Renee DeSilva  00:00

Welcome back to The Table. I’m Renee DeSilva, CEO of The Health Management Academy and your host. This week, I’m excited to have Tina Freese Decker join us at The Table. Tina is the president and CEO of Cornwell Health, the new name for the now combined Spectrum Health and Beaumont Health. For context, Cornwell is the largest health system in Michigan, with 60,000 team members, 22 hospitals, 300 outpatient locations, and 1.2 million lives covered under its health plan. Here are a few of my takeaways from the conversation. First, Tina is a strong believer in the power of systemness. And I loved her definition, which is to have shared system wide goals, but valuing the local environments to realize them. Nearly 18 months after the integration, Tina walks us through how this is taking shape across core well. Next, it was great to unpack some of core wells health equity work, which has been a successful application of their systemness efforts, led by Dr. Lynn Todman. And Charles Kubja Cornwell has engaged local communities worked hard to build trust, and is seeing real progress in critical areas like infant mortality and youth suicide prevention. And finally, I really enjoy Tina’s reflections on her leadership philosophy, including how it’s evolved over any eventful last few years. Listen for her take on why over communicating and maybe more importantly, over listening should really go hand in hand. So with that, join us at The Table. Hi, Tina, welcome to The Table.

 

Tina Freese Decker 01:30

Thank you so much. So glad to be here.

 

Renee DeSilva  01:32

I’ve been looking forward to this, this conversation. But before we dive in, I’d love to just start with your background, I know that you were studied Industrial Engineering, and finance. And now you’re leading a large health system. So talk about your career path and how you landed where you are today.

 

Tina Freese Decker 01:51

Well, I love my career path. Because it’s been an purposeful, yet I’ve been able to explore a lot of things that have helped me evolve as a leader, and as a person where I want to go. So I have always wanted to help people get healthier, and make it easy, easier for people to provide that health care. And that’s why I chose to go into health administration. And it’s also why I chose to do a master’s in industrial engineering, because I just wanted to make it easier and simpler for people to get what they needed and to provide what they were needed. So I love the fact that when I went to the University of Iowa to get those two masters degrees, I had a great connection with alumni and was was connected into Michigan for a fellowship, and the opportunities to work in what was then a Spectrum Health now core wall health have been immense from rural health care to urban health care from health plan, and, and then care delivery, I got to see so many things during that fellowship, as well as then the jobs. So we went from that that had just been really beneficial. And I’ve loved the fact that I’ve been able to be engaged in starting a metal crew, or bringing a medical school to the city that I live in. All of those things just helped make me a better leader and a better person to go through those experiences. And it’s been wonderful to work with just phenomenal leaders and physicians and caregivers within Michigan to really care for the communities that we serve.

 

Renee DeSilva  03:31

And Tina with the with your a little bit of a rearview mirror lens, do you feel like you set out on a path to be a CEO? Or do you think that sort of happened organically meaning you are sort of you were your opportunities presented itself and the path unfolded or how much of that was something that you maybe were looking to achieve?

 

Tina Freese Decker 03:55

If I can remember correctly, I’m confident that I had to write an essay when I came in to the Master of Health Administration of what my career goals were, and I’m sure that I wrote I wanted to be a healthcare system CEO. But I have a firm belief in your in your career progress, that it’s never about the position or the title, it is about the impact that you can have. And it’s about the learning that you can do in each of those roles. So well that’s been my career goal. To achieve that, I also felt it was really important to get the experiences and the lessons to learn as I advanced through my career. So I love the fact that I started first and strategic planning and got to do so many different things from a strategic development, business development. And then a number of areas that just attached to that. I love the fact that I was in operations in a more rural environment and got See how you connect with a board with a philanthropy with medical staff relations, recruiting physicians to a community developing capital campaigns. And so all of the positions that I’ve had all the opportunities have just made me a more robust person and leader. And I think that’s what’s most important is that you continue to grow and learn as you advance to where you want to be. When I think about my current right now, when I think about my current job right now, as the CEO for core will help, it’s this immense responsibility to one take care of the people that work with us every single day, we have 60,000 people. And so I consider that how do we give them the growth opportunities, the learning opportunities, so that they can do their job well, every single day? How do I help our community get healthier? So what are the new programs and services that we can offer? How do we connect with them to engage in trust and help them along their health journey? And then how do we shape healthcare for the future so that it is even better for my kids, and eventually, my grandkids as we go forward? So I think about this immense opportunity that we have, and I am just thrilled to be able to be a leader in healthcare at this time.

