South Florida Hospital News
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August 2016 - Volume 13 - Issue 2


Retired Bank Executive Transforms Failing Healthcare System into a Thriving Institution

Five years ago, Jackson Health System was nearly on the brink of disaster only to be brought back to life under new leadership. It took a savvy, retired bank executive to take the helm during those dark times and turn the ship around.
Carlos A. Migoya knew that becoming president and CEO of Jackson Health System would be the greatest challenge in his professional life. Despite no healthcare experience, Migoya knew that he could learn the ins and outs of the industry and assemble a team of results-oriented leaders to support the world-class nurses, doctors, and other caregivers that made Jackson’s clinical care so famous.
“What Jackson needed was someone to come in and look at the health system as a business,” explains Migoya. “Because of my background as a businessman, I was up to the challenge. I knew that if I could help steer Jackson back onto the right path, that this could be my greatest legacy.”
Migoya spent his entire career in the banking industry, retiring after more than 40 years. He came out of retirement to work as the City Manager in Miami to help tackle the city’s budget issues. While there, Migoya was approached about the opportunity to become CEO of Jackson. While he had no previous healthcare experience, he knew that was something he could learn.
“Jackson was not a broken public hospital, but rather a broken business,” Migoya says. “And I was confident that I could assemble a team that would make a difference.”
Migoya calls Jackson Health System one of the community’s greatest assets, a place with a longstanding mission to provide high-quality medical care to every resident of Miami-Dade County regardless of their ability to pay. But several years ago, Jackson was in turmoil. It was financially insolvent, under intense scrutiny, and on the brink of closure.
“Our community had lost faith that Jackson could reliably operate in a financially sustainable way,” says Migoya.
As a longtime Miami-Dade County resident, Migoya knew how important Jackson is to the community. Jackson also held a special significance for him personally. In 1978, his son was born at Jackson weighing just over a pound. At any other hospital, he likely would not have survived. Today, he is healthy, happy, and successful.
“Jackson also was meaningful to me because it is where my mother was able to save my aunt’s life by donating a kidney to her, and I have use of my hand because of the treatment I received at Ryder Trauma Center after a bicycle crash,” he says.
Migoya says that people often question why he gave up a comfortable retirement to take on this challenge. His response: “How could I not? Jackson has given this community everything. How can we not do everything in our power to make this work?”
Building a Dream Team to Lead Jackson
When Migoya became president and CEO of Jackson in May 2011, he immediately began learning the ins and outs of hospital operations, studying ever-changing healthcare laws, and developing a strategic plan to turn Jackson profitable.
One of his top priorities was assembling a dream team of experienced hospital executives and professionals from other fields with proven successes around the nation who would work alongside him to fix the business and transform Jackson into a next-generation health system.
Migoya immediately brought on board Don Steigman as the chief operating officer.
“Don has a long history of successful hospital leadership in South Florida and I knew he would be a great partner,” says Migoya.
Migoya also recruited Donn Szaro as chief strategy officer. Unfortunately, he passed away less than a year later in March 2012. But even during his short time at Jackson, Migoya says that he taught him invaluable lessons, and he definitely contributed to Jackson’s successful turnaround. Rounding out the leadership team was Mark Knight, who was already on board as the system’s chief financial officer and had strong knowledge of Jackson’s complex finances.
“Our team worked tirelessly to identify cost-savings measures, strategically boost revenues and focus on providing all patients and visitors with excellent customer service,” says Migoya.
The results have been significant. When Migoya’s team showed up in 2011, Jackson was losing $80 to $90 million every year. It closed its 2015 fiscal year with a surplus from operations of $64 million, which is the largest in the published history of Jackson’s financial statements. That comes after two prior years with surpluses topping $50 million.
“We have made that tremendous progress while improving industry measures of bedside and surgical care, focusing on the patient experience, and boosting recruitment for Jackson’s 11,000-employee workforce,” explains Migoya. “It hasn’t been easy, and we are still up against strong headwinds, but we are well on our way towards building Jackson into a health system that will remain strong for generations to come.”
At Jackson, the tagline is “Miracles Made Daily.” Migoya says that this isn’t just a saying—it’s the truth.
“Every day at our Jackson facilities, our caregivers save lives, give people a second chance, and defy the odds,” he says. “These countless success stories are why every single one of us who works at Jackson is so proud of what we do.”
Since Miami is one of the nation’s most competitive healthcare markets, Migoya believes that in order for Jackson to remain successful, the organization must become the hospital of choice for the people of Miami-Dade County.
“Jackson has long been known as the hospital that you go to if your life depends on it,” he says. “But we want people to choose to come to Jackson for routine medical care, as well. Our focus at Jackson is to provide every patient with the highest quality medical care and make sure they leave after having the best patient experience.”
As Miami-Dade County’s only safety net public health system, Jackson has long depended on financial support from local, state, and federal sources. But Jackson cannot rely on current levels of public funding to continue indefinitely, notes Migoya.
“We must thrive financially – and, increasingly, independently – to protect our long-term future,” he says.
That means it must continue to attract paying patients to offset the huge amount of uncompensated care that it funds each year.
“That’s why we are making the investment to upgrade our aged facilities and build new ones throughout Miami-Dade County,” Migoya says. “We are committed to preserving and building upon our premiere service lines, such as organ transplant, trauma, maternity, and pediatrics. For nearly a century, Jackson has been the people’s hospital in Miami-Dade County – and we are upholding Jackson’s mission to serve our community.”
Making an Impact on the Community
Jackson’s impact on the community dates far back, long before Migoya’s arrival in 2011. In the community, there is no substitute for Jackson. Had it been buried by its financial crisis, the repercussions for public health would have been dire.
“For thousands of our neediest neighbors, Jackson is the only destination – and thanks to the stronger-than-ever partnership with the University of Miami and a growing relationship with Florida International University, Jackson continues to uniquely deliver world-class academic care to everyone, regardless of their ability to pay,” says Migoya.
Over the next five to seven years, the landscape at Jackson will dramatically change as it moves forward with a $1.4 billion capital plan that includes new construction projects, the renovation of existing facilities, and infrastructure improvements that are transforming Jackson into a more modernized, patient-centered healthcare system that can better meet the future needs of Miami-Dade residents.
“This was all possible because of the support we received from Miami-Dade voters in November 2013, who overwhelming approved a countywide bond referendum campaign to invest $830 million to upgrade the health system’s aged facilities and infrastructure,” says Migoya.
With these funds, along with revenue that Jackson is reinvesting into its facilities, Migoya says that it will renovate patient units, emergency rooms, and operating rooms; open a network of urgent care centers in communities throughout Miami-Dade County, bringing Jackson’s top medical care closer to where people live, work, and play; construct a new healthcare campus in Doral; build a world-class rehabilitation hospital on the Jackson Memorial campus; and construct a new tower to house the Miami Transplant Institute and its intensive care units.
“Changing the landscape of Jackson and modernizing its long-neglected facilities will help boost patient volume so Jackson can continue to fulfill its mission long into the future,” Migoya adds. “Jackson is now a larger and stronger health system than any time in nearly 100 years of history. We have world-class employees who cherish our legacy, understand our strategy, value our mission, and are excited for our future. We have academic partners that want to move forward with us into a new generation of healthcare. And we have regained the faith of our community, which is now flocking to our doors because we are transforming Jackson into the healthcare provider of choice.”

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