St. Luke's New CEO Builds On a Solid Foundation

Chris Roth says enhancing community ties and improving healthcare access and affordability will be focus points during his tenure.

After six years as COO of St. Luke's Health System, Chris Roth took over as president and CEO of the Boise, Idaho–based health system this month. He succeeds David Pate, MD, who led the system for more than a decade.

Roth, who previously served in executive roles at Northwest Hospital & Medical Center in Seattle and Ochsner Health System in New Orleans before arriving at St. Luke's in 2007, spoke with HealthLeaders about the challenges and opportunities he foresees in his role as top executive.

The following is a lightly edited transcript of Roth's comments.

HealthLeaders: Why do you want to be a CEO?

Chris Roth: First of all, I am firmly rooted in this community. I've got family that goes way back relative to Idaho roots. My kids are here. I believe in the community and making a difference, and St. Luke's has a large footprint in southern Idaho where Boise is.

It is personal work, for sure. I believe in our mission and the course that we've been on for the past few years and the people that wake up every day to provide care. I want to make a difference in the community that I'm a part of and one in which I plan to be here, hopefully, until I retire.

The opportunity to influence the organization and make a difference in the community relative to healthcare, and dealing with some of the challenges we face, that's why I want to do it.

HL: You've been in senior leadership for a long time. How do you see your role changing as CEO?

Roth: I believe the CEO needs to serve as the chief culture officer. Culture is a team sport and leaders shape that. As a CEO, it's my responsibility to set the tone from the top. We are a caring organization, and that is the product that we deliver, so I look forward to doing that and setting the example.

Where I'll be spending my time will change. Any senior leader needs to have a balance of being both inwardly focused, but also externally focused. Community relationships are incredibly important. St. Luke's is an organization that can have an influence on public policy. I'll be spending more of my time shaping those aspects of regional healthcare and policy.

And, I'll be leading the strategy that our board has adopted and approved and driving the organization forward to achieve our vision.

The day-to-day work will change, but I'm fortunate that I have the experience and the background in the organization to know where our challenges are and where our opportunities lie. I'm going into this with eyes wide open, but it's going to be a change.

HL: Going into this first year, what do you anticipate being your areas of focus?

Roth: We have a very solid mission and a vision. As an organization, we are committed to improving outcomes, addressing affordability, improving access, and we aim to be and remain a national leader in quality and safety.

We have a solid plan and a strategy going forward. With that as background, I expect that in the next many months, I'm going to be engaged with our employees, our community, our physicians, our legislators, all individuals throughout southern Idaho, to listen and hear how we can become the best partners in the state as it relates to providing healthcare.   

HL: How does your commitment to the community affect any movement toward social determinants of health?

Roth: We have two key foundations that help build our strategy. One speaks specifically to population health. We define population health in the way that St. Luke's improves the health of people in our communities by taking accountability for outcomes in the total cost of care. We're taking financial and clinical account accountability. In fact, we have about 36% of our total revenues at full risk right now.

Secondly, we know that most healthcare outcomes are determined outside of a hospital or clinic or a health system setting. They're determined socially. We need to play a part as a key leader in addressing social determinants, but we can't do it alone. We're committed to partnering with others to help achieve those needs.

HL: What does it say about St. Luke's that they hired a new CEO from within?

Roth: Our board in the process was looking for the right leader at the right time. And I mentioned before the solid strategy and the success we've had as an organization. Anytime an organization makes a decision to go within, what they're saying is, 'We're on a strong path. We've got a good culture. We're looking for a leader to continue the great work and take us to the next level.'

HL: What do you see as some of the biggest challenges and opportunities in the broader healthcare delivery universe in the months and years ahead?

Roth: Our biggest challenge is tackling the issue of access and affordability. When I talk about access, it's meeting people where they want to be met relative to healthcare, the right place, the right time, the right care, and to do so in a way that's affordable and transparent.

We've got a healthcare system that has a lot of work to do. We have incentives that are misaligned. We have payment models and fee schedules and chargemasters and hospitals and insurance companies and the federal government that are part of this big ball of twine that needs to be unwound in a meaningful way for consumers.

Our challenge is achieving better outcomes at a lower cost, and I haven't seen many organizations in healthcare able to achieve that, but that's our aim, and that's our No. 1 challenge ahead.

HL: What role model did Dr. Pate provide for you heading into this job?

Roth: As a CEO, I have never seen anybody that was more committed to the organizational vision and in such a consistent way. He led by example. He talked about it relentlessly.

Seeing him do that over and over again, internally, externally, showed me the importance of consistency as a leader—in particular, CEO. He took some arrows along the way. There were people that doubted the vision he was laying out for the organization, and I saw him with an unwavering commitment to that. That was a good example for me.

HL: At the end of your tenure as CEO, what do you hope your legacy will be?

Roth: Two things: One, I hope and I expect that we will have made a meaningful improvement as it relates to the delivery of healthcare in the region that we serve that's high quality, including strong safety, accessibility, and affordability, and that we can look back to say we've solved some of the greatest healthcare challenges in Idaho.

Second, would be a strong, positive, thriving culture of caring individuals that is functioning as a highly aligned team and has fun in the process.