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An International Perspective –
Tradition vs Transition:
Innovative Responses
Catholic Health Australia2017 National ConferenceAugust 29, 2017
John D. DoyleExecutive Vice President, AscensionPresident and CEO, Ascension Holdingsand Ascension Holdings International
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Scope of services…
Catholic Healthcare Internationally
• Catholic healthcare comprises 26% of the world’s healthcare facilities
• 34,000 Catholic clinics, aged care facilities and special needs facilities
• 5,500 Catholic acute care hospitals outside the U.S.
• 65% of Catholic hospitals are located in developing countries
• 200 Catholic hospitals in Oceania, the highest number in the last 30 years
• 1,039 Catholic hospitals in Europe, a decrease of 49% over the last 30 years
• 1,000 Catholic hospitals in Asia, stable over the last 30 years
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• 150 fewer Catholic hospitals in the U.S., and fewer than 300 single-sponsor hospitals
• Now, about 650 lay hospital CEOs in the U.S., and zero religious hospital CEOs
Last 50 Years…
U.S. Catholic Healthcare
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Ascension: Care of Persons in Poverty a Priority
Fiscal Year End June 30, 2016
Total Assets $32.5 Billion
Total Operating Revenue $21.9 Billion
Income from Operations $753.2 Million
Excess of revenue and gains $461.4 Millionover expenses and losses, controlling interest
Care of persons living in poverty and
community benefit
programs: $1.82BILLION
*
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Our Future Vision
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Always Aligned with our Mission, Vision, Values
Our Future Vision
Our Mission Our Vision Our Values
Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable.
Our Catholic health ministry is dedicated to spiritually centered, holistic care which sustains and improves the health of individuals and communities.
We are advocates for a compassionate and just society through our actions and our words.
We envision a strong, vibrant Catholic health ministry in the United States which will lead to the transformation of healthcare.
We will ensure service that is committed to health and well-being for our communities and that responds to the needs of individuals throughout the life cycle.
We will expand the role of the laity, in both leadership and sponsorship, to ensure a Catholic health ministry of the future.
Service of the Poor – Generosity of
spirit, especially for persons most in need
Reverence – Respect and compassion for
the dignity of diversity of life
Integrity – Inspiring trust through personal leadership
Wisdom – Integrating excellence
and stewardship
Creativity – Courageous innovation
Dedication – Affirming the hope and joy of our ministry
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Strategic Direction
Our Future Vision
Our outward
promise to those
we serve
Enabled by focused
inner strengths
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• Delivering improved health outcomes
• Ensuring an enhanced experience for those we serve and their families
• Creating an enhanced experience for providers
• Making healthcare delivery more affordable
Quadruple Aim
Our Future Vision
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Three Core Themes
Our Future Vision
We are a Vibrant Catholic Health Ministry
We are Entrusted Stewards
We are Re-imagining Health
Serving as a visible manifestation of the Catholic Church’s commitment to all people, with special focus on the complex needs of persons in poverty and those most vulnerable
Strengthening the ministry’s legacy for the future by stewarding and growing our financial resources, foster inspired people to flourish, and safeguarding the environment
Co-creating healthier communities by pursuing holistic, high-quality, affordable solutions across the continuum of care and redefining how we work together within the broader health ecosystem
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Our 2025 View of the World
Our Future Vision
Consumers will take a more active role in making health-related decisions and improving their health.
Technology will support new care models that enable providers to expand capacity, improve efficiency, and build stronger relationships with larger populations than before.
Clinical integration will be the norm, and coordination will increase across the continuum.
Healthcare costs will continue to rise and regulatory complexity will increase.
Competition for consumers, providers, and associates will be fierce globally.
