2017 Business Leader of the Year | Serving and Leading
With a dedication to exceptional patient care, Health First and its CEO, Steve Johnson, are improving quality outcomes, reducing costs and increasing healthcare services in the region.
Few topics can polarize a conversation like health care. An ongoing debate regarding the purpose and administration of rights and benefits consume television airwaves and newspapers’ ink. From person to person, opinions differ and attitudes change – because health care is personal. So it is for the residents of the Space Coast, where more than 80 years ago clinicians and community members came together for the common purpose of making health care local. Their legacy lives through Brevard’s people and services, showcasing a commitment to the county’s largest health service provider.
Over the years, Health First President and Chief Executive Officer Steve Johnson has openly discussed what attracted him to the area to lead Brevard’s largest private employer. “It was with great courage the founders of Health First embarked upon the journey to bring a health plan to Brevard,” Johnson said. “At a time when major insurance providers were leaving, they committed time and resources to ensure our community would have access to high-quality, exceptional care. It was a huge risk and the right call.”
During the past two decades, Health First’s commitment laid the framework that has become a nationally recognized Integrated Delivery Network (IDN) serving the Space Coast. Since Johnson and his team came to Health First in 2012, Brevard County has seen remarkable outcomes. These include a more than 65 percent improvement in clinical care and quality performances when compared to national benchmarks, more than 22 percent growth in jobs and wages, and reinvesting more than $366 million in capital projects and equipment, ensuring the community could receive state-of-the-art services. But according to Johnson, the number that truly matters is charitable investment.
“As the county’s only true not-for-profit IDN, our mission is to care for all who seek us in their hour of need,” he said. “Our mission is to improve the health and well-being of the community – the entire community – and we’re proud to serve and lead the county in providing the highest level of charity and uncompensated care.”
In fact, Health First has given back more than $637 million dollars in charity and uncompensated care to Brevard County over the past five years. For its last fiscal year alone, associates and organizations provided more than $158 million in services through community partners such as the South Brevard Sharing Center, Boys & Girls Clubs of Central Florida and the Brevard Health Alliance, which provides care for underserved patients with a complete range of health services.
Health First is not the first IDN, following other systems across the country such as Kaiser Permanente, Geisinger and Intermountain. However, as Health First begins to improve quality outcomes, reduce costs and increase services to the community, its leadership is increasingly sought after to discuss how other health systems can duplicate its results.
Today, Health First has 900 hospital beds, more than 168,000 health plan members, a medical group, and an outpatient and wellness division. To understand it, just look to the vision of its leader. When Johnson arrived at Health First, he provided a road map for success in Brevard’s health services. Dubbed “Health First 2020,” the strategy’s moniker was a play on words that provided not only a timeline for success (the year 2020) but a clear vision of what needed to be done so Brevard could navigate the looming health care storm.
Johnson, along with his colleagues, recognized the traditional “sick care” model needed transformation. The focus needed to shift so health service providers would not only be compensated to take care of people when they are sick, but to focus on preventing illness. Johnson and his team worked closely within their health plan to allow it to integrate all of Health First’s services, with the increasing focus on keeping people healthy.
“We will provide the right care and wellness services, at the right place, and at the right time,” Johnson said. “No more, no less. Not because we’ll make more money, but because it’s the right thing to do.”
Where It Started
Johnson did not graduate from high school and step on the fast track to professional preparation. Instead, like many in his blue-collar hometown, he went to work in the local U.S. Navy shipyard and freely admits he had no “academic mentors.” However, a combination of wanting that elusive “something more” and a desire for knowledge caused him to enroll in a local community college, where a whole new world opened before him.
“I discovered I loved to learn,” he said.
That realization awakened a hunger Johnson has never shed. He earned his undergraduate degree in Psychology from the University of Puget Sound, Washington, before he and his wife, Cathy, moved to Lawrence, Kansas to attend the University of Kansas. There he earned a master’s degree in Human Development, followed up by a doctoral degree in Psychology.
