical relevance by developing custom applications for the hospital.

“Being able to build our own content within Epic gives us a level of control that was never possible before,” Milligan says. “It lets us deliver innovations that directly address clinicians’ most pressing needs.”

CodeRunner, for example, is an application Milligan developed to help organize the chaos of Code Blue situations. The program automatically compiles essential information, like the reason for a patient’s admission, recent procedures, key lab values, and recent medicines on a single, easily accessible page. Since the application was introduced, several other health systems have adopted it for their own use.

To improve the acceptance and effective use of Epic, Milligan has also dramatically changed training methods associated with it. Many organizations use a “fire hose” approach that presents everything users need to know all at once. He has replaced that with a continuing education program that puts training in the context of users’ work environments. As an Epic Credentialed Trainer, Milligan has developed lesson plans that focus on single topics and are presented during two-hour sessions every two months at each Asante campus.

“Customized lesson plans enable physicians to train fellow clinicians, which improves learning and produces tangible results,” Milligan points out. “It has also given the

IT group nearly real-time feedback on Epic issues that our analyst builders are able to address almost immediately.”

As part of improving internal data management and responses to customer requests, Milligan and his team have prioritized listening and simplifying many IT processes. For example, requests for reports are now reviewed and clarified by the newly created role of the clinical data analyst. This analyst speaks with end-users before work begins in order to discuss business requirements and ensure they are addressed effectively the first time. This eliminates the need to repeatedly refine reports.

The request architecture itself has also been improved.

In the past, multiple queues categorized by specific departments created a confusing backlog of requests—at one point, more than seventy report requests going back three years were waiting to be processed. Now, with a single request pathway and a collaborative approach to allocating the work, the backlog has been reduced to ten requests.

The ITS-Analytics department has also introduced the role of principle trainer. The trainer instructs end users on how to interpret reports and get the most use out of the resulting details.

“We used to build reports, give them to requesters, and then let them figure out what to do with them,” Milligan says. “Results are much more beneficial if we take time to show how to use the product we’re delivering.”

Milligan’s team is in the process of rolling out data on-demand. Using simplified tools, users will be able to build their own reports, which will provide unprece -

Congratulations

Dr. Lee Milligan Chief Medical Information Officer, Asante

Halo Communications is proud to work with healthcare leaders like Dr. Lee Milligan. We admire his commitment to innovation and his dedication to improving the lives of patients and employees at Asante.

dented scaling capabilities. Milligan estimates that after two years in operation, on-demand access will effectively double report productivity without adding additional cost or new team members.

Another objective is to amplify the work Asante is doing with predictive and prescriptive analytics. Milligan believes this will be crucial for effectively addressing the demands of population health.

“We may be able to predict something like who is most likely to be re-admitted to the hospital, but then, what do we do about it operationally?” he asks. “At the end of the day, we need to consistently deliver practical capabilities and actionable, reliable information.”

These achievements haven’t gone unnoticed, and many of Milligan’s colleagues are impressed by his ability to leverage technology to improve patient care.

“I have the good fortune of working with many health-

care leaders, and Dr. Milligan really stands out,” says Jose Barreau, CEO and cofounder of Halo Communications, a provider of clinical communications platforms. “He is knowledgeable and on the forefront of technology in healthcare and knows what physicians and nurses need to deliver great patient care.”

All of these changes are just a portion of the comprehensive restructuring, refinement, and innovative solutions Milligan and his team continue to work on. From data governance and transparency to rigorous validation processes, they are all preparing Asante to meet whatever challenges the future may bring.

“Ultimately, my job is to develop and execute ideas that are aligned with our business needs and address evolving challenges,” Milligan says. “So, in addition to creating new solutions, my ongoing challenge is making sure everyone understands why all this matters.” AHL

Homegrown Talent

After being recruited from out of state, Michael Wood is building a local talent pool in Oklahoma City

By Galen Beebe

Like some of the employees in the information security department at Oklahoma Citybased INTEGRIS Health, Michael Wood was recruited from out of state. He began his IT career working in the loading dock at a Texas healthcare organization. Rather than wait for IT, he often fixed local computer issues; soon, a manager invited him to transfer to the IT department. When that same manager moved to INTEGRIS, he recruited Wood to join the health system’s security group.

Although his path to IT is not a common one, his journey from out of state is. Wood, now assistant vice president and information security officer at INTEGRIS, is trying to change that.

To recruit new talent, Wood is working with the Oklahoma Center for the Advancement of Science and Technology (OCAST), a state agency that helps companies advance and retain science, technology, engineering, and mathematics talent in Oklahoma. The agency provides funding and connects students with local positions, where they get hands-on experience solving complex problems.

