A Publication of WTVP

Michael Bryant was named president and CEO of Methodist Health Services Corporation in June 1999. Previously, he served as senior vice president at Robert Wood Johnston Health System and president and CEO of Hamilton Hospital, both in Hamilton, N.J.

Bryant received his bachelor of science degree in business administration from Indiana University in 1978. He also received his certified public accountant certification from the State of Illinois in 1978. After completion of his master of business administration degree in health administration at the University of Chicago in 1985, Bryant was named vice president for finance and treasurer (chief financial officer) for Diversified Health Services, the parent of Hamilton Hospital. From 1985 to 1992, he was responsible for the total financial management of the parent corporation and subsidiaries.

While serving as chief financial officer for the parent corporation, Bryant was named chief operating officer for Hamilton Hospital (now Robert Wood Johnson University Hospital at Hamilton). He worked with the medical staff leadership, developed a plan, and recruited a vice president of medical affairs and clinical chief, and increased the medical staff board certification from 40 percent to almost 90 percent.

In 1989, Bryant was promoted to CEO of Robert Wood Johnson University Hospital at Hamilton. As CEO, he worked to position the hospital in a competitive environment into the county's premier community health system without laying off employees, negotiated an affiliation with the Robert Wood Johnson University Hospital, affiliated with UMDNJ-Robert Wood Johnson Medical School, established a satellite center of the Cancer Center of New Jersey, and more.

During Bryant's tenure as CEO, the hospital acquired a 180-bed long term care facility and built the county's first ambulatory care center, consisting of a freestanding surgery center, comprehensive rehabilitation program, and the Cancer Institute of New Jersey at Hamilton.

In 1996, the hospital, nursing home, and ambulatory surgery center earned the JCAHO's highest rating of accreditation with commendation.

While in New Jersey, Bryant served as a commissioner for the Hamilton Township Redevelopment Authority, and chairman of the finance and marketing committee. He also served as the chairman of the Hamilton Township School District Strategic Planning Committee.

Bryant also received many awards, including the Rotary International Vocational Service Award, the Leadership New Jersey Fellowship, the Outstanding Young Citizen's Award from the New Jersey Chamber of Commerce, the YMCA Man of the Year Award from the Hamilton Area YMCA, and the Good Guy of the Year Award from the New Jersey Women's Political Caucus.

Tell us about your background, schools attended, family, etc. How did your background help prepare you for your current position?

I was born the second of four children, and the first son, in Jeffersonville, Indiana. My father passed away when I was only 8 years old and I remember my Mom taking me aside and telling me Dad would always be with me as my "guardian angel." He has been that for me all these years. I can't begin to articulate what a source of comfort and strength my parents both have always been to me, each in their own way and I know those early lessons in loss and struggle helped to create who I am today.

After high school, I attended Indiana University, graduating in 1978 with a bachelor of science degree in business administration. A week before graduation, I took the certified public accountant exam and passed it the first time.

In 1985, I earned my master of business administration degree from the University of Chicago, with a concentration in health administration and marketing. I knew then that it was important for me to be part of an organization that makes an impact on people's lives.

My wife, Paula and I met in 1981 while she was a junior at Indiana University (she, too, is a CPA and a Hoosier–two great qualities). We have three children, Elyse 14; Eric 11; and 7 year old Evan. Just days after he was born, Evan had open heart surgery, which thankfully not only saved his life, but enabled him to lead a normal, healthy life. Evan's condition was such that had he been born just five years earlier, he would not have survived. Fortunately, technology and research have advanced so greatly that situations like his can be addressed quickly and lead to a normal, healthy life. In 1993, the American Heart Association in New Jersey honored Evan as their Person of the Year–we were all really proud to be his family.

How has your CPA certification helped in your career?

Understanding financial and economic issues is essential in dealing with the complex and changing business of health care today. Having a financial background has been a tremendous benefit throughout my career in health care, as it was always my belief that a successful executive needs to be comfortable with the fundamentals of financial principles. After graduation from IU, I went to work at what is now KPMG in Chicago. Working for a large public accounting firm provided a unique set of experiences that only public accounting can provide. During those years I began to do health care audits and projects and once I started in health care I found it was all I wanted to do. I loved it. Health care feeds my need for challenge, and my desire to be a part of an organization that makes a difference socially.

