Robert Garrett, CEO, Hackensack Meridian Health
In an interview with Invest:, Robert Garrett, CEO of Hackensack Meridian Health, discussed the trends and challenges in the healthcare industry, including integrated care that includes ambulatory care and other care models beyond the four walls of the hospital. “The outcomes are fantastic, and the patients are as happy, if not happier, than if they were to get their care in the hospital,” Garrett said.
What differentiates Hackensack Meridian Health from other major health systems in the region?
We are the largest and most comprehensive healthcare integrated network in New Jersey, with 18 hospitals and 500 discrete patient care locations throughout the state. We continue to lead the way in innovation; we have the Hackensack Meridian School of Medicine, the first new, private medical school established in New Jersey in over 60 years. We have the No. 1-ranked adult and children’s hospitals in New Jersey. Hackensack University Medical Center is ranked among the top 20 hospitals in the United States, the first time a New Jersey hospital has been included in the U.S. News & World Report Honor Roll. Hackensack University Medical Center is also ranked No. 1 in the NY-NJ metro area by U.S. News.
The network also includes the Center for Discovery and Innovation, a world-class research institute, which played a pivotal role during COVID in terms of new therapeutics. We have an extensive home care program that is growing as more health care is delivered inside people’s homes.
Hackensack Meridian Health is approximately a $10 billion organization in terms of total revenues. We have close to 38,000 team members and approximately 8,000 affiliated physicians. It is a large system, but our real focus is on our individual communities. Healthcare is local, so we assess the communities’ needs, then match those with programs and services designed to accommodate them.
The medical school has graduated over 400 students since it started, and many of those graduates are practicing medicine in New Jersey. That was one of the objectives of the school: addressing the physician shortage in New Jersey. The unique curriculum focuses on what doctors will need to succeed. A good example of that is the Human Dimension program. Every medical student is required to match with two families in underserved communities throughout New Jersey for the entirety of their education to see what’s preventing people from staying healthy. There are a lot of social factors involved, like lack of transportation, unstable housing, and lack of access to healthy food. Because of these innovations, we’re going to have a new generation of doctors who not only focus on treatment but are equally focused on prevention. If we think about the increase of chronic diseases in the United States, a lot of that has to do with the lack of prevention.
Our Center for Discovery and Innovation was created to leverage the vast clinical resources of Hackensack Meridian Health to move breakthrough science into clinical practice and improve patient outcomes. During the pandemic, because of the expertise of our center, we were able to get a therapeutic out within eight days after the first case was seen at one of our hospitals. That was a game-changer on the front lines, and for emergency room physicians, in particular, to have that treatment option available. They are continuing the research in infectious disease, with grants from the National Institutes of Health to study future variants of COVID, and other types of infectious diseases that potentially cause a pandemic.
The John Theurer Cancer Center is the No. 1-ranked cancer program in New Jersey by U.S. News & World Report and is also part of the NCI-designated Lombardi Comprehensive Cancer Center at Georgetown University. Our experts are leading research to develop cures for both common and rare cancers.
Our large ambulatory care network enables more health care delivery outside the four walls of the hospital. The 500 different locations provide personalized care that’s more convenient and closer to people’s homes. Our health and wellness centers are a one-stop shop, including urgent care, a surgery center, doctors’ offices, a laboratory, and imaging under one roof. That’s what healthcare consumers want: world-class care without travelling to a hospital. They want it in their neighborhoods, communities, or even in their homes. Five of our hospitals offer what we call a hospital from home, where patients are seen 24/7 in their homes. They are monitored remotely, and healthcare professionals come in every day. The outcomes are fantastic, and the patients are as happy, if not happier, than if they were to get their care in the hospital.
What are the key challenges for Hackensack Meridian Health and the broader healthcare Landscape?
