Exit Interview As He Prepares to Leave the SPHS, Vince McCorkle Looks Back, and Ahead

Looking back on his 17-year career with the Sisters of Providence Health System, Vincent McCorkle said his time has been notable for several of what most people — and he is in this category himself — would call “bad business decisions.”

And he’s quite proud of all of them.

That’s because, while these might have become losing propositions as far as the bottom line is concerned, they are directly in keeping with the mission of the Sisters of Providence, and therefore they meet critical, and almost always unmet, needs within the community.

And so, McCorkle’s office, which he has been cleaning out in preparation for his departure and next career challenge — president and CEO of the Akron (Ohio) General Health System — is decorated in part with gifts from people essentially thanking him for making those bad business decisions.

There’s the drawing, a self-portrait, crafted by a homeless man and given to McCorkle for the system’s continuation of its Health Care for the Homeless program, that hangs on one wall. Meanwhile, on his credenza is a bamboo model of a boat given to McCorkle in thanks for the system’s willingness to continue something called the Vietnamese Health Project after state funding for the initiative was discontinued.

There are other bits of memorabilia, if that’s the proper word, in McCorkle’s office that speak to his time here, including one very recent addition. It’s a card fitted inside a glass plaque that sits on his desk. The wording amounts to what McCorkle calls a pledge, or commitment, to perpetuate the legacy of the founding Sisters of Providence, who are now few in number and getting on in years; only a few are under the age of 70.

“Everyone is committed to look at it at least once a day; it reminds us of why we’re here and what we’re called to do,” said McCorkle, noting that a leadership group of 100, now named the ‘Legacy Leaders,’ agreed to make that commitment.

In short, he continued, SPHS administrators are called upon to honor the mission of the Sisters of Providence, which, in some cases, requires making decisions that are not bottom-line-friendly, such as the transitioning of Providence Hospital to a behavioral-health facility, and the closing of the residential component at Brightside for Families and Children.

“Sometimes we’ve been criticized for making bad decisions, as in the case of Providence Hospital, which has never had a positive operating margin,” he explained. “So one could say, ‘that’s a bad business decision.’ We say it’s a ‘different decision’ because I can’t imagine what this community would be like if we weren’t finding ways to provide those services.

“This morning, before 9 o’clock, we dosed 993 people on methadone,” he continued. “If we stopped doing that, within 24 hours, 95{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} would have an insatiable appetite for a fix, and within 48 hours, they all would, so you can imagine the impact on Springfield, Holyoke, and the surrounding communities if we didn’t sustain those services. It would be devastating.”

While meeting those needs within the community, the SPHS, under McCorkle’s leadership, is effectively positioning itself for the future of health care with steps that include the recent formation of what the system calls a ‘micro accountable care organization’ (ACO) that is designed to enhance care management to improve care and reduce cost, improve the management of chronic disease, reduce hospital admission and readmissions, and, essentially, make health care providers more accountable (more on that later).

For this issue, The Healthcare News conducts what amounts to an exit interview with McCorkle, a wide-ranging look back at his tenure with the SPHS and also a look ahead to the future of the system and health care in general.

Career Track

McCorkle told The Healthcare News that, over the course of his long career with the SPHS, he’d been approached by headhunters on numerous occasions, perhaps quarterly by his estimates, with career opportunities.

And by his recollection, there were only two times when was interested enough in the position in question to pursue it with any degree of intensity. The first was a position within the Catholic Health East system, of which the SPHS is a part, which intrigued him enough to make inquiries, but not enough to leave the system, in large part because he didn’t think the SPHS had the requisite leadership in place to move forward in his absence. The second was the job in Akron, which he will assume in July because he believes it will make an intriguing capstone to his career and because, this time, he does believe the system is well-positioned for the future and has that leadership in place.

“I certainly did not see myself as indispensable to the system,” he explained, referring to his belief that the time is right for a move now, for both himself and the system. “I thought it was at a place where it could transition very smoothly. We have a very engaged and committed board, which is very important. And, sometimes when you say ‘medical staff,’ it connotes a cohesive group and it’s not, but our medical staff is in its evolution, and it’s well-positioned for the future.”

McCorkle was just 41 when he joined the SPHS, and while he didn’t at that time think it would be his last job, over the years, that mindset began to prevail. “I’ve never been one to spend a lot of time managing my career, and I try not to take myself too seriously,” he said. “But I take the role and responsibility I have seriously, and I like to say to people that I’ve had a love affair with the Sisters of Providence; they are just an incredibly remarkable group of women.

“I believe there’s no other health organization in the country like SPHS because of the range of services we provide,” he continued, “and we really are responsive to the needs of the community. The people who serve in our organization wake up every day knowing they can make a difference, and there’s great pride in that.”

Looking back on his time with the SPHS, McCorkle said there were many difficult decisions to be made over the years. The move in 1996 to transition Providence Hospital from acute care to a behavioral-health facility certainly fits that description because, while the move was deemed necessary, hundreds of employees were laid off. So does the decision made earlier this year to discontinue the residential component of the Brightside program.

The failed attempt to merge with Holyoke Hospital in the mid-’90s was another key moment in McCorkle’s tenure, as was the successful fight — one taken to the state attorney general’s office — to get Health New England (HNE), created and operated by Baystate Health, to include SPHS facilities in many of its coverage packages.

The common denominator in these and other initiatives, including the ones to continue programs such as Health Care for the Homeless and the Vietnamese Health Project, is that, ultimately, these were the right decisions for the community and, in most cases, involved access to needed services, said McCorkle.

Elaborating, he said the system is very deliberate with such actions, gets input from all stakeholders, and eventually makes what he calls “value-based decisions” arrived at after thorough community-needs assessments.

