Summa Health presses forward amid uncertainty

Summa Health System had a tumultuous start to 2017 following messy contract negotiations that ultimately culminated in the resignation of its CEO Dr. Thomas Malone, but system officials are pressing forward as they search for a new leader.

Summa, along with the rest of the health care industry, faces uncertainty with the likely repeal of the Affordable Care Act. That uncertainty is compounded at Summa given the sudden leadership change, but system officials are confident they can weather the storm and move ahead, as planned, with an ambitious $350 million facilities plan. In particular, Summa leadership points to success with its accountable care organization, the launch of an electronic medical record and favorable ratings from Moody's Investors Service and Fitch Ratings.

With any leadership transition comes some uncertainty and instability, "and we're certainly going to experience that over the next couple of weeks," said Ben Sutton, senior vice president for strategy and performance management. But leaders at all levels of Summa "firmly believe" in the system's vision and direction going forward, he said.

Malone, who had served as CEO for only about two years, resigned Jan. 26 after vocal opposition to a decision to not renew the contract of the independent physician group that had staffed its emergency departments for decades. Upon reaching an impasse in negotiations, Summa brought in new ED physicians at midnight on New Year's to replace Summa Emergency Associates.

Still, details remain scant regarding Summa's search for a new leader.

System spokesman Mike Bernstein said the search is "progressing well" but he declined to confirm whether there is a search committee in place and whether the system is looking at internal or external candidates. Sutton and Bernstein also both indicated the board is seeking an interim CEO, but a memo from the board last week regarding Malone's resignation makes no mention of the role being interim. It said Malone will continue in the role of CEO for up to 60 days as the board "conducts a search for his successor" and focuses on "finding the best leader." It remains unclear whether the board is seeking an interim or a permanent role.

Health care organizations are unique in the number of stakeholders often consulted during an executive search, including board members, physicians, other providers, hospital contributors and community officials, said Ralph Dise, president of executive recruitment firm Dise and Co.

Dise, whose company has not been contacted for Summa's search, said that a CEO search typically takes 90 to 120 days, plus an additional two to four weeks for the candidate to move and begin a job. Ninety is on the fast side.

Bernstein said it was the board's intention to complete the process in up to 60 days. But it remains unclear whether this is an internal or external hire for an interim or permanent role, all factors that would change the pace of a search.

If Summa is aiming for the 60-day mark, "It would be hard to get it done in 60 days," said Dise, who also stressed that leading Summa would be the "opportunity of a lifetime" for a candidate who's the right fit.

"People who operate at the highest levels of health care are turned on by challenge," Dise said.

Tom Campanella, director of the health care MBA program at Baldwin Wallace University, said that trust and communication will be critical for the new leader.

From his perspective, an internal hire or someone who has a history with the system would be ideal — someone who has already developed trust with some of the key players.

"But it can't just be a trust issue; this person obviously now more than ever needs to be a visionary, somebody that really can motivate people and really work to evolve the organization to even being that much more of a winner in this time of change," Campanella said. "And my hope is, because I have a lot of respect for the people at various levels from physician and administrators at Summa, that they do have some internal viable candidates."

In mid-January, less than two weeks prior to Malone's resignation, Summa's board announced a series of steps giving it more direct oversight of administrative moves following the controversy regarding the sudden change in ED staffing.

The moves included hiring an "executive coach" to report directly to the board, as well as creating an advisory medical staff panel, taking on direct oversight for all physician contracts for the rest of 2017 and revising its contract renewal process "to avoid a repeat of the recent emergency department transition."

Valerie Gibson, chief operating officer of Summa and president of Summa Health System hospitals, said they are still working on forming the physician advisory panel, "but as a team, we're fully focused on moving forward and continuing our relationships with our physicians."

The panel was expected to be made up of independent and employed physicians and advise the board on medical staff issues.

Bernstein declined to confirm whether the board would continue with the other initiatives publicly shared last month, saying that the board "has asked that those details remain internal."

Gibson said leaders are also working with existing committees, including medical staff executive committee and department chairs. She said she has no other indications of leadership changes and that "we feel very solid about our executive leadership team and that we're going to be carrying the mission forward."

The contract turmoil and leadership change come as competition heats up in the Akron health care scene, particularly given that in 2015 the Cleveland Clinic took on full ownership of Summa's rival, Akron General. University Hospitals too has quietly staked a claim, having acquired several Akron-area physician practices in recent years.

Allan Baumgarten, a Minnesota-based consultant who studies health care markets across the country, said that as the Clinic can sell its broad network of internationally known specialists, it's important for Summa to counter by touting its own range of highly qualified specialists close to home.

"And that's important as well because, financially, I would say that most hospital systems are looking to specialties in general — and certain specific specialties like cardiology and orthopedic surgery and oncology — as important sources of patients and revenues," Baumgarten said.

Sutton said that the Clinic's presence certainly increases competition in the market, but it doesn't necessarily change much for Summa. Sutton stressed that Summa's commitment to population health and value-based care will set it apart. It's worth noting Summa was one of the early adopters, especially locally, of the ACO model. ACOs are designed around the concept of providing high-quality, coordinated care at a controlled cost.

Summa's facility project has been moving ahead as planned. Design work is underway, and Summa's target is still to break ground on the work at its Akron City campus toward the middle of the year.

For the most part, Gibson said, physicians are aligned with where Summa is headed and they will help move the system forward. While some opposing voices may remain, Summa is focusing on moving forward and putting things in the past, she said.

"We're continuing to work every day to ensure that we have as much stability as possible in this transition," Sutton said.