An Appointment With: Michael Dowling, Northwell Health President and CEO
General Management
What does the 2020 vision for Northwell Health look like?
Northwell Health will measure success in 2020 on our ability to maintain a strong financial footing while preserving our mission to improve the health of the communities we serve. Achieving that is a significant challenge in the midst of the dynamic, ever-changing environment in which health care providers operate.
There’s growing competition among both traditional providers and new entrants trying to break into the market such as Google, Amazon and CVS, to name a few. Government intervention looms over the horizon. No matter what others are doing, delivering great care should always be our first priority. Our patients are why we’re here.
Taking a stance on issues we believe in is another area we won’t shy away from, whether it’s immigration reform or common-sense gun legislation. We’ll stand up for our beliefs, not because it is easy, but because it is hard. We need to be a voice for the disenfranchised in the communities we serve.
Explain why the year ahead is a crucial one for Northwell’s capital investments.
Beyond preserving our mission in the year ahead, we look to:
- increase our investments in basic infrastructure, technology and people;
- expand inpatient bed capacity at Long Island Jewish Medical Center and North Shore University, Staten Island University Hospital and Southside hospitals, which are routinely at or over capacity;
- target continued ambulatory growth;
- try to maintain a good payer-mix balance; and
- achieve a higher operating margin, which would strengthen the health system’s credit rating, enabling us to borrow at lower interest rates as we continue to invest in our future.
I’m excited about the transformation at hospitals happening throughout the health system, from the new Corey Critical Care Pavilion at Peconic Bay Medical Center opening this month to the planned groundbreaking of the Petrocelli Advanced Surgical Pavilion at North Shore University Hospital this spring and the ongoing transformation of Southside Hospital into a regional destination for top-notch care on the south shore. We will continue to work with our Upper East Side neighbors and city agencies to develop a plan that will enable us to move forward with the redevelopment of Lenox Hill Hospital.
In what ways will ambulatory care fuel future growth?
At Northwell, we are well positioned for success in 2020 and beyond, based on the continued maturation of the clinical, academic and research enterprise the health system has built over its 28-year history. Beyond our 23 hospitals, the health system now has 744 outpatient locations – and we’ll have 786 by the end of this year, including:
- 21 additional primary care practices (increasing the number of practices to 239);
- 23 additional specialty centers, including seven more kidney dialysis centers (increasing the number of centers to 18);
- two additional outpatient cancer centers, including one in Eastern Long Island and another on Staten Island;
- three additional urgent care centers (increasing the number of urgent care centers to 55); and
- two additional ambulatory surgery centers (increasing the number of ambulatory surgery centers to 18).
Due to our ambulatory patient expansion, it’s noteworthy that Northwell’s revenues, projected at $13.5 billion in 2020, will be a 50-50 split between inpatient and outpatient. By comparison, the inpatient/outpatient revenue split was 70-30 percent in 2005.
The recent addition of Concorde Medical Group in Manhattan and its 23 physicians) and clinical affiliations with two large private physician practices, CareMount Medical and AdvantageCare Physicians, further expands our reach into the communities we serve.
How will the Presidential election impact health care?
If the last decade of health care reform and regulation are any guide, then the outcome of the 2020 President race promises to bring more changes to the industry in the coming years. Regardless of what party controls the White House and Congress, health care will receive more than its share of government scrutiny.
Meeting our patients’ needs poses a whole other set of challenges in this uncertain regulatory environment. On the business side, providers are relying to a much greater degree on government payers like Medicare and Medicaid, as relationships with commercial payers continue to become more complex. On top of all that, there’s a growing push from the federal government for increased transparency, with a push toward greater value, cost containment and increased access to care.
Most importantly, we’ll continue to stand by our values. While it may be coincidental, one week after hosting our first Northwell Health Gun Violence Prevention Forum in December and pledging $1 million toward research, prevention, education and advocacy efforts to combat gun violence, Congress approved $25 million in funding for gun safety research – the first time in a quarter century that it has allocated funds for that purpose.
Why is developing and retaining talented employees important to the health of the organization?
To succeed in this environment requires providers to be adaptable, flexible and entrepreneurial. You need to be comfortable dealing with ambiguity, while relying on a progressive culture and a strong talent base. Educating and empowering our employees along their professional journey is personally important to me, but also essential for the long-term success of the health system.
That’s why Northwell created the Center for Learning and Innovation, rebuilt the foundation of the health system upon its own medical school, the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, as well as the Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies. These and other educational opportunities allow Northwell and its workforce to grow and stay ahead of the competition in a fast-moving industry.