In recent years, INTEGRIS has transitioned to a largely virtualized server and desktop environment. With virtualized systems, a single piece of hardware can run hundreds of desktop instances, allowing employees to connect to their desktops from multiple workstations, such as a laptop or tablet. “We all have our own instances of a desktop running in the data center and we connect to that instance,” Wood says. “I can connect to it from anywhere because it’s not something that’s sitting at my desk.”

Virtualization gives the IT group centralized control, allowing them to apply the same policies to every desktop. As a security measure, the system auto-builds a new desktop after a user logs off or a computer has been idle for many hours. This protects sensitive information from security breaches.

Initiatives such as this give the healthcare system a recruiting advantage as well as a technological one. “It is appealing to people to come to an environment where they know that there’s going to be a significant piece of technology to manage,” Wood says.

A partnership with OCAST would allow the information security group to secure funding for future technical

projects, but perhaps more importantly, it would keep brainpower in the state of Oklahoma. “We’re constantly pulling from an ever-shrinking pool,” Wood says. “If we’re helping to keep it replenished, then when we do need new talent, we can go there.”

Having a small community has its benefits as well as its drawbacks. Wood and his team regularly attend information security and technology conferences in Oklahoma, such as the Information Warfare Summit, a decade-old conference that draws hundreds of attendees each year. These networking opportunities help establish the security group’s place in the local ecosystem. “It’s such a small community that we can create those relationships,” he says. “That’s one of the advantages of it being smaller.”

INTEGRIS largely competes for talent with oil and natural gas companies, which often have high salary budgets and robust benefits programs. To maximize retention, Wood strives to create tailor-made development programs for employees. New hires see these development opportunities as a benefit, and it allows INTEGRIS to

“It is appealing to people to come to an environment if they know that there’s going to be a significant piece of technology to manage.”

Michael Wood Assistant VP, Information Security Officer INTEGRIS Health

compete with higher-paying companies in the energy space. “They’re willing to overlook the fact that you don’t have as robust a bonus program or that you don’t pay at the top of the market in Oklahoma City because they know that they’re going to be able to develop themselves,” he says.

Wood and his managers work with individual employees to identify the learning opportunities that will be most beneficial to them, whether that be attending a conference or completing a degree. “There are different specialties within the security group, so we don’t offer them a specific training,” he says. “We tell them that the funding is going to be there for them to train and that we’ll work with them to identify the things that they’re interested in learning.”

This funding demonstrates the organization’s support for the security group—another selling point for new recruits. Although the organization has long supported the security group, Wood has worked to strengthen ties between business and information security leaders. Among Wood’s biggest challenges is translating what the security group does to business leaders who don’t understand the technical jargon. “You have to get it down to a common language where everybody can understand what you’re talking about,” he says. “Otherwise, they’re just going to turn off.”

To make risks clear to board members and senior leaders, Wood translates the security program into business terms. “They’re used to seeing risk from a red, yellow, green perspective,” he says. “If we can translate those things into monetary terms, that’s something that resonates with them.”

The security group has partnered with the business to create an information security advisory committee made up of executive leaders and physicians that helps to govern the information security program. This counsel gives business leaders a personal stake in the security group as well as a financial responsibility. “They’re more engaged,” Wood says. “When I meet with them, the different members are asking, ‘What can we do for you?’”

The last recruiting tool that Wood uses is INTEGRIS’s mission itself. “INTEGRIS is a pretty wellrecognized brand in Oklahoma,” Wood says. “People like what INTEGRIS is here to do, and they want to be a part of it—to improve the health of the people and communities we serve.” AHL

Make Room for the Brilliant”

Peter Kung defines the innovation framework to accelerate strategic growth at SCL Health System

By Jeff Silver

eter Kung joined SCL Health System—a faith-based, nonprofit healthcare organization with coordinated care through eleven hospitals and more than one hundred physician clinics with other comprehensive health services, primarily in Colorado and Montana—as system vice president of innovation and virtual health in 2015. He continued a legacy established by the Sisters of Charity of Leavenworth by improving the health of people and communities, especially the poor and vulnerable. Today, however, the new frontier in healthcare encompasses an industry undergoing transformation that provides Kung and his team an opportunity to bridge the gap between innovation and operations and accelerate SCL Health’s strategic growth.

SCL Health’s senior leadership charged the innovation and virtual health team with identifying, developing, and deploying high-impact ventures that improve access and experience for the people and communities they serve.

