Jeffrey Flaks takes over as CEO of Hartford HealthCare amid time of expansion and consolidation across Connecticut

Aug. 29--A decade into a blockbuster expansion across Connecticut, the owner of Hartford Hospital is making its boldest move yet, with the acquisition of St. Vincent's Medical Center in Bridgeport.

For Hartford HealthCare's next CEO Jeffrey A. Flaks, it's a moment that's been years in the making.

"We spent the last ten years, in many ways, building Hartford HealthCare," Flaks said. "We're going to spend the next ten years, optimizing what we have created and expanding it."

Hartford HealthCare owns Hartford Hospital and five other hospitals in Connecticut, but its purchase of St. Vincent's establishes a beachhead in Fairfield County -- and challenges the long-held dominance of Yale-New Haven Hospital in the region.

Flaks, who takes over Sept. 1, said the health system will bring its model of integrated health care -- a network of home care, rehab locations, urgent care, outpatient surgical centers and physician practices -- to Fairfield County. The alternate locations are all tied together with a electronic record system that travels with patients, with access to the expertise of a teaching hospital and the larger health system.

"That's what makes us different," Flaks said. "It's really the ecosystem that we create. So, we do believe, in that region, that we will be able to demonstrate great value to the people that we serve. We're going to make a difference for people."

Flaks, 48, succeeds Elliot Joseph, who is retiring. Joseph assembled the pieces of Hartford HealthCare's expansion over the last decade. When Joseph took over in 2008, the health system ran Hartford Hospital and one other acute-care hospital, MidState Medical Center in Meriden.

A decade later, Hartford HealthCare will operate seven hospitals once it completes its acquisition of St. Vincent's, coming after the addition of Hospital of Central Connecticut in New Britain and Southington; Backus Hospital in Norwich, Windham Hospital in Willimantic and Charlotte Hungerford Hospital in Torrington.

Hospitals are just one component of the expansion, however. In 2009, Hartford HealthCare had about 30 locations in Connecticut and about $1 billion in annual net revenue. Today, the health system will have about 350 sites in both suburban and urban locations and over $4 billion in net revenue, once the St. Vincent's deal is complete.

After the St. Vincent purchase, Hartford HealthCare will employ 25,000.

A time of consolidation and change

A growing network of urgent care, out-patient surgical centers and home health services seeks to relieve pressure on hospital emergency rooms, bringing health care earlier and more swiftly to patients, and care that is less expensive and closer to where people live.

Flaks, a West Hartford resident, has been a critical part of the transformation of Hartford HealthCare, first as chief operating officer at MidState in the mid-2000s and later, as the top executive at Hartford Hospital. In 2013, he was named chief operating officer of Hartford HealthCare. Flaks became president three years later and was widely seen as the successor to Joseph, whom Flaks had recruited from Michigan where the two had once worked together.

Flaks takes the reins as top executive at a turbulent time of change in the health care industry as consolidation challenges traditional ways of delivering health care. The change is coming without any clear indication of how it will all shake out, and who will benefit the most: the corporations or the consumer.

In Connecticut, CVS Health Corp.'s acquisition of Hartford-based Aetna Inc. has combined a health insurer and a pharmacy benefit manager. CVS promises to bring health services to neighborhood CVS stores, to keep closer tabs on patient health to cut down on more expensive treatment costs.

Consolidation among health care providers also has picked up pace. The volume of hospital mergers nationwide rose from 50 in 2009 to 115 in 2017 and settled back a bit to 90 last year, according to the National Institute for Health Care Management. The need to reduce health care costs that are rising more steeply than inflation is often cited as a major reason for the tie-ups.

But critics say there is, as yet, no clear evidence that savings resulting from hospital mergers are being passed on to consumers.

Emily Gee, a health economist at the Center for American Progress, a think-tank in Washington, D.C., said consolidation may mean lower operating costs for the combining hospitals.

"It doesn't mean savings are being passed on to patients," Gee said. "There's a difference there."

At Hartford HealthCare, Flaks said consolidation is benefiting the consumer, with lower, out-of-pocket costs and more options for medical care.

"So, as we're reinventing the system, we're creating new ways to take care of people, more affordably, more accessibly for them," Flaks said. "From our perspective, it can be more affordable for us to operate those [alternative] facilities, but at the same time, we have to maintain our critical access capabilities to be here 24-hours a day, 7-days a week. We have to keep that in balance."

