Getting Up to Speed New SPHS CEO Enters the Health Care Fast Lane

Dan Moen describes himself as “an adrenaline junkie.”

He explained by pointing to several pictures of a red racecar adorning the bookcase of his office. “I race at Lime Rock and Sebring regularly,” he said of two road courses in Connecticut and Florida, respectively. “I started with open wheels, but now I race mostly sports cars, and I love it.”

He continued by grabbing a framed copy of a Worcester-area magazine story highlighting his exploits in something called hydrofoiling, an extreme form of waterskiing in which one is actually riding on a sled-like device several feet above the surface of the water.

Moen is also feeding his habit with his latest career move — assuming the helm at the Sisters of Providence Health System (SPHS). While not as outwardly hair-raising as those other pursuits, this assignment comes with its own stern set of challenges. Indeed, while SPHS and its various component parts, including Mercy Medical Center, are facing the same fiscal challenges as other providers, the system itself has the specific challenge of meeting a mission, set more than a century ago, to essentially serve the historically underserved.

And often, this means programs that struggle to pay for themselves, and often don’t.

Meanwhile, there is the regionwide and nationwide matter of coping with health care reform — or what Moen calls “access reform” — and the need for what he termed “payment reform.”

“Every hospital is going to be challenged over the next three to five years, maybe longer, and moreso than I think we’ve ever seen before,” he told HCN. “The pressures on the cost side are enormous at this point; the state budget is in serious trouble, the federal budget is in serious trouble, and employers are experiencing premium increases on health insurance for their employers that are just unsustainable. Things will have to change.”

All this adds up to a challenge that is bigger and, in some ways but not all, different than the one Moen was facing at Heywood Hospital, a 125-bed facility in Gardner, just north of Worcester. And it was, and is, an intriguing-enough challenge for him to first accept an invitation to interview for the position and then accept it when it was offered.

“At one point I thought I’d finish my career at Heywood — I’d spent 21 years there and was enjoying a good run; it’s a fine institution,” he said. “But when the recruiter called me on this one, it really made me start to think about the rest of my career, and I said to myself, “if I’m going to do something else with my career, now is the time to do it. I looked at this and saw some new challenges for me, and the fit was right.”

Elaborating, Moen said SPHS, with its wide range of services and focus on accountable care (which moves toward rewarding good peformance and better outcomes, rather than sheer volume), represents “where health care is going,” and he wanted to be on the front lines of that movement.

“When you look at some of the work that’s being done here to build a model for accountable-care organizations, I don’t see a lot of institutions at the level we’re at here,” he explained. “Some of them are just getting their hands around what it all means. I’m enthused that we’re already looking at the model of care that’s going to help us be successful in the future, because starting from scratch is a big undertaking.”

For this issue, the Healthcare News talked at length with Moen about the challenge he’s accepted, how he’ll approach his latest high-octane endeavor, and topics ranging from physician recruitment to having his major competition (Baystate Health) 800 yards away, instead of 15 miles, as was the case at Heywood.

Getting Revved Up

Moen has enjoyed an intriguing, 28-year career in health care, one that has offered him a number of vantage points and insight into services — and those to whom they are provided.

Indeed, he started out as a radiologic technologist, or rad tech, as they’re called, at several hospitals, and later taught that subject at Quinsigamond Community College and Northeastern University.

He said that direct-care experience has helped in a series of administrative roles he’s had in the past quarter-century, including that of CEO at Heywood and, before that, Holden Hospital in Holden, Mass.

“Coming from a direct-patient-care position,” he explained, “my values center around the quality of patient care, the experience the patient has when he or she comes into the institution, building a positive reputation for the institution out in the community, but also connecting with the community and not being isolated.”

Moen told HCN that he certainly wasn’t looking for a career move, and had already turned down a number of recruiters’ requests to interview, when the SPHS position came onto his radar screen.

“I was so involved in what I was doing, and was still having fun with it — we were doing a lot of innovative things,” he said of his work at Heywood. “There wasn’t the opportunity to make a change until the right opportunity came along, and this was it.”

Since arriving on Jan. 24, Moen says he’s spent most of his time listening — to employees, fellow administrators, patients, area business owners, and government leaders — and is just getting started with that exercise.

“The learning curve is just getting to know so many people — hundreds of people in the organization and lots of people out in the community,” he said. “Having been in my previous institution for 21 years, I pretty much knew everything and everybody; one of the exciting things about coming to a new opportunity is getting to meet a lot of new people. Everyone has something to bring to the table, so I try to learn from every conversation I have out there, both inside the organization and outside, because I call it servant leadership, if you will; it’s a situation where I feel we’re really here to help other people do their jobs well, and we’re here to serve the community.

