When Richard Lofgren, MD, joined Oklahoma City-based OU Health as its inaugural president and CEO in 2022, the health system had recently launched as Oklahoma’s only comprehensive academic health system, bringing together the former OU Medicine hospitals, clinics and physician practices under a single organization.
Today, the system has 11,000 employees, including more than 1,300 physicians and advanced practice providers in the state’s largest physician network.
At the time OU Health was formed, annual revenue was approximately $1.6 billion. The system’s revenue is now trending toward $3.6 billion, according to the system. Admissions rose 22.3% over the same period, with nearly 1 million outpatient clinic visits recorded statewide.
Additionally, OU Health expanded key service lines during that period, including a more than $200 million investment in pediatric heart services and growth of the Stephenson Cancer Center, the state’s only National Cancer Institute-designated cancer center.
This growth occurred during Dr. Lofgren’s tenure, which will end June 30 when he retires. Jonathan W. Curtright, MBA, MHA, the system’s current COO, will succeed him as president and CEO effective July 1 as part of a board-approved succession plan.
In a conversation with Becker’s, Dr. Lofgren reflected on nearly 40 years in healthcare and the work of building OU Health during a period of significant operational and financial change.
A board-certified internal medicine physician and administrator, he has spent his entire career in academic medicine. He joined OU Health from Cincinnati-based UC Health, where he was president and CEO.
He also held leadership roles at the University of Kentucky in Lexington, the Medical College of Wisconsin in Milwaukee, the University of Pittsburgh and the University HealthSystem Consortium, which has since become part of Vizient.
Dr. Lofgren said his experience leading organizations through periods of change and turnaround ultimately drew him to Oklahoma.
“I think when organizations struggle, there is a real tendency for leadership to tell stories that suggest the challenges they face are external to their control,” he said. “You can’t make meaningful change until you are honest with yourself as an organization and really counter those false narratives.”
That mindset shaped his approach at OU Health, which launched amid the unwinding of the University of Oklahoma’s partnership with Nashville, Tenn.-based HCA Healthcare and the operational and financial disruptions that followed the COVID-19 pandemic.
From there, he said, the work becomes about culture.
“It’s about listening and leading a cultural transformation,” he said. “It’s putting together a compelling aspiration. For OU, it was recognizing that our place in the ecosystem was that we needed to be the flagship academic health system serving the entire state and delivering on the promise of destination programs and life-altering care that requires an academic ecosystem to be successful.
“Our focus is Oklahoma. Our aspiration is to change outcomes. I think it’s making that compelling story and then making sure everybody can see it.”
While Dr. Lofgren emphasized culture and strategy, OU Health also faced significant financial challenges in its early years. The system carried roughly $1.4 billion in debt, had about 30 days cash on hand and was at risk of violating bond covenants, he said. Leaders implemented layoffs and other cost-saving measures as part of a broader effort to stabilize the organization and complete its integration.
“I wasn’t stunned by it,” Dr. Lofgren said. “Colleagues around the country told me about the financial distress and asked, ‘Why would you take the job?’ I think it’s because the opportunity here was so rich, and I actually thought it just needed focus.
“There are two simultaneous pieces to transformation. Even in the face of financial issues, you need to have a vision of where you’re going and an aspiration. Developing a strategy for how you’re going to get there has to happen at the same time.”
He acknowledged that part of the system’s strategy involved difficult decisions to preserve cash, including layoffs and temporary changes to employee benefits.
At the same time, he said he asked the entire organization to focus on only three things: care quality, the human touch and experience, and improving the efficiency of their microenvironment.
“I didn’t talk about finances at all,” he said. “I said if we do those three things, we’ll be financially fine. Those asks were all within everybody’s sphere of control. There was no longer the ‘other guy’s responsibility.’ I needed people to focus on our strategy and culture, the quality of care and being relentless as good stewards of efficiency. With that, people rallied. We had tremendous growth and fairly quickly stabilized our finances.”
That philosophy also shapes how he views today’s industry challenges.
“The greatest issue facing the health of the country isn’t the lack of technology,” he said. “It’s that we have a healthcare delivery system that’s clumsy, almost impossible to navigate and increasingly not affordable. As industry leaders, that’s our responsibility to focus on.”
He added: “I’m not blind to the headwinds, but we need to focus on making healthcare affordable and accessible. That’s why I’m passionate about redesigning health systems. When I think about the headwinds, you want to build an organization that’s resilient, with a culture based on strong values that are shared by everybody and tightly aligned. We know who we are, and we remain focused on who we are. If I become obsessed with the environment, then I take my eye off the ball.”
Amid this backdrop, Dr. Lofgren is preparing to pass the baton to Mr. Curtright, who helped build the system’s strategy and culture.
Dr. Lofgren said the long-term success of OU Health will depend on the foundation built during its early years.
He pointed to the organization’s alignment around the three core missions of academic medicine: patient care, education and research.
“What makes us unique, what differentiates us in the market and where we add value to the community is integrating all three missions,” he said.
“When you treat them separately, you lose that synergy. It has to be integrated and aligned to really get the full value of what an academic health system does for its communities.”
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