“We have focused our creativity, agility, and capability for high-velocity decision-making toward delivering highvalue, people-centered innovations,” says Kung.

To reach those objectives, Kung is developing an internal innovations framework that follows a disciplined approach. One of his strategies has been contextualizing a quote from Jonathan Fields: “ritualize the mundane to make room for the brilliant.” In this vein, Kung and the team have streamlined rudimentary, but necessary, elements, such as discovery, process, and governance so they have capacity and freedom to operate in nontraditional ways.

Additionally, Kung and his team continually work toward supporting SCL Health’s strategic priorities, empower employees to deliver new value to their communities, and build creative confidence across their ministry. Associates are able to innovate reliably and repeatedly over time, filtering ideas and opportunities, evaluating alignment with other strategic priorities, and creating business cases for senior leadership.

“Having all the pieces in place creates rigor and efficiency in the innovation process and makes productive results repeatable and reliable,” Kung says. “The framework empowers staff and encourages them to view a range of issues from fresh perspectives. It also supports higher probability of success on impact and scope.”

Peter Kung System Vice President –Innovation and Virtual Health

SCL Health System

Paul H. Trantow

SCL Health tested the approach this spring. Nearly three hundred valid ideas suggested how to create the ideal patient journey, both within and outside the hospitals and clinics. The organization awarded funds and sponsorships to eleven outstanding teams that have since executed their ideas and reported results in early 2018 to senior leadership.

Within the team’s portfolio, SCL Health has already launched eight different enterprise-wide initiatives along with many targeted innovations, all of which have contributed to a seamless patient experience and enhanced access. Two highlights include a collaboration with J2 Interactive, in which they customized a customer relationship management (CRM) platform to support SCL Health’s Medsto-Beds service—an interactive application that integrates outpatient pharmacy at the hospital with EHRs to enable pharmacists to get medications to patients before they discharge. In addition, the service creates the opportunity to educate patients on proper medication instructions and compliance. Patients can also use the platform to submit questions after they leave the hospital.

“Ultimately, it is our goal to create impactful and sustainable innovations that deliver value and the best experience to those who matter most—our patients.”

Paul H. Trantow

The second highlight is CareShare, which also uses the CRM platform to assist coordination between postacute providers after discharge. Care navigators can easily see who needs additional assistance and use the platform to automate communications with multiple care teams.

SCL Health’s innovations also include efforts in the social determinants of health. Their recent collaboration with ridesharing company Lyft provides nonemergency transportation services to patients facing transportation barriers.

“Many of the patients we serve rely on public transportation, which can make accessing medical care challenging,” Kung says. “Helping patients get to or from our clinics and hospitals is a simple and critical step in improving health outcomes.”

The SCL Health team focuses on developing innovations that service real-world issues, and avoids what Kung refers to as the “ivory tower effect” in which one of two dynamics occur: innovation either becomes too far removed from the organization’s ongoing experiences and opportunities, or it is so close to ongoing activities that changes are incremental and could have eventually occurred within the evolution of normal operations.

Kung believes that SCL Health has been able to find the sweet spot for innovation. Solutions have been far enough from core operations to be different, and practical enough that their value is easy to see.

For example, SCL Health has partnered with Lantern, a mobile-based cognitive behavioral therapy program through which users are paired with health coaches to address stress, anxiety, and depression. SCL Health offers the program through its community benefit arm to underserved populations, while it is also offered as an employee benefit. After using Lantern for one month, 78 percent of Lantern users saw clinically meaningful outcomes in their symptoms. Among individuals with clinical levels of symptom severity, symptoms were reduced by 31 percent.

Within the behavioral and mental health service lines, the innovation and virtual health team also initially deployed telepsychiatry capabilities within two of its hospitals. This will help better utilize scarce resources and make care available more quickly, Kung says.

SCL Health continually pushes the envelope to improve the health of its patients, both within and outside its hospitals and clinics.

“In order to create meaningful change, we need to reimagine our work in ways that push beyond what we already know and may completely change the game,” said Kung. “People interact with health systems differently than they used to. Ultimately, it is our goal to create impactful and sustainable innovations that deliver value and the best experience to those who matter most—our patients.” AHL

SCL Health is building innovative software to educate, engage, and empower patients. They rely on J2 to make it possible.