 

Renee DeSilva  06:22

I love that it’s a mix of, you know, purposeful, having an intention, and then meeting the needs of the organization in the community as you go, which is a perfect sort of way in which I think your impact will unfold. So I’d love that. Let’s dive more into Corbell. Health. So you’re I think about a little bit over the one year anniversary of Spectrum Health and Beaumont Health coming together, and then rebranding as core? Well, maybe we should start with the original impetus for the integration. Talk to us a little bit around how you saw those component parts coming together for greater impact and breadth and depth in terms of serving the people of Michigan.

 

Tina Freese Decker 07:03

You know, we asked ourselves every day, how can we be better so people can have better health. And this is the impetus of the integration and all the work we are doing to create a better health system to serve our communities. One of the distinguishing and exciting features that I love about our integration is that it creates a true system serving unique areas, from urban to suburban to rural, we have children’s health and post acute Physician Clinics, and we have health insurance party health, that has 1.3 million members. With this integrated model, we can test different ways of providing health care, and prove out which ones will truly transform healthcare for the better. And then we can start implementing that across the system. So that’s what gets me excited is that we are challenging the status quo, and innovating and trying new things to actually get to help people be better than to have better health.

 

Renee DeSilva  07:58

And when you think about I love that these objectives around, you know, serving the needs of both urban and suburban communities figuring out an integrated view through managing the the the lives with the health plan. When you think about if you were to look back with the benefit of some time, maybe five years from now, what markers have you set for your team members, your board your community on what success would be looking like at that point?

 

Tina Freese Decker 08:26

Well, it’s my desire to write a paper about our learnings and hopeful success as we go forward. I think there’s the elements that I would measure our success and our in our vision statement. We want to make health more simple, affordable, equitable and exceptional. And so I’m looking at those four areas to see how do we track our progress to achieve that. And there’s a number of ways that we can do it. We’re making progress and many of these but but a lot of it when you’re truly changing how care is delivered and how we think about it, it’s going to take time to accomplish the goals. And so your point about five years is probably realistic. And it may be even longer as we really tried to drive better and greater health for our communities. But there’s some good, there’s some good progress. One of the progress that I’m seeing is our advanced primary care clinics. You know, we are refocusing and on health, wellness Prevention and Behavioral Health at every step of the way in a person’s life. And it’s part of our vision part of trying to get to do more affordable and more exceptional as we move forward. So we’ve opened three clinics now, and we’re serving people who are 65 Plus in their journey toward health and wellness. And for our first clinic that’s been open I think about a year it’s reduced the emergency to emergency department utilization and increased patient satisfaction. So that’s a key part of affordability and the exceptional experience. And so this is just one of Those examples that if it works, and these pilot ways, we want to then spread it throughout the entire system.

 

Renee DeSilva  10:07

I love that. So let’s, let’s talk about that the value of systemness. And I know that you you have some strong views on why that’s important. Maybe just for the listeners, could you give your definition of how you define systemness?

 

Tina Freese Decker 10:25

Yeah, that when I think about systemness, it is working together to solve a common goal, common problem and move forward, it means that we’re better together than separate. And it’s this idea of one may not always be one way. But it’s focused that you’re going to try to achieve your vision of simple, affordable, equitable and exceptional and be able to let go of the things that we’ve always been doing before and finding that better way to serve the population, the people that that we serve every single day. And so that’s what I think system is. Yeah, system is, is hard to do. Yeah. Because it’s, you have to make decisions, that are tough decisions, you have to recognize that there is value in the local environment and local culture that you have to embrace and allow that to flourish. At the same time, you want to make sure you are efficient and effective with having the standard approach, because that’s what people are looking for is they’re looking for consistency in your brand, and what you’re offering. And so it’s this delicate balance of both and both are important. But the emphasis is how do we get better health for the people that we’re serving?

