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Lessons from Piedmont Healthcare's 'hub-and-hub' growth strategy

In recent years, Atlanta-based Piedmont Healthcare has been on an accelerated path toward growth.

The 11-hospital system started as Piedmont Hospital in Atlanta, more than a century ago. But thanks largely to growth between 2015 and 2018, it is now one of the largest systems in Georgia, serving more than 2 million patients annually.

Growth began to take off under Tim Stack, who served as CEO from 2001 until 2012. During Mr. Stack's tenure, the system added three hospitals to become a five-hospital system. 

Kevin Brown became CEO in May 2013, and acted on the belief that Piedmont Healthcare and similar nonprofit systems with limited resources needed to improve efficiency in areas such as IT, so providers could give the best patient care possible, said hospital officials.

From 2015 to 2018, Piedmont Healthcare added six hospitals — in Columbus, Ga., and in the Georgia counties of Newton, Athens-Clarke, Rockdale and Walton — through mergers and acquisitions. The system now has more than 600 locations, 2,300 physicians and 23,000 employees.

Becker's Hospital Review recently caught up with Jack Tillman, who was selected as vice president of real estate for Piedmont Healthcare in 2018, to discuss the system's growth strategy, the goal behind it and what he recommends hospitals look for in partners for growth.

Editor's note: Responses were lightly edited for length and clarity.  

Question: Piedmont Healthcare describes the system's growth strategy as "hub and hub." What does this look like? 

Jack Tillman: Piedmont's clinical "hub-and-hub" growth strategy is really about the scale at which we are now operating across the state of Georgia. With our roots and organizational history here in Atlanta, Kevin Brown our CEO laid out a "plan on a page," a roadmap for Piedmont centered around quality, safety and service, with stewardship, strategic growth and talent as the anchors for our vision of transforming healthcare and creating a destination known for the best clinicians and a one-of-a-kind experience that always puts patients first. Our hub-and-hub growth strategy enables clinical hubs to execute our vision in our largest markets in Atlanta, Athens and Columbus, [Ga.].

Q: What are the goals behind the system's growth strategy?

JT: The major goal behind our growth strategy is to allow us to have relevance in Georgia by delivering on safety, service, and by providing high quality, cost-effective care to communities where mutually beneficial opportunities exist.

Q: What efforts are still needed for the system to reach its growth goals?

JT: Piedmont has literally doubled in our operating metrics over the last several years, and we continue to examine communities where we think our purpose and vision are aligned. We now operate in communities where 70 percent of Georgian's reside.

Q: How does your role fit into the system's growth strategy?

JT: My role is everything to do with Piedmont's capacity to build, buy or sell assets in support of the mission. Real estate is an asset class that can go unconsidered for a busy hospital or health system focused on bedside investments. At Piedmont we've been paying attention to opportunities to create economic value from our real estate assets and deliver more or better access to our patients through our primary care and retail clinic platforms.

Q: How has your leadership style evolved since joining Piedmont in 2018?

JT: As a relatively new leader at Piedmont and after a long run at a former large university with an academic medical center where I'd built up years of trust through relationships and experience, my leadership style has had to evolve, and one habit I've been developing this year is in being more intentional about making unstructured time to be with new colleagues, particularly clinical colleagues, and asking them about ways we can make the place better, then working hard to connect the dots or helping them to engage with others across the system they don't know as a result of our recent growth.

Q: What should hospitals look for in partners for mergers and acquisitions?

JT: In my view, hospitals looking for partners should pay serious attention to the culture and people of their potential new partners. Being in partnership with a new health system has as much to do with everything that happens after the M&A process, like how well the financial and electronic medical records integration teams work, as it does to the people and culture of the new operating model, or the financial models of the organization post transaction. As with most things, it's always about the people, in my view.


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