Reshaping the Wheel

David Mason explains how he is helping two start-ups introduce smarter tech to perpetual devices in healthcare and agriculture

By Aaron Orsini

isruption has become a term synonymous with the world of start-ups. We hear of transportation being turned upside down and payment systems getting replaced with slicker, more modular approaches. But now, imagine when someone seeks to reinvent something that’s existed since well before the creation of the wheel. That’s exactly what David Mason is aiming to find out with his team’s latest developments, which serve as a hardware update for two truly perennial technologies: ice cubes and bushel baskets.

As the former senior director of patent portfolios and competitors at Align Technology, Mason has accumulated twenty-five years of patent law wisdom, which he is currently applying to the development of two compact and elegant solutions that could have a major impact on their respective industries. His personal philosophy is both succinct and benevolent.

“What I’ve learned from practicing patent laws for twenty-five years is that you can never stop learning new ways to be healthier, or to help others become healthier, as well,” Mason says.

It’s a concept that led him to Thermal Therapies in July 2017, where he is currently the company’s chief operating officer. The concept behind the start-up founded by Don Giberson, a former Silicon Valley executive, is relatively simple: injured athletes and physical therapists alike have long used the ice-on, ice-off method to treat swelling and aid in recovery. That approach has its complications, however, including inconsistent temperatures, the need to often replace ice, and no means of remaining within the bounds of an optimal temperature range.

A number of devices have been marketed to improve those issues, but Mason believes Thermal Therapies’ device is a leader in terms of compact and elegant design. Mason says the technology is similar to a refrigerator and is

David Mason COO AgPro Robotics Thermal Therapies

Katharine Hardt-Mason

roughly the same size as a small Igloo container, and adjustments can be made to the temperature whenever the user needs it and in whatever environmental condition they may be in.

“When we approached doctors who do orthopedic surgery on athletes and other patients, the problems of icing—which is too cold to use at first, then melts quickly— are commonly expressed,” Mason says. “Also, the modern systems that are out there typically do not work well in high-temperature environments. So, if it’s a system used in an area that gets above eighty degrees, it’s hard to cool down the water.”

And that’s where Thermal Therapies is looking to make its greatest impact—knowing that a highly portable device may have applications beyond the conventional hospital, branching out as well into home, school, work, and potential military applications.

As of now, Mason is leveraging his background in patents to help position the team and prepare them for initial sales and contracts. At press time, the team has a letter of intent for one thousand units per year, over two years, from one of the major pad manufactures, with other, more comprehensive rollouts forecasted for the near future.

“Thermal Therapies is growing, building, and modifying the solution to make the system quieter, programable, battery powered, and more lightweight,” Mason says. “What began as a science experiment on the kitchen table in Silicon Valley has become a refined design with encasing and structure.” And while Mason has made great strides in his work with Thermal Therapies, he’s also busy working with another innovative company.

The Science of Farming

Similar to Thermal Therapies, the start-up company AgPro Robotics reimagines another time-honored technology—the bushel basket—by making it smarter and more dynamic in terms of mobility and portability, which improves the health and safety of farmers, as well as their efficiency.

Over the last century, bushel baskets went from handheld to horse-pulled to machine-powered. In more recent years, the bushel basket has evolved into large, roving devices that move in tandem in front of the pickers. Although these larger machines may service eight or ten workers, the large and cumbersome machine must be driven to keep pace with the slowest worker and maneuver through the farm.

“Working with berries is a historically manually intensive labor because of the small size, and sometimes delicate nature of the product,” says Mason, who also serves

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Bushel baskets are large machines that help berry farmers harvest their crops more efficiently.

as chief operating officer of AgPro Robotics. “With AgPro, we’ve introduced a small, electric harvesting aide that can increase the productivity of up to four workers harvesting strawberries by about 30 percent while also reducing their physical labor that typically causes injuries.”

In addition to being more dynamic, AgPro’s devices are also smarter than other devices on the market. In most farms where berries are harvested, harvesters walk down rows of plants, pick off the fruit, and place it in a tray or bucket. Then, they run to the end of the row, the fruit gets weighed, harvesters get credited, and then they run back and pick some more. During the day, the average harvester will shuffle more than four miles up and down a row of crops for a half mile of plants.

The device from AgPro founded by Erik Jertberg, a third-generation berry farmer, is a semi-autonomous transport aid that follows harvesters as they pick produce, and when they fill up a tray, the harvesters merely turn around and place the tray on the device before grabbing the next tray to fill. In future releases, the device will also weigh the produce picked, keep track of who picked it, transport the picked produce when a constraint is reached so the worker can continue to pick, keep the picked produce level on uneven terrain, take images of the crops, and share all this data with the farmer to understand worker productivity and crop health. Since July 2017, the start-up has

been making waves. AgPro Robotics has already engaged Creative Manufacturing Solution to build the field-tested product as captured by its pending patent and product materials and videos, spearheaded by Mason. Earlier this year, the company presented at the invite-only CA Strawberry Automation Conference and occupied a fortyby-forty foot booth at the World Ag Expo in California.

