Children’s Healthcare CEO: ‘Our jobs are to get every penny we can out of the dollars that are available’

Obesity. Health care reform. Those weren’t the types of issues Donna Hyland, CEO of Children’s Healthcare of Atlanta, thought she’d be dealing with when she became an accountant three decades ago. After several shorter stints at different companies, including Home Depot, Hyland landed at Scottish Rite Children’s Medical Center 25 years ago — and never left.

Donna Hyland

Donna Hyland

She rose through the ranks, helping to forge the 1998 merger of Scottish Rite with Egleston Children’s Health Care, which created one of the nation’s top pediatric hospitals. Later, the combined operation took on the added responsibility of operating Atlanta’s other pediatric hospital, Hughes Spalding.

Hyland, 52, talks about health care reform, the controversial anti-obesity campaign she launched, and what happened when she did not do her “due diligence” before accepting that first job at Scottish Rite.

Q: After graduating with an accounting degree, you ended up working at Home Depot early in your career, when the retailer’s headquarters was in a renovated grocery store? What did you learn?

A: The customer is No. 1, 2 and 3. That was [co-founder] Bernie Marcus’ philosophy. For us, it’s patients. When you work at a place like Children’s Healthcare, people walk in the door and they put their child in your hands. That is an awesome responsibility. You have to make sure we are doing everything possible to take care of those kids — 325,000 a year. And they are not coming here because they want to be here. Their parents bring them here because they’re sick.

Always keeping that customer focus was a helpful lesson from Home Depot. Also, Home Depot was growing so fast in the early 1980s, you never had enough resources. So you were constantly getting every ounce of productivity out of everything you had — whether it was people or physical assets. That was helpful to learn because when you work at a nonprofit like Children’s, you have to squeeze the most productivity out of the dollars that we have.

Q: You did not do your homework before taking a job that a friend recruited you for at Scottish Rite. What happened?

A: I knew nothing about hospitals in 1987. Because I trusted my friend, I really didn’t look at the financials. So I got there as the new controller and on day one, somebody brought in a box of checks and said, “We have $600,000 worth of checks to send off and we have $200,000 in the bank. You need to go through these checks and decide which vendors we’re going to pay.”

I sat there with my mouth open. Then I asked myself what’s my methodology going to be? It was common sense. What do we have to have? What are the critical supplies? Who’s yelling the loudest? People were calling constantly: “Where’s my check? Where’s my check?”

This was one of those great learning experiences. I was the controller and, oh my gosh, I didn’t even ask before I took the job — do you have any money? Is this place solvent?

Q: About 10 years later, you were involved in the Scottish Rite-Egleston merger. With health care and other industries continuing to consolidate, what did you learn?

A: The biggest challenge you have in pediatrics is getting scale. In every business, scale is an issue. But in pediatric health care, it is particularly acute. There are three adults for every child and kids do not get as sick as often as adults. With the merger, we were able to consolidate the back office functions — marketing, public relations, accounting and human resources. We didn’t have two CEOs any more. We were not spending marketing money fighting each other. We ended up saving $38 million in two years.

At the time of the merger, every employee was scared. But we said to people that we were not going to do anything at the clinical settings, because that’s where the care is delivered. So everyone calmed down.

The thing that was hardest was getting doctors from different cultures to work together. The staff came together pretty quickly. But the physicians were coming from a private practice setting (Scottish Rite) and an academic setting (Egleston). It was very challenging to get them to work together in the beginning. We tried to force some of that. What we learned very quickly is that you don’t do that with physicians. That’s one of the reasons that hospital mergers fail. Fortunately, we had a few instances of doctors working together that became examples for the rest of the physicians.

Q: Despite the recent Supreme Court ruling, there is still a lot of uncertainty surrounding health care reform. How are you dealing with it?

A: The thing we learned from the merger is what happens when you leverage capabilities, especially when 55 percent of your patients are Medicaid. So, almost two years ago, we organized the Pediatric Health Improvement Coalition, which is made up of the pediatricians and the children’s hospitals in Atlanta, Augusta, Macon, Columbus and Savannah. We are trying to come up with solutions to bring forward, because if we are waiting for the government, we are probably not going to like them — and nobody ever prioritizes kids.

