TMC’s new Chief Strategic Officer: happy to “be home”

ResslerFor TMC’s new Vice President, Chief Strategic Officer Dave Ressler, it’s great to be home.

Ressler returned to TMC earlier this year following a thirteen year stint as CEO – four years at Sierra Vista Regional Health Center, and nine years at Aspen Valley Hospital in Colorado.  He worked at TMC in 1999 as Vice President, Business Development, and spent time as a Marketing Coordinator for TMCare Health Network and as an Account Executive and Marketing Manager for TMC’s owned HMO, Partners Health Plan, starting in 1986.

As you can imagine, a lot has changed since then.  Ressler says one of the biggest differences is how LEAN the organization has become.  At TMC, he sees a hospital that is capable of delivering high quality healthcare while managing the costs of that care.  “At the same time, I see the organization positioned with an ACO and a motivated medical staff ready to work together to provide the full continuum of services needed to manage and improve the health of the population through a coordinated effort. This is all in line with TMC’s role as the only independent community hospital in Tucson.”

As TMC’s Chief Strategic Officer, Ressler is responsible for assisting TMC President and CEO, Judy Rich, with creating, communicating, and implementing strategic initiatives, as well as sustaining them.  Ressler will use data to support the development of innovative programs or services.  He’ll also help identify emerging trends and recommend new initiatives that will help TMC grow.

His role is especially important considering how healthcare is changing, and the financial difficulties of the Southern Arizona market.  “An organization can’t continue to operate as it always has with the same recipe that may have proven successful in the past,” he explained.  “I will be involved in helping the organization to develop new competencies and, most importantly, further its alignment with our physicians to insure the mutual success of both.” As part of his responsibilities, Ressler will work closely with Arizona Connected Care, the ACO in which TMC is a member, the Medical Services Organization, Innovative Practices, and TMC’s wholly owned physician practice, Saguaro Physician Group. “Our long term success and ability to perform and meet the community’s healthcare needs is predicated upon our community partnerships and our relationships with our physicians and other providers, and I look to working collaboratively to advance our efforts”, Ressler commented.

That’s exactly what he did most recently at Aspen Valley Hospital, where Ressler is credited with turning around a hospital that was facing significant financial difficulties, and helping it flourish on all fronts.  After establishing such success in Colorado, why come back to Tucson?

“I wanted to return to the first hospital I ever worked in, and become involve in an organization that I believe is forward leaning.  I wanted to help it continue to be successful in the future,” he said.  Ressler believes we are currently in the middle of defining opportunities that will shape TMC in years to come.  “I’m excited to be working with the administration and the board to define specifics about how TMC is going to position itself to take advantage of – not  just respond to – the sweeping change that is occurring.”

Another big influencer in his decision to come back to Tucson – it’s where he considers home.  “My parents are here and I love the desert.  I find that Tucson is uniquely large enough to offer all of the cultural events that you’re looking for and yet still be a small town.”

Adjusting to the culture of wellness that is developing at TMC will be an easy task for Ressler, who loves to run, cycle, hike, camp and do anything outdoors with his family.

Tim Hartin settles in as TMC’s new Chief Legal Officer

Tim Hartin TMC Chief Legal Officer

Tim Hartin
TMC Chief Legal Officer

It took Tim Hartin 25 years to find what he calls the perfect job, but he’s confident he’s finally discovered it as TMC’s new Senior Vice President and Chief Legal Officer.  “This environment is a good fit for what I like to do and what I want to do.  I love the fact that TMC is a non-profit hospital that serves as a true resource for the community.  I like being right here in the hospital and having everything under practically one roof,” he said. 

Hartin brings a wealth of experience that he will rely on to solve problems at TMC.  The Harvard Law School graduate spent time practicing business and health care law in Virginia and Wisconsin before moving to Texas.  He served as Assistant General Counsel at Baylor Health Care System in Dallas, and most recently served as General Counsel for Shannon Medical Center in San Angelo. 

Early in his career, he figured out that he prefers working in a stand-alone hospital rather than dealing with corporate law.  “So much of what I do is different than what most lawyers spend their day doing.  My job is based on organizational culture and relationships.  I’m sitting here with my clients, so there’s going to be a different kind of relationship than you’ll find anywhere else,” he explained.  And that relationship, he said – whether it’s with patients or physicians – is best fostered by starting with an offer to help rather than instantly making demands.  “There’s no shortage of ways to help around a hospital.”

