New Frontiers of Health: A Partners in Care Interview with Rod Hochman

“We’re big believers that taking care of people in their own homes is the way to learn what’s really going on with someone.”

Rod Hochman, MD, President and CEO of Providence St. Joseph Health is to be honored at the 18th Annual Vision & Excellence in Healthcare Leadership Tribute Dinner, presented by Partners in Care Foundation. In the lead up to the Tribute Dinner at the Beverly Hilton, Los Angeles on May 15, 2017, he sat down with Partners in Care CEO, June Simmons, for a wide-ranging discussion covering healthcare in the community setting, the failings of the healthcare system in relation to mental health, Providence’s focus for the future, and the most important part of being a good leader.

Ask Rod Hochman to talk about the story of Providence St. Joseph Health, the organization of which he is President and CEO, and he will most likely begin by asking a question. “How many organizations do you know that are 160 years old, have a net revenue of $22 billion and were founded by women?” Of course, the answer is very few, if any. Add that the women were Catholic Sisters who travelled from Europe and Canada, and that the organization they founded now employs 106,000 people serving 11 million patients annually across seven states and the success story of Providence St. Joseph is even more improbable.

That improbability, a pioneering spirit and a sense of pride in doing things differently is something that clearly energizes Hochman. “Why have we been successful? Because our philosophy has been to go deep in every community we serve” he notes. “We don’t just do hospital care, we do outpatient care, community-based mental health services, home care, telehealth services and even housing.” Indeed, in addition to 50 hospitals, more than 820 clinics, and 43 telehealth sites, Providence St. Joseph Health – the name for the new organization that combined Providence Health & Services and St. Joseph Health last year – also boasts a high school in Burbank, CA, and the University of Great Falls, in Montana among its services.

But it is “commitment to the mission” that Hochman sees as the “secret sauce” in Providence St. Joseph’s growth to become the fourth largest not-for-profit health system in the U.S. “The whole mind, body and soul connection is really key to the heritage of Providence St. Joseph as a faith-based organization. We think they’re all related and that you can’t treat one without the other.

While we celebrate our Catholic heritage, Providence St. Joseph is actually a diverse family of organizations that includes partners with unique heritages that encompass other faith traditions and secular backgrounds. Providence St. Joseph Health includes Providence St. John Health Center, Facey and Hoag in Southern California, as well as Convenant Health in West Texas, and Swedish Health Services, Kadlec Regional Medical Center and Pacific Medical Centers in Washington state. We respect the diverse traditions within our organization. The one thing that connects us is our collective mission to provide quality care to all, especially the poor and vulnerable.”

The best way to achieve that mission, Hochman believes, is to be embedded in the communities that Providence St. Joseph serves. “We’re big believers that taking care of people in their own homes is the way to learn what’s really going on with someone” he says. “We are passionate believers that we are going to solve healthcare issues, not through more doctors, but through a team-based approach, working with people like social workers and home health aides – community-based teams that can help extend the reach of what we do in healthcare. We also need to leverage technology to deliver care in more convenient settings. We are offering ways for people to be able to request a house call using an Uber-like app or see a doctor virtually from the convenience of their smart phone or tablet.”

“To deal with mental health it has to start at the community level, it can’t be just at the hospital level, so our whole initiative is to involve the communities we serve.”

Rod Hochman credits his early experiences working for his father’s refrigeration business with helping him make the decision to become a doctor. “My summer job was delivering fridges in Manhattan. Sometimes I had to work the phone, and I would try to talk to customers in a reasonable tone, which probably wasn’t going to work in New York in the 70s. Then my dad would get on the phone and yell at the customer and hang up and tell me that was how I was supposed to do it. So I figured that not only did I not want to go into refrigeration, that even if I did, his business wasn’t going to survive and I’d better find some gainful employment,” he jokes.

The gainful employment started at the age of 15 with a program called Doctors of Tomorrow, which continues today and provides young people with hands-on clinical experiences, collaborative community-health service projects, and activities focused on leadership development. After a summer working with an orthopedic surgeon, he knew he’d found his calling, going on to gain his medical degree from Boston University School of Medicine, followed by stints as a clinical fellow at Harvard Medical School and Dartmouth Medical School. “Since the age of 16, I think I’ve spent more time in a hospital than I have at home,” he says.

That extensive experience, as both a physician and later as a healthcare executive, has provided Hochman with some deep-rooted convictions about the challenges faced by the healthcare system in the 21st Century. “If you look at US healthcare outcomes, we rank somewhere about the level of Costa Rica. If you compare our system with Western Europe or Japan, not only are their health outcomes much better, they spend about a third of what we spend on healthcare. If you look and compare what they spend on healthcare, housing, education, and nutrition, the number is almost the same. So we spend a disproportionate amount on healthcare – about $10k per American – but much less on housing, education and food. But the fact is that there is a direct correlation between healthcare status and level of education, and that’s been shown in numerous studies. In addition – and this example is most extreme when you look at homelessness – when you look at people’s housing situation, that usually correlates closely with someone’s healthcare outcomes. The things that determine someone’s health status really have more to do with things like where they live, how they’re educated, and how able they are to access good nutrition. The other variable that separates us from Western Europe, and from Japan in particular, is that we spend much less on preventative health. In the U.S., when we give healthcare, it’s almost after the fact.”