As health care providers, we also have an obligation to not only treat people when they’re sick or injured, but to promote healthy lifestyles and help people avoid getting sick in the first place. We’ve made concerted efforts to think about the communities we serve in a holistic way. That means gaining a better understanding of the social determinants of health that have caused significant disparities in life expectancy in our most-vulnerable communities, where chronic disease is prevalent. We’re responding to those needs by pursuing problem-solving solutions, whether it’s providing access to fresh produce and nutritious meals through our hospital-based “Food as Health” program, educating people about the importance of HIV testing and Pre-exposure prophylaxis (PrEP) medication for at-risk populations, or training community-based health workers to help local residents adopt and maintain healthy behaviors. It’s all part of our mission to improve the health of the communities we serve.
A rewarding career journey at Northwell Health
General Management
Meet Marina Gizzi, manager of operations in the Emergency Department at Long Island Jewish Medical Center (LIJMC). Starting at LIJMC as an A/R (accounts receivable) clerk, Marina didn’t just find a career opportunity here at Northwell, but a new confident outlook on her professional life.
“I always had a hard time in school, I struggled academically for many years and didn’t graduate college when all of my friends did. This affected my outlook on what the future would hold for me,” says Marina. “It wasn’t until I started working at Northwell that I was given the confidence I needed to continue pushing myself and my career goals.”
And push herself, she did. Since starting at LIJMC in 2013, Marina has gone on to earn her Bachelor of Science and Master in Business Administration, both with the help of Northwell’s tuition reimbursement program. It was something she only imagined for herself after gaining confidence in her own potential. “I have been so blessed, from day one, to be part of Northwell because I can genuinely say they have gotten me to where I am today – two degrees and now four job opportunities later. With Northwell’s wonderful tuition reimbursement program and with the support of my ED family, I learned that it’s never too late to achieve your goals.”
Marina continued to develop her skills not only through continued education but in each of her roles on her journey. Her career has grown from A/R clerk to senior secretary to admin support associate before finally becoming manager, all within the ED.
Today, Marina manages concierge, the discharge lounge, ED unit receptionists, and case management assistants among others. Additionally, Marina works with position control, our recruiters and helps manage appreciation celebrations for our team members. During the COVID-19 pandemic, Marina also helped organize the influx of generous donations our community members sent to the hospital, a memory she holds as one of the most rewarding parts of her job so far.
It’s a role that wouldn’t have been possible without the support of her leadership and her family – both her Northwell family and her immediate family. “My ED leadership team and mentors at LIJMC are always encouraging us to better ourselves. The message that they have instilled in me is: never settle for anything less than what you deserve,” says Marina. “The support and opportunities that this organization provides are unlike any other. I know I will continue to learn and push myself because my future at Northwell will continue to be bright.”
Find a career well cared for at Northwell Health. Apply today!
An appointment with: Michael Dowling, Northwell Health President and CEO
General Management
As the new year begins, it’s important to reflect on the lessons we learned and how we can move forward to an even better future. This is especially true this year as we transition together into a new normal of life post-COVID-19. We spoke with Northwell Health’s President and CEO, Michael Dowling, to hear his thoughts on what 2021 has in store for the health care industry.
Despite everything 2020 brought, what is the 2021 outlook?
Next year will undoubtedly be a year of transition. We will still be in the COVID world, but we should have a different attitude about it and be realistic with expectations. The first part of the year will focus on managing the situation; two situations actually.
First, COVID cases will continue to increase at this pace unless we do our part — wearing masks, social distancing and proper hand washing — to minimize the spread. We will also be managing the delivery of the vaccines.
The rollout will not be quick. It is a marathon. And when you consider that there are 70 million people working in essential jobs — teachers, day care staff, corrections officers, US postal workers and public transit workers — we may be looking at June before the vaccine is available to the general public and we start to see some sense of normalcy.
You always have an optimistic view. Will there be a new “normal”?
When I think of 2021, I think of opportunity — to reimagine what we want our lives and professions to be — not just as a result of what happened to us, but of how we reacted to it.
We can all make this change. Ask yourself, what do you want to be? How do you want it organized? What kind of structural changes will you make? What do you want to focus on?
Regardless of your answers, the key is to forget what your pre-COVID world was and focus on your future.
What will factor into advancing health care?
For health care, these areas will have most precedence in 2021.
- Enhance productivity and become more efficient: It’s tremendously awkward to say, but one of the “best” things to come out of COVID has been our ability to accelerate productivity, be more efficient and adaptable. Next year, most health systems will still be recovering from the pandemic’s financial impacts, especially the safety-net hospitals. We need to build on the lessons we have learned.
- Accelerate the digital age: COVID has changed our relationships with technology. Ninety-percent of the meetings I have today are through Zoom or Microsoft Teams. The amazing thing is most of us had never used Zoom before COVID. And the convenience offered by telemedicine and virtual care has improved our customer focus and quality. This will be a big arm of care delivery from now on.
