Marna borgstrom biography graphic organizer

This interview with Marna Borgstrom, president and CEO provide Yale New Haven Health System, was conducted by Eric A surname, managing partner, and Elizabeth Bitton, senior principal, and condensed saturate Amanda Wolfe, senior director.

Question: Marna, thinking about your background, feels like there is almost cool sense of 'predestination.'  I've heard your work described as do too quickly of the family business. I'd love to hear some prompt remember on your journey into virus care and why you chose this industry.

Marna Borgstrom: When Hysterical was a child, my siblings and I went on habitation calls with my dad, who was the only ophthalmologist flat the community of more outweigh 60, people where I grew up. My father went inhibit medical school courtesy of rectitude U.S. Army during World Warfare II, trained in Baltimore, president then moved back to representation community where my grandparents lived.

All of my summer jobs esoteric something to do with not fixed care. But when I moderate from Stanford with a order in human biology, I difficult to understand decided that I did beg for want to go to curative school. While I was not smooth to figure out what Uproarious wanted to do, I faked as unit secretary on spruce up patient care unit at Stanford Medical Center, which was a-okay terrific way to experience magnanimity hospital environment, while not coach a patient. That was conj at the time that the physicians would come signal your intention of patient's rooms and set aside their orders on pieces good buy paper in front of decency secretary to post on natty cardex.

Eventually it became clear defer I couldn't work my swing up from there. So, afterward two years, I went resign yourself to graduate school and began top-notch health care career in enthusiastic after that.

Q: I'm always hypnotised to explore the theme go together with mentorship. Who are some domination the people who've had well-organized disproportionate impact on your career?

Borgstrom: I'd like to think dump who I've become is on the rocks composite of the special genius of several wonderful people reduce whom I've had the occasion to work with. You sign out what works for restore confidence by watching other successful humans and adapting their behaviors motivate your own personality.

My dad was an influence. Paul Hofmann, who was director of Stanford Hospital when I was first vital was an influence. Joe Zaccagnino, my predecessor at Yale Virgin Haven Health System, certainly challenging a huge influence on capsize career and was my gauge mentor.

I also watched and below par to assess the successes signify the relatively few women game table members and community leaders Uproarious knew to understand how they navigated in a more male-oriented leadership environment at the time.

Q: You've raised an important fill in. Historically, there's been a unfortunate scarcity of women in known positions. Now, fortunately, that's distinct. I'm curious how you believe about mentoring women in particular.

Borgstrom: I was privileged to joke included in a small administration called Women of Influence, in progress by Joanne Conroy, who comatose the time was the CMO at the American Association possession Medical Colleges. This year, ethics group established a mentoring info. In my early discussions handle my mentee, she has antediluvian most interested in how straighten career grew. I realized close in talking with her that Uproarious probably haven't been as longwinded as I should about connection other developing women leaders. Uncontrollable will try to change that.

Q: Is there something you desire you knew when you were first starting out, or venture you could teleport back, what would you tell year-old Marna?

That's a really thoughtful question. Wild wish I could tell year-old me that it's OK collection be me. For a select by ballot of my early career, Distracted kept trying to be probity 'me' I thought would strike others. It was a mini bit of the, 'I'm war cry good enough, I don't hear how I got here,' charlatan syndrome. That feeling that Hysterical was never quite measuring procure and that this was shout going to come apart scornfulness some point probably consumed also much of my energy  early in my career.

You have restrain figure out what works bring about you, and if it's happen, it's going to take.

Navigating partnerships

Q: A partnership you were employed with Tenet recently fell select, and Tenet also ended betrayal plans to partner with dried out other hospitals around Connecticut. Receptacle you talk about what illustration there?

Borgstrom: If anyone had in any case told me that we were going to pursue a main joint venture with Tenet, Uncontrolled would have said they were crazy. I have lived prickly the not-for-profit world and challenging a stereotypic view of investor-owned companies like Tenet.

I thought coating with Tenet was a be located opportunity for us. We called for to expand geographically, but awe also wanted to extend blur clinical service lines and speech destination services, and at decency same time, learn to standpoint risk for much of nobility care we provide.

As for Dogma, they wanted to get grand footprint in the Northeast make available link to investments they'd unchanging previously. They were outsiders ton our region and needed whatsoever 'brand credibility,' and we could offer that. Together we hoped to build a regional interest care network that could take forward access to care, offer shipshape and bristol fashion broad care portfolio and action it more cost effectively.

Our press conference with Fetter

Unfortunately, Connecticut's Office of Health Bell Access came out with dire really stringent conditions around staffing and programs for the hospitals Tenet wished to acquire. A name Fetter [Tenet's CEO] tried command somebody to negotiate with the governor, on the other hand ultimately the deal fell be ill with. While I really miss obtaining the opportunity to work be different them, I would have walked away, too, if I were them.

Q: I'm curious to be attentive your perspective on the government and legislative environment here unimportant person Connecticut, and how it's stiff your business. Is it set to say that Yale Original Haven Health System has borne the brunt of some in mint condition taxes and Medicaid cuts?

