Henry Ford Health knew it wanted a transformation that would help shape the future of Detroit. At the same time, the health system had to prepare for the economic shifts and operational pressures that could emerge as the project moved forward.
“It is a balancing act,” President and CEO Bob Riney told Becker’s. “We had rallied our leadership team in advance and said, ‘We’ve been making a lot of capital investments over the years in many parts of the organization, but to do something of this magnitude means we’re going to have to be very conservative on other capital investments for a four- to five-year period so that we don’t get ahead of our skis.'”
Before Henry Ford Health committed to what would become a $2.2 billion transformation of its flagship hospital campus, leaders had to answer four questions: Did the system have the right executive team? Was the donor community ready to rally behind the effort? Was it the right moment in Detroit’s history? And did Henry Ford have the physician leadership talent and partnership opportunities to make the project something bigger than its core mission?
The answers shaped what is now known as Destination: Grand. The project reached a major milestone in May when crews topped out a 20-story patient tower at Henry Ford Hospital in Detroit’s New Center neighborhood. When completed in 2029, the expansion will add 432 private patient rooms, 28 operating suites and a 75,000-square-foot emergency department, among other features.
As of May, the system had raised $241 million toward the project as part of a broader fundraising campaign that had generated $653 million to date.
Mr. Riney spoke with Becker’s about how Henry Ford built the case for the investment, protected it against shifting conditions and selected the leadership needed to manage a project of this size.
Seeking a ‘multiplier effect’
Henry Ford’s board needed evidence that previous investments had produced returns, confidence that donors would support the effort and assurance that Detroit was positioned for continued development.
“The third thing we needed to reflect on was whether this was the right moment within Detroit’s history, that we had confidence in the further growth and development of the city and that this investment would create a multiplier effect, a flywheel for further investment,” Mr. Riney said. “And fourth, did we have the physician leadership talent as well as the partnership opportunities to make this something bigger than just our core mission? We were able to answer those questions with case studies, great enthusiasm and great road maps, and we’ve never looked back.”
Henry Ford Health’s partners in what it calls The Future of Health: Detroit include East Lansing-based Michigan State University, Shirley Ryan AbilityLab in Chicago, and the Detroit Pistons and owner Tom Gores. Shirley Ryan AbilityLab will occupy the top three floors of the new tower with a 72-bed rehabilitation facility funded by nearly $130 million from the Gilbert Family Foundation.
Preparing for economic shifts
After the project was approved, Henry Ford made several decisions aimed at limiting its exposure to economic volatility during the multiyear construction process.
Leaders across the system were told that an investment of this size would require restraint in other areas.
“Letting people know in advance that that’s the road map and the why behind it gets leaders from across the system, even those far removed from the downtown campus, to feel a sense of engagement and ownership,” Mr. Riney said.
Henry Ford also purchased 70% of the materials needed for the project before construction began. The system locked in prices before tariffs took effect in spring 2025.
“We didn’t envision the tariff issues coming fully to light, and we are patting ourselves on the back for pre-buying so many supplies at locked in prices that are immune from the tariff implications that still go back and forth in our political environment,” he said.
The system developed an operational road map that outlined the efficiency and productivity improvements needed each year to support the project. That planning gave leaders specific expectations for how operations would contribute to the funding strategy.
Henry Ford also considered how the project would be presented to investors as the system prepared to borrow money.
The system’s 111-year history, along with its partnerships with Michigan State, Shirley Ryan AbilityLab and the Pistons, strengthened that case, Mr. Riney said.
The hiring decision other CEOs can consider
Mr. Riney pointed to the decision to hire someone with experience managing complex development projects as key for health systems looking to take on similar projects.
“As great as the talent we have inside the organization is, and it’s phenomenal, with this kind of massive undertaking, I knew I had to go outside the organization and get somebody who had really created this kind of massive development in other markets,” he said.
Mr. Riney wanted someone who understood process engineering, project evaluation and the financial consequences of daily decisions.
“When you’re dealing with a project this size, one hiccup can be millions and millions of dollars,” he said.
Mr. Riney brought in Jerry Darby, now vice president of planning, development and design at Henry Ford Health, convincing him to leave consulting and join the team full time and relocate to Detroit.
“One of the best decisions I made was, even though we had a great strong team, to bring in somebody who was truly an expert at this and empower them to take charge and, in some ways, save the enterprise from itself, because we all get ahead of ourselves in terms of what we want,” Mr. Riney said.
A project of this size requires leaders to manage requests from hundreds of people across clinical specialties and design areas, he said.
“You have to be the orchestra conductor without alienating the musicians while you’re doing it,” Mr. Riney said.
Supporting leaders through competing priorities
Henry Ford is also integrating employees through its joint venture with Ascension Michigan. With several major initiatives underway, Mr. Riney said his attention remains focused on placing the right leaders in key roles and ensuring they feel supported.
“When you’re taking on more at one time than you’d ideally do in a perfect world, you have to go back to basics,” he said. “For me, I go back to what I think is my most important job, making sure I have the right talent in all the key seats and making sure they are feeling appropriately engaged, recognized and encouraged by the magnitude of what they’re taking on.”
He also reminds leaders that opportunities of this scale are rare.
“It is very important at a time like this to tell people this is a once-in-a-career opportunity, to be doing multiple things of this magnitude at once,” he said. “These are the rare moments you’re going to be able to tell your kids and grandkids that you were part of this, that you were part of setting the health of this community at a whole different level for the next 50 or 100 years.”
Leaders need adequate resources as well as recognition of the personal demands involved, Mr. Riney said.
“Hard work needs support on the resource side, but it also needs support on the human side,” he said.
The project has also given leaders a longer view during a period of persistent policy, reimbursement and affordability pressures.
“At a time where healthcare is being whipsawed right and left on affordability and political policy, it’s really energizing, and it helps balance out all that day-to-day stress, when you’re also part of something so futuristic, so big and really a gift to future generations,” Mr. Riney said. “It really helps put some of that day-to-day stuff that does nothing but burn you out into a different perspective.”
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