Health Care Hall of Fame - 2008
Pat Groner
Pat Groner helped pioneer outpatient surgery, assisted-living, helicopter transport
During Pat Groner’s 33 years at the helm, Baptist Hospital in Pensacola, Fla., grew from about 100 beds at its opening to about 500. Called Baptist Health Care Corp. by the time Groner retired in 1983, the system had purchased an affiliate in rural Santa Rosa County and exponentially added specialties, such as cardiology and oncology, establishing one of the first four intensive cardiac-care units in the country.
When he arrived in Pensacola at age 30, Groner accepted the position as administrator of the then-brand-new facility because he foresaw himself being surrounded by “bright, young, innovative people,” he says. “It was well-financed, and the spirit of the place was such” that he felt inexorably drawn to Baptist.
Jim Vickery, who succeeded Groner as president in 1983 and held the position until 1999, reflects that his predecessor took a huge leap early in his career. “He came here while the hospital was in the final stages of construction,” Vickery says. “That had to be a very significant challenge for a young man with some hospital experience but without a huge amount.”
Vickery describes Groner, 87, as energetic, determined and resilient. “He would take a disappointment and bounce back as well as anybody I’ve ever seen,” he says. “He had a great faculty for developing or adopting ideas that had been pursued in other places and applying them locally, sometimes with minimal resources, and sometimes with some local obstacles.”
“He’s an innovator,” says Tom Smith, who served from 1991 to 2003 as chief executive officer of Voluntary Hospitals of America, which Groner co-founded. “He’s always restless about the status quo and finding new and better ways to do things. … He’s a curious fellow who has a passion for making things better.”
It might seem ho-hum today, but when Groner led the creation of Baptist’s outpatient surgical services in the early 1970s, the advantages were not well-known. “In the early days, patients always remained overnight,” Groner says. “We talked to Blue Cross about covering outpatient surgery—they did, and it was a huge success. It was not long before all of the (insurance) companies were covering outpatient surgery.”
Recognizing the need to care for the nation’s growing elderly population, Groner implemented housing programs in the 1970s and early ’80s, which predated the boom in such assisted-living environments. When the University of West Florida was founded nearby, Baptist bought contiguous property. “We have all that common boundary,” Groner says. “Our employees are full-time students.”
Groner pioneered the use of productivity incentives in a not-for-profit environment, developing measurable standards and successfully challenging the Internal Revenue Service rules for reward sharing. In 1977, he published the book, Cost Containment Through Employee Incentives Program, which laid out his vision and methodology. “Ours were based on departments—dietary, nursing, maintenance, surgery,” Groner says. “Each developed their own standards, but they followed a similar pattern.”
In 1977, Baptist became the third hospital in the nation—and by far the smallest—to use helicopters to transport the sick and injured. Groner recalls that the helipad was used nearly 400 times the first year, in a “relatively small town,” with a county population then below 100,000. “To recommend that, and pursue that—given the high cost, and the uncertainty of its utilization and its future—was a pretty courageous stand for a chief executive officer to take. And it’s been very successful, and it continues,” Vickery says.
While at Baptist, Groner also formed regional alliances to help small, rural hospitals find cost-savings by collaborating with larger systems—and the Baptist Regional Health Services, became a national model for such alliances.
Vickery notes that the program addressed issues of cost and service on a regional basis “back at a time when that was not a popular thing to do.” He says that Groner had “energy to put together a program like that, getting people who might not be as excited as you are to move forward with you.” In some sense, VHA was modeled on it, too, he adds.
Perhaps the biggest challenge he faced during his tenure came from a foot-dragging board member who delayed approval of a planned pediatric unit until an upstart competitor, Sacred Heart, suddenly announced one. “Something he was supposed to have accomplished for approval in four, five, six months took a year and a half,” Groner says. “And just, choom, they announced it like that, and the pediatricians all left.”
