As president and CEO of Boston's Tufts Medical Center and Floating Hospital for Children for more than seven years, Ellen Zane has helped reverse financial losses and develop the hospital into a thriving and successful organization.Ms. Zane has led several initiatives that have strengthened the Tufts MC's relationship with the community and community hospitals, including a community physician network, the Distributed Academic Medical Center model, the New England Quality Care Alliance and the Asian Access program. She has expanded the center's research programs by creating closer ties with Tufts University School of Medicine and has helped Floating Hospital for Children regain its financial and organizational strength.
She plans to retire in September, at which point she will continue to serve the center as a consultant and vice chairman of the Board of Trustees.
Q: What is your proudest accomplishment at Tufts Medical Center and why?
Ellen Zane: I'm extremely proud of the team I built here — my senior leadership team has been pivotal in taking a hospital that was in severe financial distress, stabilizing it and making it grow dramatically. In addition to that, I would have to say that establishing our Distributed Academic Medical Center model is my proudest strategic accomplishment. In this model, we send our academic physicians to our affiliated community hospitals in order to help provide care in the local community, and bring only the truly high end/tertiary cases back here to Tufts Medical Center. This model has enabled us to grow our volume significantly, it has enabled our affiliates to stop the "leakage" of care out of their own markets to the Boston hospitals and it has helped them grow their volume as well. It has also helped save money for the health system overall and helped more patients get their care closer to home. Our Distributed Academic Medical Center model is a true win/win.
Q: What was your biggest challenge as CEO of Tufts Medical Center? How did you overcome this challenge?
EZ: Possibly our biggest challenge has been our well-below average payment rates from health insurers. It has challenged our balance sheet which challenges every aspect of our operations. For starters, about 21 percent of our patient population is on Medicaid. That percentage falls just short of making us a "disproportionate share hospital," which would make us eligible for additional payments, but is about three times as much as most of our academic medical center competitors. On top of that, we are one of the most poorly paid academic medical centers in the state by the private payers. The state Attorney General's office released a report last year that proved and highlighted this. It is a myth that private insurers are overpaying because they have to make up for the shortfalls of public payers — the hospitals in our market that receive the highest private rates generally do not have the highest Medicaid populations. This continues to be a challenging situation for us, but we have been forced to take a very strong position with the insurance companies to receive fairer rates. I always say that we don't want the top rates in our market, I just need to be at the average of our competitors. We value being a "value provider."
Q: How were you able to so drastically improve the medical center's finances?
EZ: We had to do a lot of blocking and tackling. Even before we started establishing our Distributed Academic Medical Center, we realized the first thing we needed to do was create a community referral network. In 2005, we established the New England Quality Care Alliance, which encompasses the physicians who work here at the Medical Center as well as community physicians. When we started we had no community physicians affiliated with us; now we have nearly 1,000. All along we have encouraged these physicians to continue referring to their community hospitals for routine, community-based care — but we have worked to earn their tertiary referrals. NEQCA, combined with the relationships with our community hospital affiliates, have really made the difference for us.
Q: What is the most important lesson you learned as leader of Tufts Medical Center?
EZ: I have learned many things, among them: I am only as good as the people around me. No single leader can "turn around" an institution as large as an academic medical center. It takes everyone within the organization understanding the truth about the depths of the issues and what it will take for the institution to rebound. The style of communication is key. A leader's communications need to be clear, concise, credible and frequent. Being a good listener is also part of being a good communicator.
Q: You were the first female CEO in the hospital's 215 years. What advice do you have for women who are or hope to become hospital leaders?
EZ: Like many women in health care, I started out as a direct caregiver – I trained as an audiologist and speech-language pathologist. But I found that I enjoyed the challenge of management and administration and so I moved in that direction. I always say "big jobs come in only one size." Take management opportunities (that usually involves taking professional, career risks) that become available to you, and if they're not available in your current workplace, go somewhere else. Each step is going to help prepare you for the next one. Remember, if big jobs were easy anyone could do them. Taking risks differentiates you from those who are scared by risk. Mentors in my life have been invaluable, but my mentors weren't necessarily women; in fact, the most influential people in my early career were men. Find leaders you respect and learn from them.
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