1. INSPIRED CARING: Transforming for population health Mark Herzog, FACHE President & CEO

2. 2 Holy Family Memorial Intense local competition; regional dynamics 90 provider multispecialty group practice employment model Hospital services include OB, Orthopedics, Cardiac, Cancer 1,500 employees and volunteers - average tenure 15+ years Faith-based organization serving for 115 years INDEPENDENT, SINGLE-MARKET,TIGHTLY-INTEGRATED SYSTEM

3. 3 Holy Family Memorial’s Mission Holy Family Memorial is a network of health professionals who, rooted in the healing ministry of Jesus Christ, provide services to help individuals and our communities achieve healthier lives. Adopted 2008

4. 4 Core Belief: Doing What’s Right “Start by doing what is necessary; then do what is possible; and suddenly you are doing what is impossible” St. Francis of Assisi 1181-1226 “Are you meeting the needs of a community, or the needs of a corporation?” Sr. Laura Wolf 2013

5. IMPROVEMENT Lean Healthcare Six Sigma INNOVATION Bright Ideas SPUR TRANSFORM FOR POPULATION HEALTH Outside Eyes Flatten Organization Culture of adaptability HFM’s Reform Roadmap HFM’s Reform Roadmap Transforming Culture and Care MOVING CULTURE & CARE TO THE RIGHT Staff & Physicians Leadership Community Partnerships

6. 6 Connecting with our Keynote “The health of the community includes more than the physical health of the people. It includes political, economic, educational, mental, social and religious health.” Rev. John G. Simmons, as quoted by Emily Friedman June 4, 2013

7. 7 Policies & Programs Health Factors Health Outcomes Health Behaviors (30%) Clinical Care (20%) Social & Economic Factors (40%) Physical Environment (10%) RANKINGS BASED ON THE FOLLOWING: FOUR TYPES OF HEALTH FACTORS MEASURED: Adapted from Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute County Health Rankings Population Health Model Population Health Model UNIVERSITY OF WISCONSIN

8. At 21 st & Franklin Street SEPTEMBER 2012 8 At 21 st & Franklin Street June 2013

9. 9 Source: County Health Rankings & Roadmaps: A Healthier Nation, County by County 2013 Regional County Comparison Clearly, there’s more to population health than great healthcare! Socio-Economic Development is job one. RANK Out of 72 Fox ValleyGreen Bay Manitowoc Clinical Care 7 th 13 th 15 th Health 20 th 30 th 40 th Outcomes

10. 10 DEVELOPING LEADERSHIP CAPACITY 1. Intentional culture shaping 2. Continuity & Development of Self, Staff & Providers 3. Continuous renewal- Strategic Program Unit Review 4. Learning Partnerships Source: Dean Lindsay

11. 2001: 10 Senior Leaders 2012: Focus on Wellness & Prevention 2012: 90 Employed Providers 2012: 90 Employed Providers 2001: 90 bed hospital 2001: 90 bed hospital 2001: 35 Employed Physicians 2001: 35 Employed Physicians 2001: Focus on the Sick Population HOSPITAL CaregiversMISSION SENIOR LEADERS 2012: 35 bed hospital 2012: 35 bed hospital 2012: 4 Senior Leaders 2012: 4 Senior Leaders HFM‘s transformation 2001-2012 11

12. 12 Transformation Metrics Transformation Metrics 2001 - 2012 43% reduced admissions 5% inpatient market share loss 8% outpatient volume growth 39% growth in clinic visits Margins last 3 years 0-2%, 200 Days cash S&P BBB+ stable outlook Safest patient is the one never admitted!

13. 200% 100% 150% Manitowoc Fox Valley Green Bay Transformation’s Impact on Hospital Utilization and Expenses Population adjusted regional growth in hospital charges 2001 to 2012:

14. 14 Why Should This Matter? What if every hospital provider focused on “Right Care”? What could redirecting these resources to addressing the true drivers of population health achieve?

15. 15 How did we do it? How did we do it? Through a Flexible and Nimble Business Model A Culture of Learning Meaningful Physician Engagement Shifting Focus From Beds to Clinics Planning, Governance, Operations, Culture Shaping Flexibility and Adaptability

16. 16 Population Health Partnerships CLINICALOPERATIONALCOMMUNITYLEARNINGBUSINESS CareTech

17. Performance Accountability Review Performance Accountability Review How well did you perform over the last year? Source : NCHL “Rearview Mirror”

18. Leadership Team Assessment Leadership Team Assessment Can you lead this organization into the future? 30% Weighting  ABLE TO: competent to lead  WILLING TO: desire to lead 20% Weighting  PROMOTABILITY: Advancement potential 50% Weighting  COURAGE TO: internal fortitude to lead  CULTURE SHAPING CONGRUITY: ability to fit in current culture & transform to ideal culture “Headlights”

19. 19 Transformational Leadership Transformational Leadership What Brought You Here Won’t Take You There 1. Surprises in assessing future leadership capacity: a.Only 30% of leaders are strong in both tools b.32% of leaders scored low on the leadership assessment c.17% of the highest PAR score leaders had low leadership assessments 2. Closing the gap:  Leadership Institute  Fellowships  Internships  Mentorships  Dyads

20. 0%20%40%100%80%60% The CULTURE Difference Over 70% participation in network pride survey: 20 I am proud to work at HFM I recommend HFM services I am excited about HFM’s future HFM leadership welcomes my ideas and suggestions for process improvement 2008 2011

21. 21 The Key to Population Health? Ronnie Bryant, President & CEO of Charlotte USA among the most effective Economic Development Corporations in the Nation Dream big and set your boundaries clearly. …Then take out the lines.

22. The Next Steps HFM catalyzing efforts to improve socio-economic performance by leading economic development, etc. Fostering continuum relationships  Embedding primary care in LTC facilities  Embracing Open Innovation with partners Maintain Core Strengths: Our mission, community engagement, and operational discipline foster culture and leadership Negotiate from a position of strength 22

23. RIGHT CARE RIGHT SETTING RIGHT OUTCOMES THE RIGHT CHOICE 23 Copyright © 2013 Holy Family Memorial. All rights reserved.

24. The Holy Family Memorial Story