The company is also aligned with one of the largest berry shippers, Driscoll’s, which has featured AgPro in numerous marketing materials.

With both Thermal Therapies and AgPro Robotics, Mason is confident in terms of market demand and measurable technological improvements. AgPro in particular has a promising and wide-reaching market demand, especially given that a majority of berry farms exist in a focused region of California, a berry’s throw away from where the tech is being developed.

AgPro has already attracted the support of a leading fruit producer. And once IP is solidified, Mason and his team will be well-positioned to help farmers more readily enjoy the fruits of their labors.

“The goal is to get a product to market this year for strawberry growers and to develop the concept for aiding other crop harvests in the coming years, so that the valuation improves to the point of being desired by larger entities in the next five years,” Mason says. AHL

Courtesy of AgPro Robotics

A New Analysis of Government Healthcare

How Accenture’s Joseph Fiorentino uses data and analytics to help improve health outcomes

By Clint Worthington

or Joseph Fiorentino, managing director of health and public service at Accenture, the future of government healthcare can be found in data and analytics.

Fiorentino has spent the last fifteen years in the field of government healthcare, picking up on industry trends through his work at Accenture and beyond. Based on his observations, as the pace of system reform accelerates in government healthcare programs, state agencies are increasingly realigning payment and quality measurement to set their programs on the path to reform. They are broadening the sources of data they use and incorporating interagency data and clinical data into new reimbursement strategies and outcome-based assessment.

With data-driven decision-making becoming a critical feature in government healthcare programs, states will require deep analytic capability. With his experience in government and IT, Fiorentino is now working to spearhead initiatives to improve the use of analytics in public health policy decisions, as well as the state of government healthcare overall.

One of Fiorentino’s major concerns with healthcare is the increasing cost of care for many Americans, particularly those on Medicaid. Issues such as declining health quality, rising medical costs, and the opioid epidemic are only some of the problems he believes analytics can help support. Furthermore, Fiorentino is particularly worried about the prevalence of unnecessary, low-value procedures being performed on patients who may not need them, resulting in greater costs for providers and patients alike.

At Accenture, a leading global professional services company, one of his main goals is to help the company increase the analytic capability of state healthcare systems to improve health outcomes and drive valuebased care. A major emphasis of this initiative surrounds holistic, managed care, and finding ways to improve the bundling of services across clinical, social, and behavioral programs, in addition to incentivizing behavior to improve outcomes. “Accenture has consulting in their DNA,” he says, adding that this gives the company an edge in addressing some of the most challenging healthcare issues facing state government.

At the heart of Fiorentino’s work is his perspective that government healthcare needs to move “from hindsight to insight.” Government healthcare agencies who want to leverage analytics for meaningful action can “start small” by focusing on faster deployment of new analytics capabilities and tools by piloting with the intent to scale and driving adoption by raising the analytics IQ across the organization. Through analytics, Fiorentino believes it is more efficient to enable data-driven experts on a cloud-based data

platform that provides userspecific tools and data and analytic services to facilitate better, more agile service delivery. Cloud-supported analytics allow for the rapid curation and implementation of state-of-the-art algorithms and applications in a fast-changing environment.

One of the ways Accenture does this is by delivering a data platform that enables an ecosystem, including with companies such as Milliman, a leading provider in healthcare analytics. Milliman’s MedInsight platform, for instance, provides benchmark tools that help providers analyze costs, quality of care, and more—valuable metrics that can be used in a larger ecosystem of information rather than building from the ground up.

“Why build it when we can just partner?” asks Fiorentino, citing platforms such as Milliman’s as ideal examples that can contribute to this interdisciplinary approach to healthcare.

But according to Fiorentino, there are three major obstacles to overcome in the current state of data analytics in government healthcare. First, it remains difficult, if not impossible, to find all of the skills required for analytics success within any one individual. A successful analytics project brings together talent working as an interdisciplinary, high performing analytics team. One approach is to establish “pod” teams that have a mix of roles, including data scientist, analytics modeler, visualization expert, data engineer, business analyst, and business domain expert. By combining these capabilities, analytics pods can take an integrated view of business problems. Fiorentino works to build interdisciplinary and collaborative teams that bring together everything from business skills to data science, information technology to analytics, and more. “We have an incredibly impressive talent pool that allows me to bring these different dimensions together and blend it with our client’s talent pool,” he says.