“I truly enjoyed working in clinical operations and then treating post-acute brain injury individuals with severe developmental disabilities,” Johnson recounted. “My time at the bedside afforded me the opportunity to recognize areas of improvement within hospital operations. By integrating skilled healthcare professionals with successful business principals, we were able to improve quality outcomes at a reasonable cost.”
It was shortly after that Johnson realized he had a gift for management. He began to find success with the help of a series of leadership, management and business mentors. In managing and turning around struggling programs, Johnson found he was as interested and challenged by this aspect as his clinical work. Not only was it stimulating, but it was also something in which Johnson discovered he could make a difference.
“Providence, which I believe in, guides you to find those areas where your gifts can have the greatest impact,” he explained.
Johnson left management on the clinical delivery side and worked in managed care for three years. He believed it was essential to understand this emerging industry to serve well in health care with a desire to understand it. In the early 1990s, managed care was changing the industry. While Johnson had success in the various programs he ran – including one that blossomed from 250,000 patients to more than one million in several states – he confided there was one piece he found disheartening.
“It seemed increasingly as though my job was to tell people they weren’t covered for one thing or another,” he recalled.
That was not why Johnson got back into health care on the delivery side. He wanted to influence change.
It was around that time SSM Health Care reached out to Johnson. The faith-based, not-for-profit health system based in St. Louis owns and operates 16 acute-care hospitals, one children’s hospital and two long-term care facilities, employing 23,000 people within a four-state area. SSM wanted Johnson to step in as regional vice president overseeing the psychiatric arena, which was losing $12 million a year. For Johnson, conventional wisdom told him to get out of it.
However, the president and chief operating officer who approached him had been propelled to because of moral obligations – the responsibility of treating the whole person includes caring for the mind as well.
Johnson turned that program around, tripling its volume while contributing $40 million in annual operating income. He then led its rehabilitation hospital, as well as its psychiatry hospital – the largest of its three acute care hospitals at the time. Johnson later became president of hospital operations for all of SSM’s St. Louis operations.
With health care continuing to navigate turbulent changes, Johnson recalled a conversation with former board chair Jim Shaw, who provided him with an intriguing concept. Shaw drew a comparison between Health First and his time in the defense industry.
“What we need to realize is Health First is not a health care company,” Shaw explained. “It’s an integration company whose product is healthcare, to fit the pieces of the organization together to work for a common goal of improving health.”
Many years before, the defense industry had diversity in its management structure, and the goals of each department did not align to a common vision. This lack of unity drove up costs and lessened quality, compared with working in tandem to achieve goals together. A transformation, deemed “Integrated Science,” began more than 20 years ago for the defense industry, aligning people, processes and resources for a unified, consistent approach to achieve the greatest possible outcomes. As Health First’s leadership began to review the Integrated Science approach, they quickly recognized health care was on the same precipice as the defense industry, whose leaders adapted to Integrated Science many years ago. Johnson and his team are in the process of implementing the model’s strategies and techniques, aligning the organization’s approaches while providing the highest quality care in the most economical way.
Many people might look at Johnson’s career and consider it complete. However, his mission goes beyond numbers on a spreadsheet and words on a page. Almost weekly, he personally attends Health First’s New Associate Orientation and greets the newest additions to the IDN. During his discussions, Johnson speaks of the “sacred calling” that draws so many to the medical field.
“When a person chooses health care as a profession, they’re dedicating their lives to serving others,” he said.
But being a Health First associate is more than a job. It is about serving others in ways that extend beyond the brick and mortar of the buildings. It stretches beyond paperwork and computers. At the heart of Health First is the associates’ drive to provide hope when all seems lost. It is a comforting smile, a warm touch and holding the hand of someone in their final hours.
Health care’s future may be unclear. However, the community can depend on Health First to continue a commitment to serve, which began more than 80 years ago.
“As we look to the future, one thing is perfectly clear,” Johnson said. “The associates are families and friends that live and work right here in Brevard County. Health First will be here to answer health care’s sacred call for many years to come.”
When your values are clear to you, making decisions becomes easier. – Roy E. Disney