“If you look at the demographics of Springfield and Holyoke, the population has plateaued, and going into the future, there isn’t the expectation of dramatic increases in population,” he said. “But the population is aging in place, so one of the challenges is determining how our organization strategically positions itself to be able to meet those changing needs in the community.

“And it’s not something where you can say it’s cause-and-effect — this happened, so we’re going to do this,” he continued. “You’re looking for trends that are below the surface, but they really affect the lifeblood of the community; you look at those things, and you try to reposition the organization.”

Such was the case with HNE.

“There was a time when we felt that access to the Health New England commercial product was incredibly important for our organization,” he explained. “It was a very difficult decision for us. To engage the parent, Baystate, another community, not-for-profit organization, in a way that could adversarial was difficult, but we thought it was in the best interests of the community to have a strong Mercy, and that means viable.”

A Matter of Accountability

As for the transition of Providence Hospital, McCorkle, then president of that facility as well as Mercy, said it was another difficult decision that has, by and large, been validated by what the system has been able to accomplish there.

“I really don’t believe there’s any family that hasn’t been touched by addictive disease or mental illness; to this day there are waiting lists for Providence — the demand is great for those services,” he said. “It’s not infrequent that I get gut-wrenching calls from people who are crying, saying, ‘I don’t know where to turn, but I just found out about my husband or my daughter … what do I do? This will destroy our family.’

“I can direct them to the appropriate caregivers at Providence,” he continued. “I tell them that’s not because I don’t care, but because I want to respect their privacy and the privacy of their loved one. I tell them they’re not going to hear from me again, but if they need me, just call.”

When asked about his management, or leadership, style, McCorkle said he has always viewed himself as a coach or mentor, whose primary role is to get everyone within the system to share in its values, while also pursuing their own professional goals. And for some, this is difficult, so the system takes great pains to recruit carefully.

“We look at the initials after the name,” he said, “but we spend a lot of time trying to get to know the whole person, what motivates them, and what gives them satisfaction. People who join our operation … they either opt out in the first 90 days, or they become incredibly long-term members of our organization.”

McCorkle said he leads regular Monday meetings with senior managers to gather input, create dialogue, and solve problems collaboratively. The same methodology applies to a process he calls “strategic management.”

“Each month, we get key stakeholders together in the same room,” he explained. “We don’t talk about data, really, but we try to take data points and say, ‘what are the implications?’ It’s not to make a diagnosis, but to generate discussion. A lot of times ‘a-has’ come out of that discussion because, many times, we’ll look at data points and say, ‘I know what that means.’ Then, we’ll talk some more and go, ‘whoa, whoa, maybe that’s not what it means.’”

McCorkle said the SPHS has undergone a great deal of change over his tenure, all of it aimed at making the system more efficient and better-positioned for the future of health care. He said that, when he first joined the system, it operated from what he called a ‘holding-company model,’ whereby each organization behaved independently, with its own CEO and board of trustees.

All that has changed, said McCorkle, creating the word “systemness” to describe the new mindset. “If we had five CEOs then, we have one now; if we had five boards of trustees then, we have one strong board now,” he explained. “We have studied what can be consolidated, what can be centralized, and where we can collaborate. We have one strategic plan, one marketing plan, and one finance department. We think we’ve become very effective — when you look at the SPHS of today, it is very integrated, it has done very innovative things when it comes to partnering with physicians, and I strongly believe that we’re now well-positioned for the future.”

Which brought him back to the discussion of accountable care organizations, which, he believes, represent the future of health care in the nation, and especially Massachusetts, and the SPHS would appear to be on the cutting edge.

Mercy Medical Center and Hampden County Physician Associates have, as an alternative to Medicare fee-for-service provider arrangements, entered into a risk arrangement with a managed Medicare plan, and assumed care coordination and financial responsibility for 5,100 members, McCorkle explained. A structural framework has been developed to closely manage care, deliver disease-management services to high-risk patients, provide quality oversight and medical direction, and tightly manage budget and costs.

Performance incentives have been aligned so that health cost savings are shared by participating HCPA physicians and Mercy if quality and cost effectiveness benchmarks are achieved, placing an emphasis on efficiency and quality, rather than volume and intensity.

“As I sit on the board of the Mass. Hospital Assoc., I hear of only one organization that’s ready to do that (accountable care), and that would be us,” said McCorkle. “That’s because we’ve essentially been doing this for 10 years. We’ve volunteered to be the pilot for Massachusetts, and we’re very excited about that opportunity.”

As for the position in Akron, McCorkle said it will give him the opportunity to lead a much larger facility (650 beds compared to 355 at Mercy) and take on a new and different kind of challenge.

“Although I never expected to leave the Sisters of Providence Health System — I thought I’d finish my career here — from a professional standpoint, there are some challenges and opportunities for me there [Akron] because it’s a free-standing health system. I viewed it as a opportunity to be a capstone to my career and take the things I’ve learned along the way and hopefully add some exceptional value to that organization.

“At the same time, I thought I had positioned SPHS for the future, both strategically and from a leadership-succession perspective,” he continued.

Moving Experience

When asked what was left for him to do at the SPHS, McCorkle said it mostly comes down to continuing in the roles of coach and mentor, and thus help make the transition as smooth as possible.

Meanwhile, he’s still cleaning out his office and finding everything from old magazine articles to more expressions of appreciation from people he and the system have helped have helped over the years.

Most people wouldn’t want to be reminded of bad business decisions, but McCorkle doesn’t mind at all. If that’s what he’s most remembered for, then he will consider his time with the SPHS an unqualified success.