Tracy Nuckolls Former TMC Chief Legal Officer

Tracy Nuckolls
Former TMC Chief Legal Officer

Hartin replaces Tracy Nuckolls who retired in April after 35 years of service to TMC.  “I’m envious of Tracy because I’ve wanted every job I’ve had to be the last job I ever had.  I think I’m finally here – at the last job I’ll ever have.  Tracy found that early on and I envy him.  What a wonderful thing.  It’s something I always wanted for myself.” 

How’s it been stepping into a role that was held by someone who was so successful, for so long?  “The great thing about being Tracy’s successor is that everything is running really well already.  I didn’t have to rush in and do anything different.  Sure, I’ll make some changes, but Tracy left me a well-oiled machine, and my time here so far has been an absolute pleasure.”  Hartin realizes those changes won’t happen overnight though.  “TMC is a big, complicated organization that is open 24/7, so we can’t make sudden changes because we always have a house full of patients.  It takes time for things to evolve.”

The best part about his position?  There’s always something different coming across his desk.  “You never know what it’s going to be when the phone rings, and I love that – it’s a lot of fun.”  He is especially passionate about tackling patient-driven issues and piecing the facts together to ensure the best decision is reached.  “There are the patients, the medical staff, and the business all mixed together.  It’s my job to make sure everyone gets taken care of.”

The future of health care in Southern Arizona is, as he described it, an enormous mystery.  “Right now, health care is in the process of being reengineered from every direction including, unfortunately, Washington.   The challenge for TMC is to make their best guess about what health care is going to look like, and place their bet on how they’re going to be a part of that.  TMC has put its bet on the Accountable Care Organization, or ACO.  I think for this market, it’s a pretty good bet to make.  We’re off to a running start in this market since we have such a big profile, and I think that will only help us down the road.”

Report to Our Community event highlights TMC’s new Orthopaedic and Surgical Tower

report5Tucson Medical Center hosted this year’s Report to Our Community event, which provides an overview of the annual report to community leaders, public officials and the media, detailing the many community benefit programs TMC has spearheaded in the prior year.

This year’s event was special, as it was held in the lobby of the soon to be open, Tucson Medical Center Orthopaedic and Surgical Tower.

It was only appropriate to host the release of the Report to Our Community in the tower, as the tower is part of a strategic investment in the future of TMC and its ability to continue providing quality health care to the community.

Community tours of the four story building kicked off the event providing a first look at the new medical offices, clinics, private patient rooms and state-of-the-art surgical suites.

The tower is on schedule to open May 6 and will be the only orthopaedic and surgical facility of its kind in Southern Arizona.

“This building really speaks for itself, demonstrating the solid foundation and stability of Tucson Medical Center,” said TMC Board of Trustee Chairwoman, Louise Francesconi.

Francesconi joined TMC President and CEO Judy Rich during the Report to Our Community to discuss how TMC has strategically positioned itself to service the health care needs of the community for years to come.

“Charity care is part of what we do as a community hospital. We take care of everyone who comes to us for care,” said Rich.

In 2012, TMC recorded $48 million of community benefit costs, of which a large portion is charity care. On a net operating revenue of $448 million, TMC’s community benefit was 10.8%, well over the 5% average expected to maintain non-profit status.

And the majority of this uncompensated care, which refers to charity care and bad debt, is a result of the thousands of people who were dropped from AHCCCS in 2011.

“Medicaid restoration, for us is critical. So we’re going to be watching closely to see what happens with that,” explained Rich.

TMC’s stable leadership has been able to withstand the challenges of current legislation changes and tough economic environment, while establishing a framework to ensure the vitality of the hospital.

Over the last 5 years, TMC has invested $200 million dollars building the Orthopaedic and Surgical Tower, renovating hospital units, and adopting Electronic Medical Records (EMR) as standard practice, to name a few.

“We know that our roots grow very deep into this community and every decision we make is made on behalf of being here in the future. We’re very well positioned with the technology we need, resources we need, and the facilities we need,” said Rich.

