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Analysis

No Regrets for Intermountain Healthcare's Top Leader

By Philip Betbeze  
   June 08, 2018

CEO Marc Harrison, MD, is focused on Intermountain's potential for growth and transforming healthcare.

Marc Harrison was named president and CEO of Salt Lake City's Intermountain Healthcare in May 2016. Immediately prior to taking the job, he was CEO of Cleveland Clinic Abu Dhabi.

He might have passed on the Intermountain opportunity and waited for a chance to lead the Clinic itself. 

About a year later, longtime Cleveland Clinic President and CEO Toby Cosgrove, MD, made the decision to retire. The pick to take his place: Harrison's successor at Abu Dhabi—Tomislav "Tom" Mihaljevic.

But Harrison has no regrets. Intermountain, a regional health system, is a world leader in its own right.

Charles Sorenson, MD, whom Harrison replaced in May 2016, built the organization into an integrated health system, complete with a health plan (Select Health) that gained national reputation for its work on clinical integration and eliminating variation from clinical practice, with resultant improvements in quality and efficiency. 

Though Harrison wants to continue that leadership, he also has other goals, including the development of virtual health and "distance health" capabilities, intellectual property development, and what he calls "novel joint ventures" with local physicians that are aimed at cutting healthcare's cost and improving its quality. 

As a cancer survivor, Harrison says that experience has given him an acute sense that clinicians and other caregivers are interacting with patients at the most vulnerable times of their lives; it's also given him knowledge of what patients go through when they place their trust in clinicians.

Following are the highlights of his recent conversation with HealthLeaders.

"I feel incredibly fortunate to be leading Intermountain. This is the perfect job for me. I love the population health and value orientation that Intermountain has. In addition to providing high-end quaternary and specialty care, we also serve as the primary safety net for people without means across the state and region. That feels really good. The aspect of leadership that involves service to the community is something I've always loved. I'm great friends with Dr. Cosgrove, but here, we're trying to build a model system in terms of driving value, and that is what I feel I'm meant to do. I don't wish I was anywhere else. I'm where I want to be." 

"The health system of the future needs to deliver care where, when, and how people want it and at the highest-possible quality and lowest-possible cost. Our history of being careful with resources and innovating around quality delivery, as well as our experience around the payer-provider model, puts us in a unique place as an operational and thought leader. Our target is to be the first consumer-centric, digitally enabled consumer health system. I also love the fact we're not just a fully employed physician model. We treasure our 1,500 employed physicians, but we also have 3,500 aligned physicians. Organizations that will drive the future need to be able to work with both." 

"A good example is some really nice work we're doing with Select Health with St. Luke's up in Boise. They're achieving superb results in terms of safety and quality. Those projects allow us to test replicability and will let us know if we can generalize this work across the country. Our digital and distance health is now in five or six western states in hospitals we don't own, and they achieve outstanding results in standardizing clinical care and keeping people in their home area. That's a piece of reliability as well. We have about a hundred clinical services we deliver virtually at this point, and have formalized them into a virtual hospital that we'll share with others and to some extent forgo some revenue." 

"Some systems like ours seek to absorb transports. We’re happy to take those, but we’re more interested in using our virtual capabilities to have people stay in their home hospitals. I’m fascinated by whether we can systematically support rural hospitals and have these hospitals remain financially viable. Extracting patients from these hospitals is the right thing to do if you have no other option, but if there are ways to keep them in place, that’s wonderful because they can stay strong for their communities. That’s not the primary motivation for the virtual hospital, but the future of bricks and mortar is to some extent unclear."

"There’s nothing about my ego that needs us to be on multiple continents. The reason to interact with people at a distance is to learn things that will benefit our primary mission. I don’t have a checklist of countries that I want us to be in. My international experience has been wonderful in that I recognize how deep and diverse the global talent pool is. Salt Lake and Utah in general is much more diverse than most folks recognize. At one of our middle schools, we did a health screening service project and 80% of the kids were people of color."

"Nothing is easy in healthcare. It's a complicated industry, and we're in a volatile political time. The best thing to do is pay close attention to things one can control, and for us, that's care at high quality with consistency at the lowest-possible cost. It's rare to bump into anyone here who's not an expert in what they do. That talent means we can do things that stretch the organization. We're moving fast. I have no disappointments around speed. In fact, the team has overdelivered in terms of improvements in operational excellence, safety, and quality. It appears we're having an excellent year from a financial standpoint." 

"Another way for us to grow is through intellectual property. We've spun off Empiric Health, which allows clinicians to understand the costs of delivering a given service. Our anchor client is Loma Linda [University Health]. Internally, we saved about $90 million in a year with it deployed in half our system. That's without mandating that clinicians change anything. We've also spun off a company called Navican, a precision cancer company. They're able to help patients with advanced cancer to have their tumors sequenced, ID'd, and have a global virtual tumor board determine whether to use targeted biologics or other therapies. Others will spin off in the next six months to a year. We're also looking at some novel JVs with physicians in our region." 

"Select Health is a growth lever. If we choose our partners judiciously, we should be able toachieve the same results with other health systems. It takes quite some time to get good at running health plans. The final piece is the delivery of distance services. For a relatively small investment, well under $100 a square foot, we’ll stand up a [virtual] hospital that will deliver care to millions of people compared to the roughly $600 a square foot that it costs to stand up a traditional hospital."

"I am not ready to declare victory on capitation. That would be foolhardy. It’s an effort of continuous improvement and ever-changing expectations on how we take care of patients. The future is understanding and influencing social determinants. I was talking with our SVP of population health, and I said, ‘If I could take $50 million from Select Health and tell you to keep the members well, could you do it?’ She was honest with me and said not in an objective way. How you apportion care, patient by patient and member by member—we’re trying to figure it out. That’s a totally honest answer."

"If I had a tendency to coast in life at all, which I don't think I ever have, the cancer diagnosis has accelerated my desire to make change because you don't know how much time you have. It's given me a real sense of urgency."

"I'd like to see us deliver the highest-quality care in the U.S. at the lowest per-capita cost. I want people to feel like they can have some control over their health and well-being. Good health systems will have a lot more tools to help people have that sense. The idea of digital is not to depersonalize, but the opposite. If we can do that, I'll be the happiest guy around." 

Philip Betbeze is the senior leadership editor at HealthLeaders.

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