- Identify what quality means and seek it: It’s time to reassess. Health care delivery is going to be different. If you talk to providers, they will equate quality primarily with clinical outcomes. But for consumers, it’s service and convenience. There needs to be a balance.
- Accommodate the remote workforce: Speaking of technology, I believe 10-15 percent of our workforce will be remote, even after COVID. A large portion already is right now. I did not expect this months ago. The main issue will be to decide what part of your workforce should be remote, as well as identify ways to manage and monitor it. What does a remote workforce do to your real estate? You have to look at everything. At Northwell, we manage buildings that accommodated thousands of people and they are now mostly empty with team members working at home. It’s a big part of our assessment process for the post-pandemic situation.
- Culturally, become as innovative as we were pre-COVID: Moving forward, we need to incentivize the innovative DNA within our organizations that was obvious during COVID. Do not lose steam and maintain a positive, team-oriented culture, which is very important in the midst of all this change, especially as we go remote. We can’t lose that perspective. A hybrid of in-person and remote can lend itself to much-needed balance.
- Deal with inequities of care: We must go upstream. New partnerships are changing the way we operate. And our expanded focus on healing our most vulnerable communities will continue in 2021, and well beyond. We need to get our employees, doctors and other team members to commit to this agenda, then develop long-term reasonable strategies.
What’s in store for health care as a profession?
When I think of 2021, I think of opportunity — to reimagine what we want our lives and professions to be — not just as a result of what happened to us, but of how we reacted to it.
Doctors, nurses, environmental services, respiratory therapists, security workers and all healthcare heroes were celebrated for working the front lines. Their sacrifices, dedication and compassion are truly what makes them remarkable as individuals, as well as the work they do. I’m very proud of all of them.
Building off of that momentum, this remains an exciting time to join health care, especially at Northwell Health, where we were recently ranked No. 65 on Glassdoor’s 100 best places to work list (Northwell is also one of Fortune‘s 100 Best Companies to Work For). Our team members are engaged and eager to help lead us out of this crisis.
Aldony’s journey to leadership at Northwell and in the Military Reserves
General Management
Growing up, Aldony “Al” Fernandez always dreamed of serving our country and being a soldier.
“I had the mindset that one day I would join the military and become an officer to not only serve our country, but also help guide, lead, and mentor others,” says Al.
This goal of helping to protect our country came true after Al had already started his Northwell career journey. After joining the organization in 2015 as a talent acquisition (TA) specialist, Al joined the US Army National Guard in 2016.
Today, Al has become a leader in the Reserves, and at Northwell as well. Along with his promotion to manager for the ambulatory region in 2018, Al has recently been promoted to a Lieutenant in the Army.
“Northwell is the most military friendly company that I know of,” says Al. “I have felt nothing but support and respect through my time at Northwell. Everyone has been not only understanding of my need to balance my work life, Army life and personal life, but also proud and thankful of my service.”
When he began his Northwell career, Al had the drive to keep learning. As a TA specialist, he worked on a number of projects both inside and outside of his department, took classes at Northwell’s Center for Learning and Innovation (CLI), and read self-development books. Since his promotion, Al has continued his CLI training with the Leadership Essentials Sessions.
But it was while training to become a Lieutenant where he found invaluable lessons in leadership.
“As I was attending the Army Officer Candidate School to become a Lieutenant, I took many leadership, counseling, and tactics classes. This plus the intense training helped me understand the value of leading rather than just managing,” shares Al. “It has truly defined what the word ‘team’ really means and the great accomplishments that working together as a unit can allow us to achieve.”
Northwell’s continued support of Al’s military leave has enabled him to continue to thrive both in the office and in the Army.
And serving in the Reserves has only made Al happier in his position at Northwell: “It has been a tough road, but definitely rewarding – today I am proud to call myself a Lieutenant in the US Army National Guard. It’s made me prouder of our organization and who we are, and it has helped me become selfless and a better leader here at Northwell.”
7 reasons why we love being a Health Information Professional
General Management
We’re celebrating the hard-working health information professionals who are a part of the Heath Information Management (HIM) team at Northwell Health. Our HIM team members work daily to acquire, analyze and protect patient medical information. With such an important job, there’s a lot to love about being a HIM professional! Check out our team members’ top seven reasons!
1. Opportunity to grow
The health information landscape is constantly changing as technology and applications advance. As health data increases, so do the possibilities for health information professionals. There are always new opportunities to advance your skills as a professional through education, state-of-the-art applications, and collaboration with other units within Northwell.
2. Driven by health data
Any information related to health conditions, quality of life, reproductive outcomes, and causes of death for an individual or population is classified as health data. Working as a health information professional allows us to analyze trends and ensure this aggregated health data is shared across our health system. By prioritizing health data, we’re helping to drive positive outcomes and experience.