Francesconi added that the investment TMC is making extends across a broad spectrum that begins and continues through TMC’s employees and the health benefits that are necessary for the hospital to provide to the community.

Becoming an Accountable Care Organization and establishing Arizona Connected Care is one of the major ways in which TMC can improve care management, developing special measures to discharge patients with all of the information they need keeping hospital readmission rates low.

“It’s extremely important to us, as a hospital, that we keep people out of here and at home and healthy,” said Rich.

TMC has also taken notice and became involved in the Canyon Ranch Institute’s Life Enrichment Program. This program was originally developed to help people who don’t have the financial resources to go the Canyon Ranch Institute and be immersed in a curriculum promoting healthy lifestyle choices.

“We’ve training 11 of our own TMC staff to become mentors and coaches in this program, and selected our first group of patients in the community – patients who would not have otherwise had the opportunity to experience such a program,” said Rich.

She went on to share an expression she’s coined, ‘nothing to me without me.’

“This means that we are here to serve people who have something to say about how we do that. We recognize that as a patient you have something to say about how we take care of you, what your needs are, and what the most important thing to you is. Our patients have a lot to add in how we provide care.”

The Patient Family Advisory Council is in place to support the very thing that Judy’s phrase addresses. This committee gathers information from families of patients and TMC professionals, and provides solutions so that the hospital cares for patients in a different more focused way.

The event wound down with a few questions from attendees and announcements that select tours of the orthopeadic tower and surgical tower would be offered immediately after the talk.

Francesconi and Rich offered a few closing remarks.

“The leadership and Board are confident in the partnerships and programs that TMC is engaging in, and that they truly are in the best interest of our patients and the people in our community,” said Rich.

Making a difference: helping the whole patient through transitional care

When 86-year-old Mary McGillivray had a health scare last summer and was rushed to TMC’s Emergency Department, it wasn’t what happened in the hospital that brought her the greatest sense of relief.  It was the care she experienced – when she was home.

Mrs. McGillivray was admitted with severe abdominal pain.  After an assortment of tests, doctors determined she needed her gallbladder removed.  She underwent an operation, and anticipated going home shortly – until her heart developed atrial fibrillation.  A week later, her heart finally converted to a normal rhythm.  She received a thumbs up to head home, but had to be on oxygen – which was a whole new world for her and her husband, Edward.

“We had a lot of questions about the oxygen, and using the tank correctly.  We managed to make it through that first night, but I was a mess – and then Karen showed up,” said Mrs. McGillivray.  Karen Popp, RN, is a Transition Nurse & Care Advocate for Arizona Connected Care (AzCC), an LLC owned by primary care physicians, specialists and TMC that is Southern Arizona’s first Accountable Care Organization, or ACO.

An ACO is a network of physicians, hospitals and other health care providers who share the responsibility of caring for patients in a coordinated manner.  Mrs. McGillivray’s primary care physician, Dr. Mark Zaetta at New Pueblo Medicine, is one of the approximately 200 doctors currently in the ACO, which qualified her for the Transition Intervention Program, this specialized post-hospital care.

While at the McGillivray residence, Popp answered an assortment of questions about oxygen.  “When dealing with oxygen for the first time, there is a lot to learn.  When you compound that with being discharged from the hospital, new medications and new instructions, it’s hard for a patient to retain the education that’s been given to them at discharge.  Then, when they are ready to retain it, there’s nobody there to teach them,” she said.

That’s exactly what this program aims to do: empower these patients with education, and help them stay out of the hospital.

For Mrs. McGillivray, the knowledge she received was priceless.  “Karen told us how to do everything, showed us, and then made sure we knew how to do it.  I was so grateful to have her and her expertise.  I felt like ‘somebody knows what they’re doing, and they’re taking care of me.’  It was just marvelous,” she raved.  “Edward felt more confident taking care of me.  The visits were a lifesaver for both of us.  Without Karen, I don’t know how I would have survived,” she said.

Months later, Popp continued to follow-up.

“It was really nice to know that she cared.  With Karen, I felt like I had a partner throughout my entire recovery process.  It gives my children peace of mind that I’m being well taken care of.  And it gives me peace of mind to know that if I do have to be hospitalized in the future, I’ll get this same standard of care,” Mrs. McGillivray said.

