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From Specialist to Full-Service Health: A Transmogrification

Feb 28

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Tuesday, February 28, 2017  RssIcon

How does a $20 million community mental health center (CMHC) become a $128 million full-service health and human service provider organization in 14 years?

We learned about that journey at The 2107 OPEN MINDS Performance Management Institute, in the session, From Specialty Care To Primary Care: A Town Hall Discussion On The Strategic Challenges & Opportunities In Integrated Care. The town hall session featured Hank A. Milius, president & chief executive officer of Indiana-based Meridian Health Services; Kirk W. Shafer, CPA, Meridian chief financial officer/chief administrative officer; and Amelia Clark, Meridian vice president of Community Health. In the session, Mr. Milius explained the rapid growth as a product of meeting community needs, changing demand in the health care field, and seizing on market opportunities when they arise.

The trajectory in the service line evolution at Meridian is fascinating. In 2005, Comprehensive Mental Health Services rebranded as Meridian Health Services. During the next few years, Meridian became a Licensed Child Placement Agency (LCPA), established the Suzanne Gresham Center for the treatment of children and families, opened a psychiatric hospital, and began serving 20 Central Indiana counties with its dually diagnosed Crisis Assistance program. And more recently, Meridian added primary care in multiple locations, offering family practice, internal medicine, pediatrics, and obstetrics and gynecology (OB/GYN). This year they will be adding an urgent care center.

When Mr. Milius arrived the organization was budgeted to lose $1 million and soon only had one psychiatrist. Today it is profitable, debt-free, and has over 40 medical staff members. Knowing all of the above still begs the question: How did Meridian grow so much, so soon? According to Mr. Milius, it started with a commitment to having no debt and good margins through a sound business model. Having that financial foundation allowed them to confidently invest in new initiatives. Additionally, he said it was important to understand the realities of the reimbursement structure, then optimize organizational operations around that.

Another way in which Meridian laid the groundwork for growth is by hiring smart, talented executives who bring creative new ideas, and breaking down organizational silos so they can collaborate more easily. For example, when Milius developed hospital services, he hired acute care management experience from outside Meridian. This allowed new ideas and complemented strengths on the Executive Staff.

“It’s a great team effort,” Mr. Milius said regarding this and other new initiatives. “We agree on goals and I empower them to get the job done.”

With this mindset, Meridian has continued to grow: Earlier this month, it opened Meridian MD Convenience Care, an urgent care facility housed within Jay County Hospital in central Indiana. The office is designed to treat non-emergency issues in a convenient, efficient way — it offers 2 to 8 p.m. hours on weekdays and 8 a.m. to 12 p.m. on weekends, and has three exam rooms that treat conditions such as cold and flu, insect bites and stings, allergy symptoms, cuts, and the like. And Meridian is looking into opening new integrated care sites — with a focus on whole-person health — later this year at two yet-to-be-determined sites.

The list of challenges Meridian encountered during this surprising transformation is extensive. A clash of language and cultures. Managing four different electronic health records (EHR). Serving 39 counties instead of three. And, suddenly having the attention of the “big players” in the Indiana health care system.

What is required to make an organizational change of this size and scale? I learned a few tips from our three executives. First, have a big vision, but be willing to take small steps to get there. Second, stick to your management knitting and make operations profitable so you can fund new innovations. Third, hire the expertise you need — there is no time for your team to “learn on the job.” Finally, develop organizational nimbleness and an ability to adapt quickly.

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