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Ascension Care Delivery Map
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Ascension Continuum of Care Sites
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AMBULATORY CARE AND DIAGNOSTICS
Ambulatory Surgery Centers 66
Occupational Health Programs 55
On-Site Employer Clinics 76
Free-Standing Imaging Sites 110
Retail Lab Collection Sites 155
Primary Care Clinics 565
Retail Care Clinics 12
Retail Pharmacy Sites 45
Sleep Centers 31
Specialty Clinics 613
Virtual Care Programs 70
EMERGENCY SERVICES
Free-Standing ER and Urgent Care Sites 74
Emergency Medical Services (EMS) 21
SENIOR CARE AND LIVING FACILITIES
Assisted Living 15
Continuum of Care Retirement
Communities8
Independent Living 2
Long Term Acute Care/Skilled Nursing 23
Multi-Service Line Communities 7
Other Senior Living (HUD, Other) 2
PACE Programs 3
HOSPITALS BY TYPE
Acute Care Hospitals 109
Rehabilitation Hospitals 5
Behavioral Health Hospitals 9
Long-Term Acute Care Hospitals 2
TOTAL 125
Hospitals Not Majority Owned –
Joint Venture or Management Agreement15
2,500
Sites of Care
POST ACUTE SERVICE SITES
Durable Medical Equipment 15
Home Health Services 42
Hospice Services 16
Outpatient Rehabilitation Centers 148
COMMUNITY SERVICES
Community Health Centers 16
Dispensary of Hope Sites 9
Mobile Clinical Services 26
Wellness Centers 23
Community/Social Programs 157
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One Ascension Journey
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1. Integration of Ascension Identity and Brand Strategy
One Ascension Journey
• Successful launch of Ascension brand in 2 U.S. states – Wisconsin and Michigan, first signage in place
• Next four markets beginning in the coming year
• More people remember the Ascension name now – and research shows it means more to people that the local system is part of Ascension
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2. Innovations in Safety and Clinical Quality
One Ascension Journey
• Enhanced capabilities of clinical leaders to lead with quality
• Person and Family Engagement pilots
• Leadership in infection prevention
• Clinically integrated systems of care
• Focus on eliminating preventable disparities in care
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Ascension’s Quality Journey
One Ascension Journey: Innovations in Safety and Clinical Quality
2002-2008 Zero Preventable Deaths
2009-2015 Healing without Harm (High Reliability)
2016-2022 Zero Preventable Health Outcome Disparities
• Significant improvement
• Proven system spread for multiple initiatives
• Spread to other systems• Institute for Healthcare Improvement
• U.S. Centers for Medicare and Medicaid Partnership for Patients collaboration
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Mortality Reduction
One Ascension Journey: Lives Saved Each Year Compared to FY04 Baseline
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One Ascension Journey: Improved Health Outcomes
Reductions in healthcare-associated infections:
11.8% decrease from baseline for observed/expected (excess readmission index) 30-day readmissions for all diagnoses
7.2% reduction from baseline for Heart Failure Readmissions
Catheter-associated
urinary tract
infection, ICU
28% decrease
Colon surgery --
surgical site infection Complex 30-day
8.9% decrease
Abdominal hysterectomy --
surgical site infection
standardized infection ratio, complex 30-day
37% decrease
Clostridium difficile
13.2% decrease
Methicillin-resistant Staphylo-
coccus aureaus
bacteremia
5% decrease
Knee Surgical
Site Infection
13% decrease
Overall Catheter
Associated UTI
9.2% decrease
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One Ascension Journey: Decreasing Insurance Costs
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3. Advocacy and Services for Those Most Vulnerable
One Ascension Journey
• Focus on eliminating preventable disparities in care
• Socially just minimum wage
• Speaking out in support of 100% access/coverage, Medicaid expansion, and mental and behavioral health reform
• Addressing human trafficking through advocacy and service
• Ascension Medical Missions At Home
• Veterans Choice
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Ascension’s Principles in Analyzing Healthcare Reform Proposals
One Ascension Journey: Advocacy
• Legislation must preserve a strong safety net
• Legislation should not reduce access or coverage; it should expand it
• Legislation must strengthen and stabilize the individual market to make insurance more accessible and affordable
• Legislation must push the pace of transformation to a system based on value, not volume
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Ascension is called to improve health and healthcare through sustainable, values-inspired innovation
Two Divisions
Delivery
Be a Mission-focusedmulti-market health
delivery system with a demonstrated ability
to deliver high-quality,low-cost, personalized and
compassionate care
Solutions
Continue to innovate, incubate and acquire
new solutions and capabilities to strengthen
our national health ministry in a rapidly changing
environment
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Ascension
Healthcare Division
Ministry Markets
Ascension Living
Ascension Medical Group
Ascension Community
Clinics
Ascension Clinical
Holdings
Ascension At Home
Solutions Division
Ascension Information
Services
AscensionMinistry
Service Center
Ascension Care
Management
Ascension Investment
Management
Ascension Global
Mission
Ascension Ventures
Ascension Holdings
Ascension Leader
Institute
• Ascension Leadership Academy
• The Resource Group
• Medxcel Facilities Management
• Ascension Holdings International
Ascension SmartHealth
Solutions
One Mission.One Integrated Ministry.One Ascension.
