New HCMC leader looks to improve systems, care and costs

Early in his career, Dr. Jon Pryor labored in the pit — a busy emergency room — at Hennepin County Medical Center. ¶ Now he's reached its peak as the new head of one of the nation's biggest safety-net hospitals. Its mission is to balance treating the poor, training physicians, decreasing costs, increasing revenue and providing cutting-edge care.

Thirty years after his time in emergency, Pryor said the "heart and soul" of HCMC remain the same. It's "still very committed to serving the underserved with a dedicated staff and faculty," he said. Of the other parts of its broad mission, he said: "If we do this right, the ability to access our system should improve, costs should go down and quality of care should go up."

Pryor, 56, took over as CEO of Hennepin Healthcare five months ago, becoming one of Minnesota's most influential and highest-paid public employees with a $700,000 annual salary. His tenure began at a time of tectonic shifts and uncertainty in health care.

He comes heavily qualified, with medical degrees, a career as a urologic surgeon, an MBA and clinic management experience, and a two-year consulting job with McKinsey & Co.

Pryor's fascination for systems is incessant. "When you go to Caribou or Starbucks, you can think about process improvement," he said. For amusement, he likes to dissect and analyze marketplace successes and struggles, such as asking why Southwest and JetBlue are doing well while Delta and United airlines struggle.

Among the changes already in place when Pryor came on was Hennepin Health, widely considered a nation-leading success in providing managed care for Medicaid patients. Its first year went well, allowing the county to create its own integrated system for ­providing social services with medical and behavioral health care.

Since his arrival, Pryor has ushered in change himself. In the past month, he oversaw a system redesign in the emergency department that he said already has decreased patient waiting times. The change puts arriving patients into two streams: one for more serious needs requiring more intensive treatment and the other for easily treated concerns.

About 50 percent of physicians in Minnesota have trained at the facility, which hasn't always had the shiny reputation of suburban hospitals. But HCMC has undergone a significant physical transformation in recent years, evident even in a casual tour. There's a new intensive-care unit, a new bariatric wing and a new pediatric intensive-care unit set to open next month. Birthing ward rooms have been expanded to give plenty of space to families.

HCMC board member Sharon Sayles Belton, the former Minneapolis mayor, cited other services, including a Level I trauma center, a top-notch burn unit, a statewide poison center and a 24/7 psychiatric emergency department. "We're the hub of a very good medical system," she said.

Both Pryor and Sayles Belton say the new CEO's success will hinge on his ability to draw a greater number of privately insured patients. As he said, "If they aren't banging on the door in five years," that would not bode well. Such patients are needed to increase and stabilize HCMC revenue.

Of the 150,000 patients who visit HCMC, about 46 percent are on Medicaid, the program that reimburses hospitals at the lowest rate and actually costs it money. At other Twin Cities hospitals, only about 10 percent of patients are on Medicaid, an HCMC spokesman said.

Another 26 percent of HCMC patients are on Medicare. Only 15 percent are ­privately insured. About 8 percent have no insurance.

Sayles Belton said changing the patient mix is imperative, along with reducing costs and reliance on county ­property taxpayers. "It's all about accountability," she said. "At the end of the day, these are not platitudes."

Pryor's history with HCMC began in 1983, when he started a two-year run as "pit boss" in HCMC's emergency department. He recalled how, when the snow stopped falling in the historic April 1983 storm, he helped treat a deluge of heart attack patients felled by ­shoveling.

Settling in, Pryor said he intends to spend a half day practicing medicine. The rest of his time will be spent working on his job's broader goals.

Sayles Belton, now a vice president at Thomson-Reuters, said that when the board was searching for a new CEO, it was "looking for somebody who could lead the hospital in a time of significant change."

Pryor "has that expertise. He has that experience."