Q & A with Tom Breitenbach, CEO of Miami Valley Hospital, 1988-1998
Tom Breitenbach joined Miami Valley Hospital in 1979 as chief financial officer. He served as president and CEO from 1988 to 1998. In 1995 he cofounded Premier Health Partners, an alliance between MVH and Good Samaritan Hospital (closed in 2018). The company later expanded to include Middletown Regional Hospital (now Atrium Medical Center) and Upper Valley Medical Center. Tom retired in 2010 as CEO of Premier Health Partners, now Premier Health.
Tom and his wife, Carol, live in Oakwood. Tom sat for an interview Dec. 19, 2012, in the Health Information Center of the new patient tower.
Take us back to 1990-91 or so and tell us about Miami Valley Hospital and its status in the community.
Nineteen ninety one to 1992 was a recessionary year, so it was not unlike what we’ve faced for the last three or four years. There were a lot of layoffs and plant closings in the Dayton area, just like now. But Miami Valley was very well positioned for the future. Rush Jordan had been CEO from 1978 to 1987 and he really brought Miami Valley up from being almost a county type hospital to being the best hospital in Dayton. So in the early nineties we were building on his legacy, basically.
What were your long-range goals at the time?
We knew we needed to expand our plant, make our campus more attractive and clean up the neighborhood surrounding the hospital. The main goal was to have Miami Valley be the best hospital in the region, serving everyone. The most important way to accomplish that was to make sure people living south of Dayton, those with commercial insurance, would come here for their care.
In 1995, you created Premier Health Partners, an alliance between Miami Valley and Good Samaritan hospitals. Why was that necessary?
It was an interesting time. Back in the early to mid-nineties, Hillary and Bill Clinton tried and failed to implement national health insurance. That failure really traumatized the industry and really caused a lot of consolidation. People knew the handwriting was on the wall — we had to get more efficient and become a better industry. So nationally there was a major movement to consolidate. Miami Valley at the time was clearly the leader in the region and we wanted to consolidate its position, but even more importantly, we wanted to be sure that whatever happened that local control would be maintained. There were five hospitals in Dayton at the time, but Miami Valley and Grandview Hospital were the only ones that had local control. The rest were controlled by religious institutions outside of Dayton. The board's goal was to have a high quality, locally controlled institution.
Did you have any fears that Premier Health Partners wouldn’t work, that it might fall apart?
There were many organizations that merged back in those days that have now come apart. So our goal was basically to become “married” permanently and have no failure or breakup. I think the biggest fear may have been that we were merging a Catholic hospital with a secular hospital that had a Protestant heritage and how would the values of both institutions work. We were very meticulous in dealing with the various Catholic values to be sure we honored those values and yet kept local control. I think the proof is in the pudding. Now, some 18 years later, it's still a very strong organizational partnership and I think it's been very successful.
What sets Miami Valley apart from it competition?
It’s the safety net hospital for the community. There is more indigent care given at Miami Valley than in any other place in Dayton, and it’s also the best hospital in Dayton. Consumers have for 14 or 15 years voted Miami Valley the best hospital in the region, and the clinical data supports that. Miami Valley also has been one of the few double A rated hospitals by Moody’s in the state.
You’ve been a vocal proponent of a national healthcare system. What are your thoughts on the Affordable Care Act?
Obamacare, as some call it, was a result of political horse trading, so it was the best law that probably could've been produced, given all the political dynamics that were occurring. I think the concept is a great concept. The flaw is that it subsidizes too many high-end people and doesn't do enough to take care of the poor. If I were President Obama, I would probably lessen the subsidies for the middle class and give more subsidies to the poor. But that's kind of a picky point. I think the direction is right and it will be revised substantially in the next five to 15 years, but at least we’re on the journey to provide coverage for everybody in the country, which we've never had before.
Talk about the genesis of Miami Valley Hospital South.
When I did my administrative residency in my early twenties, there was a place called Bethesda Hospital in Cincinnati. It was an intercity hospital that had started a suburban hospital that was very successful. So 20 years later when I was up here, we could see the way the demographics were rotating out of the city with the growth of our suburbs. We thought we'd better at least have a footprint somewhere in our southern suburbs. Tim Jackson (former chief financial officer) and Tom Arquilla (former vice president of business development) found a good plot of land in Centerville.
