Carlos Migoya, who left Cuba at age 11, is an American success story. After Migoya retired from a successful career at Wachovia bank, Miami's new mayor in 2010 asked him to serve as city manager. Less than a year later, the city named him president and CEO of its financially ailing Jackson Health System. Migoya—named one of Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016—led the public system's turnaround, including a tough downsizing, and it's now in the black. Modern Healthcare reporter Steven Ross Johnson recently asked Migoya about the turnaround and other issues. This is an edited transcript.
Modern Healthcare: What were the key factors behind the turnaround?
Carlos Migoya: The financial turnaround focused around being efficient, making sure that we had the proper resources in the right places. We've done that in a form in which we've started to improve our quality.
We've started some improvements on the brand by working on the facilities and the patient-centric environment. We're starting to see more paying patients coming in the door, not just working on our mission of (serving) the uninsured. Being a public hospital, it's important to continue our mission, but we need to make sure that we continue to find funded patients to help us pay for that mission.
MH: Why are you calling 2016 a transformational year for Jackson Health?
Migoya: Up until now, it has been a financial turnaround. Right now, our focus is more around the patient experience and the quality and safety side. In order for us to have a complete transformation, we have to be in the top 10 percentile in the country on both patient experience as well as in quality and safety.
We have a capital plan of $1.4 billion to work on facilities. But the hospital, although it's nice to have the right facilities and equipment and information technology, is made up of people. So, the idea is to have great doctors and great nurses (and) do it in an environment that is appealing to patients and their families.
MH: Did it call for any kind of cultural change within the staff?
Migoya: That is exactly what we're working on today. Besides being a top public hospital, we're also a top academic center. We have 1,100 residents. So making sure that the residents and doctors and nurses are not just providing great clinical care, but they're also giving the right hospitality to patients and their family members is important. That's where the cultural change is coming.
MH: How will Jackson Health adapt to the reduction in federal funding that's coming?
Migoya: Our capital campaign is not just about modernizing the entire plant, but getting our care closer to the community. So we're building urgent-care centers. We just got approved for a certificate of need for a hundred-bed hospital on the western side of the county. This gets the University of Miami and Jackson Health Medicine closer to the community. It's the 'Dr. Robin Hood' mentality: How do we get the paying patients to pay for the ones who can't afford to pay?