Competition in Detroit healthcare today feels a bit like the 'Big Three' days of the auto industry, with major players like Trinity and Ascension vying with Henry Ford for market share.
This article appears in the July/August 2019 edition of HealthLeaders magazine.
Wright Lassiter III jokes that the only person he really knew in the state of Michigan when he took the job at Detroit's Henry Ford Health System was then–University of Michigan basketball coach John Beilein, who was Lassiter's coach as a player at Le Moyne College in Syracuse, New York in the 1980s.
It's now been five years since Lassiter was recruited from Alameda Health System in California to Henry Ford to serve as president of the health system and successor to retiring CEO Nancy Schlichting. After taking over as CEO in January 2017, Lassiter leapt into a respected health system that had won the 2011 Malcolm Baldrige National Quality Award but was also moving on from a failed merger with neighboring Beaumont Health that broke due to cultural differences. Detroit was also still recovering from the city's 2013 municipal bankruptcy.
Like he did at Alameda, Lassiter is pushing HFHS to be ahead of the industry in areas such as access and value, which he feels will keep HFHS financially healthy as the industry slowly shifts from fee-for-service. Competition in Detroit healthcare today feels a bit like the "Big Three" days of the auto industry, with major players like Trinity and Ascension vying with Henry Ford for market share.
HealthLeaders recently caught up with Lassiter, who has been a member of the HealthLeaders CEO Exchange, on what the future holds:
HealthLeaders: What are your priorities at this point?
Lassiter: We have had strong leaders before me, like Gail Warden and Nancy Schlichting. And even before them, we've had leaders for the past 40 years who started us down the path of ambulatory care. My overarching priority for the organization is to take advantage of a fully integrated healthcare organization because I believe that the industry is finally starting to move in a direction that could reward organizations like ours for the commitment we make to value-based care and the integration with our health plan.
I think for the first time in our history we should cross the $7 billion of revenue threshold this year. That's remarkable for an organization that only has five acute care hospitals and three behavioral health facilities. Normally organizations with that much revenue would probably have a couple dozen hospitals. So, we've been living ahead of our time and haven't been fully rewarded for some of that wisdom. What I'm trying to do is to make sure that we fully live up to the moniker of being an integrated delivery system.
HealthLeaders: How are you looking to grow in a metropolitan area that isn't growing?
Lassiter: As we look at the market that we serve here in Michigan, it's clear we are in a state that doesn't have a lot of population growth except in the Medicare age range. So, the focus for us must be first to make sure that we can grow where the market's growing. We're looking acutely at how we serve a senior population more effectively than any of our competitors. We're doing that through our Health Alliance Plan and our delivery system assets. We're trying to find growth with our Medicare Advantage population.
HealthLeaders: How are you creating new access points for consumers?
Lassiter: We all know that consumers want a more evolved and more user-friendly digital experience. We're focusing heavily on how we make ourselves one of the most digitally adept organizations for consumers to access. We're trying to do that in lots of different ways. Last year, we had about 3.5 million digital encounters. That includes patients and health plan members utilizing our electronic health records, or the MyChart tool to see lab results. We're using Apple Health to consolidate electronic records. And we recently went live with [Amazon] Alexa to allow users in our markets to find links to the nearest walk-in clinic or urgent care facility.
HealthLeaders: Have you created access points outside of the digital ones?
Lassiter: We opened Henry Ford QuickCare in 2015. Inside of the organization, we call it our "millennial clinic" because it has no parking spaces. Our customers can do everything online. They use a tool called Clockwork MD to schedule an appointment, much like you would use OpenTable for a restaurant reservation. You get a text message when the doctor is 10 or 15 minutes away from being ready to see you. We've got bike share stations out in front of the clinic as opposed to a parking lot. We're trying to do things to create a customer-friendly, visually engaging environment for our patients and our members.
HealthLeaders: Last August you announced an agreement with General Motors to create a direct-to-employer plan for their active employees. Other health systems have tried direct contracting before with mixed results (e.g., Providence St. Joseph Health and Boeing, 2017). What made you think the time was right for Henry Ford?
Lassiter: I'll go back to the first answer I [mentioned], which is that having the ambulatory infrastructure in the game that we're playing in healthcare today means we can take on risk and do it at a decent dollar. I have been talking to other health system CEOs for years who've been ahead of the curve trying to create that infrastructure for the day when someone's going to pay for it. Finally, it looks like we've got some people to pay for it. GM included.
HealthLeaders: And so far?
Lassiter: Right now, we have only been in a few months, but so far, so good. We have a reasonable enrollment. The enrollment was a little bit softer than we expected. I think the [subsequent] announcement that GM was shedding some staff may have factored in a little bit. I would just say that we have about 300,000 patients already enrolled in significant risk arrangements across the system, whether it's our NextGen ACO or our MSSP ACO with our Jackson Health Network, and full risk arrangements with our own health plan. We have done extremely well since we started the NextGen ACO with shared savings every year. So, we understand the patients that we're caring for and we understand what needs they bring to us.
HealthLeaders: How are you using data, especially analytics, to make sure you really know about those populations?
Lassiter: When President Obama put forward the ACA mandate that everyone has an EHR, what folks didn't fully anticipate then was that the EHR is just the beginning of the journey, right? It gives you the platform, the foundation, but if you're really trying to deal with intervention and more aggressive public health strategies, you need something far more than just an Epic or Cerner system. You need analytics that are both predictive and prescriptive. That helps us know what's the right intervention for a community in Southwest Detroit that is primarily Latino versus a community in East Detroit that is primarily African American.
HealthLeaders: Even with a good electronic health record and data infrastructure, how do you make sure you are still connecting with the community?
Lassiter: Sometimes the digital interfaces aren't the right solution. It may be doing things as simple as sending some caseworkers out to churches and barbershops. We had a short-time pilot that utilized postal workers to extend the healthcare community to check for social isolation for seniors. It was based on a program in the U.K. It got canceled around some concerns over labor issues. Still, you can't ever presume that one size fits all. In some cases, you can use slick digital enhancements and digital interfaces. In other cases, we need to go back to the old ways with face-to-face intervention.
The HealthLeaders CEO Exchange annually gathers leading hospital and health system CEOs for a custom dialogue on only the critical issues facing the future of their organizations. The 2019 HealthLeaders CEO Exchange will be September 25–27 in Park City, Utah. For more information, please email firstname.lastname@example.org.
Jim Molpus is the director of the HealthLeaders Exchange.
Photo credit: Courtesy of Henry Ford Health System