It’s been nearly three years since Hackensack University Health Network and Meridian Health merged, forming a system with 17 hospitals, including three academic medical centers in New Jersey. But the system under CEO Robert Garrett (co-CEO John Lloyd retired in 2018) has been anything but complacent. In January, it entered into a unique partnership with behavioral health provider Carrier Clinic. Garrett recently talked with Modern Healthcare’s editorial board about that endeavor and other plans for Hackensack Meridian’s future. The following is an edited transcript.
MH: Explain the partnership with Carrier Clinic.
Garrett: We had three major objectives with that merger. One, to integrate behavioral health because we’re finding that up to 50% of all patients—cancer, diabetes, what have you—have behavioral health issues. So the first order of business was to really destigmatize behavioral health and make it a part of mainstream healthcare.
Second, was to expand access. With Carrier, we will expand the number of addiction treatment centers in New Jersey. It’s our feeling that many residents will travel clear across the country to receive addiction treatment. The first addiction treatment center will open by the end of this year in Bergen County. And we hope to emulate that model throughout the state.
We also plan to add behavioral health to our 30 urgent-care centers, where patients would have access to a psychiatrist 24/7 either in person or by telepsychiatry. The third goal is to leverage technology to diagnose and treat patients. Carrier Clinic has done some great things with artificial-intelligence-enabled enhanced facial recognition. So clinicians can instantly diagnose by picking up facial tics, etc., that are aligned with a proper diagnosis. We are very excited about this merger because we really believe it has the potential to be a game-changer.
MH: How has your medical school helped you reach your goals?
Garrett: We opened our medical school in July 2018 and our first class was 60 students with 2,300 applicants. Our second class is 90 students and almost 5,000 applications. We really developed an innovative curriculum.
We have a three-year program, saving that fourth year of tuition. We’re very mindful of affordability, but it also gives Hackensack Meridian an advantage because those students would automatically, if they desire, be matched for a residency spot within the system.
We also have what we call a community immersion program, so medical students get paired with two families during their studies, families from underserved communities, and they get to see firsthand some of the challenges those families have staying healthy. They understand more of the social determinants of health. There’s a lot that they see firsthand about nutrition, housing, transportation, all sorts of issues. We feel it will make a more compassionate physician, a more empathetic physician, but also a more proactive physician in terms of prevention and treatment.
The third innovation involves interprofessional academics. Our academic partner, Seton Hall University, relocated the college of nursing and its school for health sciences and medicine to our campus and students of the different professions attend classes together. They share science labs and truly understand each other’s role on the healthcare team. There’s lots of data out there that shows when barriers are broken and these professionals really work as a team, patient outcomes and patient experiences improve.
Seton Hall has decided they have too many other things on the table right now, so they’re not going to be our academic partner anymore. So we are going through a re-accreditation process now, whereby the school will be totally accredited in Hackensack Meridian’s name. So by sometime next March, we hope that we can become academically independent so that any students who graduate after that time would actually get their degree in the Hackensack Meridian School of Medicine name.
MH: How does Hackensack Meridian compete with other area schools, including NYU, which offer free tuition?
Garrett: Our board allocated $100 million for scholarships. We’ve also been fortunate that the state of New Jersey allocated between $4 million and $5 million a year for scholarships as well. We made the case first to (then-)Gov. (Chris) Christie and now to Gov. (Phil) Murphy. Both governors saw the value. This is New Jersey’s first private medical school in 60 years.
We’ve redeveloped the former location of the Hoffmann-La Roche corporate headquarters. They put millions of dollars into that campus only to abandon it when they moved to San Francisco. So we were the lucky recipients of a state-of-the-art campus that had incredible laboratories. That location is providing an economic boom to the area. So the state was very supportive with tax credits, not just for the medical school but for a major research and innovation institute on that campus.
It’s called the Center for Discovery and Innovation. We’ve recruited scientists, some from New Jersey but others from around the country, to do their research, and the focus has been on cancer and infectious-disease research and regenerative medicine. With cancer, we’ve been working in a collaboration with Georgetown University and we’re on a path to become National Cancer Institute-designated as a comprehensive cancer center. The research with Georgetown has been in the field of immunotherapy.
MH: This is all separate from your Bear’s Den initiative?
Garrett: The board allocated a $25 million fund for the Bear’s Den, which has two components. We partnered with the New Jersey Institute of Technology to establish an innovation center, and we created an ideation center as a part of that. The idea is to attract new companies, new products that can transform healthcare, but also to encourage ground-up innovation from our 34,000 team members. So we established this panel of judges like Shark Tank and we have invested in two major companies.
Proposals go through an ideation process and then team members present their ideas to a panel of judges that includes clinicians, businesspeople, entrepreneurs and an intellectual-property attorney.
MH: How do you see Hackensack Meridian growing over the next year?
Garrett: We have the 17 hospitals, but we also have 500 patient-care locations throughout New Jersey. We have ambulatory-care centers, we have surgery centers, fitness and wellness centers, urgent care, assisted living, post-acute care, the full continuum. We have physician offices as well as part of those 500 care sites. I see a lot of growth over the next year in the nonhospital side of the business. There are concentrations of where the ambulatory-care network is strong and complements the hospitals and there are other areas of the state that still have gaps. As an example, on the outpatient side, we don’t have ambulatory-care centers in the north and we don’t have as many nursing homes that we own or partner with in the north. So that’s a real focus over the next year.
MH: Through acquisitions?
Garrett: Possibly through acquisition and potentially through partnership. For surgery centers we like to partner with our surgeons, and we also have partnerships with United Surgical Partners. There are also opportunities for expansion in urgent care, and that’s probably in all three of Hackensack Meridian’s regions—north, central and south.
In terms of the hospitals, at Hackensack University Medical Center I see a major expansion in our transplant programs. We currently have one of the largest bone marrow transplant programs in the nation. We also have a kidney and pancreas transplant program, but we are starting to make plans to get into heart transplant and liver transplant as well.
We also partnered in a 50/50 joint venture with Memorial Sloan Kettering to establish and operate new cancer centers in New Jersey, and we’ve announced our first location in Lawrenceville, just south of Princeton, and I think that model could also be replicated in other areas as needs exist. The idea is to bring world-class cancer care close to people’s homes.
MH: Do you think you’ll go national at some point?
Garrett: I think regional healthcare systems are the most successful systems. We have programs that draw patients from around the country, like our bone marrow program. But I think the regional structure is a really solid structure because in a lot of ways, healthcare is still local and we still have a responsibility to our local communities.
Part of the problem that some of the national health systems have faced is that maybe they lose that local connection. There are synergies and efficiencies that you can gain from being in one particular region or one area. I think strong regional networks also are highly integrated.
I see a lot of health systems as confederations of hospitals. They acquire different hospitals, but they make no effort to really integrate them so you can have common clinical protocols, so you can improve care, improve access.
We have an entire integration team, and when we are involved in a merger or an acquisition, or even in an affiliation, before that transaction closes, months before, we put together an integration plan, so that when Day 1 comes, we can really hit the ground running.
