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With over three decades of C-suite leadership experience, I currently serve as Principal…
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James Terwilliger shared thisA winning strategy means little if an organization can’t deliver on it. As margins tighten and healthcare grows more complex, health systems’ ability to turn plans into results is becoming a key differentiator. I hope this article resonates with colleagues across healthcare and beyond. Please share your feedback if you have a moment. #ECG
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James Terwilliger shared thisThe New York Times reported today that employer healthcare costs could rise by as much as 11% in 2027 unless employers reduce benefits or take other actions. Other forecasts point in the same direction. This should be more than an employer-benefits story. It should be a call to action for large healthcare delivery systems. For the past two decades, scale has been the dominant strategic objective in healthcare. Health systems have built larger physician enterprises, broader ambulatory networks, and increasingly integrated delivery models. Those investments were intended to improve quality, expand access, and create greater operating leverage. The question now is whether health systems can deliver on that promise. Health systems must translate scale into productivity. Reducing unwarranted clinical variation, improving access and capacity utilization, managing length of stay, optimizing sites of care, and simplifying administrative complexity are no longer just margin-improvement initiatives. They are essential tools for improving affordability. The answer cannot simply be passing higher costs through commercial pricing. Large health systems increasingly possess the data, clinical reach, and organizational capabilities to influence the total cost of care. While they cannot control every driver of healthcare inflation, they should accept greater responsibility for the costs they can influence. This points to a broader shift that I believe is becoming increasingly important: scale was the dominant strategic objective of the last two decades; execution may be the dominant strategic challenge of the next. Strategy remains essential, but the real differentiator will be the ability to translate strategy into measurable changes in clinical practice, operating performance, cost, and patient experience. The true value of scale is not size itself. It is the ability to integrate care, reduce unnecessary variation, use capacity more effectively, move care to the most appropriate setting, and improve both clinical and economic outcomes. Direct-to-employer partnerships provide another opportunity to put those capabilities to work by aligning health systems and employers around access, outcomes, and total cost rather than simply the price of individual services. An 11% increase in healthcare costs is not sustainable. As employers, employees, and purchasers face growing financial pressure, affordability should stand alongside quality and access as a core health system obligation. Scale got us here. Execution determines whether we deliver on the promise. https://lnkd.in/gSVTwK3eEmployer Health Costs Are Expected to Spike in 2027Employer Health Costs Are Expected to Spike in 2027
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James Terwilliger shared thisTim is exactly right. One lesson I learned over many years as a health system executive is that quality and safety are not competing priorities with growth, transformation, physician alignment, or financial performance—they are prerequisites for all of them. Organizations can sometimes outperform on strategy for a period of time despite operational challenges, but they rarely sustain success when quality and safety are not deeply embedded in the culture. It's encouraging to see these conversations returning to the center of executive and boardroom discussions.James Terwilliger shared thisDespite the numerous challenges facing the American healthcare system (and at the risk of jinxing myself), I have been witnessing a trend over the last 18 to 24 months that I find incredibly encouraging: the return of patient safety and quality to the top of organizations’ strategic priorities. It has been gone for a while. The reasons for this sudden resurgence are unclear. Perhaps it is the growing attention the public is paying to the organizations that report on these measures (Leapfrog, CMS star ratings, etc.). Maybe it is the increased direct link to financial rewards and penalties from government and private payers related to these measures. It could be the re-realization of governing boards that their highest and most import fiduciary responsibility is to ensure that the care provided in their institutions is safe and of the highest quality. Or perhaps C-suite leaders have come to realize that without the provision of safe, high-quality care, nothing else really matters—and strategic plans will gather dust on a shelf. Whatever the reason—and maybe it’s a combination of all the above—let’s not lose this recently found momentum. I was fortunate to be practicing as a surgeon in 1999 when the IOM released its seminal report “To Err is Human: Building a Safer Health System.” I was also fortunate to meet the luminary of the patient safety movement at the time, Dr. Don Berwick. In a nice bit of serendipity, his office, the original Institute for Healthcare Improvement (IHI), was across the street from mine. (He also introduced me to my wife, but that’s a story for another time.) Don remains a friend to this day. Since that time, as both a practicing surgeon and health system CEO, patient safety and quality has been a passion of mine. Over the past 25 years, there were times when I was the most popular person at a party, easily engaging others on the topic. And then there were times when I felt like I was wandering in the desert, trying to engage my colleagues on the subject. No one seemed interested. I feel like the momentum is building back in the right direction. So, if your organization is re-embarking (or continuing) on its zero-harm, high-reliability journey, I would ask you to jump on board with all your energy and all your ideas. As healthcare providers, there is really nothing that is more important.