3. Making a difference for our patients
Working in healthcare means we as employees have the privilege of helping patients without working inside a hospital. Although health information professionals may never meet the patients directly, they are working hard to ensure that they are not only protecting the patients’ privacy but ensuring the accuracy of their healthcare information.
4. Bridge between the hospitals and patients
A patient’s care doesn’t end when they leave a hospital. Collaborating with different units across our health system allows us to bridge a patient to their care. By helping patients get proper and speedy service to obtain their records, we’re helping the patient stay connected to the quality care they received through the completion of their treatments.
5. Continued education
Educational opportunities are promoted by health information leadership who work hard to ensure our teams have the tools and skills they need to be accurate, compliant and successful. With the support to continue our education from leadership, including access to tuition reimbursement programs through Northwell, we’re able to grow with our growing industry.
6. Teamwork and leadership
Health information professionals at Northwell aren’t just a team, we’re a family. Working truly together under the guidance of supportive leaders helps our entire team to succeed.
7. Protecting our patients
Protecting our patients goes beyond just ensuring data security, it’s protecting their care. As health information professionals, we ensure that the patient data is always accurate, secure, and available when they need it most.
An Appointment With: Michael J. Dowling, Northwell Health President and CEO
General Management
What does the year ahead hold for Northwell Health?
As we kick off 2019, it’s important to understand that the business of health care has never been more challenging, from navigating state and federal regulation to ever-increasing competition and integrating emerging technologies. These demands make the mission of delivering world-class health care to the communities we serve a test of resolve that requires discipline and focus from everyone at Northwell Health, beginning with the frontline staff on up.
That said, I believe we’re in a good place. There are phenomenal things going on. Very positive things will continue to happen, so long as we continue to adapt and be creative. We are the number one provider of care in New York, with a market share of nearly 30 percent – almost double our next-closest competitor. That’s a credit to the staff and leadership throughout the health system. You can only succeed if you have great passion and a dedicated staff. Because we have both, I’m bullish and optimistic about our future.
How will Northwell meet these challenges?
We will meet these challenges by being innovative, providing the best service and delivering the best quality.
Fundraising and philanthropy need to be an important component for the health system to thrive. In the past, philanthropy accounted for one-third of the funding required for any capital expansion project. Debt and operations made up the rest. That’s no longer the case.
Thankfully, the launch of the health system’s “Outpacing the Impossible” fundraising campaign in October and its $1 billion goal puts us on track to fund the projects that will move Northwell forward over the next decade. Philanthropy is increasingly important, especially for a nonprofit operating on a one percent margin. Our greatest contributors remain the employees. No gift is too small.
Can you explain how Northwell plans to continue to grow?
Our focus is targeted growth. We need to make investments in infrastructure, technology and clinical excellence, including new physicians along with new capabilities. There needs to be an emphasis on building alternative funding streams to offset the continuing reduction in insurance reimbursement from Medicare, Medicaid and commercial payers, as well as a focus on efficiency and productivity.
Give an example of why investing in capital projects matters?
We suffer from a legacy problem. The health system right now encompasses 17.8 million square feet of real estate with more than half accounting for the hospitals themselves. Most of our hospitals date to before 1950, which means when you try to modernize, you’re doing it in a space that was originally built 70 years ago or even longer.
We currently spend nearly $500 million to maintain our infrastructure with no return on investment – that’s just to maintain our facilities. That money is built into our budget every year. None of the new technologies we take for granted existed when these hospitals were constructed. Obviously, the expectations that existed back then are different than today. The leaders back then who planned these projects couldn’t possibly have anticipated the current state of health care delivery. That’s why we have projects in various stages of completion happening at facilities throughout the health system. Modernization is expensive but necessary to our survival.
Why are partnerships in Brooklyn and with Nassau University Medical Center important?
It’s our civic responsibility to help communities where a lack of access and health disparities exist. These efforts may have any financial benefit to us, but it’s the right thing to do. It’s easy to be successful by being selective and only investing in programs and services that make money, but our mission is to improve the health of our communities, especially those where there’s a high proportion of people at risk for chronic disease and other socio-economic factors that contribute to poor health.
For example, we’re currently lending our support in Brooklyn to help Brookdale, Interfaith, Kingsbrook and Wyckoff hospitals, as well as providing management and operational expertise to Nassau University Medical Center. These are all financially distressed hospitals that care for people in medically underserved communities. We have an obligation to run our own health system well and to be successful as an organization. But we also have an obligation to use our resources to help others who are less fortunate. We can’t walk away from difficult challenges. Other health systems do that. That’s not us. Our mission is imbedded in our culture.
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