Flaks said the system of electronic records is a major cost savings, eliminating duplication of tests and procedures and creating an authoritative, up-to-date picture of a person's health. Hartford HealthCare patients, Flaks said, also are an active part of the equation through an app that can be accessed through a cellphone or computer.

"We're breaking down the the historic silos that evolved in health care over a century," Flaks said.

More focus on Hartford

As Hartford HealthCare navigates expansion in an era of health mergers, its profile in the industry has been rising.

The health system's $150 million Bone & Joint Institute at Hartford Hospital -- now coming up on its third anniversary -- is attracting the attention of other health providers from around the country. The institute recently hosted visits from health systems from Detroit, Orlando and New York City, interested in the work being done in Hartford.

Hartford Hospital also recently garnered a positive rating for its cardiac surgery and vascular care capabilities.

"The Society of Thoracic Surgeons rated Hartford Hospital with a maximum 3-Star rating in 4 out of 5 cardiac categories; the only center in Connecticut to achieve the 3-Star rating in 4 categories, a recognition that places Hartford Hospital among the top tier of hospitals in the United States," Flaks said.

The STS National Adult Cardiac Surgery Registry is the largest single-specialty database in the country, with over 1100 participants.

Later this month, Hartford will be one of the four sites nationally, along with Houston, Boston and New York, to host The Israel Export & International Cooperation Institute The institute is exploring how Israeli companies might use Hartford HealthCare's physician expertise for developing and marketing products in the United States, Flaks said.

All the attention in the growing health care industry could benefit Hartford and the rest of Connecticut.

"This is health care as an economic driver," Flaks said. "When you think about the amount of investment today in biotech, pharma -- at Hartford HealthCare, we believe if we can accept and develop the right culture, the right capabilities, we believe we can be a major contributor to the economic health and well being of the state of Connecticut."

So far, Flaks said, the reception from the administration of Gov. Ned Lamont has been welcoming, after years of strain with former Gov. Dannel P. Malloy over the hospital tax. The legislature is expected to consider a modification of the tax. The details have not been disclosed publicly, and Flaks declined to discuss them.

In Hartford, the health system also is the anchoring partner along with the UConn School of Business, Trinity College and Connecticut Innovations in opening a medical technology accelerator on Constitution Plaza this fall. Also this fall, Hartford HealthCare plans to announce a significant expansion of its Hartford Hospital campus, costing tens of millions of dollars.

The health system will add more private and intensive care beds as well as new and larger operating rooms.

Flaks said Hartford HealthCare also is watching the efforts by the financially ailing UConn Health Center to enter into a public-private partnership. The health system, he said, has a program for residents and fellows from UConn.

When asked if Hartford Healthcare might consider investing, Flaks said, "We are always interested in being engaged in the discussion."

Improved patient management

Hartford HealthCare expects to complete its acquisition of St. Vincent's Oct. 1, but it already has been laying the groundwork for the strategic model established elsewhere in the state. Flaks said the health system already has merged with a large home health agency in the region and has already begun to deploy primary care offices.

Communication in the health system's network got a boost last year when Hartford HealthCare opened its Logistics Care Center in Newington. If a patient is not in the right location for treatment, the system can determine where and when a bed is available.

"It oversees every bed," Flaks said. "It oversees all of our ambulances. All our helicopters. All of our critical care capabilities."

If there is a patient in Norwich, for example, and needs, say, behavioral health treatment, a bed may be available in Farmington.

"Patients would have to dwell sometimes three or four days in the emergency department," Flaks said. "Sometimes, they would sit in a hospital waiting...and have tremendous delays in care which affects quality and causes anxiety and creates risk."

With the new system, patient transfers jumped from 900 a year to 7,500, Flaks said.

Despite the new ways of delivering health care, Flaks said hospitals still remain the nerve center, the safety net for community, especially in times of tragedy and turmoil.

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Flaks learned that early in his career while working as an executive at another St. Vincent's hospital, the one in New York City where he was working the day of the Sept. 11 attacks.

St. Vincent's was the closest hospital to the World Trade Center.

"What it underscored for me more than any other moment I could imagine probably in my lifetime, hopefully, is ... what a health system, that case, a hospital meant to a community in time of tragedy," Flaks said. "I saw the best in humanity, from organ and tissue donors to blood donors to volunteers at every level to the heroic nature of first responders, our ambulance company, police and fire all working together."

"That's the nature of what hospitals, in particular, health systems need to never lose sight of, the role we play within our communities," Flaks said. "That's what we do, and we always have to prepare to rise to that occasion."

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