New Health First CEO Kicks Off New Era of Cooperation Among Local Healthcare Providers

There has been more ink spilled over the subject of health care in the last twenty years than on national security and global warming combined.  Like the economy, no one debates the existence of the problem – it is solutions that seem to be illusive and controversial. Though everyone agrees that the answers to this conundrum are not singular, it is innovative, entrepreneurial and cooperatively-minded leaders who are most likely to establish the right direction. Into these substantial challenges, the new CEO of Health First, Steve Johnson, is hitting the ground running.

Part of what attracted Johnson to this position was the courageous and groundbreaking leadership Health First’s recently retired CEO, Mike Means, and the Board that served with him demonstrated throughout his career. Means joined two of the largest hospitals on the Space Coast, Holmes Regional Medical Center and Cape Canaveral Hospital, then added Palm Bay Hospital and most recently opened Viera Hospital. But the most innovative and daring move was introducing Health First Health Plans and taking proactive moves towards health and wellness maintenance.

According to Johnson, “The current system in this country, in many ways, tends to primarily reward physicians for curing sickness, when it occurs. Incentivizing sickness care will always be essential, but the future, everyone in the health care industry agrees, lies in prevention and sustaining health. Health First was forward-thinking enough to build four Pro-Health & Fitness Centers and other programs that are aimed at helping people stay healthy, not because at the time it was cost effective, but because it was forward-thinking and the right thing to do.”

The Journey to the Top

Johnson didn’t graduate from high school and step on the fast track to professional preparation; instead, like many in his blue collar neighborhood, he went to work in the Seattle shipyards 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 loved learning,” he said, which awakened a hunger, it is obvious, he has never shed. After completing his undergraduate degree in Psychology from the University of Puget Sound (WA), he and his wife Cathy relocated to the Midwest where he earned a Master’s degree in Human Development and a Doctoral degree in Psychology, both from the University of Kansas.

“I enjoyed the clinical side of my profession and moved into treating Post Acute Brain Injury patients; these are the ones with the severest damage and I found it to be fascinating and rewarding. However, I soon realized that if the systems that were designed to facilitate the care worked, it all worked. It is like creating an environment where all the elements are in place to maximize success,” he recalled. Soon, like discovering his academic inclinations, Johnson realized he had a “gift” for management. In fact, he realized that his abilities to manage and turn around ailing programs were as interesting and challenging as his clinical work. It was not only stimulating, but in Johnson’s case, it was something in which he was highly successful. He observed, “Providence, which I believe in, guides you to find those areas where your gifts can have the greatest impact.”

One thing that drove him into the management side of the health care equation was his desire to understand “Managed Care.” In the early 90’s, it changed the industry and in spite of his success in the various programs he ran – one of which grew from 250,000 patients to well over one million in several states – Johnson confided that “it seemed increasingly as though my job was to tell people they weren’t covered,” which was not why he got into the health care industry.

During that time SSM Health Care – a faith-based, not-for-profit health system headquartered in St. Louis, which owns and operates 16 acute-care hospitals, one children’s hospital, and two long-term care facilities employing 23,000 employees within a four state area – contacted him about being the Regional VP over the psychiatric arena, which was losing $5 million a year. To Johnson the conventional wisdom said, “Get out of the psychiatric arena,” but the president and COO who had approached him felt a moral obligation, “How do I live up to my responsibility to treat the whole person if I don’t treat the mind?” Johnson turned that program around, tripling its volume, while contributing $40 million in annual revenue.

On the Horizon

Steve Johnson is moving one of the largest employers in the county into a future that has incredible potential. There are technological breakthroughs being brought online every year, yet there are also far reaching questions demanding answers. One change of monumental concern to Johnson and other hospital CEOs is the reduction of funding for Medicare and Medicaid.

Johnson recently told FLORIDA TODAY, “The single greatest health care issue facing the residents of Brevard County in the coming year will be the continuing and perhaps increasing, cuts to Medicare and Medicaid. More and more Brevard County residents are depending on these programs, yet (Florida) Gov. (Rick) Scott proposes to cut them by billions of dollars.” Scott’s aim is the help balance Florida’s budget by cutting Medicaid by almost $2 billion and to reach that goal requires paying many hospitals less to treat Medicaid patients. This reduction would require approval of the Legislature and follows a 12 percent reimbursement reduction most hospitals dealt with last year, a scenario Johnson doesn’t see how the hospital system can absorb.

When asked where the greatest potential for care improvement, coupled with a reduction in cost could be found, Johnson paused. “I’m not a physician or a medical futurist, but the single most important technology that we can utilize right now is implementing an integrated electronic health record system. That way every health provider can leverage the value in a patient’s health history to minimize duplication of tests and procedures while maximizing data in real time. This not only can, but must be done.”

“The second, which raises even greater concerns about privacy issues, is utilizing the information we can now gather from human genetics.” As physicians have traditionally asked questions about family medical history, geneticists will soon be able to identify the genetic potential for everything from heart disease to cancer, almost like an early detection system. Johnson continued, “Having this kind of information could be critical in helping a person develop a plan for preventative health. Imagine the quality of life enrichment and the economic savings over a lifetime. But it will only be embraced if that information doesn’t, in any way, penalize or prevent them from getting coverage.”

New Leader, New Era   

Most everyone in the community, and certainly everyone in the medical community, is aware of the “health care feud” that has raged between two of the major providers over the last few years. But with Wuesthoff Health System having been taken over by Health Management Associates (HMA) – who is not connected in any way to the ongoing lawsuit that is still being pursued by the health system’s former leadership, now known as Space Coast Health Foundation, with Health First – a new era of cooperation may be in sight.

As Johnson said, “All conversations are worth having and without integrity, transparency and communication, the trust that is necessary to move forward and overcome our mutual obstacles can’t be achieved.” Adding that, “Dollars spent on legal fees are dollars not spent on improving health care to the community.” He went on to say that he and Wuesthoff CEO Steve Patonai have met regularly for breakfast. He is also enjoying a similar relationship with CEO George Mikitarian of Parrish Medical Center, which recently partnered with Health First to allow their members to use the Parrish Health & Fitness Center.With a more united front to deal with the plethora of health care issues this county faces, one other question seems to loom in the back of many minds. Is Health First being positioned to be acquired by a larger company? According to Johnson, that is nothing but a rumor. “No discussions are taking place; we haven’t even been approached by anyone. If anything, I believe Health First is in the position to look at acquisitions, not sale.”