Steve Johnson and his Health First Team are Shaping the Future of Health Care on the Space Coast
by Michelle Salyer
For the last several years, health care has been a political hot button. Americans continue to hear that “the landscape of health care is changing,” but what does that really mean for Brevard County?
“All over the country, communities like Brevard are losing control over their local systems,” says Steve Johnson, Health First president & CEO. “They’re being bought by larger systems, typically in large metropolitan areas, and then the higher end of care all goes to those metropolitan areas.”
That’s why Johnson and his new executive team spent 2012 paving the way for an “integrated delivery network” that will allow Health First to drive its own destiny and not simply react to the evolution of the health care industry.
Johnson took the helm of Health First in September 2011, overseeing the entire organization, including the county’s largest multi-specialty physician group; three community hospitals — Cape Canaveral Hospital, Palm Bay Community Hospital and Viera Hospital; the tertiary/higher-level trauma center, Holmes Regional Medical Center; outpatient and wellness services; insurance, Medicare and commercial health insurance through Health First Health Plans; and four Pro-Health & Fitness wellness centers.
Actualizing its Assets
Health First’s comprehensive portfolio of assets — which Johnson groups into three categories: pre-acute, acute and post-acute — is what initially drew the new leader to Health First.
Pre-acute assets are those “that are dedicated to keeping people well and keeping people out of hospitals,” he explains. These include fitness centers, wellness programs and disease management programs, such as the Health First Aging Institute. Acute assets include Health First’s four area hospitals, while post-acute assets cover services such as home care, hospice, pharmacy and rehabilitation.
“It really is unusual for a community this size to have those kinds of clinical assets,” says Johnson. “The prospect of helping to knit those together in a fashion that will allow us to keep health care control local and keep high levels of sophisticated health care in Brevard — that was exciting. That’s what was so attractive about Health First.”
Johnson’s plans to create an “integrated delivery network” hinge upon each of these assets, specifically Health First’s independent health plan, Health First Health Plans. “The health plan (is) the component that will integrate the pre-acute, acute and post-acute assets in a seamless environment of care, and allow us to place individuals at the right level of care at the right time.”
More specifically, says Johnson, Health First is shifting its focus from restorative care to preventative care. Rather than, “Wait until you’re sick or broken to come see us and we’ll fix you,” he says, the organization will focus on issues such as, “How do we keep you from being sick in the first place? How do we make you healthy? How do we help you make wise choices?”
Streamlining the Structure
To begin making these ambitious changes, Johnson’s first order of business was to initiate an organization-wide restructure. “Structure drives process and drives execution. If you have a great strategy and lack the appropriate structure, it’s not going to work,” he says. “Like most organizations, we were structured organizationally to reinforce the silos of care. We were duplicating services and we were needlessly consuming resources in multiple locations. So, we changed the structure to deemphasize those silos and to create a systems mentality and a systems perspective.”
For example, adds Johnson, “We used to have four hospital presidents. We don’t anymore. We have one hospital president over the three community hospitals and one hospital president over Holmes. All of the operations beneath them are handled by site administrators.”
Building on Strengths
Among Health First’s greatest strengths are its personnel, believes Johnson. He promoted several existing staff members into new executive roles and also recruited among the nation’s top health care leaders (see sidebar).
Enhancing and stabilizing Health First’s base of physicians was also an important part of his long-term plan. In February, Health First completed its acquisition of Melbourne Internal Medicine Associates (MIMA), previously Brevard County’s largest independent physician group. “We spent the better part of last year working very carefully with MIMA and figuring out how we could acquire that group and retain everything that was good about it, and create synergies with our existing medical group in a way that, in the end, would be good for all of the doctors and, most importantly, for the folks in Brevard,” explains Johnson.
Forward momentum also has been fueled by the November 2012 settlement of antitrust litigation against Health First by Wuesthoff Health System that began in 2005 and then continued by the Space Coast Health Foundation, an organization funded from the 2010 sale of Wuesthoff to Health Management Associates.
“Both sides were spending millions of dollars and it was enormously distracting,” says Johnson. “In order to get ready for these huge changes that are coming at us, we wanted to clear that up.” Now, Health First and the Space Coast Health Foundation have agreed to jointly fund additional services to be distributed through the Brevard Healthcare Alliance (BHA), which offers primary health care services to citizens regardless of their ability to pay.
