Core had the opportunity to interview CEO of TriHealth, Mark Clement. Read more to learn about how he transformed the health system to commit to value-based care.
When Mark Clement, President and CEO of TriHealth, joined the health system in 2015, it had multiple hospitals and other business units that operated semi-independently without a common culture, vision and values, or an overarching strategy. Under Mark’s leadership, they did the hard work of building that system culture and committed fully to value-based care and population health in their clinical and business models. By 2022, they were ready to tell their brand story and partnered with Core Creative to do so.
In a recent conversation with Mark, he shared his insights into “Getting Healthcare Right”, successful change leadership, building system culture and more. He and Quint Studer also recently spoke about building a culture that drives and supports value-based care at the American College of Healthcare Executives Congress; supporting data in this article is derived from that presentation.
TriHealth is a Cincinnati-based $2.8 billion integrated healthcare delivery system, made up of 5 hospitals and over 140 ambulatory/outpatient sites of care. Named as the highest performing Accountable Care Organization (ACO) in the state of Ohio and one of the highest performing ACOs in the U.S. by Anthem Blue Cross Blue Shield, TriHealth cares for over 600,000 patients, or one third of the greater Cincinnati community, with half in value-based arrangements and 60,000 of them full risk. They are Cincinnati’s third-largest employer, with more than 13,000 team members. Their care has had a remarkable impact on the health of the people of Greater Cincinnati, and is a true success story on the power of population health.
In his frequent public appearances, Mark speaks about “Getting Healthcare Right,” addressing our nation’s broken health system in which we spend more and get less than any other western nation, focus on sick care, are fragmented, reactive and poorly coordinated, and are overly complex to access, resulting in glaring health disparities. His vision for getting healthcare right has been a rallying cry for the TriHealth team, creating a powerful sense of shared purpose throughout the organization.
We asked Mark why more systems are not transitioning to value-based care models, to get healthcare right. “It’s because it is hard, hard, hard and it is risky. It is a fundamental change in your clinical and business model. In traditional fee-for-service, it’s all about volume. In value-based care, it’s all about delivering value as opposed to volume, and that means delivering the right care in the right part of the continuum,” he said. “We needed to build up an integrated system that was able to seamlessly provide whatever care a patient needed in the right part of our health system.”
TriHealth has successfully accomplished that imperative, now driving 90% of its revenue from ambulatory care. And they’ve achieved so much more, including:
In short, TriHealth’s highly-engaged people and culture are driving industry-leading care and an exceptional, differentiated patient experience. Their superior screening rates and chronic condition management saved more than 1,200 lives last year alone.
Getting there required years of disciplined change and passionate culture-building.
Mark explained, “We went to work on building a system culture that didn’t exist before. We had a Good Samaritan (Hospital) culture and Bethesda North (Hospital) culture. We had a physician enterprise culture. But we didn’t have a system culture. That’s hard work to build a culture.”
That hard work was informed by Kotter’s framework, The Eight Steps for Leading Change.
“It starts with building support for a shared vision of the future,” he continued. “It’s confronting reality. What’s the current situation? Why is the current state not sustainable long term? And then articulating a compelling future state that people can get excited about. For us, it was really based upon a moral imperative. We could double down on a broken system, fee-for-service, or we could embrace a better way. And that better way would allow us to better carry out our mission and improve the lives of patients that might not have been improved under a traditional, fragmented, reactive system.”
“Then you build a guiding coalition,” he said. “We built support with our board, with our physician leadership and our senior leadership. You don’t wait for everybody to get on board. You just go. And then that coalition will support the larger organization, the nay-sayers and the fence sitters. They will get on board as they see the changes beginning to make things better.” Clement noted that in TriHealth’s case, the change was met with little resistance. “I think people were ready for change and excited about operating as a system, excited about embracing the future.” A related step is to generate early wins. “Harvest your early wins — which is celebrating successes — so people begin to see that the change really is making things better.”
Mark also shared insights into the importance of enfranchising physicians to help lead the organization, investing in leaders throughout the organization, and developing evidence-based leadership practices. “We knew that to build a world-class, patient centered, high performing culture, we needed to invest in our people. We went through a boot camp for three years, teaching leaders to lead based on evidence-based practices. We developed a TriHealth way of leading, a TriHealth way of serving, and a TriHealth way of delivering care. What we’ve learned is that when we’re consistent (in those practices), there’s no better hospital or health system anywhere.”
Mark believes that telling the value-based care story to consumers, employers and team members is essential. When Mark first met with Core Creative in 2022, he recalls saying “We’ve been working really hard to build a culture and we didn’t want to tell our story until we were ready and able to consistently deliver on the promises we make to the community and our people. And we think we’re ready to tell that story.” Together, TriHealth and Core redefined the brand promise, brought it to life in the market, and extended it to service lines and an updated employer brand promise. Now, three years later, he feels (and data validates) that the brand work we’ve done together has both reflected and amplified the culture.
“I think there is a pride that is palpable within the TriHealth team member community and physician community. There is a growing feeling at TriHealth where people really feel like we’re good and the community is recognizing it. Our team members feel good about working here. The employer brand work that you helped us with really resonates with team members. I think that has played a big role. There’s a lot of pride in being part of this organization and they know we’re good.”
We asked Mark what else he would tell other leaders who are working to transform and deliver value-based care and/or implement population health models. “One of the mistakes that a lot of leaders make when they set out to either change their culture or improve their culture is they think they can do it in a year or two. Jim Collins (author of Good to Great and other pivotal books) said it’s 5 to ten years to fundamentally change and embed the changes in your new culture. I think that’s right.”
In addition to being a dedicated runner and cyclist, Mark is an avid reader. Here are a few of his favorites that he’d recommend to you.
Leadership in Turbulent Times, by Doris Kearns Goodwin
The Splendid and the Vile, by Erik Larson
The 7 Habits of Highly Effective People, by Stephen R. Covey