Hochman is equally clear on what he believes are the failings of the healthcare system in relation to mental health which, with the recent creation of the Institute for Mental Health and Wellness, is a signature issue for Providence St. Joseph. He describes it as a “travesty” that mental health and wellness have been isolated from healthcare. “The first problem is that healthcare and mental health got separated during healthcare reform in the 90s and ever since then mental health benefits have been persistently underfunded disproportionate to healthcare benefits,” he explains.
“The second problem is that mental health is like cancer was 20-30 years ago, or HIV, when nobody wanted to talk about it. Now those things have been brought out into the open and we’re much more able to take effective care of people. But mental health still has this stigma – yet when we discuss our plans for mental health with others, there hasn’t been one senator, congress person, business leader, you name it, who can’t relate a personal story about someone they know, either in their own family or among their friends, who’s been affected by mental health issues.”

Hochman believes that the solution to the problem lies in partnering with community-based organizations. “Our belief is that to deal with mental health it has to start at the community level, it can’t be just at the hospital level, so our whole initiative is to involve the communities we serve”, he says. “There are a lot of community-based organizations already out there that have many of the answers we need. Partnering with these organizations is critically important. Solving healthcare is not about one organization on its own – but organizations like ours can be catalysts for change and a good place to develop partnerships and bring community based organizations together. A lot of times, there’s great work going on in the community, but it tends to be scattered among many different groups and by getting those groups together we can really make a significant difference.”

“By my calculation we’ve survived 40 administrations in DC, so we’ll survive whatever comes next.”

Despite the tumult taking place in healthcare Rod Hochman is, he says, “optimistic about the future. By my calculation Providence St. Joseph has survived 40 administrations in DC, so we’ll survive whatever comes next.” He puts his confidence down to a focus on three key areas which he believes will enable the organization to retain both its pioneering spirit, and its cradle to grave approach to delivering healthcare.

The first of these areas is what he describes as “strengthening the core” – delivering services in a way that combines patient satisfaction with high quality and cost effective care. “We spend a lot of time making sure that we get our billing system right that we get safety and quality right. We have 50 hospitals – they’ll hopefully be hospitals 50 years from now and we have to make sure they’re functioning in the best capacity possible.” The second area is population health. “Healthcare can’t be one size fits all. It has to be individualized, and different populations have different needs – particularly chronically ill populations, and poor and vulnerable populations. We serve folks in seven states and a mom on Medicaid in Washington has very different needs for services than an executive at Intel in Oregon. We’ve had a health plan in Oregon for 30 years that serves 650,000 people, so we’ve had a long experience in dealing with population health and we consider it an important part of where value-based care is going. “

The third area is what Hochman refers to as the “digital platform.” Providence St. Joseph has made significant investment in technology in recent years, earning the organization recognition as one of the ‘Most Wired’ organizations in healthcare by the American Hospital Association’s Health Forum and the College of Healthcare Information Management Executives. “Healthcare and higher education have been the last two hold-outs in jumping aboard the digital bandwagon, but Providence St. Joseph has really made an effort to embrace technology. We have over 100 employees who formerly worked for Amazon and Microsoft now working for us, helping us bring this digital transformation together. We’ve gone through the transition of moving to electronically based health records, and of dealing with appointments online. All of our hospitals are on the same electronic health records, which is unique for a health system of our size.” Providence St. Joseph also manages health records for more than 50 other healthcare entities, enabling rural hospitals and clinics to access technology that they wouldn’t otherwise be able to afford. But it is at the patient level that Hochman sees the greatest advantages. “We really believe that you should be able to get on your smartphone to schedule an appointment, to be able to talk to a nurse, to be able to transact in the same way that you do with other industries. Technology is an important part of where we’re going and how we’re getting there. It’s going to continue to make enormous differences into the future.”

As he prepares to fly to Los Angeles to accept his award, which is presented annually in recognition of an individual who has affected pioneering change as a healthcare visionary, Rod Hochman is clear about who he feels deserves the credit for Providence St. Joseph’s phenomenal success. “This award has very little to do with me and a whole lot to do with us as an organization. It’s about the 106,000 people who come to work every day at Providence St. Joseph Health. They’re the real secret. I’m always humbled and amazed when I go out to our clinics and hospitals and meet the people on the frontline and see the miracles they’re performing on a daily basis. So I’m accepting this award on their behalf. Good leaders worry about their people first, and then about the people that they’re serving.”

For information on sponsorship opportunities and tickets to the 18th Annual Vision & Excellence in Health Care Leadership Tribute Dinner, please go to picf.org/tributedinnersponsorship, or contact Stephanie Wilson, VP, Development at Partners in Care Foundation, at swilson@picf.org 818.837.3775 x121

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