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  • St. Luke’s Mike Fenello: Moving towards population health through feedback, structural change
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St. Luke’s Mike Fenello: Moving towards population health through feedback, structural change

By Mike Fenello, News and Community
December 18, 2018
David C. Pate MD, JD

Mike Fenello is a key leader for us as we transform from fee for service to pay for value. He has been a traditional hospital leader under fee for service, where hospitals are profit centers and operating structures are typically hospital-centric.

Now, he has a new job – vice president of population health – a position designed for the realities of a value-based world, focusing on how to better care for patients to keep them out of our hospitals. Mike is uniquely suited for this new role. He understands hospitals and how to run them efficiently, but he also understands the need for us to achieve better outcomes of care at a lower total cost of care.

Here is Mike to tell you in his own words about his journey, and ours.

- David C. Pate, M.D., J.D.


Mike Fenello
Mike Fenello, St. Luke's Health System Vice President of Population Health

I moved to Idaho in 2009 to become administrator at St. Luke’s McCall. In 2015, I moved to Twin Falls as the administrator at St. Luke’s Magic Valley Regional Medical Center. To say it has been an interesting and satisfying chapter in my life would be an understatement.

In all the change, however, one thing has stayed constant: our role as a mission-driven organization.

St. Luke’s mission is to improve the health of people in the communities we serve, and population health is our foundation for doing so.

From a business perspective, this means taking accountability for the outcomes of care and the total cost of care for defined populations.

From a personal standpoint, it’s a journey. It takes time and requires the collaboration and effort of many community partners. It’s about being able to design care the way that we would like it to feel for the people we love the most.

In light of this exciting work, we are in the process of rethinking our operational governance so that it can best serve our efforts – and our patients – moving forward.

In October, I was appointed to one of three newly created positions of vice president of population health. This structure will help us to revamp how we connect with our community and work to further our commitment to population health within our organization.

We are working to strengthen our operations, more clearly define roles and responsibilities, affirm ownership and accountabilities, reduce bureaucracy and clarify decision-making, with efforts focused on structure, operational governance and results.

And then there’s the “why.” Connecting with the “why” of our mission allows me to link our efforts with those of the community organizations with which we collaborate to better our communities’ health.

A great example of this connection is our recent work on a healthy conditions assessment for the City of Twin Falls. Starting in June 2018, with the help of an outside company, community stakeholders have discussed strengths within the community and areas that could be improved upon.

This process included collecting data, determining hot spots, identifying interested parties, conducting interviews, bringing people together to problem-solve and plan and finally, to focus limited resources.

Based on this work, leaders are changing the way they have thought about their organizations’ contributions to community health and how we might all move forward together.

We are working to build a better and healthier community, but the work from this assessment is just beginning. Now, we’ll start the hard part, figuring out what we can accomplish. We are excited to roll up our sleeves and get going. We know we are better together.

Population health is going to open a window for us. We expect that we will learn a great deal about very complex problems and some simple fixes that can be implemented quickly, working in partnership with others.

I’m not going to say it’s an easy time to be in health care, but in my experience, for whatever reason, nothing easy is particularly meaningful in the end. And I’d rather be involved in the meaningful stuff.

About The Author

Mike Fenello is vice president of population health of St. Luke's Health System, based in Boise, Idaho.