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James Terwilliger shared thisAlignment is easy to declare and hard to prove. This HBR piece is a sharp reminder that silence in the room is not the same as commitment to change. Among the potholes identified in "The False Alignment Trap" are: 1 - “We’re aligned” is often leadership shorthand for “we’re not actively disagreeing.” 2 - False alignment creates the illusion of momentum while quietly undermining execution. 3 - Real alignment requires productive discomfort. https://lnkd.in/gxZqgiWh
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James Terwilliger reposted thisI am lucky to work at ECG Management Consultants where I have full leadership support to focus my career on areas that I am most passionate about. Access to affordable, high quality behavioral healthcare should not be a luxury - it should be a right. #MentalHealthAwarenessJames Terwilliger reposted thisECG partner Katie Fellin notes that despite rising demand and a shortage of providers, behavioral health services are still reimbursed at lower rates than physical care. Without true parity, many providers will remain out of network, limiting patient access to affordable, timely, high-quality care. May is Mental Health Awareness Month. https://ter.li/31eg93f7 #ECGMC #MentalHealthAwareness
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James Terwilliger reposted thisJames Terwilliger reposted thisA vision is only as good as your ability to make it a reality. That is what a COO does every day. They make ideas comes to life for our patients and their families. From a helipad at a critical access hospital to the technology that underpins our entire operation. This is usually a behind-the-scenes kind of job, so I was thrilled when Becker's Healthcare gave a shoutout to Westchester Medical Center Health Network's very own Anthony Costello as one of 70 COO’s to know, leading operations at academic medical centers nationwide. Anthony has served the patients and families of WMCHealth for more than three decades. He works tirelessly to ensure their healthcare journey through our hospitals and clinics is seamless and, most importantly, infused with compassion and care. He has led too many transformational projects at WMCHealth to list here. But a few stand out: our 280,000-square-foot Ambulatory Care Pavilion - and the complex work behind it to staff it, relocate services, and expand access; the reimagining of the HealthAlliance hospital campus; and the brand-new 162,000-square-foot Critical Care Tower rising outside my window, which will open to patients in 2026. Congratulations Anthony! And thank you for what you do for our patients every single day!
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James Terwilliger shared thisWell thought-out, impactful piece from the Beacker's leadership team highlighting the many of the existential issues our field is facing. While the path is not straight-forward, it is highly likely that applying the same traditional "cures" will not work.Healthcare's broken math: 11 signs the numbers don't add up - Becker's Hospital Review | Healthcare News & AnalysisHealthcare's broken math: 11 signs the numbers don't add up - Becker's Hospital Review | Healthcare News & Analysis
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James Terwilliger liked thisJames Terwilliger liked thisThe ECG Management Consultants team will be in Chicago for Becker’s annual IT/RCM conference. If you’re attending, be sure to connect with our experts. And don’t miss panel sessions with Henry Stokman and Sarah Kier, MBA (she/her/hers)! https://ter.li/rv8b1yqs #ECGMC Utpal Desai Christopher Ford, MBA
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James Terwilliger liked thisJames Terwilliger liked thisThe doors are open, and a new chapter in healthcare has begun in Columbia County. Wellstar Columbia County Medical Center is now serving patients, turning years of planning, collaboration, and preparation into reality. From the first surgeries to the first Emergency Department visits, our teams were ready, delivering exceptional care from the moment the doors opened. Thank you to Nelson So, FACHE and every physician, team member, and leader who helped bring this vision to life. We're honored to serve this community and excited about the impact we'll make for patients and families in the years ahead.
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James Terwilliger liked thisJames Terwilliger liked thisSuch a fun summer evening at Wrigley Field with the ECG team! One of the things I really appreciate about ECG’s culture is the opportunity to connect with colleagues beyond our day-to-day work. It was great to spend time together outside the office, catch up, and enjoy a beautiful Chicago summer night at the Cubs vs. White Sox game. Great company, lots of laughs, and as a Cubs fan, I was especially happy with the win! ⚾️ Such a great night! #ECGMC #Chicago #WrigleyField #GoCubsGo
Experience & Education
Organizations
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Greater Seattle Chamber of Commerce
Board Member
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Washington State Healthcare Association
Board - Public Policy and Advocacy Committee
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University of Indianapolis
Trustee
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United Way of Central Indiana
Board Member
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Cancer Support Community
Board Member
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Indianapolis Urban League
Board Member
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IUH Health Plans
Board Member
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Fox Chapel Baseball Boosters
Board Member
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American Cancer Society, Western Pennsylvania
Board Member
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St. Scholastica Choir
Member
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Rehabilitation Institute of Indianapolis
Board Member, Secretary
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