Allen, who took the post in December, talks with Chief Healthcare Executive about his hopes of sustaining the workforce, the greater need for partnerships, and value-based care.
Rob Allen, the president and CEO of Intermountain Health, says the job still feels new.
Allen became Intermountain's chief executive officer in December. He’s hardly new to the organization, since he served as Intermountain’s chief operating officer under former CEO Marc Harrison, who stepped down last fall to run a healthcare platform business for General Catalyst.
As CEO, Allen leads one of America’s largest nonprofit hospital systems. Intermountain operates 33 hospitals and nearly 400 clinics throughout the west.
In an interview with Chief Healthcare Executive, Allen says he outlined some of his top priorities during a board meeting on his very first day on the job.
“My priorities were to focus on our caregivers, and our patients, and to simplify the work, and the processes there to truly become the partner in health and healing for our caregivers and our communities, as we move forward,” Allen says.
“So those are the priorities that we're building around, as I take on this responsibility at Intermountain, all around focusing on serving well, and delivering on our mission of helping people live the healthiest lives possible.”
During the interview, Allen shares his views on sustaining Intermountain’s workforce, the increased role of partnerships, the challenging financial environment for hospitals, and why the system is placing its bets on value-based care.
(See part of our conversation with Rob Allen in this video. The story continues below.)
Simplicity for caregivers
Three years after the emergence of the COVID-19 pandemic, health systems across the country say they are struggling to find and hold onto workers. Intermountain is facing those challenges as well, as Allen says there are “more gaps in the workforce than I've ever seen in my 30 plus years in healthcare.”
“It's a challenge that's different, that's going to take a while to solve,” he says. “We're not going to solve it in the near future.”
Allen says he’s thinking a lot about how to help re-engage workers.
“The reality is all of us whether we're clinicians or administrative business like I am, all of us got into health care for common reasons,” he says. “We saw it as a place that we could do good, that we could serve people, that we could make a difference. And I really believe that a big part of our burnout can be attributed to the disconnection from mission and purpose and why people got here.”
Intermountain is focusing on retaining workers, and that’s why Allen talks about simplifying their workflow and allowing doctors and nurses to concentrate more on patient care. He said Intermountain has been testing a new dictation tool, and early returns show some doctors are saving up to two hours a day.
Allen says he also wants to find ways to simplify workflows for nurses so they can spend less time on administrative tasks and more time on patient care.
“I think we're at a really key point in time of opportunity to bring to bear the effort and energy of our caregivers to help us find solutions, and to bring to bear technology that's evolved around us, and now is in a place that can actually serve these needs much better than it could even just a year or two or three ago,” Allen says.
“So I think that's a key area that we're focused on,” he adds. “And when we talk about simplicity, it's about making sure we take care of our people so they can take care of our patients and communities.”
Many doctors and nurses say they are frustrated with the increased violence they are experiencing in hospitals, and it’s a problem at Intermountain, Allen says.
“We face it, like I think everybody around the country is facing it,” he says. “And unfortunately, it's a risk our caregivers face every day.”
Allen says the system is exploring ways to improve safety for workers.
One of Intermountain’s hospitals has placed security guards in the line of sight of high-risk behavioral health patients, and he said that has led to a “dramatic reduction, of about 60%, in the incidence of attacks on our caregivers.”
“We're doing a lot of review of additional technologies to keep our people safe,” he says. “We're looking for hotspots of areas where there's risk. And we just want to keep learning and responding and together with our caregivers finding solutions for the challenges that are there,” Allen says.
But he adds, “I hate the fact that we have to think about security … But it’s the world we live in, and if we don't keep our caregivers safe, then we can't count on them to take care of our patients.”
Partnerships: ‘We can’t do everything alone’
A year ago, Intermountain completed its merger with SCL Health. Allen says he is “thrilled with how the integration is proceeding.”
“These types of things are a lot of work,” he says. “And there's risks in them. And I think the leadership and the boards did a beautiful job of setting the stage, making key decisions in advance of the actual merger date, which allowed us to jump in immediately and go to work around the structure and the vision that was laid out to the high level.”
