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CoxHealth President and CEO Steve Edwards says he's working to flatten the organizational structure of the 9,000-employee, $1 billion health system.
CoxHealth President and CEO Steve Edwards says he's working to flatten the organizational structure of the 9,000-employee, $1 billion health system.

Another Edwards Era

Posted online
The new year marked a new era at CoxHealth, but it’s the second era for the Edwards family.

Steve Edwards officially became the health system’s fifth CEO since 1965, and one of those executives was his father.

Charlie Edwards served as CoxHealth’s President and CEO 1985–1993, and Steve Edwards grew up in the organization, closely knowing each of the top executives during his lifetime. The younger Edwards once worked to pick up cigarette butts from the Cox South campus before heading off to Washington University to earn a master’s degree in hospital administration.

Edwards brings 20 years of experience with the health system to his new office on the fifth floor of the Hulston Cancer Center. He has caught himself a few times reporting to his former office down the hall, where he spent four years as CoxHealth’s chief operating officer.

“There’s something symbolic about that, I guess,” Edwards said with a laugh.

The COO office remains vacant because Edwards eliminated the position from the organizational chart – one of his first orders of business as CEO.

The COO position is the third upper-level management position dropped in the last year as CoxHealth adapts to a changing environment where the costs to provide health care are being scrutinized on all sides by parties such as the Center for Medicaid Studies or insurance giant Anthem, Edwards said.

“As we ask more of all of our employees, it just seems inconsistent to not ask more of ourselves,” Edwards said.

Edwards has his own plans to flatten the operational structure of the nonprofit system to allow decisions to be made faster by those most familiar with the ramifications of a given change.

“As organizations get big, they run the risk of pushing too many decisions up the ladder instead of down,” Edwards said of the health system that has grown to comprise four hospitals, the area’s largest home-care provider, 58 clinics serving 25 counties, roughly 9,000 employees and $1 billion in annual revenues. “As you flatten it, one of the advantages is that in time you get more agility, pushing decisions to those who are in the trenches.”

Previously, 21 people regularly reported to Edwards and his predecessor, Bob Bezanson. Edwards is knocking down that number to the academically recommended seven direct reports by dividing CoxHealth’s services into five groups, and he’s asking senior management to take on a broader range of responsibilities.

The five groups that report to directly to Edwards are:
  • financial services, including accounting, real estate, and warehouse and receiving;
  • system resources, which joins the legal department and media relations;
  • hospital and home care, which features administrators of Cox hospitals, Oxford HealthCare and Cox College;
  • integrated physicians group, which covers clinic physicians; and
  • business development, which marries marketing with CoxHealth Network – the system’s group insurance contractor.
The seven individuals reporting directly to Edwards are Jake McWay, head of the Financial Services Group; Charity Elmer, general counsel; Dr. Dan Sontheimer and Laurie Duff, representing the System Resource Group; Dr. John Duff, leading the Hospital and Home Care Group; Dr. Ken Powell, director of the Integrated Physicians Group; and Williams, representing the Business Development Group.

On Jan. 1, four executives were promoted: John Duff, to senior vice president and chief hospital officer; Powell, to chief integrated physician; Ron Prenger, to vice president and chief clinical officer; and Brian Williams, to vice president of business development.

A couple of the most notable organizational changes are the joining together of hospital administration with home health care services and combining CoxHealth Network with marketing.

The changes aim for better continuity of care and to keep patients from unnecessary and costly hospital visits, said Duff, who managed the health system’s four hospitals and now also is in charge of home care services and Cox College.

“We’ve recognized that as patients flow through our hospitals, many of them at the time of discharge will need outpatient services,” Duff said. “My role will be to help coordinate the services that we provide within the hospital and the ones we provide after the patient leaves to make sure that it is as seamless as possible.”

Williams, who leads CoxHealth Network and marketing, said the new structure fits with the changing dynamics in health care.

“I think the hospital being integrated with home health care and all of our three major physician clinics reporting to one person – Dr. Powell – also sends an overt message to the organization of how important it is that all those systems integrate and that business development be a support arm for the operations folks as well as system resources and the financial services group,” Williams said. “The closer that we can get decisions made to the bedside of the patient, the better the organization will be.”

Prenger now effectively serves as operations manager for the three Springfield hospitals, after previously managing the service lines, or resources needed for patient care, for the in-town hospitals. He reports directly to Duff and works in concert with vice presidents Tyler Hedden and Pete Leer to manage the majority of patient-centered services and resources in town. Hedden and Leer are each taking on more responsibilities and pushing decision-making downward, Prenger said.

“There’s a bunch of Type A personalities here, and we all like new challenges. Flattening the organization not only gives us opportunities to do more things, but it creates the ability to be more nimble,” Prenger said, adding that while managers have questions about the changes, he hasn’t fielded complaints from associates taking on more responsibilities.

With an organization comprising 83 percent women, Edwards said he also is working to increase Cox’s female leadership. Two of the newly established seven-member core group are women: Elmer and Laurie Duff, vice president of corporate communications.

John Duff, who’s married to Laurie Duff, said he works directly with four female executives – Karen Kramer, Karen Thomas, Genny Maroc and Anne Brett – and he relies on them to not only make decisions, but also to delegate authority.

While Duff said he thought the structural moves were energizing to the CoxHealth management team, he acknowledged that the changes would be challenging.

“There is always some trepidation about what the change brings,” he said, noting he thought Bezanson was a great leader in his own right. “I think though that the majority of individuals I’ve met with are pleased, particularly with the plans to really delegate effectively more responsibility and control of their areas to our senior managers.”[[In-content Ad]]


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