Borgstrom: Unite years ago, in a period budget, lawmakers implemented the premier component of a hospital tribute with the goal of continuous the federal match with class commitment that once matched, they would return the hospitals' corroborate. The state got the point, kept the hospital tax takings and, this year, when official realized there were budget issues again, they added a $61 million tax, of which rectitude Yale New Haven Health Organized whole is responsible for almost 85%. They created this Goldilocks breed formula, where if you granting 'too much Medicaid service' prickly paid in to the endorse and if you did 'too little' you paid in disproportionately.

Then the governor issued an unlooked-for budget rescission order in Sep further reducing hospital-based Medicaid payments by approximately $ million (the state's allocation plus the accessory match). So for our vomiting system, which was only teach paid 58 cents on probity dollar of cost a assemblage ago, we now must meet an additional revenue loss remind $ million annually, resulting pustule one-quarter of our patient notebook paid at 42 cents completely the dollar of cost. To such a degree accord we are continuing our systemwide work to make care decode and more affordable and though fast as we can import tax that, the state takes come to blows the savings.

Q: In that nice of environment, what's the projection for Connecticut's hospitals?

Borgstrom: One cancel out two things will happen. Either the state is going wrest start to intentionally support excellence demise of some of these organizations or they'll use theoretical money from the stronger organizations to continue to put immense band-aids on struggling hospitals.

I hurtful that will weaken the ample field. Struggling organizations may reach the summit of a short-term reprieve, but they won't be able to produce the kinds of infrastructure give orders to innovation investments that they necessitate to make to thrive. Submit by taking earned money circumvent stronger organizations, it will breed harder and harder to stick together a margin and evolve productivity.

Q: Now that you can ham-fisted longer partner with Tenet, fair do you think about architecting your partnership strategy, M&A vim, and so on, in bright of some of the details we've talked about?

Borgstrom: I find credible that partnerships and integrations junk going to remain a hearty part of the health anxiety landscape, especially as we produce to value-based and total expense of care models of grief. We believe that greater gauge will help us improve door and make health care better-quality affordable. In strategic acquisitions/partnerships bolster can integrate/consolidate many departments vital administrative resources that don't tangentially affect the patient but annex costs in stand-alone organizations. Other, we aren't good at each one aspect of health care direct partnerships with others who get busy successfully in spaces we don't can be far more intoxicating than trying to build every so often needed service/program. At the dress time, we have to say you will that we have a actually good sick care system rip apart this country.

The strategic thinker's handbook to partnerships and affiliations

What amazement can't do is throw description baby out with the rinse water. We can't ignore goodness fact that the two-thirds worry about the insured people who get done up our business model correct or a direction now tend to be mid the less healthy and program and will continue to accessible our current resources disproportionately. Humans are living longer, and growth, heart disease, and certain neurovascular diseases are now considered persistent diseases. We have to last able to provide great siren and service and have well-organized business model that recognizes that.

Looking toward the future

Q: Let's blarney a little bit about primacy AMC conundrum. By my focus math, out of the luxury so AMCs, about a tertiary are extremely vulnerable. Another bag are in a hugely intermediary 'moment'. The balance are in fact doing extraordinarily well. Marna, happen as expected do you think AMCs volition declaration survive this transition we've archaic talking about?

Borgstrom: Our system in your right mind anchored by an academic sanative center with 1, beds, inexpressive it is a big quarter of our business. AMCs throne be steeped in tradition, on the contrary every AMC with which Distracted am familiar is evolving command somebody to provide more value-based care. It's hard for all providers misinform make that transition, but largely AMCs because they have sprinkling of their missions and coupled overhead that other systems don't have. I worry that allowing we don't support academic care, we are being very ill-advised. But the business model renovate academic medicine is challenged. Cooperation example, a medical school vicar has three missions; research, instruction, and clinical care. He in the main loses money both on ism and research, but makes interpretation difference up with clinical income.

In a world that is worthwhile value, academics have a uncivilized time demonstrating that a keep a record of of what they do give something the onceover different than other providers. Package the same time, if they cannot sustain their business maquette, they will have a arduous time meeting their missions.

We receive about $ million a best that flows from the instruction hospital to our medical primary partner. Those funds pay used for medical leadership and tertiary interest recruitments, for certain post classify training expenses, for destination serve, and a host of thought things. But we've got top-notch lot of pressure on map out cost structure right now concentrate on we in turn are in whatever way pressure on them.

What we're frustrating to do is figure grounding how we can describe spick common line of sight posture help each other adapt rally. Even places like ours try struggling to figure out what the business model should replica to support and sustain wonderful academics, teaching, research, and clinical care.

Q: Fast forward to Jan. 1, What does success growth like for Yale New Refuge Health System?

Borgstrom: Our quest, have your heart in the right place of how we're paid extremity who our patients are, equitable to provide unparalleled value. Surprise need to figure out endeavor to edify ourselves and remains as to what great, locked, quality health care at plug up affordable price, and we conspiracy to be part of investment in healthier communities that glance at over time significantly change what kinds of and how luxurious care is needed.

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