Chief Operating Officer for CHI St. Vincent

LITTLE ROCK--When Chad Aduddell moved to Little Rock in 2012 to become president of Catholic Health Initiatives (CHI) St. Vincent Infirmary, he was tasked to confront the major challenges of operating in the black during a period of declining reimbursements and looming healthcare reforms that ended up dramatically increasing the number of insured patients.

Doing more with less requires hospitals to hone management by looking for opportunities to reduce costs through improving operational efficiency, while enhancing care to improve treatment outcomes. Aduddell, who had proved himself as having turnaround experience at hospitals in Oklahoma and Texas, rose to the challenge by helping oversee consolidations that included the acquisition by CHI St. Vincent of Mercy Hot Springs in April 2014—which shares with CHI St. Vincent Infirmary the distinction of being the oldest hospital in the state, both established in 1888.

Aduddell now serves as the Chief Operating Officer for CHI St. Vincent and provides operational leadership for the 282-bed hospital now named CHI St. Vincent Hot Springs, along with three other acute care facilities: CHI St. Vincent Infirmary (615 beds), CHI St. Vincent North (69 beds), and CHI St. Vincent Morrilton (25 beds).

Aduddell said the turnaround work had to fit the mission of CHI St. Vincent to create healthier communities and be consistent with their ministry to serve the poor, needy and underserved. Financial performance couldn’t come at the cost of quality or providing compassionate care. Yet failure to operate in the black threatened not just healthcare services, but the strong economic base that provides jobs for thousands of people.

“Healthcare has now grown to represent more than 18 percent of the national economy,” Aduddell said. “Costs continue to increase at an unsustainable rate, reimbursement is going down and, at the same time, we need to provide access to more people because of the Affordable Care Act (ACA). While the ACA is not perfect, the private option and Medicaid expansion has increased coverage to 240,000 Arkansans who weren’t covered about a year ago at this time. Ultimately, we have to create value by improving quality outcomes and safety, improving the patient experience, increasing access and decreasing costs.”

Before the hospitals were combined into one operating system, both were facing significant challenges including Mercy Hot Springs operating at a loss.

“Bringing those two legacies together into one consolidated Catholic healthcare ministry gave us the opportunity for growth, for economies of scale and for increased efficiency by reducing duplication and waste,” Aduddell said. “There was a lot of work to do, but we took two good-sized organizations and merged them into one that was larger, stronger and more efficient. Efficiency takes leaders who have the experience to go out and find opportunities to improve processes and efficiency, take waste out and negotiate favorable prices with vendors and suppliers.”

Since the integration with CHI St. Vincent, that Hot Springs hospital has grown its business and is now operating near capacity.

“The hospital has never been this busy,” Aduddell said. “The ER and clinics are busier than ever. Just in this short period of time, it has turned around. It is thriving. It has been very positive for us and the community has been so supportive.”

Aduddell said it is likely that more consolidation will be seen in the future.

“Relationships that didn’t exist before may exist in the future,” he said. “We don’t think the acquisition of Mercy Hot Springs is the end. We think that is the start. We believe that we need to continue to grow. We want to grow into a statewide network, and we believe that is going to be necessary for us to be sustainable long term.”

Currently CHI St. Vincent is in discussion with Conway Regional Hospital regarding a potential partnership.

“From the beginning, one of the goals in the relationship was for both organizations to retain their identity,” Aduddell said. “We want to come together in a way to gain economies of scale, creating win-wins without a purchase or merger. We are taking that same approach talking to other facilities across the state, ways to partner together for both organizations to find value.”

The term used in healthcare is “to bend the cost curve.” The cost curve has been on a steep growth rate that is unsustainable.

“So we are looking at ways to partner with other community hospitals across Arkansas to create value and take cost out of the system,” Aduddell said. “We see growing into a statewide network as an important part of our goal, and we are actively working on that today. We are also developing the Arkansas Health Network, a clinically integrated network with physician leadership to prepare for the next era of healthcare, the goal of which is to shift the focus from volume to value. Today, we are paid in a fee-for-service environment. The thought is that in the future, the focus will be on proactively managing the health of a population of patients, and not just moving volume through the system.”

Aduddell showed an early aptitude for leadership. He had an athletic scholarship to the University of Tulsa where he was elected captain of the track team.

“I wasn’t by any means the best athlete, but I was a pretty serious and competitive guy, driven with an intensity to do things the right way,” he said. “So even with things like practice, I was always able to lead my teammates to take preparation very serious. That has been my approach to life: be prepared.”

While he considers himself a quiet introvert, he was also president of his college fraternity. He said that was odd because he wasn’t a particularly social person. “It certainly wasn’t because of my charisma, but because I was respected by my peers and was able to lead them in a way that was productive for the entire organization,” Aduddell said.

Aduddell’s first job after receiving a master’s degree in business with a healthcare administration focus was working for the St. Anthony Hospital in Oklahoma City, Okla.

“I learned a lot from those guys that I still use today,” he said.

One is that feedback is the breakfast of champions. Even when receiving criticism, he looks at it as an opportunity to learn and improve.

A second lesson is the importance of face-to-face communications.

“I was amazed that the chief of staff of this 650-bed hospital in Oklahoma City, Dr. Richard Boothe, always made time for me,” he said. “I try to make time for people to be here one-on-one. I’m not a big e-mailer. When you want to read emotions and intent, so much gets lost in emails. I’ve resisted sitting here and pounding out that two-page email response, I prefer to talk in person.”

And a third piece of advice he received was, “It is good to be right, but it is better to be right and effective.” You can be right, but not effective.

“It is not about me being right,” he said. “It is about being effective, I try to look for the win-win.”

Aduddell said he and his wife, Angie, have enjoyed living in Little Rock and greatly appreciate the beauty of the Natural State. They have four daughters, ages 5, 7, 12 and 14. He coaches girls’ soccer and with family and professional responsibilities, doesn’t have time for hobbies. But he still loves running, and uses his early morning jogging time to not just stay fit and reduce stress, but reflect and prepare himself for the day.