“It’s not just about giving them the meds they need. It’s also about putting them on a path to self-sufficiency.”

Joseph Fiorentino Managing Director of Health and Public Service

Accenture

Another issue Fiorentino works to solve is the implementation of big data architectures that work hand in hand with traditional architecture to provide better outcomes for their work. “These are not traditional data sets,” says Fiorentino, citing a wide range of data from different angles and the need to combine this data effectively. How to take that data and glean real insight from it is a question Fiorentino regularly asks. His solution is to foster a sense of collaboration within the ecosystem Accenture is developing, in which organizations start with the question, pull the necessary data, and work within their ecosystem of partners to achieve results.

The practical issues of sharing and storing the data they accumulate is yet another obstacle to overcome in Accenture’s ecosystem, especially the growing need for hybrid architecture to support it. “Especially in state government, funding decisions are made by consensus because it involves multiple agencies working together,” Fiorentino says. “Organizations need to be able to share data effectively, access said data, and make its findings actionable.”

The ultimate goal for Fiorentino and Accenture is to help their government clients build an ecosystem that serves the people as best it can. With a public healthcare system that is constantly in flux, he and his team spend a great deal of time working within the industry to anticipate changes. “Politics and ideology aside, it’s about putting the individual first,” he says. For Fiorentino, an important factor in his job is to marry individual patients’ circumstances with the appropriate support. “It’s not just about giving them the medications they need. It’s also about putting them on a path to self-sufficiency,” he says. If successful, this approach to data analytics can cut down on the performance of costly, unnecessary procedures, which then leads to more effective, cost-efficient care.

For Fiorentino, Accenture’s goal is to help its government clients create a sustainable analytics practice that is interdisciplinary, collaborative, and insight-focused. “The biggest mistake you can make is to work in a vacuum,” says Fiorentino. Drawing from a variety of client experience, existing data tools, and working with an ecosystem of creative partners, Fiorentino and his team use these capabilities and experiences to educate others, gain quick insights, and facilitate evidence-based interventions that can help health care providers and patients make better decisions for their health. AHL

Milliman MedInsight® is one of the healthcare industry’s most robust platforms for data warehousing and healthcare analytics.

For 20 years, MedInsight has been leveraging data for payers, providers, state governments, and other healthcare organizations to produce business intelligence and insight into key performance metrics. MedInsight’s portfolio of products includes solutions that provide precongured or custom reporting and data con gurations, as well as individual tools that can address speci c business needs.

www.medinsight.milliman.com

Milliman MedInsight would like to congratulate Joseph Fiorentino on this honor. Joseph has been instrumental in providing vision and managing the relationship between Accenture, Milliman MedInsight, and other analytic providers. Milliman MedInsight is proud to be a part of Accenture’s re-envisioning of providing analytics to state health and human services organizations.

Reckoning with the World’s Health Challenges

Cofounder

and CFO Donna Lecky reveals how HealthVenture champions healthcare and technology solutions around the globe

By Jenny Draper

Donna Lecky knows how to transform ideas into products with real-world impact. Her full-service investment firm, HealthVenture, is revolutionizing the digital health space by cultivating early and seed-stage start-ups from the ground up. “Our global mission is to meaningfully impact healthcare by launching innovative solutions. We are a full-service firm dedicated to solving healthcare needs in all areas where digital healthcare can play a major role,” Lecky says.

HealthVenture originated at Yale University’s School of Management. Lecky and her cofounder and CEO Sri Muthu, previously the head of technology for innovations at Wells Fargo, met as students in the MBA for Executives program. With a concentration on healthcare, they teamed up for assignments, and in 2016, they together developed Muthu’s capstone thesis—the genesis of HealthVenture.

“Our thesis is that digital health solutions substantially improve personal health and well-being,” Lecky explains. “We know that end-to-end support for academic medical entrepreneurs accelerates the creation of impactful solutions. So, we cultivate an elite cohort of healthcare entrepreneurs to build scalable digital health solutions for the global market.”

Lecky and Muthu further developed and formally launched HealthVenture in the fall of 2016. Their individual expertise formed a complementary partnership between finance, treasury, tax, law, operations, and IT. Lecky and Muthu leverage their skill set gleaned from their combined fifty-plus-year careers.

