Executive Perspectives in Healthcare – Richard Lofgren

Lead Cincinnati sat down with some of the most powerful hospital executives in the region for wide-ranging discussions about the present and future of healthcare. 

Below is our conversation with UC Health president and CEO Dr. Richard Lofgren. You can find our conversation with Mike Keating, president and CEO of The Christ Hospital, here. 

Check back on Thursday for the final piece with St. Elizabeth Healthcare's Garren Colvin, executive vice president and chief operating officer, and Gary Blank, senior vice president, chief of patient services and chief nursing officer.  

As one of the nation’s top 25 public research universities, UC Health is revolutionizing discovery-driven care. UC Health brings together the region’s top clinicians and researchers to provide outstanding care. At UC Health physicians are more than doctors they are teachers and researchers at the University of Cincinnati College of Medicine, and as a result patients receive high quality and innovative medical care.

In 2013, Richard Lofgren, MD, MPH, FACP, became president and CEO of UC Health. Dr. Lofgren is a board certified internal medicine physician with 35 years of healthcare administrator experience. Dr. Lofgren took time to answer LEAD Magazine’s questions about UC Health. 

LEAD Cincinnati: How does UC Health’s healthcare model differ from other systems in town. What sets you apart?

Richard Lofgren: UC Health is the only academic medical center in the entire region, and as such, I think we have unique obligations and responsibilities to the community at large. First and foremost, we are the organization that brings major programs to the community. It allows us to build programs that require truly a multidisciplinary set of providers – not only physicians, but within the entire healthcare team. It really leverages our academic backbone and brings translation of research. So, our role, in many respects, is the ability to take care of the sickest of the sick. In fact, my commitment to Cincinnati and the community is that, regardless of how sick or how complex your problem is, you can rest assured that you can get world-class care here in Cincinnati. And I think that’s a distinctive role and a unique role of UC Health.

LC: Would you mind elaborating a bit on some specific programs US Health Offers?

RL: The program that is probably the most notable is the Level One Trauma center. We’re in the process of trying to further expand our transplant program and offering and bringing back the heart transplant program. And you know right now, people who require a heart transplant program leave the region and state – that’s something we need to fill. We have unique programs and leading programs in the neurosciences. We have a leading institution at the absolute forefront of stroke and stroke care. We’re at the front of mood disorders and other complex neurological disorders. We are the organization that has the ability to take care, importantly, of life-threatening cancers. Patients get tremendous benefit from the fact that we have people who are doing the science and are at the cutting edge and bringing the latest in technology and translational research to help people in Cincinnati. We have programs in heart, lung and vascular even unique, enriched programs like pulmonary hypertension, which is an unusual disorder that many people don’t know about. It’s a potentially fatal disorder, yet we’re the leading organization and one of the only certified pulmonary hypertension programs in the United States.

LC: What challenges are you experiencing in the ever-changing role of healthcare in the country?

RL: I think that the most critical thing facing the health of our country is actual affordability. So a lot of the changes that are happening in the marketplace are trying to address how to make healthcare sustainable. The personnel want to be part of the solution to help make healthcare sustainable – and sustainable means high quality, accessible and affordable. But affordability is at the core of this. In terms of how we make healthcare affordable, one of the things that I think got lost in the dialogue is that, in fact, when you look at the affordability of the spending, 10 percent of the people spend 70 percent of the money. Unfortunately, a lot of that spending isn’t preventable, but it’s manageable. So, our commitment and strategy is to figure out how we can take care of people more efficiently. How can we take care of a lung cancer patient while using 30 percent fewer resources while getting better outcomes? It’s by driving efficiency. I think the pressure in the possibility to provide world-class, high-end advanced specialist services and in a more efficient manner at 20-30 percent the cost is where our obligation lies.

LC: What is one of the biggest challenges in overseeing such a large organization?

RL: I think one of the things about UC Health that’s both exciting and unique is that, on one level, the University Hospital is the second-oldest teaching hospital in the United States – it has a 200-year history. And UC Health is only 3 1⁄2 years old. So, I think one of the unique elements is that there’s this rich tradition and yet the organization is relatively young. We’re really helping to guide the complexity into becoming a truly integrated clinical enterprise. The reason it’s vital that we become an integrated clinical enterprise is because all the elements of the organization have to be working in concert to drive efficiency. The purpose of coming together like that is for me to figure out how we can take our current existence and make it more efficient. That really changes how various parts of our organization relate to each other. 

