Mark Sullivan wasn’t new to Catholic Health when he took over as CEO in March 2018. In fact, he’d been with the Buffalo, N.Y., system for nearly three decades. Still, his goal was to try to look at the organization with fresh eyes. In mid-August, Sullivan announced a major reorganization at the leadership level with the goal of streamlining operations and better positioning Catholic Health to address patient needs across the continuum of care. Sullivan spoke with Modern Healthcare Managing Editor Matthew Weinstock about the changes. The following is an edited transcript.
MH: You’ve been CEO for a little over a year now …
Sullivan: 537 days.
MH: But who’s counting, right?
Sullivan: Right.
MH: What’s surprised you?
Sullivan: It was important for me to start with a beginner’s mind. Being the chief operating officer for 12 years, one of the things I wanted to do is come in and start fresh. So I actually went through orientation for seven hours. I rounded at all the sites and tried to … evaluate as if I was moving from out of town. I was not surprised at the high quality that Catholic Health delivers day in and day out, but it was very interesting to get to know the staff a little bit more in different areas and then also the community.
I probably visited with well over 600 people in the first 100 days out in the community, whether they were elected officials, community leaders, advocates or other partners, to really get a feel for what Catholic Health meant to them. So there was a lot of time spent on the outside as a CEO as opposed to the inside as the COO.
Although I was next to the CEO for 12 years, it doesn’t mean I was in the same chair.
MH: How hard was it for you to put those blinders on and pretend like you didn’t know the organization as well as you do?
Sullivan: I’ve been here 26 years. I started as an intern while I was in college at one of our hospitals. When I was informed I was CEO, even applying for the position, one of the things I needed to do is really put myself in that position mentally to articulate a vision of how I would lead. I created a 100-day plan and through the prism of the new job I shelved operational responsibilities and asked myself to always start with that beginner’s mind and look at things differently.
My No. 1 priority was the health of the organization, not the operations of the organization. I break it into three categories. No. 1: patients come first. They must be satisfied, have high quality, and really know how much we care for them.
The second two are tied: make sure our physicians are engaged and feel like we’ve given them the tools they need to advance the care for patients. And then the 10,000 associates, how do we keep them engaged, keep them inspired to follow our ministry and the mission of Catholic Health?
MH: That leads into the reorganization you announced in mid-August. What was the goal?
Sullivan: I wanted to establish a leadership team that has diversity; not only diversity on where they’ve come from in their career, but diversity in points of views, diversity culturally, whatever those aspects would be that could really reflect the people we’re caring for.
We needed to make sure the corporate shared services that support our ministries were not the tail wagging the dog; that they knew we are in existence to care for our patients and we are in existence to support the (clinical and operational) leaders who deliver the care. In order for me to do that, I had to reconstitute the way our leadership team was designed.
I broke it into three areas—home- and community-based care, ambulatory services, and acute care. These leaders now all report to the COO and they’re working across the continuum. I’ve removed silos based on destinations where people receive their care and silos based on performance at individual hospitals. These operators now are working as one team with common goals and common measurements and are meeting more frequently.
We’re taking care of the patient where they want to be cared for, and it’s important for us to meet them where they feel their care needs to be. That could be from their couch to their cellphone to the ambulatory surgical center.
What I want to make sure is that those senior VPs are working together and that we’re helping patients where there’s overlap. We’re making sure that patients end up with the right level of care. It’s not about individual divisions or ministries. My operators in our hospitals know the importance of making sure that our emergency rooms are coordinating with home care and ambulatory care to make sure that if a patient shows up (they should see if) there’s an opportunity to work on some social determinants to help the patient not show up at an emergency room unless they really need to. That’s really a game-changer for us because we’re really focusing on what the patient needs and wants and not letting the healthcare model drive meeting those needs.
MH: How do you go through that when the payment model isn’t fully there yet?
Sullivan: It’s repairing a plane in flight. Basically, we have one foot in fee-for-service and one foot in value-based. It really isn’t about revenue for Catholic Health. No money, no mission, of course, but we also have to look at the cost of care, especially with more out-of-pocket expenses for patients.
There will be valleys when it comes to financial returns for any health system that’s trying to balance both those areas, but if you can provide high-quality care at a really efficient cost and focus on that, you can navigate through those rough waters between fee-for-service and value-based payment. We’re very fortunate to have some pretty progressive payers in the Western New York market that look to Catholic Health for innovation and how we work together to focus on the patients and take out unnecessary costs.
MH: You recently acquired a surgery center. Can you talk about your growth or expansion plans in that space?
Sullivan: We realize that we need to be nimble, dynamic and diverse, and I say those terms related to the bricks and mortar. We also need to make sure—and our balance sheet reflects this—that we have enough resources to invest in things outside the acute-care setting while we’re investing in the acute-care setting.
