Alumna Patricia Maryland is president of health care operations and COO of Ascension Health, the largest nonprofit health care system in the country that bases its reputation for innovation on a spiritual mission to serve all, especially the poor and vulnerable.
Ascension’s willingness to engage with underserved communities is the hallmark of its approach. For more than a decade before the passage of the federal Affordable Care Act, Ascension had committed itself to work for 100 percent access to quality health care. When the Affordable Care Act finally passed, Ascension immediately mobilized to help 40,000 people enroll in insurance plans. And in between, it began to redefine how health care systems engaged in public health.
Leading that effort since 2013 is Maryland, a 30-year veteran in health care leadership throughout the Midwest. In 2005, she was named chair of the Citizens’ Health Care Working Group, whose recommendations formed the basis of national health care reform. She previously had headed its ministries in Michigan, whose aging industrial communities needed special attention, and was recently named one of Modern Healthcare’s top 25 minority executives in health care for 2014.
"What we love about work focused on public health is that it doesn’t stay within four walls," she says. "If we ask how to keep a community healthy, number one, it’s making sure that the public has access to quality care. We define that as providing each person the opportunity to access the right provider in the right setting at the right time—not using an emergency room for a non-acute visit, for example. We work closely with registered nurses and clinical social workers working with PCPs (primary care physicians). We identify high-risk patients with multiple chronic conditions. We take an issue or problem, solve it, test it, and spread it nationally."
In Saginaw, Michigan, homeless members of the community who consent to wellness checks receive a unique incentive: they have their laundry done free of charge. Children, teens, and parents in Pasco, Washington, can participate in Bodywork nutrition and activity programs at community centers, learning to prevent obesity. And in Flint, Michigan, where supermarkets had fled the inner city, Ascension helped to create the Healthy Dollar store, offering an oasis of fresh produce in the middle of an urban food desert. Awarding seed grants averaging about $50,000, Ascension worked together with local health departments, churches, and health communities developing business plans to establish sustainable businesses.
Ascension adopted another simple local idea and spun it into a distribution system for free medications for those in need. When a Nashville physician wondered how to put unused pharmaceutical samples to better use, a vision for a free distribution system was born. Inaugurated by Saint Thomas Health, an Ascension member, Dispensary of Hope has evolved into an effective national system that redistributes prescription drugs with the cooperation of pharmaceutical manufacturers. Maryland says the program, which also offers diabetic supplies, has recovered more than $10 billion in potentially unused sample medications over the past seven years.
As states grapple with new structures for Medicaid programs, Ascension has led efforts to connect the unemployed to Indiana’s Pathway to Work system. The project helps Hoosiers apply for health care coverage, then link into job search programs. "Our ministry covers three quarters of the state," points out Maryland. "Our STAR program reaches individuals who have been out of work for a while to enroll in job readiness programs—even finds them clothing for job interviews—then also provides opportunities for employment within our health ministry. We make every effort to ensure that these individuals have every opportunity for success."
Ascension continues to leverage other facets of its operations to support its mission. Ascension Information Services found more than $30 million in cost-savings that have been directed back to its health ministries. The system also continues its work overseas, most recently in the Cayman Islands. Ascension partnered in the first phase of Health City Cayman Islands (HCCI), the construction of a 104-bed tertiary care hospital. HCCI is the idea of an Indian physician, Devi Prasad Shetty, in collaboration with government leaders of the Cayman Islands who envision ultimately not only a hospital, but an educational facility, a biotech park, and an assisted living community. The mission of the joint project with India’s Narayana Health is to provide high-quality health care at low cost and to try to adapt its approaches to care in the United States and even further in the international health care community, while providing new career and economic growth opportunities for residents of the Cayman Islands.