Prior to HealthVenture, Lecky led the tax, tax counsel, benefits and treasury functions at Omnicare, a subsidiary of CVS Corporation, and HealthSouth Corporation. In her previous twenty years, she worked in various tax leadership roles while servicing healthcare and financial services clients at KPMG, Ernst & Young, and Deloitte. She earned a bachelor’s degree in accounting from Temple University’s Fox School of Business, a juris doctor from Howard University School of Law, and completed the Emory University School of Law LLM taxation program. To further hone her skills in venture capital, Lecky also completed the University of Oxford’s Private Equity Programme in 2016.

Today, the Connecticut-based company comprises four strategic entities: the incubator, HealthVenture Labs, which is an intensive, 120-day incubator program working with start-ups to develop, build, and launch a minimally viable digital health solution. The consulting firm, Health -

Donna Lecky Cofounder & CFO; Managing Director HealthVenture Corporation; HealthVenture Capital

Kelsey

Marie Crawford

Venture Advisory, which accelerates innovation goals at mid- to large-sized healthcare companies. The investment arm, HealthVenture Capital, is a venture fund that invests in disruptive, scalable, and sustainable global technologies. And the Tulasi Foundation supports girls and women to innovate and deploy healthcare solutions.

Supported by the Yale community, HealthVenture localizes the search for clients with global potential. That mindset manifests in pitch competitions, which are held 3–4 times per year in strategic countries. HealthVenture also holds boot camps in communities covering design, financials, operational structure, staffing, and pitching. These events, in addition to fundraisers, exemplify the firm’s grassroots commitment to community by supporting and developing entrepreneurial skills for clients, prospects, students, and non-clients alike. HealthVenture also works with local hospitals and universities to directly consult on their innovation practices and is launching a healthcare innovation center called Health-Haven Hub with local and global innovation groups.

“Credibility and reputation are key to our business, and since our inception we have developed several strategic alliances. We are partnering in varying capacities with organizations in the US and in Asia,” Lecky says. Some of those alliances include the Yale School of Management, Yale Center Beijing, The Elm City Innovation Collaborative, CT Innovations, the Global Network for Advanced Management—which consists of thirty-one elite business schools around the world—and the Hong Kong Science and Technology Park, just to name a few.

To date, HealthVenture has launched pitch competitions in New Haven, Connecticut, and in Beijing, and has spon-

sored a number of related events. More than eighty teams have applied, thirty were invited to pitch, seven teams are being supported for prototyping, and the company is investing in three of the teams—two from the United States and one from Asia.

“Our competitions allow HealthVenture to identify and vet incredible teams, showcase innovators from around the world, and enable us to connect digital health startups and potential investors,” Lecky says. “We’ve designed a highly selective intake process based on stringent due diligence practices. And while you want to support all prospects, there has to be a return on investment. We evaluate the business model, the financials, the composition of the team, any significant stops and starts, and whether there is clarity around what the start-up is trying to accomplish. Our clients are disruptors. We tune in to the team’s communication style—both verbal and nonverbal. Are they passionate because they have a great idea that they want to get off the ground, or are they passionate because they already have traction?”

HealthVenture’s due diligence of a start-up is typically a 6–8-week process. It reviews the start-ups analysis and considers how the innovation will translate internationally. “If we’re not sure about the financials or if the valuation is difficult to discern—which can often be the case for the stage of start-ups with which we work—we’ll go to our toolbox,” Lecky says. “We will leverage our relationships with multi-national companies to gauge interest. Finally, we run the numbers to ensure that it all makes sense for HealthVenture’s investors and the start-up.”

HealthVenture’s clients, such as MindNest Health, are disruptors. MindNest was founded by Dr. David Grodberg,

Donna Lecky speaks at an event at Yale Center Beijing.

medical director of the Yale Child Study Center Clinic in New Haven. His innovation is a digital health platform that trains parents to implement the same evidence-based interventions that are used by experts at academic centers.

“The innovation was designed to help parents navigate in a world where children have a diagnosable medical health condition,” Lecky says. “There are few resources that support families in this way, all while reducing the stigma that unfortunately is correlated to challenges surrounding mental health. This is a solution that has substantial global implications. Think of how many families our client will touch and help globally—that’s bigger than HealthVenture. It’s impactful and significant, and we are proud to be associated with Dr. Grodberg.”

This fall, with the support of the India Institute of Management, HealthVenture will host its inaugural pitch competition in Bangalore, India, on the heels of its annual competition in Beijing. Future pitch competitions are scheduled for Mexico in 2019 and in Africa in 2020, as supported by its alliance with EGADE Business School Tecnologico de Monterrey and the University of Cape Town, respectively. The aim is to boost investor, partner, and start-up interest around the world.