Now after 12 years as a CEO in health care, it is clear that the importance of finance issues has taken on a much greater role than ever before. Due, in part, to my accounting background, I have a better appreciation of the economic consequences of the decisions we make, and how those decisions will impact my organization's commitment to the community it serves.

After living and working in Peoria for one year, what surprises have you had? How does Peoria compare to its reputation?

As a new resident of Peoria, there are a few things that have come as a surprise. For example, I was pleasantly surprised by the collegial welcome extended to me by Jim Moore and Keith Steffan at OSF Saint Francis Medical Group, by Norm Laconte at Proctor Hospital, and both Drs. Michael Bailie and Don Rager from the University of Illinois College of Medicine at Peoria. This did not happen to me when I became a CEO in New Jersey. In addition, meetings on the East Coast rarely began before 9 a.m.–I discovered there is a strong tendency for early morning meetings here (Peorians love 7 a.m. meetings), which I admit, required a major adjustment on my part. I'm still trying to adjust.

Peoria certainly does not live up to the reputation it has outside of this area. This is a beautiful community filled with warm, friendly people. My opinions about downtown, and the opportunities and potential for Peoria have been recently chronicled. As a native Midwesterner and someone who lived in Illinois for a number of years, I looked forward to living in Peoria. In fact, my wife and I considered opportunities in the Boston, Cleveland, and Denver areas, but we were most comfortable with the people we met here; the commitment Peorians have to families, and the environment we felt was conducive for raising children. We both knew immediately that this was the place for us. However, there clearly is a less than positive reputation surrounding Peoria that I am now encountering as I attempt to recruit senior executives. When we get candidates to visit Peoria, they are pleasantly surprised–and Peoria then sells itself.

What attracted you to Methodist Medical Center, which apparently has had some internal problems? Can you address some of those problems, and what you have done, or plan to do, to fix them?

Methodist's internal problems were exactly the reason I wanted to accept the position. The opportunity to define a new culture based on commitment to patients and service was an opportunity I found exciting. Methodist has a 100-year history of doing some very exciting and innovative things, but in our recent past, it appeared to lack direction and focus. I believe that what Methodist needs at this time in its history are teamwork, high standards, and commitment to patient service and community values. These are things I focus on.

I enjoy challenges and solving problems. I enjoy addressing issues that impact patient care, or the community. My wife teases me because overcoming challenges is what motivates me. My last 11 years as CEO at Robert Wood Johnson University Hospital at Hamilton is a perfect illustration. Shortly after I was named president and CEO there, the New Jersey State Department of Health announced the first-ever state health plan in draft form. This plan indicated the state wanted to close my hospital, saying there were too many hospitals in our county (we were rated last out of five hospitals). Fortunately, the state health plan was never implemented, but over the past 11 years we accomplished things such as: becoming one of four hospitals in the state with the highest JCAHO rating; our hospital went from last to first in marketshare; we were the lowest-cost hospital in the state during two of the last three years of my tenure; and the fifth most profitable hospital in the state.

The two key issues at Methodist I believe are at the core of the hospital's previous inconsistent performance were lack of focus and commitment to mission and values, and lack of communication to key stakeholders.

My goal is to focus on patient service; first, last, and always. Methodist has wonderful employees, volunteers, physicians, and board members who are very committed to patient care and to the community. However, in this age of declining revenues, its harder to keep a focus on "patients first, last, and always."

The need for a new mission and values statement that reflect Methodist Medical Center is critical to keeping our focus on patients and service in the years ahead. We engaged a local firm to assist us in developing a new mission and values statement by the end of 2000. This will be a grass-roots effort that will include input from employees, physicians, board members, and the community. In my experience, the mission statement is the mechanism that unites the organization. For example, if all employees within the organization have commitment to the vision and values, and are given responsibilities that they can handle, they can do what's right and make the right decision. When a staff member is caring for a patient, you want them to make the right decisions using the values and principles of the organization for the best interest of the patient and their families.