 

Renee DeSilva  11:47

I think you said it perfectly. It’s one of those things where it says easy, right? Like one system, one focus one experience, but does hard in terms of all the different ways in which you have to tackle that. So I applaud the efforts around that. And I think I think your sentiment around systemness and local flavor, if you will, are not necessarily mutually exclusive. And so I love that, that blending up sort of two, two ideals there. I think that’s fantastic. So I wanted to go a little bit more into one of the things that we at the Health Management Academy have been impressed with in terms of as our team has gotten to know yours, which is around your approach around diversity, equity and inclusion. And so I think it’s been under the leadership of Dr. Lin Todman, you all have done a lot around a different kind of way of thinking about what does it means to create both institutional trust and neighborhood level trust to get to that promise around greater health and health equity. So maybe just bring to life a bit more about how you all approach that

 

Tina Freese Decker 12:56

everyone should get the health care that they need to achieve their fullest health potential, period. And unfortunately, this doesn’t always occur. And there’s a number of reasons why. But that’s our our big focus right now is to make sure that this is addressed and that people can get to their fullest health potential. So Dr. Lin Todman, and Carlos que vea are leading our health equity and Equity, Diversity and Inclusion areas. And they’ve been putting so much information and resource resources in to really understanding the data and to engaging with our communities. Because as you mentioned, trust is critical. We found that out in the pandemic, clearly, when we needed to collaborate with many community organizations, many community partners, and people to help with the vaccine acceptance strategy. And so I think it will take time. And it’s important that we show up in the community, with people that are from the community to engage in conversations about overall health. We also have to be okay with listening. I think listening is, is an area where we might not do it so well right now as a society. And it takes time to listen. And it takes time to develop that trust. But it is critical as we move forward. We have to hear those voices that are sometimes on heard, so that we can be more innovative and more connected and more trusting. And I also think when we do that, we find out some amazing opportunities and ideas that are out there that we just had no idea about. So our work for health equity and inclusion and diversity and belonging is about engaging with many people are taking the time we are being honest about it self aware. We’re approaching it with curiosity and vulnerability in everything that we’re doing. I mean, from the community level, from the individual level and from the overall society level?

 

Renee DeSilva  15:07

I think it’s pretty powerful. What what, what jumped out at me in terms of maybe what feels unique? And maybe ahead of the curve around how you all approached it was this sort of bi directional measurement, like just like we would measure quality metrics or things like that, like, what does trust actually look like when it’s present within the community and with an institution and then really anchoring around? How do you design an equity strategy that’s sensitive to all of those those elements? And so just, it’s been impressive to watch from afar how you all have tried to add some structure to what can feel like a soft, nebulous thing, like we need more trust, yes, but what does that actually look like? And then how do you do that at scale, I thought that was pretty creative work from your team there.

 

Tina Freese Decker 15:47

Thank you, you there’s two more examples that I can share with you about developing trust. You know, one example is our work with infant mortality. And it’s called strong beginnings. It’s a community collaborative, within Kent County area, and in 2003, Kent County had the highest black infant mortality in Michigan. And it was just huge. It’s unacceptable. So we got together as a community, and we formed the strong beginnings collaborative. And today we’re seeing the results the program is working. We’ve limited the disparity and infant mortality for those enrolled in the program. And two of the key areas that helped us do that as we listened to the participants and what was going on. And we create a strong father’s program to connect family life. And then we also created a mental health program. And so with both of these, plus the traditional way of looking at infant mortality, we were able to eliminate that disparity. And what I love about it is that we are seeing many more babies of every color live to their first birthday and beyond because of this work. And that takes a lot of trust, getting in working together, coming up with new solutions together to move forward to help people be healthier. The other one I want to mention, is a tie to mental health. It’s our school based Blue Envelope program that’s focused on suicide prevention. And again, this is community engagement, it is going into the schools and into physician practices to train people about what to do if someone has a suicide is leaning towards suicide. And we’ve trained in that first year when we did it in 2019. We trained about 250 people. And they activated the protocol, the safe protocol that we have 82 times in that first year. And so now we’ve expanded to 126 school halls, we’re in 38 districts and 10 counties. And we’ve trained more than 8000 staff members who have impacted about 60,000 students. So again, it’s this development of a community engagement and trust, and how do we educate and talk and work with others to solve a common societal issue that we significantly need to address right now?

