Cleveland Clinic's Strategy: State of The Clinic

Cleveland Clinic's strategy
In his annual State of the Clinic address, Cleveland Clinic President and CEO Tom
Mihaljevic, MD, highlighted several key initiatives the 18-hospital system is implementing to
improve care for patients, expand its footprint and provide a better experience for clinicians
and other employees.
Six things to know:
1. Strategic plan. During his Feb. 26 speech, Dr. Mihaljevic said Cleveland Clinic's strategic
plan will focus on the following five goals:
 Serving as lifelong partners to patients

 Engaging caregivers as members of teams
 Embracing digital tools to enhance the patient and caregiver experience
 Optimizing resources as stewards of the organization
 Doubling the number of patients served
2. Serve more patients. A record 2.4 million patients received care at Cleveland Clinic's
facilities in 2019, and those patients accounted for 9.8 million visits. In 2020 and beyond,
Cleveland Clinic will serve more patients in more locations, Dr. Mihaljevic said. "Only 1 in
200 Americans receive care at Cleveland Clinic," he said. "Yet we know every person could
benefit from the quality of care we provide. Therefore, it is our ethical obligation to serve as
many patients as possible."
To achieve this goal, Cleveland Clinic is updating some existing facilities and also building
new ones. The system is expanding Fairview Hospital in Cleveland, constructing a cancer
center at Cleveland Clinic Abu Dhabi, opening Cleveland Clinic London in 2021, building a
new neurological institute, expanding the Cole Eye Institute and building a new hospital in
Mentor, Ohio.
3. Patient safety. "Becoming the safest place for healthcare is a journey that never ends," Dr.
Mihaljevic said. He noted that Cleveland Clinic has improved patient safety in recent years
by using safety checklists before procedures, having daily huddles about safety issues, and
encouraging caregivers to speak up about safety issues. In 2019, Cleveland Clinic decreased
serious safety events during surgery by 46 percent. Between January 2017 and August 2019,
the system reduced central-line infections, sepsis mortality and patient falls with injuries.
4. Care for clinicians and other employees. Dr. Mihaljevic said Cleveland Clinic has taken
several steps to improve the caregiver experience. A few examples he cited were offering
fully paid maternity and parental leave, increasing the system's minimum wage to $15 per
hour and making improvements to the system's EHR. "Care for caregivers" will continue to
be one of the system's top priorities, he said.
5. Community benefit. Last year, Cleveland Clinic's community benefit reached $1 billion.
Dr. Mihalijevic said Cleveland Clinic will continue to support local communities through
initiatives to address public health challenges, including vaping and opioid addiction, a
community service time off program for employees and an ongoing pledge to hire job seekers
from surrounding neighborhoods.
6. Financial performance. Solid financial performance is necessary to achieve the strategic

goals Dr. Mihaljevic discussed during his speech. Cleveland Clinic ended 2019 with
operating income of $390.2 million on revenues of $10.6 billion. That's compared to 2018,
when the system reported operating income of $266.4 million on revenues of $8.9 billion.
"This success allows us to reinvest in our mission, caregivers and communities," Dr.
Mihaljevic said.
CLEVELAND, Ohio – The Cleveland Clinic saw its operating income take a hit in 2018,
dropping 19 percent to $266 million, according to numbers released Wednesday.
CEO Dr. Tom Mihaljevic attributed that decline to the continued increase in the cost for
providing care and decline in reimbursement rates.
“We have to fight to keep costs low and care affordable for patients,” Mihaljevic said during
his State of the Clinic address at the InterContinental Hotel.
The system’s revenue rose 6 percent last year to just shy of $9 billion.
To combat the rising cost of healthcare, Mihaljevic plans to continue the system’s focus on
operational efficiencies, particularly in its new properties and as it expands. The Clinic in
January integrated two Florida-based health systems – Indian River Medical Center and
Martin Health System – into its system.
To that end, the Clinic is establishing a Center for the Study of Healthcare Delivery to study
the processes of healthcare delivery, to make sure care is coordinated and that tests given are
timely and not redundant. Through standardized care, the system can reduce costs, Mihaljevic
said.
However, he stressed that the Clinic is a not-for-profit hospital, focused on patient care, not
profits.
“We’re not here to make money. We’re here to serve our patients,” Mihaljevic said after the
address.
The Clinic plans to double the number of patients it serves – to 4 million – in the next five
years, he said.
“We feel that we have an ethical need to expand the quality of care that we know how to
provide to as many people as possible,” Mihaljevic said. “In tomorrow’s healthcare, the
biggest change in our strategy is to become a proactive healthcare organization.”
That growth will come from a focus on telemedicine and on population health, he said.
“Digital growth is going to be by far the largest,” Mihaljevic said.

The Clinic also will reach new patients through its expansion efforts in and out of the state.
Cleveland Clinic Abu Dhabi is growing 30 percent each year, and the 200-bed Cleveland
Clinic London is slated to open in two years.
The Clinic also plans to begin work this year on a new hospital in Mentor, expanding its
presence in Lake County. Mihaljevic said it was too early to estimate what the capacity of the
new facility would be, but confirmed it would offer both inpatient and outpatient care.
“Responsible stewardship will allow us to grow, and we will grow both physically and
digitally. We’ll invest in our home base and our core infrastructure here in Ohio,” Mihaljevic
said during the address.
He said there are parts of the Clinic’s main campus “that desperately need more space and
more availability.”
The Clinic plans to invest this year in its neurological institute, which is in one of the oldest
buildings on campus, in the Cole Eye Institute and in Fairview Hospital.
The system also is in the process of upping its minimum wage in the U.S. The system in
January increased its minimum wage to $14 per hour for most of its hourly workers,
excluding some local union employees. By 2020, the health system will increase that rate to
$15 per hour.
Beyond that, the Clinic is focused on improving employee safety as violence against
healthcare workers continues to increase, he said.
“It’s an epidemic nobody talks about,” Mihaljevic said. “It’s been getting worse. This has not
happened overnight.”
Last year alone, the Clinic confiscated 30,000 weapons from patients, mostly in the
emergency department. He attributed the increase, in part, to the opioid epidemic and to
related mental-health concerns.
The Clinic has added panic buttons to employee badges, installed metal detectors and offered
employees police escorts to the parking garages, among other security measures.

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Cleveland Clinic's strategy

Six things to know:

 Serving as lifelong partners to patients

6. Financial performance. Solid financial performance is necessary to achieve the strategic

“Digital growth is going to be by far the largest,” Mihaljevic said.

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