LC: What does the future of UC Health look like?

RL: The University of Cincinnati and the College of Medicine is a well-established, upstanding research and medical center. With the demise of the health alliance, the University of Cincinnati’s foresight created UC Health to serve as the clinical engine and support the mission of the University of Cincinnati. UC Health is not a successor organization to UC or to the health alliance. It was a new organization with a fresh mission to explicitly define and support the academic mission of the university. To be a research-intense organization, there should be a symbiotic relationship between the researchers and the clinical piece. If you want to attract outstanding researchers, then you have to have an outstanding clinical program, and an outstanding clinical program needs outstanding research to help found it. It’s a wonderful symbiotic relationship – great clinical programs help advance specialty services and attract outstanding researchers. UC Health needs to be the clinical engine supporting the academic mission. To be successful, we need to live into our full potential as the region’s only academic medical center, and actually be the key medical center for the region, providing unique, advanced specialty services which then, in turn, attracts greater research. And then when we get greater research and the great minds, we actually can enhance the program for good and it feeds off one another – and that’s where I see ourselves. I see our principal mission as the provision of advanced specialty services, to be the preferred provider and referral center for the region.

LC: How has the Affordable Care Act affected UC Health, and how do you see it doing so in the future?

RL: There are people that think that there’s Medicare, Medicaid and Obamacare – they think that Obamacare is a program, and it’s not. It’s a collection of initiatives. There’s no question that the expansion of Medicaid has had a tremendous and very important impact on our patients. It has significantly enhanced individuals’ abilities to access healthcare. So we’re seeing an impact with the expansion of Medicaid. I think the other element that’s controversial is the exchanges. Obviously, it got off to a lumpy start, so it hasn’t had much of an impact. I’m not sure where that’s going to go.

LC: What is UC Health doing to expand its cardiovascular care and cancer institutes, and how is that growth going to benefit the community?

RL: One of the things I think is most important is that we need to be at the forefront of some of the new challenges in the case of the care of patients with heart disease. It used to be the dominant thing was coronary artery disease, not degenerative heart disease and valvular heart disease.

Our advanced therapeutics in degenerative heart disease, valvular heart disease, and electrophysiologic diseases were a major area of focus for us, besides being a comprehensive cardiac program. And the cancer programs, again, one of the things that is important for the regions is that you’re on a very focused mission to become NCI designated (National Cancer Institute), comprehensive cancer center. NCI actually has several benefits – the first thing is that it adds access to the latest in the NCI. It’s a magnet for attracting the best and the brightest researchers. It brings new therapeutics to the community. And, quite honestly, it brings innovation and the potential of corporations in the biotech communities as well. We’ve acquired some investment from the community as well that impact not just the University of Cincinnati but impacts the entire community as well. I believe that of the 30 largest cities we’re the only one without one. Basically, it’s unusual that a community of this size doesn’t have the benefit of an NCI – that’s been an important mission for us as we move forward.

LC: Did you want to touch on developments in women’s health as well?

RL: One of the areas that we’ve been developing broadly that mainly focused more on the West Chester campus, is to focus on the special needs of women. I think one of the areas in particular that’s been a tremendous benefit and strength is recognizing that there are a number of unique health issues that women experience that tie to menopause. And, quite honestly, the health issues and problems that women experience don’t really fit nicely into one discipline – it’s not an OB issue, it’s not a medical issue and it requires a whole new thinking. So we’re working closely with Dr. Larkin who has an expertise not only on women’s health in general, but specifically about the number of issues that stem from the time of menopause. One of the things I’ve been excited about when I arrived here in the women’s health program is an understanding of the importance of having a multi-disciplinary and comprehensive program where all the disciplines – cardiac, neurology, primary care and OB are working to take care of a patient. In addition, the women’s health program is capable of taking care of women from any part of the spectrum, it’s not just about menopausal care – it’s a whole spectrum.

For more information about UC Health visit uchealth.com.