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Ascension Ventures
Solutions Division
• Strategic healthcare venture funds focused on the medical device, technology and service sectors
• Four funds and more than $800 million in assets under management
• Limited partners include several prominent Catholic and nonprofit health systems representing:
• 474 acute care hospitals
• $88 billion in combined annual operating revenue
• 500+ adoptions by LPs of solutions referred by Ascension Ventures
• Provides financial and strategic returns, including key insights into emerging technologies, products and services
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Ascension
Healthcare Division
Ministry Markets
Ascension Living
Ascension Medical Group
Ascension Community
Clinics
Ascension Clinical
Holdings
Ascension At Home
Solutions Division
Ascension Information
Services
AscensionMinistry
Service Center
Ascension Care
Management
Ascension Investment
Management
Ascension Global
Mission
Ascension Ventures
Ascension Holdings
Ascension Leader
Institute
• Ascension Leadership Academy
• The Resource Group
• Medxcel Facilities Management
• Ascension Holdings International
Ascension SmartHealth
Solutions
One Mission.One Integrated Ministry.One Ascension.
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Virtually Enabled Care
Ascension Holdings
Making Care Available Anywhere, and Deploying New Technologies to Support It
Direct to Consumer(D2C)
Specialty Consults(B2B)
@Home Monitoring
• Portfolio of services including contracting, operations and logistics, integrated change management, and implementation services
• Operates a group purchasing organization that benefits members by leveraging their contract portfolio to increase efficiency, decrease waste and reduce costs for participants and suppliers
The Resource Group
Ascension Holdings
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Results Driven: $1.0B+ Annual Expense Reduction
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Supply Chain Global Reach
Ascension Holdings International
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International Value Creation Platforms
The Resource Group’s international offering is only the first step of international expansion. In the future, other offerings could include other Solutions subsidiaries, quality-safety consulting, system consulting and hospital management consulting.
Now
System Consulting
Future Ascension International Offerings
Next
Future
Quality/Safety Consulting
Biomedical Engineering
Hospital Management
System Readiness And Processes
System Readiness And Processes
System Readiness And Processes
Food Services
Facilities Management
System Consulting
Quality/Safety Consulting
Biomedical Engineering
Food Services
Facilities Management
The Resource Group Global Solution
The Resource Group Global Solution
The Resource Group Global Solution
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1999INDIA20152012 2014
EUROPE2018
SINGAPORE2017
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Up-close learning from a high-quality, low-cost international model
Health City Cayman Islands
• A public-private partnership leveraging Narayana Health’s model for strategies and operational approaches that can be applied within Ascension while bringing care to an underserved population
• Opened in 2014 as a 104-bed cardiac and orthopedic specialty hospital
Accomplishments:• Built facility at ½ U.S. cost• Deliver procedures at ½ U.S. cost• Expanded service lines
HealthCityCaymanIslands.com
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“The U.S. healthcare industry has been
slow to adopt innovations developed
in other geographies.”─ Anthony R. Tersigni, EdD, FACHEPresident and Chief Executive Officer
Ascension
“The future cannot be just an extension of
the past. It must embrace new technology,
implement innovative approaches and aim
higher than people thought possible before.”
─ Dr. Devi Prasad ShettyChairman, Narayana Health
Board Chair, Health City Cayman Islands
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• Embracing the rapidly changing healthcare landscape
• Investing in innovation
• Developing partnerships that advance our Mission and Vision
• Supporting population-based economic models that reward value
Ascension is…
Maintaining our Vital Presence
“Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will.
“For just as each of us has one body with many members, and these members do not all have the same function, so in Christ we, though many, form one body, and each member belongs to all the others.”
A Vital Presence
Romans 12:2, 4-5
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Strategic Direction
Our Future Vision
Our outward
promise to those
we serve
Enabled by focused
inner strengths
ONE MissionIntegratedMinistryAscension
Strengthening Catholic healthcare
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Questions and Conversation
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