Groner greatly affected the industry. He played a key role in co-founding VHA, a cooperative of not-for-profit hospitals that formed to address a multitude of issues, from personnel sharing to idea sharing, although the organization over the years has come to focus primarily on economies of scale through group purchasing. VHA membership has swelled from the original 29 to 2,300 today, with group purchasing reaching $1 billion by 1986 and $30 billion today, handled through a separate organization called Novation, says current VHA President and CEO Curt Nonomaque.
“Conceptually, we felt that if we put together a critical mass of leading hospitals from different communities into the right kind of corporate structure, we could do things that no other organization could do, and significantly better,” says Stanley Nelson, a fellow VHA co-founder and Health Care Hall of Fame inductee. “It was a leap of faith.”
They hit upon the group purchasing concept early on, at a time when “hospitals, from a vendor’s standpoint, were a cottage industry,” Nelson says. “Pat was enthusiastic, creative, imaginative—he never met a new idea that he didn’t like. … He was probably the most enthusiastic, energetic hospital administrator I’ve ever known.”
Allen Hicks, another VHA co-founder and Health Care Hall of Famer, echoes Nelson’s words about Groner and applies them to Wade Mountz, a VHA co-founder who’s also being inducted into the Hall of Fame this year as well. “They were high-octane, enthusiastic people who were not afraid to step out and make a decision,” Hicks says. “They had the enthusiasm that goes with leaders who make things happen.”
“They were both very instrumental in not only getting VHA started, but giving it a good start,” adds Don Arnwine, the organization’s first paid president.
Mountz sees many parallels between the careers of himself and Groner. “We’ve stayed put,” he says. “That is a tremendous advantage if you can do it because each time you have a change in leadership in an organization, there’s a chance that it will take a different direction (or) it will lose time while new management is getting in place.”
Groner and Mountz also were among those who co-founded an insurance company they set up offshore to address a malpractice crisis in the mid-1970s. The company built into its rate structures incentives to reduce premiums through reductions of adverse patient incentives. Groner, who served two terms on the American Hospital Association board, recalls that Baptist itself saved more than $1 million the first year.
J. Craig Honaman, who first met Groner as a resident in 1969 and served as senior vice president at Baptist, recalls Groner as a great mentor and credits him with helping to professionalize the healthcare administration field from its “superintendent” roots. “Mr. Groner was one of those pool of executives that made a conscientious effort to build people. He spent time with young executives such as myself,” says Honaman, now principal at H & H Consulting Partners. “He was in the leading group that moved the entire profession to a professional position, as a senior executive and leader with the necessary training and the necessarily ethical standards to run it as a business.”
Healthcare administration apparently runs in the Groner family. His brother, Frank, led the unaffiliated Baptist system in Memphis for many years and entered the Hall of Fame in 1988. And Pat Groner’s granddaughter, Jennifer, works in the Carolinas Health System and will be on hand to accept his award.
It might seem ho-hum today, but when Groner led the creation of Baptist’s outpatient surgical services in the early 1970s, the advantages were not well-known. “In the early days, patients always remained overnight,” Groner says. “We talked to Blue Cross about covering outpatient surgery—they did, and it was a huge success. It was not long before all of the (insurance) companies were covering outpatient surgery.”
Recognizing the need to care for the nation’s growing elderly population, Groner implemented housing programs in the 1970s and early ’80s, which predated the boom in such assisted-living environments. When the University of West Florida was founded nearby, Baptist bought contiguous property. “We have all that common boundary,” Groner says. “Our employees are full-time students.”
Groner pioneered the use of productivity incentives in a not-for-profit environment, developing measurable standards and successfully challenging the Internal Revenue Service rules for reward sharing. In 1977, he published the book, Cost Containment Through Employee Incentives Program, which laid out his vision and methodology. “Ours were based on departments—dietary, nursing, maintenance, surgery,” Groner says. “Each developed their own standards, but they followed a similar pattern.”
