Cleveland Clinic's Mihaljevic Embraces 'Larger Opportunity' in South Florida

The CEO of the renowned health system talks about its latest acquistions in Florida, the importance of aligning culture and caring, and the need for scale in the transition to value-based care. 

Cleveland Clinic has officially welcomed two southeastern Florida health systems under the renowned brand.

With the acquisition of Martin Health and Indian River Medical Center, Weston-based Cleveland Clinic Florida expands its footprint in the Sunshine State to include five hospitals.

Tomislav Mihaljevic, MD, president and CEO of Cleveland Clinic, spoke with HealthLeaders about the new acquisitions and the Clinic's plans to integrate the new health systems. The following is an edited transcript.

HLM: Why is Florida such an attractive market for hospital acquisitions?

Mihaljevic: We believe that there is a great need for healthcare as the population is aging. We're a known entity in Florida. We've been here for 30 years and it's just a logical place to grow because we have had thousands of patients who have experienced Cleveland Clinic care. We believe that we have an obligation to serve them in a much more comprehensive manner.

HLM: Why did you acquire these two hospitals?

Mihaljevic: We believe that there's a larger opportunity for our extended presence here in Florida. What we have experienced at our Cleveland Clinic facility in Weston is just an unprecedented demand for our services. So, we started looking for partner organizations that really fit culturally and organizationally and from the quality standpoint. The definition of ideal partners were Martin Health and Indian River Medical Center.

HLM: Martin Health and Indian River Medical Center had a lot of suitors. Why do you think they picked Cleveland Clinic?

Mihaljevic: When I spoke with the leaders of both organizations they highlighted the alignment around culture. In healthcare it's important to have a strong cultural alignment so that these type of collaborations and mergers make sense. Indian River Medical Center and Martin Health have a value system and a sentiment and a quality of their workforce that strongly mirrors Cleveland Clinic's.

HLM: What specifically did you find attractive about Indian River and Martin?

Mihaljevic: Whenever we look for organizations to partner with, we look for healthy organizations, meaning that they're organizations that in their own right perform well. But we also look for the organizations that have a similar cultural framework. Both Indian River and Martin Health are healthy organizations. They have great reputations and a stellar tradition. But also they have a culture and a sentiment that did aligns with the culture and the sentiment of organizations like us.

HLM: What differences do you think the people in the service areas of these two hospitals are going to see under Cleveland Clinic leadership?

Mihaljevic: Our priority is to provide our patients with the same quality and experience of care in every location. What that means for residents here in southeast Florida is that they will have an access to Cleveland Clinic quality of care in very concrete terms. There's going to be an expanded scope of medical services. We are passionate about increasing the quality and experience of the services. But also immediately they will have access to the combined expertise of healthcare providers from an organization that is 60,000 people strong. There will be opportunities for second opinions, for aligning plans of care with the experts in Cleveland Clinic worldwide, with an immediate benefit for patients in this area.

HLM: How will referrals work?

Mihaljevic: The vast majority of the healthcare needs are provided locally. We believe that here in Florida, with Martin Health and Indian River Medical Center joining us, we will have a full complement of services that the vast majority of people require.

Of course, not every hospital will offer every service. There are going to be certain hospitals that have different services. What we strive for is to provide an integrated system for healthcare delivery in Florida.

HLM: Were these acquisitions motivated by a need to increase your footprint in the transition to value-based care?

Mihaljevic: In order for us to provide coordinated and seamless care of the highest quality and with the lowest costs we have to have a substantial footprint. Yes, value-based care, and any care that is delivered through population health initiatives is a strategic objective for us that will ultimately lead to the better care in southeast Florida.

HLM: Are you considering any additional acquisitions in Florida or elsewhere?

Mihaljevic: None right now. We are determined to focus on our integration with our newest members.

HLM: Can you provide any details on the financial terms of these acquisitions?

Mihaljevic: We're still working on detailing the amount of capital that is needed for both of our new acquisitions, and we will be able to speak in greater detail once that assessment has been completed.

We may be looking at investments that need to focus in different areas. We have just started our work on the creation of a full integration plan, and we'll be happy to share more details, probably towards the end of the year, once we have a greater understanding of the needs of patients and healthcare organizations here.

HLM: Do you have any specific plans for population health with these new hospitals?

Mihaljevic: The big opportunity here comes through the shared electronic medical records that makes us capable of leveraging our expertise as a system more evenly for a larger number of patients. It also gives patients access to their medical data, the ability to schedule appointments, and access care in a much more seamless way.

On the population health front, that accomplishes several things. The good care becomes much more predictable, more standardized, more accessible, and cheaper, so the value of the care that we provide grows.

HLM: Is there an acclimation process for these two health systems as they join Cleveland Clinic?

Mihaljevic: Probably the most important thing to emphasize is that both Martin and Indian River can expect the full commitment of Cleveland Clinic. This is not a branding exercise for us. We're focused on delivering the Cleveland Clinic quality experience of care for every patient who walks in at any location with the Cleveland Clinic name.

There's going to be an integration process that is typically a combination of several things. First is the bi-directional communication, meaning we're not coming into new organizations with a cookie cutter approach. We learn a lot from our partners and have a conversation about the areas that they know are in need of help, so that we can improve jointly.

We do share best practices and the EMR allows us to share those practices much more efficiently. We have educational programs for our caregivers where we speak about what matters for Cleveland Clinic, what Cleveland Clinic quality and experience of care look like. Then there's a process that involves capital investments and investments in the services that patients require.