The whole idea was to capture the suburban market and its commercial insurance paying patients, which, in turn, would support the downtown campus and its mission to serve everybody, regardless of their ability to pay.
Who were some of your mentors?
I think we’re all disciples of Fred Smith, who was chairman of the board here from 1978 to 1984. He was the former president of Huffy Corporation and he had this vision that Dayton was large enough to have all the urban ills that you could find anywhere in the country, including in Chicago or in New York, but we were small enough that people working together with goodwill could solve many social issues. He basically brought that philosophy to Miami Valley Hospital. Fred Weber was equally committed to the urban core and the chairmen and trustees who followed them also embraced this mission.
That team effort through the years produced what I like to call ‘a real gem’ — we’re one of the clinically highest quality hospitals in the state, we’re very successful financially and more care is provided to the disadvantaged at MVH than at any other hospital in the region. It is really quite phenomenal and I think Fred Smith and Fred Weber deserve most of the credit for that. [Mr. Smith died in 2010 at age 93.]
Looking ahead, what are some of the biggest challenges facing healthcare?
Healthcare is about 18 percent of our GNP, which is twice as much as it is in most other countries, and it’s going to continue to grow in the years ahead. Also, the number of people over the age of 65 is going to double in the next 20 years, placing tremendous demands on the system. So the biggest challenge will be delivering high quality care in a cost effective system and making sure everyone is covered. And Miami Valley, given its urban location, will be literally right in the middle of that challenge. But if we can do those things, it will be an enormous boost for the economy.
Can you think of an experience or moment in your time at Miami Valley that really reminded you of what Miami Valley is all about?
I don’t know if there’s one moment, but whenever I was buried with market share data or financials and business stuff, all I would have to do is leave my office and walk through the emergency room, where I would see people from all classes of life who came here in need. I wanted to make sure they were taken care of in a very courteous, efficient and high-quality way. That really was what kept me highly motivated. I wanted to be in touch with what we actually did here.
What do you tell a stranger who asks, ‘What’s so special about Miami Valley Hospital?’
Miami Valley Hospital is a special place because of the people here. Well before I arrived, there was a tradition of attracting blue-chip, first-class physicians, nurses and other employees, and I was able to be a part of that tradition. I think the only reason Miami Valley Hospital continues to be the region’s leader is because of the quality of the volunteers, employees and medical staff here.
We are one of the few major metropolitan areas in the United States that does not have a county hospital, but Miami Valley, in essence, steps up to the plate and becomes a blue-chip hospital for everyone, including the poor. I feel strongly that the poorest people in Dayton get as good, if not better, care than the richest people in New York. I think that’s quite a legacy, not for me, but for everyone who’s worked at Miami Valley.
Why is indigent care so important to you?
Tom talks about why indigent care is so important to him.
Click play to watch the video or read video transcript.
When I was in college, I delivered mail in Cincinnati in the poor neighborhoods and I was appalled at the living standards in those neighborhoods. I said to myself if I ever got into a position to help, I would want to use my influence to be sure these people were taken care of in housing or with transportation or education. It turns out it was in healthcare.
At Miami Valley, it wasn’t only important to me, it was important to everyone. We have an ethic going back well before my time that we’ll take care of everybody, regardless of their ability to pay. I was just lucky enough to be the leader of the institution during a fairly long period of time in which we fulfilled that role.
More on Tom Breitenbach:
Born in 1947, Cincinnati, Ohio
Education: University of Notre Dame; BBA, Magna cum Laude
Xavier University; MBA in Healthcare Administration
Northwestern University; Graduate School of Management, Professional Accounting Program
University of Chicago; PhD Program in Business Administration (did not complete degree)
Numerous accomplishments and community activities, including:
- CEO of one of only two AA rated hospital systems in Ohio
- President and CEO, MedAmerica Health Systems, MVH’s holding company
- Established $5 million of annual grant awards for community benefit programs
- Inaugurated community-wide cardiology quality improvement program that received national Codman Award from JCAHO in 2002
- Founding board member and chair of CareSource, Inc., a non-profit Medicaid managed care plan that by 2013 had grown to more than 900,000 members.
- Chair of Ohio Hospital Association
- Chair of Dayton Business Committee