An Appointment With: Michael Dowling, Northwell Health President and CEO

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.