A $481M Cinderella Story: How CEO Carlos Migoya turned Jackson Health System around

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Carlos Migoya didn't need a new job.

A retired banker and former city manager, he had no healthcare experience when he got the job as CEO of Miami-based Jackson Health System in May 2011. But what he did have — a track record of turning organizations around — proved to be enough. Now, five years later, Mr. Migoya has led the system through a complete 180, according to the Miami Herald.

Back when Mr. Migoya first took the position, Jackson had recently lost $419 million over the course of three years. The system's outlook was far from positive, but Mr. Migoya had a bright outlook: "If I could turn around Jackson Memorial, it would be the biggest legacy I could leave for the city," Mr. Migoya recalls thinking, according to the report.

So he rolled up his sleeves and got to work. Mr. Migoya created a plan to cut costs. Before starting his position, he traveled to Tallahassee, Fla., to attempt to obtain state funds. To guarantee a fresh start, he replaced Jackson's management team.

Months later, he made a new proposal, which included benefit and pay cuts; a $52 million reduction in Jackson's affiliation with University of Miami Health System; and a workforce reduction of 11 percent — or almost 1,200 full-time jobs. The idea went over well with Florida leaders, but not with hospital staff. Still, the proposal went through, and Mr. Migoya later restored pay and gave a one-time bonus to employees.

The benefits of Mr. Migoya's turnaround are nearly palpable. By implementing a tighter screening process of patients on Medicaid, Jackson Health System is caring for more patients with health insurance. Most astoundingly, Jackson reported its fourth consecutive year of budget surpluses in 2015, most recently with a $62 million surplus.

Mr. Migoya hasn't stopped yet. In 15 or 20 years, he hopes Jackson can be a completely independent system.

But for now, he's happy to have made his mark on Jackson's legacy. "Everybody looks at the pretty buildings and they say, 'That's the legacy,'" Mr. Migoya said, according to the report. "To me, it's what's in the buildings that's the legacy. It's the ability to provide world-class healthcare in those buildings that's going to be the important piece."

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