“It’s important to work with multi-national companies that are based in the US that are interested in supporting early- and seed-stage innovators,” Lecky says. “HealthVenture is uniquely positioned to be the conduit that connects these institutional investors who have navigated these waters and who are interested in supporting firms that have global solutions.”

According to Lecky, 2017 was the most active year for digital health funding with more than $11 billion across a record-setting 794 deals in the United States. Given global market opportunities, increasing demand for innovation, and the wave of high-quality entrepreneurs, the expectation is that there will be significant capital in 2018. Other countries have ramped up their investing in digital health markets as well. Lecky says that there is heightened global recognition of the importance of digital healthcare. While there are several healthcare solutions, there is an abundance of healthcare waste around the world. Digital health solutions support and help to streamline the system, she says. HealthVenture aims to grow its international presence in the next few years to uncover these innovators, their innovations, and solutions.

“I am thrilled to be a part of this evolution. Growing HealthVenture has stretched me in many different ways,” Lecky says with a laugh. “I’ve learned to be a stronger leader and a more fluid leader. Each day I think, ‘What mark are you leaving on the world, and do your profits support an important purpose?’ Recognizing the global impact, HealthVenture allows me to answer those questions in more meaningful ways.” AHL

WHO WE ARE

HealthVenture (HV) is a full-service incubator, investment and consulting firm that provides financial backing, practical operational executive experience, technical expertise and support to take startups to the next level. Our specific focus is early and seed-stage startups specializing in all digital health: from idea development to product launch.

HealthVenture Labs

HealthVenture Labs is an intensive 120-day incubator program working with startups to develop, build, and launch a minimally viable digital health solution to beta-customers.

HealthVenture Capital

HealthVenture Capital is a venture fund investing in disruptive technologies and solutions with a mission to improve health industry on a global scale.

info@healthventure.com

We wanted to know:

Describe how you knew you wanted to work in healthcare.

Leigh Hickman Chief Legal Officer CaroMont Health

Prior to moving in-house, I defended healthcare providers in medical malpractice cases. I knew I wanted to move into healthcare when I realized that in many cases, the first time the providers and patients spoke to each other about a bad outcome was at mediation, which was often years after an event. In my current role, I work with our providers and leaders to promote transparent communication with our patients when there is an unexpected event. This often leads to early resolution of claims and better outcomes for our patients.

Sharyn Alcaraz VP, Legal Peregrine Pharmaceuticals

I stumbled into the healthcare industry when I was offered the job of general counsel with a community hospital system. It was during that first job that I was felt overwhelmed by the complexity and the vastness of the regulations governing the healthcare industry. For a while, I left healthcare to return to the technology industry, but upon my return, I found it boring in comparison to healthcare. Once I returned to the healthcare sector, I never looked back. It took experiences in other industries for me to appreciate the challenges and personal gratification of working in healthcare.

Jason Marks SVP, Head of Litigation and Government Investigations Valeant Pharmaceuticals International,

Inc.

When I went in-house, I knew I wanted to focus my time and effort on a single client, to be part of its success, failure, and be fully invested. As I explored opportunities, healthcare became the obvious choice. Not only could I make a single company successful, but I could also help people at the same time. I am passionate about what I do, and to channel my passion toward meeting unmet medical needs and bringing medical technologies and life-altering products to patients is extraordinarily rewarding.

Jeffrey A. Flaks President, COO Hartford HealthCare

I drove a delivery car for a local pharmacy in the New Haven area, and my route included nursing homes and assisted living facilities. It included physician offices, surgical centers and, in some instances, community hospitals. And, as I did that for a long time, I developed relationships with the people who worked in these different settings. By going every day, I got a chance to appreciate healthcare and the empathy that providers had toward the people they were caring for and the importance of these different healthcare centers to the community. I started to understand that I could fuel my passion and my creativity, but also apply them in a way that would make a difference for people, and that I could see the benefit of my efforts in other people’s lives.

People & Companies

J

K

C

11.5m

The total amount of dollars saved in three years from CaroMont Health’s adoption of the ACA’s accountable care organization program. (CaroMont Health, p. 162)

95m

The number of customers Cigna assists across thirty countries. (Cigna, p. 81)

The percentage of active attorneys who are women, according to the American Bar Association. (Little Company of Mary, p. 188)

The percentage of information contained within unstructured narrative fields in an EHR. (Mental Health Center of Denver, p. 44)

Congratulations

We are pleased to support the leading executives featured by American Healthcare Leader with whom we are honored to work.