In 1977, Baptist became the third hospital in the nation—and by far the smallest—to use helicopters to transport the sick and injured. Groner recalls that the helipad was used nearly 400 times the first year, in a “relatively small town,” with a county population then below 100,000. “To recommend that, and pursue that—given the high cost, and the uncertainty of its utilization and its future—was a pretty courageous stand for a chief executive officer to take. And it’s been very successful, and it continues,” Vickery says.
While at Baptist, Groner also formed regional alliances to help small, rural hospitals find cost-savings by collaborating with larger systems—and the Baptist Regional Health Services, became a national model for such alliances.
Vickery notes that the program addressed issues of cost and service on a regional basis “back at a time when that was not a popular thing to do.” He says that Groner had “energy to put together a program like that, getting people who might not be as excited as you are to move forward with you.” In some sense, VHA was modeled on it, too, he adds.
Perhaps the biggest challenge he faced during his tenure came from a foot-dragging board member who delayed approval of a planned pediatric unit until an upstart competitor, Sacred Heart, suddenly announced one. “Something he was supposed to have accomplished for approval in four, five, six months took a year and a half,” Groner says. “And just, choom, they announced it like that, and the pediatricians all left.”
Groner greatly affected the industry. He played a key role in co-founding VHA, a cooperative of not-for-profit hospitals that formed to address a multitude of issues, from personnel sharing to idea sharing, although the organization over the years has come to focus primarily on economies of scale through group purchasing. VHA membership has swelled from the original 29 to 2,300 today, with group purchasing reaching $1 billion by 1986 and $30 billion today, handled through a separate organization called Novation, says current VHA President and CEO Curt Nonomaque.
“Conceptually, we felt that if we put together a critical mass of leading hospitals from different communities into the right kind of corporate structure, we could do things that no other organization could do, and significantly better,” says Stanley Nelson, a fellow VHA co-founder and Health Care Hall of Fame inductee. “It was a leap of faith.”
They hit upon the group purchasing concept early on, at a time when “hospitals, from a vendor’s standpoint, were a cottage industry,” Nelson says. “Pat was enthusiastic, creative, imaginative—he never met a new idea that he didn’t like. … He was probably the most enthusiastic, energetic hospital administrator I’ve ever known.”
Allen Hicks, another VHA co-founder and Health Care Hall of Famer, echoes Nelson’s words about Groner and applies them to Wade Mountz, a VHA co-founder who’s also being inducted into the Hall of Fame this year as well. “They were high-octane, enthusiastic people who were not afraid to step out and make a decision,” Hicks says. “They had the enthusiasm that goes with leaders who make things happen.”
“They were both very instrumental in not only getting VHA started, but giving it a good start,” adds Don Arnwine, the organization’s first paid president.
Mountz sees many parallels between the careers of himself and Groner. “We’ve stayed put,” he says. “That is a tremendous advantage if you can do it because each time you have a change in leadership in an organization, there’s a chance that it will take a different direction (or) it will lose time while new management is getting in place.”
Groner and Mountz also were among those who co-founded an insurance company they set up offshore to address a malpractice crisis in the mid-1970s. The company built into its rate structures incentives to reduce premiums through reductions of adverse patient incentives. Groner, who served two terms on the American Hospital Association board, recalls that Baptist itself saved more than $1 million the first year.
J. Craig Honaman, who first met Groner as a resident in 1969 and served as senior vice president at Baptist, recalls Groner as a great mentor and credits him with helping to professionalize the healthcare administration field from its “superintendent” roots. “Mr. Groner was one of those pool of executives that made a conscientious effort to build people. He spent time with young executives such as myself,” says Honaman, now principal at H & H Consulting Partners. “He was in the leading group that moved the entire profession to a professional position, as a senior executive and leader with the necessary training and the necessarily ethical standards to run it as a business.”
Healthcare administration apparently runs in the Groner family. His brother, Frank, led the unaffiliated Baptist system in Memphis for many years and entered the Hall of Fame in 1988. And Pat Groner’s granddaughter, Jennifer, works in the Carolinas Health System and will be on hand to accept his award.