Lessons from the C-suite: Anthony Tersigni, CEO of Ascension Health Alliance

How the leader of the nation's largest Catholic health system sees the industry

This interview with Anthony R. Tersigni, the President and CEO of Ascension Health Alliance, was conducted and condensed by Tom Cassels and Dan Diamond.

Q: Why did you get into health care?

Tersigni: For me, it started my last year of college, when I had an administrative fellowship with the governor of Michigan. My job was focused on helping constituents access services from social agencies, health departments—basically, eliminating the red tape that was standing in their way.

Every night, I found myself going home gratified that I'd helped [those] who were often vulnerable or frustrated get through a process. To get the care they needed.

That helped me realize that health care is an industry where we often see people at their most vulnerable state—and how rewarding it would be to help get them through their anxieties, their serious illnesses.

Q: So how do you stay connected with those vulnerable patients—especially when you oversee the nation's largest Catholic health system, with hundreds of locations in 21 states and Washington, D.C.?

Tersigni: I am a firm believer in managing by walking around. That started when I was an administrative resident in a hospital, and continues today.

So the first thing I do [when visiting a health ministry] is to let the CEO know I’m coming. Then, about a half hour before my appointment, I walk through the hospital and talk to employees, patients…really any people that I come across.

Here's what I'm trying to get a feel for: Are we continuing to do what our mission calls us to do? To be more specific, I want to see we're taking care of everyone—and still devoting special attention to those who are poor and vulnerable.

It’s my way of staying grounded and addressing one of the biggest fears I have of running a $21 billion dollar enterprise: Can we get [too] far removed from the person we are trying to help?

Strategic goals

Q: Where's Ascension headed?

Tersigni: Here's the destination point for us: We need to have the capability of taking care of 30 million lives, from birth through death.

That’s the bottom line—that’s where our growth is focused.

And that's different from historically, when you'd capture a snapshot of an organization like ours by comparing hospital beds or annual revenue. But I hope in the future, [Ascension Health Alliance will stand out] as an organization that focused on taking care of people—and took necessary risk along the way—to ensure that these 30 million people navigate through life and stay as healthy as possible.

Q: How did you come up with 30 million lives?

Tersigni: It's based on our current volumes today, the percentage of the population in the states that we are in, and our growth targets.

Q: So how you do move toward actually managing 30 million lives? Or more specifically, where are the gaps in the care continuum, and what are your biggest priorities to address them?

Tersigni: We began by documenting the pieces of the continuum that we do have. And we ended up with a lot—about 1,440 different places around the country where Ascension Health provides direct, hands-on patient care of some sort.

So now we're at a [stage] of going through every health ministry to identify those gaps and really focus in on the fact that some of our health ministries are pretty robust in the continuum and others have opportunities for enhancement.

That allows us to begin identifying whether our health ministry itself can fill those gaps or we need partners in the community. It's a work in progress.

Formation of Ascension Health Alliance

Q: In January 2012, you moved from leading Ascension Health system to steering a new parent company, Ascension Health Alliance. Why create a separate organization?

Tersigni: You know it, we know it: The U.S. health care landscape is changing dramatically. Rising costs, fading revenues, and the uncertainty of heath reform implementation is increasing the pressure on us as providers. 

And so we stepped back and realized: we really need to create a forum through a new parent company—Ascension Health Alliance—that would focus on creating systems, services, and models to enable us to succeed in the new world, whenever that ends up happening.

And that allows the subsidiary—Ascension Health—to remain focused on making the incremental, operational changes along the way.

Q: Can you describe the Alliance's goals?

Tersigni: We structured the Ascension Health Alliance with three basic themes. (If you know me, you know I like to have themes that we can put on a bumper sticker.)

  • We want to continue to develop a vibrant Catholic health ministry;
  • We want to become an entrusted steward. By that I mean, not only stewarding our money, but also helping our employees’ capabilities flourish; and sustaining our environment; and
  • We need to re-imagine health and co-create healthier communities. We know we can’t do it alone—but we also know that the current environment is not sustainable, and need to change it.

Strategic growth

Q: What are the most important criteria when considering the right partner?

Tersigni: First and foremost, does the partner have an appreciation for our mission, vision, and values? And then—are they committed to staying with us, longer-term?

While many organizations want to be a strategic partner, we quickly discover that they actually want to be a vendor or even a preferred vendor. And that’s okay, as long as we understand that and put them in the proper category—for example, allow them to interface with our supply chain, and so on.

But a strategic partner is really saying: We're going to do something different. To take some risk and try to accomplish something that’s in the best interest of improving the community. And we now have a handful of strategic partners that help us through developing this continuous care.

You know, we’ve said “no” several times over the last eight years. People see us—a big organization—and sometimes it seems like they expect us to pull up to the back door with unlimited resources and say, "take whatever you want." That’s just not in the best interest of the health ministry as a whole!

Q: Because you're in a phase of bringing new institutions and ministries into Ascension, how do you integrate these acquisitions with the folks who have been part of your ministry over time?

Tersigni: Great question. Let me approach it first by saying, you can’t become a part of Ascension Health Alliance if you don’t subscribe to our strategic direction of where we are trying to get to, in terms of person-centered care. That’s a non-starter.

So here's what I'd call the “table stakes” to come have conversation with us: Be committed to our mission, vision, and values. Be committed to our quality and safety standards and be willing to do what’s necessary to get your organization to that level.

Q: So in return, how do these new ministries feel the power of being a part of the Ascension Health family?

Tersigni: When we go through our due diligence, we first send our operations resources team to a health system and begin looking at it from top to bottom.

They're not looking for what a system is doing wrong. Instead, it’s what value can we bring to every aspect of their operation.

That's all pretty quantifiable. So as we go to the closing, we know what we can save them in interest expenses annually, what we can do in terms of refinancing their debt, and on down the line.

In addition, we go through a “cultural assessment.” We want to know how organizations run: How do they make decisions? How do they treat people? What’s their approach to being good corporate citizens? That’s very important to us.

We also require them to go through what we call a five-year "integrated strategic, operational, and financial plan." It helps us learn what your community needs and what investments you need to get there, and let’s map that to your cash flow over that same period of time and see if there are gaps, if any.

And knowing that at the front end is always very, very helpful to us so that we don’t have issues later on in the relationship.

Leadership lessons

Q: You served as Ascension Health's CEO from January 2004 through 2012, before becoming CEO of Ascension Health Alliance. Beyond the strategic growth, what will your legacy be?

Tersigni: We have tremendous responsibility to make sure that a health ministry that’s been here for the last 400 years has an enduring platform to serve the next 400 years. That's one of the reasons we created an internal leadership academy several years ago.

I wanted to be certain that, when I need care in the future and come to an Ascension Health Alliance facility, I'm going to have a leader who hasn't varied at all from our strategic direction, from our mission, from our values, and from our vision.

And that will be the culmination, I think, of what I've been able to accomplish at Ascension Health Alliance.

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