Jefferson Health’s Mission to Transform Care

As a child in Erie, Pennsylvania, Joe Cacchione knew he wanted to practice medicine. “My parents told me that from the time I was able to talk, I told them that I was going to be a doctor,” Cacchione said, as he reflected on his career as a cardiologist in private practice and research institutions. Now, as CEO of Jefferson, a nonprofit academic system spanning 32 hospitals and more than 700 sites of care, his focus is on expanding access to as many people in Pennsylvania and New Jersey as possible. Below, Cacchione discusses his goal and why, like many great endeavors, it is a team effort.

Did you always want to be a doctor?

I did … I used to watch all the medical shows. And then, when I was in fifth grade, we were asked to write a letter to somebody we admired. A lot of my friends wrote to professional baseball players, but I wrote to a local heart surgeon and told him I wanted to be a heart doctor someday. That doctor sent me a book on young doctors. Years later, I was able to close the loop with him, and he was genuinely touched at the idea of having a legacy that continued.

You went from being a practicing cardiologist to an administrator in a large network. What has your journey been like?

As a practicing doctor, I was really busy. I was doing about 2,000 procedures a year in the catheterization laboratory, and then over time, I started taking on more and more leadership roles. It was a natural progression for me.

There are lots of things about leadership that are similar [to being a doctor]. But leadership and management [are different things]. As a doc, we do everything: we make sure we’re meticulous; we write orders [for medical care]. In management, we’re influencing people, delegating, and developing other leaders; it is a different skill set. So, for me, it was a bit of an adjustment, but I do think knowledge of health care really helps distinguish physicians as leaders.

What does your work look like now?

At Jefferson, we have a mission to improve lives, and that’s the overriding imperative in all of health care and academia. Jefferson had one of the first free clinics in the country as part of our medical school, and that mission of service to the community is what attracted me to Jefferson. That’s what we continue to double down on every day. Sustaining that legacy of community impact continues to be one of Jefferson’s most important goals.

How is that mission different from how other institutions — research, nonprofit or otherwise — might operate?

Jefferson is a diverse, 32-hospital system with a traditional university as its anchor; but it has community hospitals, it has teaching hospitals, and community clinics. We’re also the largest provider of primary care in the region. We have a multitude of access points, all of which are knitted together by service and community. And, the importance of our academic mission is critical for us going into the future. What will differentiate us over time is the fact that we are high-tech at Jefferson, but we want to remain high-touch, and that touch is at the individual patient level and at the community level.

What does it mean to be high-tech and high-touch?

“High-touch” is extremely important and, oftentimes, it’s cultural. I can’t tell people to be high-touch. They have to feel it; they have to live it. As AI becomes more and more prevalent, doctors will get smarter and have more information at their fingertips. What’s going to differentiate us from an AI-generated diagnosis is a doctor’s or nurse’s ability to look someone in the eyes or put their hand on somebody’s back and say, “We’re going to help you through this.” It’s not just about information transfer; it’s not just about diagnosis and care delivery. It’s about delivering compassionate care to people where they need it and how they need it.

“At Jefferson, we have a mission to improve lives, and that’s the overriding imperative in all of health care and academia.”

I know that Jefferson is part of the Regional Coalition to Eliminate Race-Based Medicine that is working on health care inequity in the Philadelphia area. Are there any specific issues that Jefferson is working toward?

For us, a pillar of equity means being accessible for everyone. We want to be the most accessible health care system to every constituent who we serve, whether it is somebody out on the Main Line, North Broad Street, South Jersey, Allentown, or the Poconos. Whether it’s care at a community hospital, clinic, or a virtual visit, we want to be able to be accessible to everybody, and that’s one of our biggest priorities. And I think that by being accessible, we’ll be able to reach more populations that sometimes get left behind.

How are you doing that?

I would love to say that we can wait for people to come [to the hospital], but we can’t. So we have to be more proactive and meet patients where they are. If someone doesn’t have access to primary care, they tend to show up in an emergency room, and that’s an inefficient way to provide care. It’s very expensive. Emergency rooms are designed for urgent, life-threatening situations, not for minor illnesses. Sometimes access to health care is about access to transit, so we have programs around virtual care, community screenings, and even home care where we go to people’s homes to see them.

And we’re doing a lot to meet people, not only in their health needs, but in their social determinants of health needs, too. We’re collecting data about health-related social needs from nearly a million patients, and we’re using that data to provide support across the spectrum of social determinants of health. We have processes now for people to let us know if they’re feeling socially isolated, if they have food insecurity or housing insecurity, or if they have the inability to buy affordable prescriptions.

For example, if you have food insecurity, we’re going to refer you over to our partners at Philabundance or MANNA. If you have housing insecurity, we’re going to refer you to Project Home. In a lot of ways, we’re working as a convener of these parties. Sometimes we’re convened, sometimes we’re the convener. We just need to do better for the communities we serve. We have some very vulnerable populations in the city that are not getting access to care. And access to quality care is the most important common path for everybody.

What do you see as the future of health care?

We have to remove the friction between the financing of health care and the delivery of health care. And it’s a huge gap. People don’t understand their hospital bills; people don’t understand why something was paid for and why something was not. We’re on a mission to partner with health plans to remove that friction. And I think we have to better align incentives for health care organizations today. Today, when somebody comes into our hospital, the health system makes more money than if somebody were to stay out of the hospital [through preventative medicine] and population health initiatives, and we’re working toward changing that.

With our own health plan, we’re incentivized to keep people out of the hospital. That benefits people, and it benefits us. Likewise, we have partnerships with IBX (Independence Blue Cross) where we’re incentivized to keep people out of the hospital and to keep people healthy, and we have to align those incentives. In the past, health care was always about having more people in the hospital; that was good financially for the hospital — it made more money. We have to align the incentives, get that friction out, and build healthier communities one patient at a time.

Favorite Philly food or place to eat: Listen, I’m Italian, and the Italian food in this town is just unbelievably good. My favorite is D’Angelo’s on 20th and Rittenhouse Square. Two brothers own it, and the food is just spot-on.

Favorite neighborhood? Rittenhouse Square for the park, dining, and shopping.

Favorite Philly pro athlete: As a proud partner of the Eagles, of course I’ll start there. I’m a huge fan of their offensive line! I’m also a huge baseball fan, and my favorite Philly athlete is probably Mike Schmidt. I’m old school, so I’d also say old-school Dr. J.

A little-known fact: I come from a family of all brothers, all of whom are coaches — football coaches, baseball coaches — and have been active in athletics their whole life. They tell me I’m the only failure in the family, because I wasn’t a coach. Actually, I did coach when I was in college. I coached eighth grade basketball, and we lost the state championship. Clearly I’m still not over it.

Why I love Philly and want to give back: Somebody said this to me last year: “Philly’s a community of grit and grace,” and that kind of matches my personality. I’m an East Coast guy. I grew up in Pennsylvania, and I went to medical school here. I love being part of this community.