Last week, Dr. Rick Gilfillan stepped down as CEO of Trinity Health, a Catholic not-for-profit system with 93 hospitals in 22 states that reports $18 billion in annual revenue. Gilfillan took over in 2013 and led the system through a $250 million transformation that he counts as his boldest move.
WHAT WAS YOUR RISKIEST DECISION? Implementing our 2020 strategy. We created a strategy to build a people-centered health system and deliver acute-care population-health management, community health and well-being. It also included an initiative to build a common Trinity Health operating platform that would make us a much more integrated system rather than a collection of hospitals.
WHY WAS THAT MOVE RISKY? One, the potential distraction for an organization that is just focused on delivering great clinical care. Doing that well is more than a full-time job. Two, the obvious threat of destroying demand for acute-care services. Our goal was to have 75% of our revenue flow through alternative payment models. Three, we needed new people with new skills. They were in short supply. And again, we had to do all that while we still providing great care. So there was a lot of execution risk. Fourth, we did it across the entire system. We felt, because each system has its own special dynamics, that rather than piloting in one market at a time, we made a commitment to have an ACO and bundled-payment programs in every one of our ministries in the space of one year from 2014 to 2015.
WHAT WAS THE RESPONSE FROM THOSE INVOLVED? There was excitement, surprise, concern, disagreement, and passive and active resistance. It varied across our different ministries because we had to sign 19 regional health ministries and what we call three national health ministries that were accountable for delivering the results for each of their businesses. Today our CEOs and our clinical leaders are committed to this transformation. We’ve had significant leadership turnover, of course. But we have been certain that new CEOs understand and are committed to the strategy because transformation at this level can only be driven by the most senior leaders engaged in making the change.