In Detroit, Bob Riney knows staying power matters

In a time when healthcare disruption is often championed by newcomers, Detroit's 109-year-old Henry Ford Health offers a contrasting lesson: sometimes the most powerful transformations come from those within.

First, consider the city: Detroit. Home to 633,218, it stands as both warning and inspiration — a testament to the vulnerabilities of single-industry economies and the power of reinvention. "Led by Believers in the City's Future, Detroit Is on the Rebound," The New York Times recently reported, chronicling the city's remarkable economic recovery 11 years after its $18 billion bankruptcy.

Against this backdrop of urban renewal, Henry Ford Health is writing its own transformation story. The system, which admitted its first patients in 1915 as Ford Motor Co. celebrated its millionth Model T, has grown into a $12 billion enterprise. Its latest chapter, a joint venture with Ascension Michigan, reestablishes it as the Detroit area's largest health system by net patient revenue.

At the helm stands CEO Bob Riney, whose personal journey mirrors the system's evolution. Mr. Riney began working at the health system in 1978 as a college student, drawn to its business principles and complexity. He has since grown with the organization through three distinct chapters: from leading human relations as CHRO, to mastering operations as COO, and now guiding the entire system as president and CEO.

Combined, the city, the organization and the leader make a compelling case that the most powerful change agents need not be new entrants who loudly promise to shake up the status quo, but those who embrace history, lean into their culture and values, and try to emulate themselves most powerfully versus trying to mimic somebody else.

"Cities, no matter how thriving they are at any one time, go through life cycles," Mr. Riney says. "Having a long-term view and knowing that you can work through the ugly parts of cycles and rise again is something that's really important. It's true of leadership and it's true of organizations."

The system's recent joint venture with Ascension Michigan, part of St. Louis-based Ascension, demonstrates this philosophy in action. The partnership, effective Oct. 1, has expanded Henry Ford Health to include 550 care locations, 13 acute-care hospitals and three behavioral health facilities. Henry Ford Health posted $80.5 million in operating income on $7.8 billion in revenue in 2023, a 1% margin. The Ascension Michigan partnership elevates combined revenue to $12 billion, with Henry Ford Health holding an 80% stake and welcoming 17,000 new employees to its now 50,000-strong workforce.

One number particularly resonates with Mr. Riney: more than 99% of Ascension Michigan employees who were included in the joint venture chose to join Henry Ford Health during the transition.

"We cannot provide incredible care to our communities if our internal talent doesn't feel genuinely welcomed, genuinely supported and genuinely engaged with us as an employer," Mr. Riney said. "I think everything stems from that. And I'm still stunned by that statistic because there's always people that will listen to a pitch from a competitor during a time of change. It told me that people really believe in what we're doing."

As Henry Ford Health reshapes through the joint venture, it simultaneously launched its most ambitious growth initiative: it kicked off its largest-ever fundraising campaign this fall, aiming to raise $750 million by 2028. These funds will help support a historic $2.2 billion campus expansion — the single largest healthcare investment in Detroit's — and the system's — history.

The development includes a new hospital facility and patient tower of more than 1 million square feet, an emergency department more than double in size of the current ER with 100 private, flexible treatment spaces and a mental health wing, 28 new ORs outfitted for the most complex of surgeries and five floors of specialized ICU rooms, including cardiovascular and neurological.

Such concurrent, large-scale initiatives reflect the strength of Henry Ford Health's leadership team, which Mr. Riney describes as a strategic blend of veteran insiders and fresh perspectives from other industries.

"I believe that healthy teams start at the top of an organization," he says. "And if you have an executive team that is aligned and welcoming of very diverse views, knowing that it ultimately leads you to the best decision, then that permeates the entire organization."

Such momentum for a legacy health system is also a signal of leadership tolerant of ambiguity and skilled in recognizing opportunity — two sets of muscles that Mr. Riney is bullish on. With 45 years at Henry Ford Health, Mr. Riney maintains an active presence among national healthcare leaders to challenge his insider's perspective. The industry's complexity, which drives some away, has always drawn him in.

"I was always drawn to complex situations," Mr. Riney said. "They don't intimidate me, they actually kind of interest me. So while people run away from gray matter and look for black and white, I'm really comfortable in gray and like navigating through that kind of problem-solving."

And when a window of opportunity is open, Mr. Riney says, leaders must make a decision. "Are you going to hook arms and walk through it and do several really big things at once or not?"

Moving forward, Mr. Riney says it'll be worthwhile to keep an eye on the "development of usual and unusual partners" at the system. He sees relationships with traditional partners like Michigan State University are moving in innovative directions, such as leveraging MSU's agricultural expertise to address the food deserts affecting Henry Ford Health patients. The system partners with specialty leaders like Shirley Ryan AbilityLab, acknowledging the value of external expertise. Perhaps most uniquely, its collaboration with the Detroit Pistons — "probably the most fully integrated partnership with a professional sports team in the country," Mr. Riney notes — is creating hundreds of mixed-income housing units and developing walkable, bikeable spaces around the new campus.

Together, Detroit, Henry Ford Health and Mr. Riney share a story that challenges healthcare's fixation with outside disruption. They show how transformative change can come from those who know their community and organization best and lean into their authentic strengths.

For Mr. Riney, a healthcare organization's identity is inseparable from its community. "Henry Ford has always had exceptional clinical care, especially in complex quaternary care," he says. "But because the city was undergoing so many challenges, the national perception was, 'Oh yeah, they're doing great things, but that's Detroit.'"

Through partnerships with other Detroit organizations, Henry Ford Health and the city have revealed what they've always known. "We've got amazing healthcare workers here, incredible physician talent, and diverse populations that drive us to find innovative solutions," Mr. Riney says. The renewed national intrigue in Detroit has only strengthened its collective spirit of evolution.

"There's some people that talk about 'the comeback,'" Mr. Riney says of Detroit. "And to that, some people say: 'We never left.'"