As a CEO, I don't provide the care. Often, I realize I am the least important person in the organization. We will create an environment where anyone working in our organization feels they have the resources necessary to put patient care first. We have gifted staff–we need to help them grow and develop these gifts at Methodist.

The second issue was the lack of communication to key stakeholders. During my first nine months here, I have concentrated on communicating more openly with employees, community, board members, and physicians–both in Peoria and in the outlying area. It is my responsibility to lead the way in reaching out and re-establishing relationships to prove we are communicating more than we have in the past.

As an example, several months ago an employee wrote an editorial to a local newspaper about the lack of attention management at Methodist provides to its employees. I would hope the same person would have a different opinion of Methodist and its management team today. Two simple but important changes I initiated include hosting quarterly employee meetings to address and explain current issues, and meeting monthly for luncheons with employees where they can ask questions and bring up concerns.

Open and honest communication within the organization is critical to long term success. We are building a culture in which we address issues. We respond to concerns, and while people may not always like the answer, they are getting direct feedback. Another example is being accessible, visible, and informal. One of the first things I did when arriving at Methodist was to move my office back into the hospital and build a new office with glass walls so there would be no mystery as to who the CEO was and what he was doing. Employees and physicians walk by, wave or stop in to say hello. I feel this contributes to building a very healthy and positive environment.

The lack of communication also extends to the community, our external stakeholders. For example, there have been rumors regarding Methodist concerning mergers, closing, and/or being sold to outside entities. I continue to hear these rumors throughout the community today. There is no truth to these rumors; however, we have not done a very good job explaining to the community how well we are doing. We let events, such as the financial improprieties that occurred in our past, create a negative impression that we have not yet addressed effectively. It is human nature for people to make up their own stories if information is lacking. In the past several months, Methodist has begun to provide information and communicate to the to restore confidence.

Regarding the past financial improprieties Methodist uncovered in its finance department, the public is aware that we have recovered all monies involved in the embezzlement. In addition, the public needs to know we hired an outstanding chief financial officer, controller, and other new individuals in key leadership roles. In addition, we instituted a very strict corporate compliance program throughout the entire organization.

Our friends and neighbors also need to understand the financial strength of Methodist. While we have had inconsistent years, the core hospital is doing very well financially. If the year continues as the first quarter, we are on a pace for our best year in at least 10 years. Our volume is 8 percent ahead of 1999; cash flow is excellent; all trade accounts-payable are paid within 30 days; and at least $17 million is committed to capital needs. We are in the second phase of a $25 million information technology program that will pace us competitively with any health care organization in Illinois. Overall, things are going very well for Methodist. As soon as our 1999 audit is completed and approved by the board, I will inform our stakeholders of the 1999 results, and actions we have taken that will demonstrate our strength.

What were your goals for Methodist when you were hired as CEO a year ago? Have those goals changed? How far have you come in accomplishing those goals?

My goal was to concentrate on rebuilding the organization internally, i.e., provide some focus and direction, and through open communication, address the culture, trust, and relationships with the employees and the medical staff. One of our key stakeholder groups not mentioned previously are the physicians. They must be involved in our leadership if Methodist is to become an outstanding organization. In the last eight months, our physicians responded with support and enthusiasm.

Our medical staff president, Dr. Jerry Crabb, is an outstanding physician committed to achieving excellence in patient care. I don't make any decisions without seeking his advice and counsel; we are building a new culture at Methodist.

Addressing our internal concerns will remain a high priority for the foreseeable future. It takes time to change a culture, and I don't want our organization to lose its momentum.

We are recruiting several executives who will join the best of our home-grown senior executives to establish the elements of a patient-centered culture that will last over time.

The potential and spirit at Methodist is far greater than what I expected to find when I arrived. Given how well we're doing financially, as well as the positive feedback we receive from employees, physicians, patients, and people in the community, I believe we are much further along than where I thought we would be after eight months. As I mentioned earlier, things are going very well for Methodist right now.