AzCC2 002

Arizona Connected Care’s Office of Care Coordination:
Amber Jones, BSN, RN – Transition Nurse;
Karen Popp BSN, RN- Care Advocate/ Transition Nurse;
Tina Wren, MA- Care Coordinator

Through the Transition Intervention Program, patients are prioritized based on their risk of being readmitted.  “The home visit follow-up care is offered to the highest risk patients first.  If other patients ask for it, they get it.  If we are talking to a patient who is at a moderate risk for re-hospitalization during a post-hospital follow-up call, and we get the feeling that they could benefit from a home visit, we offer it to them,” said Popp.  Home visits are usually an hour or more.

“The program helps patients realize they’re more than just a number.  We’re helping them pick up where the hospital left off.  When they’re in the hospital, people are doing amazing things for them.  When they’re home, they don’t always have that safety net.  Our job is to support them even though they’re not within the hospital walls anymore,” said Popp.

UnitedHealthcare patients in southern Arizona to benefit from improved care coordination and enhanced health services through AzCC

People enrolled in UnitedHealthcare employer-sponsored benefit plans now have access to Arizona Connected Care (AzCC), a physician-led, patient-centric accountable care organization (ACO) that manages all aspects of patient health care, ensuring that the proper course of treatment and preventive health measures are being followed. The AzCC ACO combines advanced analytics to measure and improve quality outcomes for patients with innovative, value-based performance incentives.

During the past year, AzCC has been providing its prevention- and wellness-focused health care to seniors enrolled in UnitedHealthcare’s Medicare Advantage plans. This new, expanded collaboration will give more than 180,000 people enrolled in UnitedHealthcare’s employer-sponsored health benefit plans throughout southern Arizona the opportunity to benefit from access to quality care from approximately 200 AzCC care providers and health professionals through this distinctive care model.

AzCC, composed of primary care physicians, specialists, Tucson Medical Center, and other health care providers, in 2012 became the first ACO qualified by the Centers for Medicare and Medicaid Services (CMS) in southern Arizona. Since then AzCC has provided care to thousands of patients while practicing the Institute for Healthcare Improvement’s (IHI’s) “Triple Aim” objective: increase patient satisfaction, improve the health of the population and reduce the cost of health care.

“We are delighted to expand our partnership with UnitedHealthcare so that thousands of additional UnitedHealthcare patients in Southern Arizona can receive the distinctive care that an ACO can provide,” said John Friend, executive director, Arizona Connected Care. “We believe this program will clearly demonstrate that proactive care focused on wellness and chronic disease management actually reduces health care costs.”

UnitedHealthcare plan participants who use an AzCC care provider do not have to do anything differently in order to receive the benefits of the ACO. Participating primary care physicians will receive monthly updates on their patients, enabling them to monitor all of the care each patient is receiving and access the patient’s care in one record.

For example, if a patient is being treated for heart disease, all the tests, screenings and medications the patient is receiving will be collected into one record to ensure that the appropriate course of care is occurring, the care is coordinated, and the patient is receiving any and all necessary services. This model will help manage services for patients with chronic conditions, such as diabetes and heart disease, while keeping the focus on health and well-being, increased patient safety and care delivery well supported by science.

“Arizona Connected Care is an important provider of health care services in southern Arizona, and we are pleased that more of our health plan customers now have access to AzCC’s innovative ACO care model that improves quality, streamlines care and reduces costs,” said Jeri Jones, CEO, UnitedHealthcare Employer & Individual of Arizona.

UnitedHealthcare is working with physician groups, hospitals and medical centers, and other health care delivery organizations across the country to achieve IHI’s “Triple Aim” objective. UnitedHealthcare’s value-based payment capabilities are designed to support this transformation of care delivery. Today, more than $20 billion of UnitedHealthcare’s annual physician and hospital reimbursements is tied to accountable care programs, centers of excellence and performance-based programs.

Participating AzCC physicians are already using advanced tools and software applications from UnitedHealth Group’s Optum business, a partnership announced in 2011. These capabilities provide health information on patients, enabling their care providers to more easily collaborate with each other on health care decisions. This information will also help AzCC care providers better understand and identify best practices for overall patient wellness and disease management, leading to meaningful health improvements over time.

To read more on this topic, check out the recent article in the Arizona Daily Star.


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461