We’ve been bringing our ideas to the state Department of Community Health. So far, knock on wood, they’ve been receptive to at least listening to these ideas. We totally get that the probability of more money going into health care is low. Our jobs are to get every penny we can out of the dollars that are available and improve the outcomes for Georgia’s kids.

Q: You launched a controversial and grim anti-obesity advertising campaign featuring overweight kids. Some public health experts criticized it for being counterproductive, partly because it could stigmatize the issue. Why did you do it? Would you do it again?

A: Georgia has the second highest rate of childhood obesity in the country. We did focus groups and we learned that 50 percent of the parents in Georgia did not think we had a problem. Seventy-five percent of the parents who had an overweight or obese child didn’t see it as a problem.

We needed to get people’s attention. We could go build all the programs in the world, but if people didn’t see there was a problem they wouldn’t take advantage of them.

I would do it again. If we don’t tackle this issue, I can’t even imagine what our workforce is going to be like 15 years from now or what health care costs are going to be like.

Each week, Sunday Business Editor Henry Unger has a candid conversation, called “5 Questions for the Boss,” with a top executive in Georgia. Some remarks are edited for length and style.

8 comments Add your comment

[...] Atlanta Journal Constitution (blog) [...]

another comment

July 8th, 2012
9:58 pm

Children’s has stopped offering people like me that have private insurance that is paying more than their fair share discounts on our overdue jacked up bills. Instead they are selling off our bills for pennies on the dollar to collection agencies. This does not make sense. When everytime you go there the waiting rooms are full of illegals. Yet I am the one who is billed $4,300+ by them. My insurance pays out over $3,200 and they send the $125 remaining to a collection agency instead of working with me, when they know I have 2 chronically sick kids that have 8+ ER admissions for true visits. Still on the latest one they billed $4,300 for 2 hrs. and were paid $3,200. I take my children to the Pedetrician reguarly, sometimes one to two times a week at $25 co pays a week. I reguarly meet my $5,000 out of pocket max. In addition to paying over $300 month for my insurance while my employer pays over $770/month.

Why don’t they make all the freeloaders pay up front. Or at least let me go to the front of the waiting room line. Those of us with insurance that is not medicaid are paying such a premium.

Lea

July 8th, 2012
10:36 pm

@another comment

So those of us who are more fortunate should get our care first? Screw the kid with the more immediately life threatening condition. His mom is poor and cant afford private insurance. They look like illegals anyway. They dont deserve to have medical care.

Should we start selling organs to the highest bidder too? Screw a needs based list. I have a million dollars. Someone give me a new kidney and they can have it!

Bob

July 8th, 2012
10:38 pm

Our state’s mortality rate is amongst the worse in the nation, as is percent of people uninsured. But don’t look to the Governor to do anything about it, he has declared he is not going to, apparently it doesn’t play well with the extremist in his latest party.

Stupid is as stupid does.

ceolalong

July 9th, 2012
5:44 am

Yeap. In fact, did you know that Currently, many insurance companies do not allow adult children to remain on their parents’ plan once they reach 19. Companies cannot do that any more. Search onilne for “Penny Health” and you can insure your kids if you are in the same boat.

CEO Trip

July 9th, 2012
7:35 am

I was in a similar situation to “another comment” a few years ago. Ask for the hospital social worker and try to work things out with them. I also agree with the illegal alien situation at this hospital. The emergency room was loaded with them and their children with minor ailments. My child had a life threatening emergency and had to wait hours to be seen.

Tammy

July 11th, 2012
5:50 am

I have worked at CHOA for almost 7 years and I have seen this woman a total of two times. They love to keep their executive team as separated as possible from the worker bees as possible.

Angel

July 12th, 2012
10:21 am

That would be 2 more times than I’ve seen her and I’ve been there twice as long as Tammy. Things were better under Dr Tally…