Taking Charge of an Atmosphere of Change
While staffing and organizational changes can oftentimes be met with resistance, fear or skepticism, Johnson feels strongly that this is a positive and necessary path. Legislation passed on December 31, 2012 included several health care cuts that impacted Health First to the tune of $1 million annually. “There are going to be more and more of those,” predicts Johnson. “So we want to get out in front and not be in a position of having to react to less reimbursement as we refocus our system. Our intention is to take the reductions and invest them in prevention services, and also invest them ideally in lower premiums in our health plan where we can insure more and more people.”
In short, says Johnson, “By creating a value-based delivery network, streamlining and getting our value proposition enhanced, we’re going to preserve and enhance a clinical asset for Brevard County. The real benefits are going to be to have a strong and vibrant health plan for the new reality of health care and for the future.”
MEET THE NEW HEALTH FIRST EXECUTIVES
Steve Johnson, Ph.D., president & CEO. Johnson began leading Health First in September 2011, overseeing all aspects of Health First’s fully integrated health system. He previously served as president of hospital operations for SSM Health Care in St. Louis, a seven-hospital system based in Missouri.
Drew Rector, executive vice president, chief strategy & growth officer. Joining Health First in February 2012, Rector now drives the system’s strategic focus and oversees its new outpatient and wellness division. He most recently served as hospital president and orthopedic service line executive at SSM Health Care.
Joseph “Joe” Felkner, executive vice president, chief financial officer. Appointed in February 2012, Felkner is responsible for all financial operations of Health First. Felkner was formerly the CFO of the Lehigh Valley Health Network in Pennsylvania.
J. Stuart Mitchell III, FACHE, executive vice president, chief operating officer. Mitchell is responsible for the operations of Health First’s hospital division, oversees hospital-based physicians and the operations of Health First joint ventures. Prior to joining Health First in May 2012, he served as managing director for regional facilities for INTEGRIS Health in Oklahoma City.
Margaret H. Haney, president & CEO of Health First Health Plans; president & CEO of Health First Insurance, Inc. With Health First in various leadership roles since 1991, Haney also serves as vice chairman, board of directors for the Health Plan Alliance and vice chairman, board of directors for the Hospital Health Plans Coalition.
Lori DeLone, senior vice president; chief information officer. With Health First since October 2012, DeLone manages all aspects of the health systems’ information technology platform. She was formerly regional vice president at PatientKeeper® in Waltham, Massachusetts.
Eddy (Ed) L. Hannah, RN, chief nursing officer; vice president of patient care services, Health First Holmes Regional Medical Center. Hannah joined Health First in October 2012 and is responsible for the delivery of high-quality patient care across the entire system. He formerly served as vice president of patient care services & quality/chief nursing officer at Boca Raton Regional Hospital.
Scott Gettings, M.D., chief medical officer. Dr. Gettings serves as CMO for the entire Health First organization. Formerly vice president of medical affairs (VPMA) of Health First Holmes Regional, he is responsible for physician utilization, as well as quality and outcomes for the entire health care system.
James M. Ronaldson, M.D., MBA, president of Health First Medical Group. The former CEO of MIMA, Dr. Ronaldson took on the role of president of the newly formed Health First Medical Group in February 2013 and is responsible for the strategic development, operational oversight and financial growth of the group.
Sean J. Gregory, president of the Tertiary Hospital Division (Health First Holmes Regional Medical Center). Gregory manages the strategy and business development for Holmes Regional Medical Center. Before assuming this role in November 2012, he served as vice president, strategy and business development for Exempla Healthcare in Denver.
R. Roy Wright, FACHE, president of Health First Community Hospitals. Formerly the president of Cape Canaveral Hospital, Wright was promoted in February 2012 to oversee all three community hospitals and serve as a corporate vice president in charge of pharmacy services. He has been with Health First since 2001.
David E. Mathias, Esq., senior vice president and corporate counsel. A Florida Bar-certified health law attorney, Mathias has been responsible for all legal matters involving Health First and its controlled affiliates since 1996.
Robert W. Suttles, vice president, chief human resources officer. Suttles, a founding officer of the company, has been on board since 1995. He is responsible for maximizing the contributions of every Health First team and associate through the effective and efficient recruitment, employment, assessment, development, engagement, collaboration and retention of committed, high-performing team members. His direct responsibilities include HR operations, talent management, employee relations, education and training and pastoral care at Health First.