🔒CEO Jeff Flaks lays out his vision for a transformed Hartford HealthCare system

As a parent, Jeff Flaks was worried when his son, a high school athlete, hurt his ankle playing basketball.

But as a CEO, Flaks was thrilled at his son’s experience last year in an Avon urgent care center run by his company, Hartford HealthCare.

First, Jared Flaks, age 17, was able to schedule his trip to the center on a Saturday online and on his phone, getting an exact time for his appointment and the room number for treatment.

When the family showed up at the center, a foot-and-ankle X-ray machine was already in place and the younger Flaks’ medical records and prior X-rays were displayed on 42-inch monitors in the exam room.

A radiologist directed the young man’s treatment remotely from a third monitor along with the on-site clinician. (It turned out to be a bad sprain.) The family’s pediatrician texted minutes later to follow up, having been automatically alerted to his patient’s urgent care visit.

“Today as a person, as a patient, you see it, you experience it — the way the care is now organized around the patient,” Jeffrey Flaks said. “Our vision in health care is to be able to support people in our communities [by] being their partner in care, to help them, so we can give them access, affordability and excellence.”

Looking back on 17 years at Hartford HealthCare and nearly two years as CEO, Flaks sees a gradual transformation of the system — turbocharged by the pandemic — into an organization that has become decentralized and focused on bringing high-level care into communities across the state.

The ability to coordinate that care statewide is centered in Hartford, at HHC’s new Access Center at 100 Pearl St., a node for scheduling, imaging, electronic health records and other technology in one location with the goal of creating “an Amazon of health care.” All information is routed through the system’s CareConnect electronic health record software.

Ladders are still strewn about on the first floor and construction workers come and go, but Flaks sees nothing but the future at 100 Pearl, where the company has leased 100,000 square feet of space and plans to house 700 to 800 workers once build-out is complete.

“What we’ve created through our CareConnect platform is a system from where home care to behavioral health and everything in between is organized around the patient,” Flaks said. “The most important aspect of this is the vision for Hartford HealthCare to be the most trusted for personalized, coordinated care.”

Downstairs from the Access Center to the rear of the front desk an “innovation center” is planned, where HHC hopes to attract entrepreneurs and startups to design the next generation of healthcare innovations. The system has formed partnerships with MIT and Israel’s Innovation Authority to promote regional and world-wide collaboration on new technologies.

Other investments in the Capital City include a $70 million expansion of Hartford Hospital’s Bliss Building to add 50,000 square feet of mostly clinical space, expected to be complete by August.

A total of 18 new critical care beds will be added, along with five operating rooms and three new MRI scanners.

“We can’t also lose sight of the critical essentiality of our hospitals,” Flaks said. “The future of the hospitals will be highly subspecialized care, real critical care services. We have to repurpose these hospitals.”

Looking to the suburbs

Despite the system’s investment at 100 Pearl and continued corporate presence at 1 State St. in Hartford, HHC’s future lies in continued growth outside of its traditional central service areas, Flaks said.

With its purchase of St. Vincent’s Medical Center in Bridgeport in 2019, HHC made a big play in Fairfield County, investing millions to renovate the aging facility. In the first year after the takeover, St. Vincent’s added 200 new providers and has been the fastest-growing hospital in the state in terms of volume in the past 18 months, Flaks said.

But hospitals won’t be the nexus of growth going forward, Flaks said, as more medical care moves outside of traditional settings.

Typical of the system’s current expansion plan is the new Hartford HealthCare Digestive Health Center, which opened in Bloomfield in April. The facility, the first of its kind for HHC, brings together endoscopy with a range of physician’s offices in a brand-new 13,000-square-foot building. In all, 26 major new buildings are under construction for HHC facilities across the state.

Specialized, easy-to-access facilities like the Bloomfield Digestive Center, bone-and-joint surgical centers and imaging centers are the future, Flaks said.

“The facilities we’re building are community-based, closer to home, where people work. They’re highly specialized, they provide more affordable care and produce higher levels of quality,” Flaks said. “We’re replacing aspects of emergency care with urgent care. We’re expanding primary care so that we can have more primary care in the community to help manage and coordinate health care. We’re building imaging centers and surgery centers so care can be done more affordably.”

When Flaks first started work at Hartford HealthCare 17 years ago, 70% of the system’s revenue was inpatient, or hospital-based; now inpatient care represents only 49% of revenue.

In fiscal 2020, the Hartford HealthCare system, which employs 33,000 people, reported $4.3 billion in operating revenue.

“That’s progress, that’s been purposeful. It’s by design,” Flaks said. “It’s how we’re transitioning this organization to being able to deliver more affordable care: in the community, in highly specialized facilities.”

As the system’s physical imprint has grown, the Hartford HealthCare Medical group has also expanded, adding 677 providers in 2020 as it acquired physician practices across the state.

The system is also pursuing integration of care from the ground up — most recently through the acquisition of Hunter’s Ambulance Service of Meriden. The purchase was finalized in early June and will allow HHC providers to begin care with mobile EKG monitoring the moment an ambulance arrives at a 911 call.

“The level of innovation in health care is really like never before and these types of alliances and partnerships allow us to do even more,” Flaks said. “How we transform health care is going to be done by reorganizing how clinical care is delivered.”

Balancing cost and quality

Expansion on the part of health systems and the integration of care through technology and partnerships is an ongoing trend and a positive if it leads to lower costs and better treatment, said Angela Mattie, a professor of management at Quinnipiac University who focuses on the health industry. (Mattie also serves on the board of Trinity Health of New England, but was speaking solely in her capacity as an academic.)

“We always want to look at these business decisions through a lens of value,” Mattie said. “Is it providing lower cost and better quality to the public? That’s where our analysis should be. If the answer is yes, then it’s a good thing.”

Existing issues around cost, access and quality have been highlighted during the COVID-19 pandemic, which brought out the stark differences in how different communities experienced a health crisis. The pandemic may ultimately help the healthcare industry address issues around health disparities, Mattie said.

Meantime, many experts predicted the pandemic would deal a crushing blow to hospital finances given the long shutdown in elective surgeries, typically revenue drivers.

Without major cost cuts or any layoffs, Hartford HealthCare reported a small profit for the fiscal year ending in 2020, Flaks said, and expects to be back to “more traditional levels of profitability” in the current fiscal year. Surgery volume saw a year-over-year increase as the pandemic waned.

Even as some service lines at the system have returned to pre-pandemic levels, emergency room volume has only recovered to 90%. The volume at HHC’s urgent care centers, however, is up almost 200%.

“It’s a good example of something we have worked hard, historically, to achieve,” Flaks said of the transition to urgent care centers, which cost much less to operate. “The pandemic accelerated it.”

The pandemic also spurred HHC to partner with community groups and expand to mobile clinics to provide COVID-19 testing and vaccinations, which will have a long-term impact on how care is delivered.

“The idea of how we delivered testing and vaccines is now going to transform how we deliver mobile, community-based health care for things like diabetes screening, bariatric screening, certain aspects of primary care, prostate health, mammography and a whole series of services,” Flaks said. “We now have the capacity to ... reach people where they are through partnerships with community leaders.”