Embracing Change

After 18 months as CEO of Indiana’s second largest health care system—and the state’s sixth largest employer—Jonathan Nalli has fully immersed himself into what he calls “a deeper purpose” to drive patient-centered excellence across the statewide ministry of St.Vincent.

Nalli faces an industry in transition, but he welcomes the political, economic and social change opportunities that come with his role as CEO.

“Health care is undergoing a massive transformation,” said Nalli. “We are moving from a fee-for-service system toward a fee-for-value system, which requires health systems to re-think the services and care we provide. However, transition in health care is a fact of life. It’s important to anticipate and embrace the change.”

As part of his larger vision, he also recognizes that St.Vincent has an important role to play in addressing the unfortunate reality that Hoosiers continue to lag behind other states when it comes to overall health and wellness. Currently, Indiana ranks 41st in the nation in overall health and wellness due to high rates of obesity, smoking, diabetes and physical inactivity.

With 20 ministries, approximately 16,000 associates and more than 2,000 employed or aligned active medical staff, Nalli—who took the reins from former St.Vincent CEO Vince Caponi in February 2014—firmly believes St.Vincent is well positioned to positively impact the health status of Hoosier communities around the state. And that’s where Nalli envisions much of this work must be done—beyond the doors of the hospital and physician offices, and out in the communities that St.Vincent serves.

IMPROVING INDIANA’S HEALTH RATING ONE COMMUNITY AT A TIME

Nalli understands how the state’s low health rankings negatively impact individuals, employers, communities and Indiana’s economy as a whole, but also represent an opportunity. This has been one of the key factors that drives his commitment to improve the overall health of Hoosiers with a comprehensive focus on prevention and wellness at the community level.

“Hospitals can play a vital role in improving the overall health of the communities where we serve and operate, but to do that effectively, we must think systemically and foster strong community partnerships,” said Nalli.

Results in hand from the most recent community health needs assessments (CHNAs), Nalli is eager to dig in with community partners and improve the health outcomes in the communities served by St.Vincent. To emphasize his commitment to community health, he is incorporating the CHNA findings into strategic planning at the system level, which will help ensure the end goal remains a priority for the foreseeable future.

GIVING HOOSIERS A BETTER QUALITY OF LIFE

To continue improving the quality of care for Hoosiers, Nalli is excited about the transition underway in the St.Vincent Medical Group (SVMG). By 2016, SVMG will have converted 20 percent of its primary care practices to team-based and patient-centered medical homes. By re-designing the practices to provide a team of support for patients, he anticipates increased access, as well as an enhanced patient experience.

“We know that for patients challenged with behavioral health, nutrition or other social service needs, a single 20-minute visit to the primary care physician is not enough,” said Nalli. “The team model brings the skill and expertise needed so that the primary care office can look beyond the disease and focus on the whole person and their health goals.”

Along the same lines, St.Vincent has also partnered with MissionPoint, a clinically integrated network of physicians, hospitals, outpatient facilities, nurses and supporting caregivers that gives its members personalized support after an emergency room visit, hospital stay, physician visit or while managing a chronic condition.

This clinical management team of health care professionals and social workers from MissionPoint are an extension of the provider’s practice. The team ensures care is supported at home to reduce unnecessary or avoidable admissions and emergency room visits with the goal of slowing health care cost growth.

“We believe in this model so much, we’ve instituted it for our associates and their dependents and look forward to sharing the results in the near future,” said Nalli.

BEYOND INDIANA’S BORDERS

“St.Vincent was founded by the Daughters of Charity in 1881 with the mission to serve the poor and vulnerable,” said Nalli. “And it is that mission that drew me to this position. I don’t see this as a job, but as a vocation.”

True to his word, Nalli stood with Governor Pence earlier this year on the St.Vincent Indianapolis campus and applauded the announcement that federal officials had approved Indiana’s request to expand the Healthy Indiana Plan (HIP) for approximately 350,000 low-income Hoosiers. Nalli was thrilled that the administration’s HIP 2.0 would provide an unprecedented number of Hoosiers with access to affordable health care.

“Prior to the expansion of HIP 2.0, hundreds of thousands of uninsured Hoosiers were falling through the cracks every day. They earned less than the poverty level, but earned too much to be eligible for Medicaid. We felt it was important to expand coverage to them and it’s consistent with our commitment to being a health care system that leaves no one behind.”

From championing greater health care coverage for low-income, uninsured Hoosiers to finding innovative solutions to improve the health of Hoosier communities, Jonathan Nalli is not only embracing change, but leading it.