When Stephen Mansfield was hired on as president and CEO of Methodist Health System in the fall of 2006, there wasn’t any drama around it.
The former CEO was simply retiring and things were running like clockwork. But with that retirement, the board saw an opportunity. The hospital’s financial performance was starting to deteriorate, primarily because of the amount of charity care and uncompensated care it had to provide — a common problem for hospitals as an increasing number of people lack health insurance.
“My feeling was, and the message was, that we need to grow,” Mansfield says. “If we’re going to be able to sustain the mission of this company and provide care to the poor who are unable to pay for their care, we’ve got grow in some new areas that can generate income to offset that.”
His first 90 days on the job were spent in conjunction with the outgoing CEO, so he did one-on-one interviews with the board, senior leadership, community leaders and about 80 medical staff members, all in an effort to understand the organization well.
By January, Mansfield was in a position to stand before the board and the entire medical staff and provide his assessment and early thoughts as to how and why the company should grow from where it was — about $460 million in net patient revenue — to $1 billion in net patient revenue by fiscal 2011.
The results in his first four years are impressive: $890 million last fiscal year and nearly doubling the net patient revenues. Additionally, the system has grown from two hospitals in 2006 to seven today.
“It’s been a pretty aggressive growth trajectory,” he says. “I don’t know many other health systems that have doubled in size over the last four years. We’re very fortunate.”
Here’s how Mansfield used two key strategies — planning and careful hiring — to hit his growth goals.
Create a plan
Mansfield simply loves strategic planning, and it’s the first thing he went into following his address to the company in January 2007. He knew that if Methodist was going to grow, it couldn’t just meander its way through it.
“Next to the right people, strategic planning is one of the most important functions you can do,” he says.
Mansfield essentially creates a four-year plan every three years, which allows for a year overlap on each plan. For example, he began creating Methodist’s 2012-2014 plan in February 2010, while still in the middle of the 2009-2011 plan.
He starts with an off-site, one and a half day conference with the board, leadership team and medical staff leadership. One of the keys to strategic planning is getting an outside perspective, so he brought in well-known, industry experts to speak about where they saw health care going.
“Have thought leaders from your industry come and talk to your leadership,” he says. “We tend to get myopic in our focus on our own organization and our own market, and we think that’s the way the world’s running, but, in fact, there may be trends occurring outside of your market that you need to take into account for your market. …
“You may not agree with all of them, and some may not work for your market or your company, but it’s helpful to expand our horizon of thinking at the beginning of a strategic planning process. Then you take it from broad to narrow and make it work for your organization and your service area or market.”
After that, he says to come back with your senior team and synthesize the thought from that session at a high level and put it into a document.
“Whoever’s going to be tasked with the primary responsibility for delivering on your plan needs to be involved in your planning process so they feel ownership in that plan,” he says.
Over the months that followed, the senior team members discussed and refined it, and in September, they presented it to the planning committee.
“We had a lot of people involved in it, because we wanted to have buy-in from the medical staff,” he says. “I didn’t want it to be Steve Mansfield’s strategic plan — I wanted it to be our medical staff’s plan, our board’s plan, our community’s plan, our employees’ plan, our management structure’s plan.”
A year after the initial conference — and still a year before the plan starts — is when he starts the budgeting process for that three-year plan. They create a planning calendar, which he calls a racetrack, that has the key things that have to happen during that time period for the plan to be successful.
“As much value as I place on planning, I don’t think it’s the final plan that’s so important as it is the process of creating the plan,” Mansfield says. “Then the real differentiator is not necessarily the plan but how well you execute on it.”
He says companies get caught up in creating a plan but they don’t involve key stakeholders and then they don’t track their progress or see how they’re doing against the plan.
“Those things are so important to making sure the plan has the impact on the organization that you want it to,” he says. “I tell people all the time, as proud as we are of our strategic plan, reality is, if you compared our strategic plan to our two top competitors’ strategic plan, there’s probably about an 80 percent overlap. So what’s the differentiator? The differentiator is who can execute the plan better.”
Once the plan actually begins, he meets every other week with his senior executive group to review key data. In one meeting a month, the key metrics of the plan are reviewed by the planning department, and the team receives feedback on how they’re doing on accomplishing and delivering on the plan. The hospitals are given updates on the things they’re measured on once a month. If anything is off, he and his team try to find out why.
“Missing a goal is not the cardinal sin,” he says. “Missing the goal and not having discussed it and asked for help along the way is.”
Lastly, to make sure people are staying on track, he also stops by people’s offices — not call them to his — to casually talk with them about how things are going.
“There’s no substitute for periodically sitting down with the key members of your team and saying, ‘How’s it going? How are things working? Do you feel like you’re getting things done that you need done? Is there anything I can do to help you? Oh, by the way, I saw that you did such and such, and that’s awesome,’” he says. “We get, as CEOs, so busy sometimes that we don’t just take the time to sit down with the key members of our team and just spend a little bit of time refreshing on the priorities and making sure that we’re acknowledging the successes. We have a propensity to assume success and sometimes to withhold encouragement, and that’s not good.”
