Jefferson’s new CEO on the future of the health system and making ‘a bigger impact’
Joseph G. Cacchione plans to integrate the system's clinical programs while keeping community health front and center.
Thomas Jefferson University on Monday named Joseph G. Cacchione, a cardiologist who received his medical degree from Hahnemann University, to succeed Stephen K. Klasko as chief executive of the Philadelphia region’s largest health system by number of hospitals.
Cacchione, 60, was most recently executive vice president for clinical network services at Ascension, a $27 billion Catholic nonprofit health system with 145 hospitals in 19 states. He is scheduled to start on Sept. 6 at Jefferson.
The Erie native spoke to The Inquirer on Monday about his anticipated approach to running Jefferson. Questions and answers have been edited for length and clarity:
Jefferson underwent a dramatic expansion under your predecessor, but still has much clinical integration to undergo. How do you look at that part of your job?
I think the best is yet to come in terms of integration. The back office is important, but what we really need to do next is integrate the clinical entities. If we’re going to make a bigger impact in the Philadelphia area, and do it in the most efficient way possible, we have to figure out where we can do what and then show value to the communities that entrusted Jefferson with their precious entities, the Einsteins of the world.
You said a health system is responsible for the health of the communities it serves. How do you measure that?
Measuring community health is difficult, but there are surrogate measures, things like avoidable emergency room visits. Do people ... have primary-care providers? Do they have food insecurity? Do they have health literacy? Those are things that are very, very important as we think about the health of our communities. There’s not one perfect measure that gets us there. We just need to start measuring things that have scientific validity. Then we have to act on those things in a purposeful way. Not all of the impacts come from the health system. They come from our partners.
How does Health Partners Plans, Jefferson’s health insurance business, fit into your vision?
Obviously it is Medicaid-forward right now. It’s got a lot of Medicaid lives in it. I think Medicare Advantage will be an important part of any provider-based insurance entity.
We’ll never out-Blue Cross Blue Cross. There’s got to be some kind of competition, but we’re going to be more of a niche player, rather than trying to be everything to everybody. I just don’t think that’s a feasible way to run our insurance business.
How do you view the financial challenges facing health systems right now?
Inside of health care we don’t quite understand why the volume of patients hasn’t come back. It’s not just total hip and total knee replacements that aren’t coming back. We think a lot of people are still on the sidelines. They have not gotten their cancer screenings. We encourage people to get their cancer screenings because we’re starting to see a little bit later-phase cancer showing up because people haven’t gotten their mammograms or their colonoscopies.
We learned [during the pandemic] that a lot of things don’t need to be done under inpatient status. The amount of revenue we get on things done in the outpatient arena versus the inpatient arena is vastly different. We’ve built an inpatient chassis. We’re going to have to be more balanced inpatient and outpatient. We’re going to have build a cost structure to fit the revenue structure.