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Douglas Hawthorne—A Chance to Do Something Big

Philip Betbeze, for HealthLeaders Media, December 5, 2013

Instead, noting growing issues with diabetes and heart disease, Hawthorne envisions Texas Health as a one-stop shop for individuals, employers, and even municipalities to improve their health. For a few years now, he's been making big bets that his health system will be responsible for, and will make its financial future on, caring for individuals over a lifetime. Making that change in focus pay off financially is the critical challenge, however.

Over Hawthorne's lengthy tenure, the organization has continued to add pieces, often leading the way nationally in acquisition of hospitals, physician practices, and innovative contracting with other pieces of the healthcare continuum. He and his team have shown repeatedly that they are willing to make big bets on where the puck is going in healthcare, and those bets have almost always paid off.

They are seven years into a 10-year strategic plan that seeks to transform the delivery of healthcare from hospital-based to community-based, with a business model that includes pieces like education, wellness, prevention, and primary care on one side (the hospital is in the middle) and rehab, home, long-term, palliative, and hospice care on the other. The goal is to make Texas Health a "national benchmark health system," and given how others have copied this strategy since the Patient Protection and Affordable Care Act was passed four years after Texas Health's transformation was activated, the move seems brilliant in hindsight.

Yet that doesn't mean it hasn't provided its challenges, and it's still too soon to understand which pieces make financial sense and which ones don't because the moves Texas Health has made have almost always been ahead of an income stream to support them, says Hawthorne. Will the strategy pay off? Hawthorne is confident it will.

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