Over the next year, Allen says Intermountain will be focusing on the clinical integration of the systems. But he says there has already been some success in that area.
“We've seen expansion of maternal fetal medicine up in our Montana area,” he says.
“We've seen alignment in our research team, which is, I think, really an exciting area for us. We have strong research that comes together. And that's helped us move forward clinical trials in cardiovascular, oncology, and respiratory services.”
Even as the integration of SCL Health continues, Intermountain has formed another new partnership. In January, Intermountain announced it was partnering with UCHealth to establish a new clinically integrated network in Colorado.
The systems said the network is designed to spur the transition to value-based care in Colorado, and is intended to provide better healthcare at lower costs for more than 300,000 people. The two health systems plan to remain independent and said they will operate the clinically integrated network as a separate entity.
“We are really excited about this partnership with UC Health,” Allen says. “Our focus is I think, you know, is on furthering value-based care, and really building processes and structures and relationships that allow us to go upstream and to take care of people in new and novel ways to keep them healthy.”
“We think the future in healthcare is going to be more about partnerships and relationships than maybe it has been in the past,” Allen says. “The world continues to change. We can't do everything alone for everybody. And our focus should be on doing good. And there's a lot we can do together with others to do good.”
When asked if Intermountain is considering a merger with UCHealth, Allen says, “We haven't even talked about that. And that's certainly not the intention of this is to create a platform for that. It's really about serving better. And as we serve better, I'm sure we'll learn what else we can do. And we'll look at the opportunities that are appropriate at the time that they come up and see if we can take new steps.”
Allen says as Intermountain examines any new potential growth opportunities, the system will look at serving patients.
“As we look at growth in any arena, we’ll be focused on what are the things that really help patients more,” he says. “We think that should be the core driver. It's about mission, it's about service. And so step by step, we'll look at what that needs to be and make sure we're serving well. And we'll make the decisions based on areas that we believe we can improve how we serve. And those are the areas we'll have interest in.”
Many hospitals are struggling with steep financial challenges, and 2022 was the worst year for hospitals financially in the pandemic, according to Kaufman Hall, a healthcare consulting firm. About half of America’s hospitals finished the year in negative margins.
Some analysts expect 2023 to pose similar difficulties for hospitals, and Allen concurs with those assessments.
“There's gonna be challenges and the inflationary challenges are real for us. And if you think of the inflation in healthcare, our revenue contracts are fixed, sometimes over multiple years,” he says. “And yet, our expenses needed to go up dramatically this last year for supplies and for labor, for medications, and those don't get offset by revenue increases, in most cases, because your contracts are fixed.”
“We're going to have to continue to be innovative, we're going to have to continue to evolve the care models to make sure we can deliver effective care within the financing mechanisms of what we're going to have to deal with to fund our businesses.”
Allen says Intermountain hopes to work with payers on better rates.
“A lot of the contract negotiations are going to be challenging in the future,” Allen says. “That said, we've had long standing relationships in our communities with the payers that we work with. And we've been able to work through tough things before.”
As Intermountain looks at a changing healthcare environment, Allen sees value-based care as the best strategy, both financially and in terms of patient care.
“From a mission perspective, I think and believe value-based care is the best approach to serve the community largely,” Allen says. “And so that's where we're making our bets and putting our resources in focus.”
Allen says the healthcare industry needs to see value-based care as more than “just a finance mechanism.”
“We talk a lot about it in the financing mechanisms side of the world, and that's an important part of it, because it allows you to finance work upstream,” Allen says. “But it really in my mind is about alignment. It's creating that alignment between the patient to the care provider, right to the organization that provides care, to the insurance, or payer side who's doing that and to whoever's purchasing it, the individual or the employer or the government.”
“If we create alignment, the path will become more clear,” he says. “And I think as we look to the future, it's going to be important for Intermountain Health, that we create a clearer path on this by creating that alignment. And I actually think that's applicable across the country.”