Despite her atypical career origins, Cahills curriculum vitae does show signs and precedents for her role at CHI, such as her ability to gravitate to top jobs and navigate complex group transitions involving numerous stakeholders.
In 1972, she started as a budget director at the Association of University Programs in Health Administration and within six years she was a vice president managing day-to-day operations. She spent three years as vice president of government relations at the Catholic Health Association before taking a job in 1983 as president of 225-bed Calvary Hospital, a cancer center in the Bronx. In the 1990s, she went to work for the Archdiocese of New York in Manhattan, spearheading efforts to establish a network of 18 hospitals and nursing homes under a joint religious sponsorship, and another alliance of 43 hospitals under 15 religious sponsors.
Colleagues say part of her success stemmed from her ability to say good things when Catholic healthcare deserved it and difficult things when it was necessary, while employing a sense of humor and a deeper grasp of how to balance finances with the social and spiritual goals of the Catholic sponsors.
Cahill was also among a new wave of lay people who took on high-level executive roles in religious hospital governance. She sees an important role for laity and women in the church, says David Lincoln, president and CEO of Covenant Health. She is continuing the legacy of the women religious and lay people who came before.
Whatever uncertainty may have existed about the original formation of Catholic Health Initiatives, Ron Aldrich says he never had any doubts about Cahills ability to lead CHI through its difficult early years. And thats a compliment coming from one of the three CEOs whose systems were ceding all their assets and individual identities in order to form CHI.
She was the perfect person to lead Catholic Health Initiatives, says Aldrich, who was CEO of Chadds Ford, Pa.-based Franciscan Health System until 1996, when it became part of CHI.
At the time, Catholic systems around the country in the mid-1990s had been reaching the conclusion that they had better strengthen their financial positions or risk joining the other Catholic hospitals that were feeding the voracious appetites of acquisition-hungry investor-owned systems. Catholic healthcare needed to change quickly and build on the strength that was there, Aldrich says.
So in 1995, 10 separate Roman Catholic religious congregations that owned more than 100 hospitals, clinics and free-standing facilities decided to merge their three disparate systems: Franciscan; Catholic Health Corp., Omaha, Neb.; and Sisters of Charity Health Care Systems, Cincinnati.
At that time, it was the largest such Catholic system in the U.S. and represented a new way of thinking, with laity holding key executive positions in the C-suite and a new diversified business model in which no market generated more than 10% of the new systems $5 billion in operating revenue.
But who could lead such a new system? After some initial factionalism between supporters of the various leaders in the existing systems, the CEOs decided that none of them should take the reins of CHI because lingering loyalties could derail the cooperative spirit. The in-house search committee, which included Aldrich, eventually narrowed the final CEO candidates to three people, and called them for interviews.
Cahill had a reputation for consensus-building when she was director of health and hospitals for the Archdiocese of New York in Manhattan. In that role she developed the Alliance for Catholic Health and Human Services, a loose affiliation of 43 Catholic hospitals under 15 religious sponsors that worked on collaborative programs in areas such as purchasing.
It was like all of her experience before had brought her to that point, Aldrich says. In the interview
her clarity around that role was so strong and clear.
The steering committee eventually voted 12-0 to hire Cahill.
After taking the helm, Cahill says she never looked backnot that it would have done her much good to try. The corporate structure did not include any structured way for the systems to pull out through a formal escape clause in the initial corporate agreements.
If you build in an elaborate exit clause, you can be sure that the first time you hit difficulty, someones going to try to use it, Cahill says. We never built an exit.