 

Renee DeSilva  18:10

I love that. Well, kudos to all the work that you’re doing there. It’s been impressive to watch for sure. Well, let’s let’s pivot a bit and get more into culture and leadership more broadly. So we actually met in 2018, when it was, I think, your first year as CEO at what was then spectrum and mine at the Health Management Academy. So I’m wondering if you can share a little bit around how have you evolved as a leader over that timeframe, especially given all that’s needed to be managed to the pandemic during that during that that piece? So talk a little bit around how you’ve evolved over that time horizon?

 

Tina Freese Decker 18:49

Yeah. Well, it’s one thing to evolve over five years now. So to go through the pandemic, yes. And an integration? That’s right. Yes. You know, both of those give you a lot of leadership lessons. When I look back five years, I, the two things that come to my mind are one, it’s okay to be real, to be authentic to show your vulnerabilities and that you care. And I think, especially right now, people are looking for the real you. And understanding that it’s a good thing to share who you are, is important. And I try to do that every day. And then the second I would say is, it’s okay to try some things and make a mistake, and then you just have to cut you have to get back up. And I’d say pre pandemic, you know, I was very nervous to try different things. And with the pandemic, we were trying things left and right to figure out how do we improve on it, and that created or develop more of our muscle in innovation and trying some things and then figuring out what works and what doesn’t work. So I think that that’s really important, too. To, you know, help yourself but also to help your team to realize that we’re just gonna keep moving forward advancing forward and not be held back because of fear.

 

Renee DeSilva  20:12

Yeah, I think that’s right. I mean, just the the battle tested nature of what what you and your peers have had to endure, I can I can see how those things would certainly bring true. I know that you’ve, you think a lot about just leadership philosophy as well. And you’ve written about the paradoxes of effective leadership. There’s always a Yin in Yang, right, you have to have a plan, but you need to be flexible and pivot. Does that still resonate with you? And maybe how does that show up day to day in terms of really balancing or threading that needle?

 

Tina Freese Decker 20:41

It does resonate with me, I think it’s really important that we develop both sides of those paradoxes, especially now, one of the paradoxes that I wrote about is that you have to over communicate and over listen, and it sounds easy, but very few of us are really excellent at both of it. And I am still a work in process. But it’s always on my mind, and hopefully felt by the many that I engage with, that I’m trying on it, I also think it’s really important that we prepare to be an effective communicator, you have to prepare and dedicate a tremendous amount of time, despite, you know, having been near leaders for many years, I think of it like being an athlete, you want to stay in top form, you want to be in shape. And usually with practice, it pays off, I think the same is true for over communicating. And over listening. To do both, it also takes a significant amount of time. It’s like engaging in a dance of communication and listening as you go through it. And so I’ve purposely and intentionally engaged in a dance of communicating and listening will pay off. And it’s just critical that we do so to tie it to the previous question that you asked me about trust, I think really good listeners also drive belonging and inclusion. And again, it’s that opportunity to develop trust, and to hear those unvoiced views and ideas at The Table to further all of our thinking and provide the opportunities for innovation.

 

Renee DeSilva  22:17

I think that’s right. And we’ve talked a lot about core wells reach and breadth and impact. I wonder, you know, against that backdrop, and just reflecting back on some of the leadership philosophies, how do you then think about maintaining that connection to values across a broad geographic scope? 60,000 team members, as you mentioned, how does how do you and your senior team really think about that piece?