How has the tight labor market affected Methodist's skilled staff?

The current labor shortage raises salaries. It is important to retain the staff that has served Methodist and our patients so well. To that end, we have made two salary adjustments since the end of 1999, which keeps us competitive. A new priority for Methodist is to respond to market conditions immediately, another very important commitment to our employees. We want to be a preferred employer in Peoria.

For health care organizations all across the United States, labor markets are very cyclical. For example, retaining good nurses is a particular challenge. We monitor staffing issues closely so that there is proper delegation of responsibilities between different levels of nursing. Certainly we don't want an R.N. doing a task that a nursing assistant could do. More than ever before, nursing units need to be efficient in their daily operations, and consistent monitoring helps to achieve efficiency in patient care.

I'm very pleased to see the work done in this community to effectively deal with the shortage of health care workers. Methodist, OSF Saint Francis, and Proctor Hospital, in collaboration with Illinois Central College, have come together to educate young people and help others to make mid-life career changes. Our local health care industry has many opportunities. This work today, hopefully, will prevent a greater nursing shortage tomorrow that could seriously affect a hospital's ability to meet patient needs. I believe it is fair to say that not one of us in the health care community in Peoria will ever let a tight labor market affect patient care. Everyone is very conscientious and concerned that we maintain the consistent high quality of compassion and care that the people in Peoria have come to expect.

How do you envision central Illinois becoming a stronger health care community? What do you believe is the community's perception of Peoria's health care facilities? What would you like to change about that? How will you do that?

My impression is that the community is very satisfied with the quality of health care available. People appear to be happy with their physicians and the level of choice the insurance plans offer. I haven't heard complaints about a lack of qualified services or facilities.

There are always opportunities to be more efficient and effective in providing patient care. In the near future, I believe the best way for central Illinois to become a stronger health care region is through a more active leadership role by the University of Illinois College of Medicine at Peoria. I'm sure the public doesn't fully comprehend the importance of the school and what it brings to this region–it is essential to Peoria. Understanding, from past experience, the advantages and opportunities that come with the presence of a medical school made the opportunity at Methodist professionally appealing. The talents and skills academic physicians bring to central Illinois puts us on par with other medical communities in the country. The research capabilities of the medical school are one of Peoria's best kept secrets. For example, the public may not be aware that the majority of graduates of the medical school stay in this region, which has greatly improved the quality of care central Illinois residents receive.

It's hard to imagine this community would have the Children's Hospital, a PET scanner, and numerous other tertiary capabilities without the presence and support of the University of Illinois College of Medicine at Peoria. There is very little reason to go out of the area for any procedure or test. The three Peoria hospitals, and physicians, should look for opportunities to join together as a united health care community to support the continued development of the University of Illinois College of Medicine at Peoria. Health care is the second largest industry in this region. It is well within our reach to become the largest.

In what areas is Methodist Medical Center a leader? In what areas are you positioning to be stronger? How so?

This is a difficult question–you can define being a leader in many ways. Statistics can certainly be crafted to reach a desired conclusion. A lot depends on how we define being the leader. Methodist is the leader in a number of areas, but I'm always uncomfortable saying "we're the leader" or "we're the best."

We are a servant leader to the community. It's up to the patients and customers to evaluate our contribution. Is being No. 1 in marketshare equal to being the leader? Personally, I think it's much more than that. At Methodist, we are in the process of re-defining our mission statement and values and where we want to utilize our resources to address community needs. If Methodist continues to put patients first in everything we do, we will be excellent. The community will testify to our efforts and service.

How have government regulations and the reduction of Medicare payments affected hospitals, Methodist in particular?

