When Carlos A. Migoya became president and CEO of Jackson Health System in 2011, he had no healthcare experience. But what the career banker brought to the table was far more important for our nation's largest public health system. Migoya knew how to run a successful business – and, at the time, Jackson was struggling financially and on the brink of closure.
"I have a different background than most hospital CEOs," Migoya said. "But the same basic principles apply in banking as they do in healthcare as they do in any business. As long as those principles are applied correctly and consistently, any business can survive and thrive."
Migoya emigrated from Cuba to Miami when he was 11. His family came with no money, but, like most Cuban exiles, they had big dreams. He watched his parents work hard to make ends meet and he credits them for laying the foundation for his successful career.
Migoya began as a part-time bank teller and rose through the ranks at Wachovia Corporation, eventually serving as regional president of Wachovia in North Carolina and CEO of the company's Atlantic region, overseeing operations in New York, New Jersey and Connecticut.
Soon after retiring from the banking industry, Migoya volunteered his financial acumen and leadership skills to the role of Miami city manager, tasked with tackling the city's ailing budget. That experience, combined with over four decades in banking, prepared him to take on his biggest challenge yet: leading Jackson.
Jackson is one of the nation's leading and most highly regarded teaching hospitals where ground-breaking medical procedures are common, yet it is also Miami-Dade County's only public hospital, serving as a safety net for the uninsured and underinsured. For Migoya, the complexity of the massive health system was intriguing. Despite his lack of healthcare experience, he knew he was the right fit for the job. Migoya believes in Jackson's mission and had personally been impacted by its top-notch medical care.
In 1978, Migoya's son was born prematurely at Jackson, weighing just over a pound. Jackson doctors saved the child. In 1991, Migoya's mother donated her kidney to her sister at Jackson for a lifesaving transplant. Migoya himself became a patient of Ryder Trauma Center at Jackson Memorial Hospital after his hand was severely injured in a road-biking accident.
"Jackson has impacted the lives of so many people in Miami-Dade County and beyond," said Migoya. "It is our community jewel and I feel lucky to have been entrusted to watch over it."
Jackson was teetering on the brink when Migoya was named CEO in 2011. The health system's finances were dire, employee morale was dismally low and the public had lost confidence in its community's health system and its leadership. But Jackson's governing board, the Public Health Trust, and the Miami-Dade Board of County Commissioners, which have jurisdiction over Jackson, had faith that Migoya could be a game-changer.
To help guide Jackson through its transformation, Migoya built an executive team made up of proven leaders in the healthcare industry. He immediately began studying Jackson's business model, identifying inefficiencies and making changes, including eliminating excess positions that were unnecessary as patient volumes continued to plummet while creating part-time positions that could be flexed up as volumes improved. Migoya also developed relationships with the leaders of Jackson's unions, which represent just under 90 percent of the health system's nearly 10,000-employee workforce.
Since day one on the job, he has made it a priority to maintain transparency with Jackson's employees, regularly sharing updates with them through email communications and quarterly town hall meetings. Though some of his decisions have been unpopular, it's undisputable that Migoya effected positive change at Jackson. After losing nearly $430 million from mid-2006 through mid-2011, Jackson earned an $8.2 million surplus in 2012 and an unprecedented $51.5 million in surplus for 2013 – exceeding budget by about 44 percent. Today, Jackson remains profitable and its budget targets a third-year surplus. Migoya credits the commitment of his executive leadership team and sacrifices by employees for the turnaround at Jackson.
Migoya still has a substantial amount of work at Jackson to ensure its long-term success in South Florida's highly competitive healthcare market. He has launched training programs for employees that focus on customer service and transforming Jackson into a patient-centric business. Jackson is focused on improving both patient care and quality measures, and Migoya is proud that these measures have dramatically improved under his watch. Patient safety has become the top priority.
Jackson is slated for dramatic changes over the next decade. Miami-Dade voters supported an $830 million general obligation bond that will be used to fund infrastructure and system upgrades, expand services and build new facilities, including a new rehabilitation hospital on the Jackson Memorial campus, a children's ambulatory pavilion and urgent care centers throughout Miami-Dade County. There will also be a renovation of the outdated labor and delivery unit at Jackson Memorial Hospital, partially due to Migoya's 2012 promise to donate his entire bonus to the Jackson Memorial Foundation if the system saved money that year. It did, and the $160,000 is being used towards the modernization of that unit.
When Migoya isn't going from meeting to meeting at Jackson, or lobbying for the health system in Tallahassee or Washington, D.C., he spends much of his time road biking. He also serves as the director for AutoNation, the largest auto retailer in the U.S., and serves on the boards of the Downtown Charter School in Miami and Jazz at Lincoln Center in New York City.