 

Tina Freese Decker 22:42

Well, it’s really important to connect with people to listen and to seek to understand, I believe a lot of this in the stories that we tell and the actions that we take, you know, connecting it back to the values that we have, for example, one of our values is collaboration. And I knew we needed to focus on collaboration and break down the barriers when I first became the CEO in 2018. So at that time, I decided to remove the door to our office suite. And, you know, it wasn’t intentional that the door acted as a barrier to collaboration or open sharing, but it just became a heavier and heavier barrier. So when we removed the heavy door, and trust me, it was really heavy. It was actually a breath of fresh air. And so we messaged and show that we wanted to connect that we wanted to collaborate. And although it’s hard to do, it’s really important. And so I think some times to travel, I think about that, that Chinese proverb, sometimes to travel 1000 miles, the most important step is the first one. So the first let’s start with a story about removing the door. And then you start to have a conversation. And that leads to collaboration, and it leads to innovation. And all of a sudden you’re more engaged and excited about what’s coming forward.

 

Renee DeSilva  23:53

Yeah, that’s powerful, just as a as a broader analogy of what needs to happen in terms of the Union, both physical doors and metaphorical doors and how we all think about that, you know, I guess where my mind goes is how then, as you look to the future, how is Cornwell? Cultivating and supporting the next generation of health system leaders with an eye towards all of these things that you’re that you’re thinking about? What’s your approach there?

 

Tina Freese Decker 24:18

Well, leadership is the energy of organization. And it’s critical that we invest in our leaders, and we really need to be intentional about it. So we’re also really focused on how leaders lead in addition to what they accomplish. We talk a lot about innovation and to drive with innovate, innovation, you need to inspire a very healthy dissatisfaction with the status quo and that motivation to make things better. So as we engage with our leaders, we know it’s not going to be easy, but we help give them a clear vision and then have them take the opportunity to raise their hands, innovate, pilot getting engaged with things. I think also the future workforce trends One more team members are really looking for a more human relationship between themselves and the organization. And the first thing we can do for that is to treat them as humans with humanity and care for their own well being. And so we’re building empathy and compassion, with and for our team members recognizing the significant change this and fatigue that’s been going through, and helping provide an environment where they can be their very best, and they can innovate, and bring new ideas for free from that fear of failure.

 

Renee DeSilva  25:33

Yeah. So that’s, that’s powerful. As you know, we spend a lot of time as we’re chatting with our health system CEOs. And I’d love your take on this. That last point of bringing greater humanity to work. Even if you reflect across your last, you know, 25-30 years in the workforce. Does that feel like we’ve shifted, meaning is the compact between employers and team members? Does it feel different now than maybe did 2025 30 years ago, and your mind does, it does to me, and I wonder how that that reflects back in your organization?

 

Tina Freese Decker 26:11

Well, we actually added the word humanity to our mission statement last year, because we felt it was so important to instill humanity in everything that we’re doing. And to make sure that we’re not forgetting who we care for every single day, and who we work with. Every single day, we did a campaign, about behind the mask, when we were still wearing masks to make sure that we were, we remember that there’s somebody’s mom, or somebody’s brother or somebody’s child behind that mask that was really important. So I do think that there is greater emphasis on humanity and compassion, and how we need to be respectful of all within the within our organization in our society. And that’s an area that we want to emphasize. Because I believe it’s the people within our teams within our organization and within our community that can help move us forward. And I’m relying on them to do their very best and to be passionate about helping others.

 

Renee DeSilva  27:16

Yeah, I love what you’re saying here, the how leaders lead versus just the outcomes that they drive, and just acknowledging the fact that what I think people are expecting from their employers that that compact has shifted, and they want that, as you said earlier, transparency, vulnerability, human connection, I think that that at the fore is really important. So I appreciate you underscoring that. I may pivot us a bit before I ask my final question, which is, if you were then just to zoom out, and I’m always curious to hear how CEOs spend their time and and what topics, animate them the most, maybe just give us one or two other top of mind priorities for you that maybe we have not covered yet during our time. Because we’ve heard a lot, so that might be a hard question to answer.

 

Tina Freese Decker 28:02

We have covered a lot. Right now. You know, me, I’m I’m constantly curious. And I read a lot. And I’m always thinking about the question that we need to be asking for our future. You know, what would be top of mind for me in this month is, you know, how are we helping our team members approach their well being? Or how are we approaching artificial intelligence? Many things are coming forward, are we able to deliver on our vision? And what more can we do for affordability? Or how do we make sure we embrace the challenges ahead instead of moving backwards? So I think a lot about those questions, and then try to figure out where we go forward. I guess it’s a benefit that I’m curious. And I read so many different things that it just brings more questions up than answers. But I think that’s part of the hard part is let’s get all the questions out there. So we can really get into a debate about what needs to happen for healthcare going forward.