There has been much written about the Balanced Budget Act and its effects on hospitals across the country and in Peoria. The more Medicare patients a hospital serves, the greater the adverse impact on that institution. Recently it was announced that the effects of the Balanced Budget Act would reduce Medicare expenditures by $190 billion, far exceeding the estimated impact of $120 billion. The American Hospital Association and others are lobbying to have some of that savings returned to the hospitals. There was some limited relief, but no where near the tremendous benefit the Federal Government has received. Congressman Ray LaHood has been a tireless supporter for central Illinois in correcting the inequities that have resulted from the Balanced Budget Act.

At Methodist, the Medicare population is 40 percent of revenues and, to date, we have been able to handle the revenue reductions. Through the first quarter of this year, Methodist is doing very well financially, despite these revenue reductions. The first three years of the reductions have been mostly uncomfortable. But the final two years of the Balanced Budget Act is when the real pain of the reductions is expected to be felt. Methodist expects approximately a $3 to $4 million reduction in Medicare revenues in 2001 and 2002. We have already begun addressing how we will offset these revenue reductions; it is an ongoing process that will continue through 2002. Hopefully, after 2002, the federal government will not enact any new legislation that will continue to reduce hospitals' Medicare revenues.

What are consumers demanding from health care providers? How are they helping to change the health care delivery system from 10 years ago?

That's a good question. Consumers are demanding more information and are much more educated on medical decisions and issues. People today are much more involved in their own health, and are much more reluctant to have decisions made without their input. This is very good. The Internet is providing immense amounts of information that, prior to its existence, were not generally available or accessible. It is very common today when a person has a disease, injury, or needs surgery that they are directed to various Web sites for information

Consumers are demanding data from health care providers that demonstrates their competency and skills. For example, the recent Institute of Medicine report indicated that between 44,000 to 98,000 people die from medical errors. This is a great cause for concern. Unfortunately, the problem with some of the data is that it is difficult to define and measure clearly enough so that a consumer can understand it. In addition, people are human beings and don't always follow statistical trends. Providers understand that, despite the best efforts of hospitals, physicians, educators, and patients themselves, people still get sick. Medicine and health care delivery can be a humbling experience. We can do better.

Consumers are also demanding convenience, service, and immediate attention to their health care concerns. People in our society expect and believe it is their right to be seen by a physician immediately; they expect surgery immediately, and they want the latest technology available immediately.

The impact of the pharmaceutical companies and the tremendous advances of drug therapy has led to the expectation that they can take a pill and correct all their health problems; many times it can. Drug costs are the fastest rising component of health care costs today, and will likely continue to be so for quite some time.

As our population gets older, medical technology and drugs allow us to live longer, and the pharmaceutical companies will continue to play a prominent role in the American culture. I was once in a meeting with Sen. Frank Lautenberg, along with other New Jersey hospital executives. We were discussing hospital finances and, among other things, increasing drug costs. He made it very clear to us that, as a 70 year old, if he has to vote for committing dollars for research to support living longer or for giving more money to hospitals, his support was going to research for more drug therapy and advances in medical technology.

Where do you see the future of health care? Where do you see Peoria's role in the national health care scene?

The future of health care is obviously is a very difficult question. We are going to see the beginning advances of gene therapy, and the issue of cloning and assisted suicide debated on a national stage.

More health care will be provided in ambulatory settings and less in acute hospital settings. Health care will become more data-driven for all providers, so that consumers can shop and have enough information to make an informed decision. Competition and the current model of employment-based insurance will continue. Like all of us in health care, the government is concerned about the increasing number of uninsured. If this number continues to increase, there is the potential that the government will want a national health care system. However, with the solid denial of the Clinton health care policies in 1993, it is unlikely we will see a return to that model in the foreseeable future.

I am proud that Peoria addresses the issue of the uninsured with the three hospitals and physicians coming together at the Heartland Clinic. A number of communities have public hospitals (like Cook County in Chicago) where uninsured patients are directed. We should be proud that this situation does not exist here.

Although I have no crystal ball to predict where the future of health care is heading, what must be done is to have an organization that is flexible and can make changes quickly. If Methodist can respond to a changing environment in an expeditious and deliberate fashion, while keeping patients first, we will be providing care for the wonderful people of Central Illinois for another 100 years. IBI