The Big Beautiful Bill passed in Washington has a lot of implications for healthcare, especially for those covered by Medicaid. That is a big challenge because $1 trillion was cut from the federal budget supporting Medicaid. Hundreds of thousands of people in New Jersey will not be covered, or their services will be curtailed significantly. Small reimbursement for hospitals treating Medicaid patients will be cut back. Some of the cuts don’t go into effect right away. One of the provisions to receive Medicaid in the future is that people will need to work. This goes into effect in 2027. That gives us about a year to prepare. People who might not be able to work will be taken off Medicaid, but they are still going to require healthcare. Then they will come into the emergency department, and that’s not the best way to receive primary care. The emergency rooms in the state are crowded and a costly way to receive care. In 2028, some of those federal matching funds that have come to the states to help subsidize the Medicaid program for hospitals and doctors will start going away. Each year, from 2028 to 2032, those dollars will be cut.
One out of three Americans does not have a primary care physician, and there continues to be a significant shortage of nurses. We’ve been trying to extend our primary care network to address this. Not only do we incentivize our students at the medical school to go into primary care, but we also have formed unique partnerships to extend that network. We have a partnership with Amazon One Medical to open several primary care centers in areas around the state where there is a lack of access. We’ve already opened two, and we hope to build the rest over the next few years. A partnership with an organization called KHealth resulted in HMH 24/7, providing access to virtual primary care providers. The patients will receive follow-up care within the Hackensack Meridian Health Network if they need more specialized treatments. We’ve also strengthened our three nursing schools. We’ve reduced our nursing vacancy factor, and our turnover rate is about half the national average. In addition, we have partnerships with external nursing schools from around the state. In some of the support services, like pharmacists, we’ve had to strike up some unique partnerships. With a prominent pharmacy school in New York, Binghamton University, we’re able to recruit and retain pharmacists from that area.
How will Hackensack Meridian Health’s investment expand access to cancer treatment in the region?
At JFK University Medical Center, we’ve opened up a comprehensive ambulatory cancer center providing chemotherapy and radiation therapy. New cancer surgical specialists have been recruited to round off our cancer program. It will provide expanded access to state-of-the-art cancer care. The John Theurer Cancer Center, located at Hackensack University Medical Center and Jersey Shore University Medical Center, has been able to roll out significant clinical trials for more than 50% of cancer patients. Our cancer program and cancer specialists must utilize the latest clinical trials because so much of cancer care is personalized now. The clinical trials can help match the best therapy to that particular patient and their genetic profile. We have expanded our bone marrow transplant program, one of the largest in the nation, to Jersey Shore, as well as CAR T-cell therapy, specifically for treating childhood cancers in a much more effective way. The benefit of a network like Hackensack Meridian Health is the sharing of best practices. It could start at one site and then be exported to different sites throughout New Jersey. We also collaborated with Memorial Sloan Kettering Cancer Center in New York to provide inpatient care for cancer patients at several of our hospitals here.
What is your outlook for Hackensack Meridian Health’s top priorities and the broader New Jersey healthcare system?
I’m optimistic about the future of healthcare, despite headwinds from Washington and elsewhere. There’s a movement toward integrated health care from big health networks in New Jersey and around the country. A good example would be in the scope of mental health. We did not have the expertise a few years ago to provide what I would consider world-class behavioral health, so we merged with Carrier Clinic, New Jersey’s largest behavioral health provider. We found that if we don’t address behavioral health, we’re not addressing the whole idea of getting better medical outcomes. So much is dependent on behavioral health. That integration has helped us to remove some of the stigma around mental health, and it encourages people to receive care. It also integrates care, because many of our patients with medical diagnoses or surgical diagnoses might also have a behavioral health issue that needs to be addressed. I see more of that type of integration happening.
I also see major investments in ambulatory care – $450 million over the next few years to add 500,000 square feet in several locations. When we receive care closer to home, that’s more convenient, accessible, and more dignified. It helps to make healthcare more affordable.
It’s important to note that we are not abandoning hospitals, and we realize that chronic illness is on the rise. In fact, we have several projects underway to strengthen the hospitals, and we are investing $2.7 billion at our three academic medical centers. We just finished an $800 million project to modernize Hackensack University Medical Center with new critical care beds, new private rooms, and new operating room suites. We’re doing the same thing at Jersey Shore University Medical Center, with a $1 billion investment over the next several years. In addition to the cancer program at JFK University Medical Center, we will be investing almost half a billion dollars so that it can meet the needs of its community. We will never waver from our mission to transform healthcare and build stronger communities.