 

Renee DeSilva  29:00

I love that. And so many of these are moving so quickly. I mean, just the whole AI topic. It’s if you if you thought about the questions today versus what the questions were even three months ago, it’s just it’s a staggering pace of change. So I think you’re right and bracing the questions and getting, you know, backtracking into the answers on a lot of these things is ever moving. So that that definitely lands with me? How do you also think about just where you find energy outside of work? Maybe this is a reflection of a question that I’m asking myself these days, but just in order for you to show up in the way that you want for your organization. Right. There’s also this put on our own mask first. Any thoughts that you’d share with with maybe me personally as a CEO or other leaders listening and how you approach that for yourself?

 

Tina Freese Decker 29:44

Well, I’d say everybody is watching us, the CEOs on where we spend our time. And it’s really critical that we spend a portion of that time on the things that make us joyful, that fill our cup up and And for me that spending time with my family, I have two kids and my husband and a dog. And whether it’s going on a walk or a bike ride with them, or exploring, through traveling throughout the US or outside of the country, to learn about other things, that’s how I refuel myself. And it’s just simple to just be with the people that mean the most to you.

 

Renee DeSilva  30:25

Absolutely. And with the beautiful Michigan summers ahead of us, that probably will be quite enjoyable the next couple of months. Right. Maybe final question. We’ve certainly covered a lot of ground today. But if you could invite any two people to continue this conversation at a table that you personally curated? Who would you pick? And why?

 

Tina Freese Decker 30:45

You always ask this question when I know, I want to know who you’re gonna have at The Table. So for me, you can because I’m really curious. And because of where we are in the environment today. I think I would want somebody from the future, someone from 25 to 30 years in the future. And I’d want to ask them, what’s really important to pay attention to right now. And what isn’t, and understand from them, you know, how do the things that we’re working on today impact the trajectory in the future. And then the second person is, I’d want someone who is a either historian, or some of the head lived in the past, because I want to know how they navigated significant change, like we’re going through right now. I think that there have been other periods in history where there’s been some nificant change. And I’d be curious to know how that was navigated what happened, and then how it set it on the trajectory to today, and what they may have done differently or the processes for that, as we really try to work towards a better society.

 

Renee DeSilva  32:01

I think that’s great. You’re, yeah, that benefit of both hindsight and foresight is really powerful when they come together. That’s a great answer mine right now, you know, back to this topic of reading books. I am immersing in Arthur Brooks’s strength to strength right now, which is all about you. It’s a great book. And I would, first of all recommend it to anyone who hasn’t read it, but would love to have that conversation with him around how do we all navigate chapters and periods of inflection and how that shifts over time. And so a little bit around a conversation outside of healthcare that I’d be happy to have that would be one that comes to mind for me right now.

 

Tina Freese Decker 32:43

And that was, uh, it his book is really good and makes you think, and I love that. And it makes you think, like you just said in chapters of what, what you think about your life, and your work and what you’re able to impact to in society?

 

Renee DeSilva  33:01

Absolutely. Well, Tina, let’s land there. I so appreciate the time and and really the last five years getting to know you has been a pleasure and just really excited by what you and your team at Cornell health are continuing to accomplish. So thank you for joining. And I hope to see you soon.

 

Tina Freese Decker 33:16

Thank you so much, Renee, this has been a pleasure.

 

Renee DeSilva  33:18

Thank thanks for joining me at The Table with Renee DeSilva, a podcast brought to you by the Health Management Academy. I hope you enjoyed this episode. And if you did, subscribe, and drop us a review on Apple podcast, Spotify, or wherever you’re listening to this podcast now for all of our episodes, including show notes and transcripts and more information about how you might join me at The Table in the future, please head to hmacademy.com/podcast. I look forward to having you back at my table next time. Talk to you again soon.