Ascension's Anthony Tersigni on accountability, integrity

Anthony Tersigni has been president and CEO of St. Louis-based Ascension since 2004. Ascension was formed in 1999 with the merger of Daughters of Charity National Health System and Sisters of St. Joseph Health System. It's the nation's largest private not-for-profit hospital system, with 131 hospitals, 1,900 care sites and $17 billion in operating revenue for fiscal 2013. Tersigni previously served as CEO at St. John Health in Detroit and as chair of the Catholic Health Association. He has made Modern Healthcare's 100 Most Influential People in Healthcare ranking nine times. Modern Healthcare Managing Editor Harris Meyer talked with Tersigni about his system's recent integrated delivery partnership with CHE Trinity Health, its growth strategy, his management style, and issues related to Catholic healthcare doctrine. This is an edited transcript.

Modern Healthcare: Ascension Health and CHE Trinity recently announced the formation of the Together Health Network in Michigan. What do you hope to accomplish and how is that working out?

Anthony Tersigni: There's a lot of talk about population health, and for us, this notion really goes back to our overarching mission of caring for the whole person, body, mind and spirit. We've been creating clinically integrated systems of care. These networks are formed at the local or regional level to foster communication, collaboration and data-sharing to enable our health ministries to more seamlessly care for the people we serve in our communities.

We've begun efforts in Detroit with Together Health to develop these clinically integrated systems of care, and we're really excited about the potential for us to collaborate with another health system. We have the doctors and hospital network in place, and we have new leadership in place. So they're off and running.

MH: You also are in talks to acquire a health insurance company operating in 18 states.

Tersigni: Actually, we have been in the insurance business for quite some time. We own six health plans in different parts of the country. So all our work developing a continuum of care is just an extension of the work that we've been doing for years.

MH: Is Ascension still in the market to acquire more hospitals, and how are you evaluating markets to decide where you want to go? And how are you evaluating partners?

Tersigni: Ascension's growth strategy, if there is such a thing as a growth strategy, is about covered lives and population health management, but not necessarily how many pieces of the continuum that we have. We have 131 hospitals but we also have 1,900 different care sites. So we look at it from a continuum-of-care perspective, not necessarily acquiring hospitals. We want to talk to those who have seen or bought into the same strategic direction we've developed and refined over the years. They range from hospitals to home-care services, to nursing homes to insurance companies. It's all driven toward population health management and person-centered care. That's really our growth strategy.

MH: What are some initiatives you've taken to better manage population health?

Tersigni: We probably have over 30 different accountable care organizations of some format, and it gives us the opportunity to see what works in terms of person-centered care, where the efficiencies can come from, and to share those efficiencies and those ideas across the system. We're beginning to use lessons from the ACOs in improving our efficiency and outcomes for the people we're privileged to serve.

MH: Please talk about Ascension Ventures, your venture capital arm.

Tersigni: One of our Ascension values is courageous innovation, so we look for solutions that will improve healthcare and the lives of the individuals and communities we serve. It's part of our larger strategy diversifying beyond just the provider space to meet the needs of the patients across the continuum of care. Ascension Ventures was created to invest in mid- to late-stage opportunities. It doesn't invest in startups. It's not your typical venture fund focused solely on returns. We share the healthcare products from the portfolio companies with not only Ascension and our leaders, but also some of our limited partners. We have approximately $550 million in assets under management. Ascension Ventures generates returns that help support our mission to provide care to the poor and vulnerable.

MH: Please talk about your management style and how you stay in touch with your people in the trenches.

Tersigni: If I've had any successes in my management career, it's because I hire people smarter than me, give them the resources necessary to do their job, and get the heck out of the way. Ascension Ventures is a perfect example. We recruited a team of young individuals from the investment management world, including a biomedical engineer. We go out and recruit subject matter specialists for our subsidiaries, and we hopefully provide the resources necessary so that they can do their job. The way I keep connected is through my various meetings with our senior leaders across the country and in my visits. I'm out of the office almost every week visiting either one of our ministries, trying to stay in touch with not only what we're doing, but making sure that we're true to the mission of Ascension. What I find is that our associates are looking for some really basic things from our leaders, and that's what I'm hoping I and our leaders are providing. No. 1 is predictability. No. 2, they want to understand what we're doing. They want compassion and respect. Those are part of our values. They want to be able to see where the accountability falls. They want us to function with integrity. And they are concerned about safety and quality of care for the people we serve.

MH: You just turned 65. Have you talked about any kind of succession plan?

Tersigni: Several years ago we launched the Ascension Leadership Academy focused on forming not only my successor, but the successors to all 150,000 of our associates across the country. We set out to identify talent across the country and nurture that talent. I review all of the talent across the country twice a year. And we try to give people the opportunity and the skill set necessary to allow them to grow.

We have done formal succession planning for me. We know who would step in if I got hit by a truck today. And then we have a formal process that is ongoing where we identify a pool of candidates, both internally and externally, for the board to continue to review as we move into the future. We're looking at succession planning across all of the senior positions all the time. Our ministry is 200 years old and we have an obligation to make sure that it survives another 200 years.

MH: Please talk about Health City Cayman Islands, a large hospital in the Cayman Islands in which Ascension is partnering with an Indian company. What's the purpose and how might that tie into your U.S. operations?

Tersigni: Health City Cayman Islands is a 2,000-bed tertiary-care hospital, the first of its kind in the Caribbean, and its opening in March marked the beginning of a new healthcare delivery system, not only for the Caribbean, but also South America. It's a long-term vision to bring enhanced healthcare to the people living in the Cayman Islands, the Caribbean region and the Americas.

The opportunity for Ascension was to learn from Dr. Devi Shetty, the chairman and founder of Nayarana Health in Bangalore, India, about his methods of providing high-quality healthcare that is accessible and affordable to all, including those who are poor. We recognize the tremendous opportunity this partnership provides us to learn new ways in caring for people we serve.

Dr. Shetty has come up with a number of innovative ideas that have worked in Bangalore. We're trying to take what worked in Bangalore and see how many of those techniques and ideas are applicable there in the Cayman Islands. We hope to learn from that and bring some of those efficiencies back to Ascension facilities in this country. It's a grand experiment of learning and working with three different cultures.

MH: In seeking partnerships and acquisitions around the country, some Catholic systems have encountered occasional conflicts involving the U.S. Conference of Catholic Bishops' Ethical and Religious Directives. Ascension recently faced some issues in Bartlesville, Okla., with the Jane Phillips Medical Center and the medical staff there regarding doctors prescribing birth control sevices. Has this been an issue for your system, how do you resolve it, and how do you persuade communities that the directives won't get in the way of medically necessary services?

Tersigni: Occasionally we find that confusion can arise about what we can and can't do as a faith-based Catholic institution. We work hard to avoid that kind of confusion. We've worked with our colleagues in Tulsa to ensure that there's clarity in this particular case, and we regret that communication probably wasn't more clear at the outset. We have continued to work on clarification of what we can and can't do there.

MH: So the physicians in Bartlesville are not under any constraints in ordering birth-control services for their patients?

Tersigni: I think it's fair to say for us that we don't believe in the corporate practice of medicine, and so we rely on our physicians to do what's in the best interest of the patients that they serve.