By Gretchen Van Benthuysen
While growing up in the Shaker Heights suburb of Cleveland, Ohio, Steve Landers’ family often could be found sitting around its kitchen table talking about what was going on in American health care.
Perhaps not the most scintillating kind of conversation for a young man, but given that his father was a dentist and teacher at Case Western Reserve University School of Dental Medicine and his mother was a hospital administrator with a master’s degree in business administration, it was inevitable.
“I was influenced deeply by my parents. I looked up to them and found their work very interesting and worthwhile,” Landers said. “Over the years I learned a lot about the mindsets, the practicality and the sensibilities of somebody who is on the frontlines of taking care of people every day and at the same time the realities of the business of health care. I got a great perspective.”
He vividly remembers them talking about the introduction of diagnostic-related grouping, a way for Medicare and health insurance companies to categorize hospital costs and determine how much to pay for a patient’s hospital stay.
“You can imagine how that changed the business of hospital care,” he said with a grin during in an interview in the meeting room next to his unassuming office that features a small family photo of his three young sons and wife, a senior vice president at Prudential in Newark. “The length of stays at the hospital became a lot shorter. It actually created the part of health care I now work in — aftercare.”
At 41, Landers, now living in Little Silver and loving it, is president and CEO of the Visiting Nurse Association Health Group, the nation’s second largest not-for-profit home health care organization, which serves 12 counties in New Jersey. Founded in 1912, its headquarters is at 176 Riverside Ave. in Red Bank.
Last month, the VNA launched its 2020 Vision Campaign, a groundbreaking initiative to provide new, innovative and enhanced care for people in their homes and communities.
Landers is a graduate of Case Western Reserve University School of Medicine and Johns Hopkins University School of Hygiene and Public Health. He is a member of several boards, writes numerous articles for medical journals and contributes to the Huffington Post.
Previously, he was the director of the Center for Home Care and Community Rehabilitation and director of Post-Acute Operations for the Cleveland Clinic, rated the second best hospital in the United States by U.S. News and World Report.
On his medical journey he became a certified family doctor and geriatrician with a special interest in geriatric medicine, home health, hospice and palliative care. What he is perhaps most passionate about is teamwork and house calls.
After four years of college, four years of medical school, one year of public health school and three years of residency, Landers was asked to join the Cleveland Clinic and started a home visiting program for doctors in a high poverty neighborhood.
“If you go back to the 1940s, most encounters people had with physicians in this country were in their homes,” he explained. “For a lot of reasons, that changed.”
His program exploded and the clinic was overwhelmed with referrals.
“I fell in love with the job because of my interest in policy and the system,” he said. “I actually got to run this practice as we started it. I learned —sometimes the hard way — how you organize a team. How to hire and oversee people. I got good at management.”
He also “got good” at researching and writing about his home health care experiences and was published in JAMA (Journal of the American Medical Association). USA TODAY picked up the story and ran a feature on the topic. He started getting emails and phone calls asking him to speak on the subject.
He found the biggest takeaway from the world of home- and community-based care was that nurses, physical therapists, social workers, health aids and hospice caregivers weren’t connected.
“I realized, when I saw the people in their homes, … I couldn’t solve all their problems myself,” he explained. “An occasional brief doctor’s visit wasn’t enough.
“From then on, the whole focus of my work is how we better connect home care, visiting nurses, hospice care and community help with medical hospitals,” he said.
At the Cleveland Clinic doctors and nurses added management to home care and post-acute care programs. The program jumped from a few doctors to hundreds.
“The Cleveland Clinic was founded on a very simple concept,” he said. “Physicians should be working in teams to provide excellent care rather than as entrepreneurs focused on a small solo business.
“I never would be doing what I’m doing (at the VNA) without this experience,” he added. “To sum it up in one word: teamwork.
“It’s now the keyword at the Visiting Nurses Association which is very invested in employee engagement and physician investment,” Landers said.
But he acknowledges Cleveland and New Jersey are very different. “I am also learning from the VNA,” he said. “This is a 100-year-old organization with an incredible community. There are things being done here Cleveland never did in terms of public health service and nonmedical outreach in high poverty areas.”
The VNA’s reputation is one reason he took the job. Another is the chance to be a CEO of an independent organization who can drive strategy, learn different skills and report to a board of directors.
Mindy Minerva, board trustee at VNA Health Group and former board chairman of the VNA Health Group Foundation, said they are pleased with their decision to hire Landers, whom she called intelligent, passionate and accomplished.
“It was very clear to all of us on the search committee that Dr. Steve Landers was uniquely qualified and the visionary leader we needed to navigate through a rapidly changing health care system and unprecedented shifts in population demographics,” she wrote in an email. “We all felt that VNA Health Group and the state would benefit from his expertise and leadership.”
Since he joined in 2012 the VNA has doubled in size and budget, he said. It now employs more than 2,100 employees throughout the state and financially has been in the black since 2013 after being in the red from 2010 to 2012, Landers said, adding he believes finances should be transparent.
“It’s a practical business thing: if finances are transparent people can work to impact it,” he explained.
As an example, he cites nurses. “Nurses are the most respected, respectable, high integrity people in the world,” he said. “If you just show them what’s going on with their organization, where we are and where you’re trying to get to, it makes the job of management a lot easier because they can help you get there.”
Landers said he balanced the budget through “lots of fundraising, lots of grants” that existed before, but he streamlined. He also built new partnerships with hospitals that didn’t exist, including Robert Wood Johnson and St. Barnabas.
“I’m a firm believer in-home and community-based care is one of the keys to the future and success of our country’s health care,” Landers said. “As people age and have challenges they want to be home.” Government programs and families can’t afford for patients to be unnecessarily hospitalized and institutionalized. “There’s a lot we can do to help people avoid some of that cost and suffering,” he said.
The VNA is not just for old people, he adds.
“We do a lot of work with younger families and children … who are either growing up in poverty or facing social risks,” he said. “We also work with families from all economic backgrounds who have a child that is not developmentally on track or has a terrible diagnoses.
“We help a lot of families with kids who want to get them home from the hospital, but they need IVs or infusion of meds, or pediatric cancer treatment, or surgery.”
With the teamwork Landers talks about, these families get the help they need.
