Sandra Bruce has served as president and CEO of Presence Health since the 11-hospital system was formed in November 2011 by the merger of Resurrection Healthcare and Provena Health, with facilities in the Chicago area and central Illinois. Before that, she served as CEO of Resurrection and CEO of Trinity Health's St. Alphonsus Health System in Boise, Idaho. Bruce is a former board chair of the Catholic Health Association and continues as a CHA committee member. Modern Healthcare reporter Andis Robeznieks spoke with her recently about the challenge of merging cultures, increasing diversity in her system's executive ranks, continuous performance improvement and the economic impact of reducing inpatient hospital capacity on communities. This is an edited transcript.
Modern Healthcare: How are you doing in merging the cultures of Resurrection and Provena?
Sandra Bruce: It's a journey to get to a single culture and we are not there yet. I think it takes five to 10 years. We have been explicit about some aspects of the culture, one of which is to become an organization that focuses on performance improvement. We are making progress there. We all tend to think erroneously that if two Catholic organizations come together, the cultures must be the same. They're not. The two organizations were operated very differently. Resurrection was a highly centralized entity and Provena Health was decentralized. The board made a decision that a more centralized model would be the most effective way forward. That has caused some discomfort.
MH: Is Presence going to expand or merge?
Bruce: We are trying to expand our geographic footprint through our accountable care organization called Presence Health Partners. We have expanded it significantly through our Medicaid accountable care entity, including many other providers that are not Presence-owned and operated. We have over 4,000 physicians participating. A third of them are largely on staff at other hospitals. They set the clinical protocols and also are involved in the negotiation of contracts with the payer. That's been part of our success in attracting them.
MH: How is the state of Illinois treating you as far as Medicaid?
Bruce: If Gov. Bruce Rauner's proposal to cut $1.5 billion from Medicaid is approved, it will have a profound if not devastating effect on our ability to serve as a safety net for the poor and vulnerable.
MH: How do you seek to make Presence Health's leadership diverse?
Bruce: In terms of staff diversity, I have done a good job here at Presence and in my career of having a diverse senior team as far as gender. I have not done as good a job at having a diverse team from a racial and ethnic perspective. We are just now formulating initiatives to make sure that the management team is as diverse as the populations we serve. For a number of years, we have said there will be women candidates in these management pools. But we have not necessarily said, “We will have ethnically diverse candidates in that pool.” So we are beginning that process.