Widening the focus
Date: April 6, 2011
As traditional revenue sources shrink and Hopkins Medicine looks further afield to make up the difference, it can rely on the right-hand man.
When Steve Thompson recently walked through the doors as the new head of Johns Hopkins International, he brought with him his experience and reputation gained from building clinical networks both in the region and around the world.
And, though he faces unprecedented challenges in this role, it’s not unfamiliar territory for Thompson. In an earlier stint as the inaugural head of International from 1999 to 2007, he took an organization that was solely focused on patient services and engineered health care programs and hospital affiliations from Singapore to the Middle East.
After leaving that post, Thompson—who’s long been Dean/CEO Edward Miller’s right-hand man and troubleshooter—spent six years as Hopkins Medicine’s senior vice president.
During that span, he was instrumental in constructing a regional network, from the expansion of Johns Hopkins Community Physicians to the integration of community hospitals, such as Suburban and Sibley Memorial.
“Steve has distinguished himself in positions of increasing scope, complexity and responsibility,” says Miller. “We see abundant evidence of his success in orchestrating the strategic expansion of our regional network. Tremendous opportunities exist for us to take our mission even farther, and it’s clear that overseas ventures are ever more critical to our financial health.”
Calling on the sum of his expertise, Thompson is using his second stretch with International to focus the organization on producing more revenue for Hopkins Medicine and to help offset financial declines elsewhere within the institution.
“All of the traditional lines of revenue that come into Hopkins Medicine are threatened and they’re basically all flat at best,” he says. Payment for clinical services provided to Maryland residents is constrained by federal health care reform and state changes to Medicaid. As the government curtails spending, the National Institutes of Health will likely face a smaller budget, which, in turn, means less research funding. Even philanthropic dollars have declined with the downturn of the economy.
An opportunity to increase the revenue stream to Hopkins Medicine may lie outside Maryland’s borders. Thompson sees JH International not as a separate entity, but as a pathway through which out-of-state patients access Hopkins, and one that allows departments and faculty members to expand their patient care, research and educational efforts through opportunities here and overseas. “International’s role in the financial health of Hopkins Medicine,” he notes, “is to ensure that Hopkins entities achieve their financial goals. JHI exists to be the international vehicle for the institution.”
With this in mind, he plans to reinvigorate inpatient volumes in complex care areas, such as urology and neurosurgery—and any of those for which patients are most likely to travel and that require a high level of expertise not found in many parts of the world.
What attracts out-of-state patients to Hopkins, Thompson says, are the clinical and research breakthroughs that offer hope found nowhere else. What keeps them coming back—and referring their friends—is the experience they have while they’re here.
“Everything we do—whether it’s in Bethesda, Md., or Abu Dhabi—it all has to have a strong anchor in the Hopkins Medicine mission.”
International’s patient services division assists thousands of domestic and international patients who travel to Hopkins from outside of Maryland each year. The multinational, multilingual staff—hailing from more than 35 countries—are expert at anticipating cultural health care expectations (such as pairing a Muslim women with a female doctor) and in navigating Hopkins’ labyrinth of locations, the nuances of traveling for medical care, and payers such as embassies, individuals and insurance companies. JHI financial counselors assist patients by providing estimated bills, as well as Hopkins departments by expediting the collection of complex international payments.
Further afield, Thompson envisions a realignment in the way Hopkins’ global agreements are developed and carried out. With more than a decade of experience since the first agreement was forged in Singapore, JHI is now in a position to refine its service offerings and streamline global intelligence gathering—scoping out new projects, understanding the ever-changing context of existing ones and informing decisions on where best to focus new patient outreach.
International currently maintains collaborations with more than a dozen medical institutions across four continents. Since 2001, the organization has guided most of them through more than 10 successful Joint Commission International accreditation surveys—raising the quality of health care in those regions and developing Hopkins expertise into a consulting line that’s now part of nearly every agreement.
Overall, the benefits flow both ways. Affiliations provide Hopkins faculty opportunities to teach, learn from and collaborate with their international peers, while health care providers across the globe gain knowledge they can apply to their local culture and create true societal impact.
On a recent trip to Chile, Dean/CEO Edward Miller witnessed one of JHI’s “wow” moments while meeting with Jaime Mañalich, the minister of health. During Manalich’s tenure as head of Hopkins’ affiliate in Santiago, the hospital became the first in Chile to receive Joint Commission International accreditation. Mañalich told Miller that he plans to take what he learned from Hopkins about safety and quality to raise the standards for the nation.
Thompson hopes to replicate this kind of impact around the world as he makes changes in JHI’s structure to better tap into internal expertise. He’s challenging directors to move beyond geographic proficiency and into specialization based on type of agreement, ranging from full management to strategic academic collaborations and beyond. In that realm, Thompson looks for greater involvement from faculty at the schools of medicine, nursing, public health and business in identifying opportunities for international collaborations in research and education.
But most important to Thompson is the role that JHI plays in helping Hopkins to improve the health of the community and the world. “Everything we do—whether it’s in Bethesda, Md., or Abu Dhabi—it all has to have a strong anchor in the Hopkins Medicine mission.” Ultimately, that means taking medicine to the next level for every patient, regardless of where treatment takes place.