Inside Intermountain Healthcare’s $600M campaign to reimagine pediatric care

The system aims to expand options at its children's hospital and provide more care for kids in their communities. Katy Welkie and David Flood of Intermountain talked with Chief Healthcare Executive about the effort.

Katy Welkie says Intermountain Healthcare is looking to transform healthcare for children, both inside and outside the hospital.

Intermountain has launched a $600 million campaign that aims to expand care and treatment options for children across the system’s wide service area. Welkie is Intermountain’s vice president of children’s health and CEO of Intermountain’s Primary Children’s Hospital, which serves an area of 400,000 square miles. Based in Utah, Intermountain operates 33 hospitals and scores of clinics across the western United States.

“When we thought about how do you really change the overall health care for children, and how do you create a model for kids, we really thought very, very, very broadly, both within the walls of the hospital, but also beyond the walls of the hospital and thinking more about preventative care,” Welkie said.

Intermountain’s aggressive philanthropic effort, dubbed Primary Promise, appears to be resonating with donors. So far, the effort has raised more than $500 million, said David Flood, Intermountain’s chief development officer and president of the Intermountain Foundation.

“We're feeling really excited about where this is going,” Flood said.

Welkie and Flood spoke with Chief Healthcare Executive about the ambitious plans to expand pediatric care, improve health equity, and the greater role of philanthropy for hospitals and health systems. (See excerpts of our conversation with Katy Welkie and David Flood in this interview. The story continues below the video.)

From womb to adulthood

The campaign aims to expand the offerings of Primary Children’s Hospital, a 287-bed hospital.

“We really want to make sure that we have the absolute best care possible for kids that receive care and really need to come to a hospital,” Welkie said.

Intermountain has developed a new fetal center capable of doing complex surgeries while the baby is in the uterus. The pediatric hospital also remodeled the intensive care unit for newborns, along with enhanced cancer and transplant programs.

In addition, Intermountain is expanding its pediatric research, particularly in the area of genomics, as part of the initiative.

Intermountain is also striving to help kids with complex and chronic illnesses make the transition to adulthood, as kids are now more likely to survive diseases that once ended their lives before they had a chance to grow up.

“We're looking at transitioning kids from from childhood to adulthood that have complex chronic health illnesses,” Welkie said. “And that may seem simple, but it's actually incredibly complex to transition kids, and to do it in every single specialty area and do it very, very well.”

Intermountain is also building a program around healthy kids and helping them overcome adverse childhood experiences, such as experiencing violence or growing up in homes with substance abuse, that can adversely affect their health.

“We want to catch that early,” she said.

Care outside the hospital

Even as Intermountain is working to offer more robust and comprehensive services at Primary Children’s Hospital, the system is looking to help ensure kids that aren’t as critically ill can stay in their own communities, officials said.

With expanded telehealth services, Intermountain can support other hospitals and enable them to keep kids in their own facilities without needing to transfer them to the children’s hospital. Nurses and physicians can call and get added support from Primary Children’s regarding children in the emergency department.

And if the patient needs to go to the children’s hospital, “it gives them extra sets of eyes and hands to provide care for that child while they're waiting for the transport team to arrive,” Welkie said.

Still, she said telehealth and added support is allowing more kids to be treated in their own communities, which is better for patients and their families.

“We've been able to keep kids locally more than we've ever, ever been able to do, which is exactly what we want to do,” Welkie said. “It's not great for the Children's Hospital revenue, but it's fabulous for the family. It's fabulous for the local communities. And that's really why philanthropy makes such a big difference is we can do the right thing and not really think about the economics of it.”

With the fundraising effort, Intermountain is also able to sustain a nurse-family partnership program, which the system has tried to run in the past but hasn’t been able to sustain, Welkie said.

The program partners nurses with moms as early as the second trimester, and they stay together until the child is two years old. The nurses visit moms in their home to help them with education and employment needs. The babies are more likely to be healthy, less likely to be born prematurely, and down the road, kids in such programs are more likely to graduate from high school.

“It is an incredibly powerful program,” Welkie said. “And this is now part of a suite of home visitation programs that we can pull out.”

Intermountain has also been taking a closer look at the social determinants of health, including mapping zip codes and identifying communities with higher risks. “Interestingly, a lot of the need is in rural communities,” Welkie said.

While the work is in the early phases, Intermountain is looking to identify partners in those neighborhoods to address factors affecting infant mortality and issues such as housing and education, she said.

Behavioral health

Intermountain officials are especially enthusiastic about expanding behavioral health services. Much of that has been spurred by the community demanding more services, Flood said.

“People are asking, what are we doing in behavioral health? And do we have enough there?” he said. “From that time, we've added more capability and opportunity to build our behavioral health programming for children.”

The behavioral health expansion is a key part of the effort, Welkie said.

“It's probably the area we get the most questions, the most interest,” she said. “And it's become increasingly a community charge to do more with behavioral health.”

Intermountain has seen a 300% increase in children coming into emergency departments for behavioral health issues over the last several years, Welkie said. It’s a trend being seen nationwide, and some health organizations have urged President Biden’s administration to declare a national emergency to address the mental health crisis in kids.

“We are seeing lots of kids with depression and anxiety, and whether that's in the emergency department, which I think is something that we really want to try and avoid. Because emergency departments aren't the best place for kids with behavioral health issues,” she said.

As family medicine providers are seeing more young patients with mental health issues, Intermountain is also working with pediatricians to give them the expertise and resources to help those patients, Welkie said.

Value of philanthropy

When asked about the success of the fundraising campaign, Flood said, “The reality is the substance of this project has been very compelling for folks.”

Some of the donations have been the largest philanthropic contributions ever given by some families, Flood said.

“They see this as legacy worthy,” Flood said.

For others, it’s the first significant donation they’ve ever made, he said.

More hospitals are going to be turning to philanthropy to support key initiatives, Flood said.

“More progressive systems are investing in significant private philanthropy programs,” Flood said. “This is the highest return on investment business line in our system. It's become a strategic imperative.”

“It's something as payers seek to pay less and less, understandably, for healthcare that's become expensive,” he added. “Philanthropy has been such a great gateway to opportunity. And I think more and more system CEOs and hospital executives are seeing that and they're not just rooting for it or expecting it. They're participating in it because they're so critical to it.”

The fundraising campaign also fits with Intermountain’s goals of expanding services while striving to keep costs down for patients, Flood said.

“To have that vision, and to not put yourself in the position of having to strap the cost for that to the backs of patients, it's hard to do,” he said. “And I think the fact that we are doing that, that makes me very proud. And I think we're touching lives and we're bridging people to the opportunity to touch lives.”

For Welkie, this is her first experience engaging in such a large and comprehensive campaign. She said it’s also been very rewarding.

“It's just an incredible opportunity to work with people who understand the power of giving,” she said. “And that's really what it is. We all love to give … and to give others who aren't necessarily in the hospital touching a patient, but giving other people that opportunity to touch patients, is very, very powerful.”