“I see one of my roles being as an information gatherer for the system, and I do that in a lot of different ways,” he continued. “Bringing that information to the institution and talking to people about it will help us make better strategic decisions, both short-term and long-term.”

Looking ahead, he said he has a number of receptions planned to advance the process of meeting and listening. Those constituencies include the medical staff and area business leaders, while at the same time, he’s also reaching out to other hospital CEOs in the region to sound them out on opportunities for collaboration.

“I know all of them very well, but this is a new day, a new opportunity for us to talk about health care needs in the area and how we can meet those needs,” he said. “There may be some things we can do together.”

At Heywood, he recalled, that facility worked with nearby Health Alliance to put a program in place to facilitate access to care. “We were helping patients and their families get health-insurance coverage that they were eligible for; it’s quite a task to get people enrolled in these plans,” he said. “We worked with Health Alliance to make it a multi-town, multi-city effort. This is the kind of thing hospitals can look at.”

Moen noted that he is now in a different kind of competitive situation than he was at Heywood, with Baystate just a few blocks to the north. He said he’s never been afraid of competition, and looks forward to it in this case, but will look for ways to collaborate as well.

A Higher Gear

When asked to describe his management style, Moen came back repeatedly to the adjective ‘collaborative.’ And when pressed to elaborate on what that means to him, he said it entails an inclusive form of management where he delegates where necessary and does not make decisions in a vacuum.

“To me, it’s more about listening than anything else,” he explained. “Listening and learning from the people who are really out there doing these important jobs on a day-to-day basis. And that feedback is included when we’re making decisions about the future of the system.

“As CEO, I view myself an orchestra leader,” he continued. “There are a lot of talented people out there in the organization, and it’s my job, and that of the administrative team, to pull all that together, make sure there’s a vision for the future, and that we take steps to get this institution ready for that future. And that’s something I think I have a pretty good history of doing.”

Moen will lead this orchestra at a time when composing quality, efficient health care is a daunting task, and in an environment where the questions about how to change a system that most say doesn’t work come much easier than the answers.

“There’s a lot of pressure on the system to be more efficient, and payment changes will put a premium on wellness and keeping people’s health at optimum levels — whatever that happens to be for the individual,” he continued. “There will be a lot more preventative care, preventing readmissions and exacerbations of chronic illness — that’s what it’s going to be.”

But while acknowledging that all this is the right thing to do, Moen said this thinking runs counter to the way most health care systems have been set up to operate.

“People get into health care because they want to do the right thing and help patients,” he explained, “but the health care system isn’t built to make that happen. But I think we’re going to see some real changes because the status quo, in the bigger health care system, is really unsustainable.

“Something’s going to have to change in our health care system in this country,” he went on. “We’ve done the access reform, and we’ve seen national health care follow Massachusetts on that. But now it comes down to answering the question, ‘how are we going to be able to provide high-quality care and do it at a cost that everyone can afford? The current fee-for-service system doesn’t reward people for doing that.”

While accomplishing the change that seems so necessary won’t be easy, Moen says the needed building blocks are, for the most part, ready and waiting to be put into place.

“We’re caught in this system that doesn’t work as well as we would like, but it will be a more efficient system and one that, I think, will reward the right behaviors if we make some of these payment changes,” he said. “A lot of the pieces are here … you’re going to see more care delivered in the home; you’re going to see intensive medical care delivered in skilled-nursing beds; you’re going to see more work being done on an outpatient basis to prevent hospitalizations. These are just some of the pieces in place.

“The question is, what are the strategies we work on to further improve the Sisters of Providence Health System and make sure we’re well-positioned for what comes down the road?” he continued. “And it could come fast.”

Getting on the Right Track

Summing up his thoughts on health care in general, and his new assignment in particular, Moen said that health care, and running a health care system, “is not necessarily rocket science.”

“It’s making sure the basics are done well, that the planning is done well, getting patients in and out, making sure there’s good quality and a good experience, and planning and implementing new services for the community in the future,” he explained. “Those basics are inherent in any hospital or health care system.”

But taking care of those basics is more challenging than ever before. And while health care isn’t as fast-paced, literally, as racecar driving or hydrofoiling, it will get the adrenaline pumping.

And Moen, as he said, is a junkie.