October 22, 2018 by Philip Lewenstein

There’s a Doctor in the House: Living and Dying with the Chicago Cubs

There are many benefits to having a doctor—in this case, brother-in-law­­­—in the family. He can translate and interpret medical terminology and information from doctors into plain English. We can consult with him on medical issues. Sometimes, he will speak directly to the doctor for us.

It’s a bonus that the “family doctor” is passionate about sports, albeit the Chicago teams: Cubs, Blackhawks, Bears, and Bulls—especially the Cubs. He is still—and will for a long time—be reveling in the Cubs’ 2016 World Series title, the first in 108 years, ending the longest championship drought in baseball history.

Dr. Lee Sacks, chief medical officer of Advocate Aurora Health, retired at the end of August, and he was recognized for his leadership on health care. His retirement party was staged at Wrigley Field, highlighted by a seven-minute tribute on the Wrigley video board and the presentation of a commemorative bat from the Cubs’ Kyle Schwarber. Not only that, but his colleagues awarded him a trip to the Cubs’ Baseball Fantasy Camp in January 2019 in Arizona.

Dr. Sacks, who has been married to my sister, Joan, for 43 years, is recognized as one of the leading health-care experts in the country. He is ranked 30^th on the Modern Healthcare magazine’s ranking of the 50-most-influential physicians in health care.

Although Sacks has been described as a visionary and legendary health leader and is a proud husband, father of three, and grandfather of five, he is at his core a fervent, lifelong Cubs’ fan. As much as his stellar family and career accomplishments, his true identity is as an intense Cubs’ supporter. Any conversation with him always includes an update on the Cubs. Many of the accolades in his video tribute include references to his passion for the Cubs.

To Sacks’s dismay, a promising Cubs’ 2018 season ended abruptly this week when the host Cubs lost their National League Wild Card game 2-1 in 13 innings to the Colorado Rockies after losing a day earlier to the Milwaukee Brewers in a playoff for the National League Central Division title.

Sacks retired from his dual roles as chief medical officer for Advocate Aurora and founding chief executive officer of Advocate Physician Partners (APP), a collaboration between Advocate’s hospitals and its independently affiliated physicians.

Advocate Health Care, based in Illinois, and Aurora Health Care, based in Wisconsin, merged in spring 2018. Advocate Aurora is the 10^th-largest not-for-profit integrated health system in the United States and a leading employer in the Midwest with more than 70,000 employees, including 3,300 physicians, 22,000 nurses, and the region’s largest- employed medical staff and home- health organization.

In large part due to Sacks’s work, Advocate became a national leader in clinical innovation, health outcomes, consumer experience, and value-based care. The newly-merged system serves nearly three million patients annually in Illinois and Wisconsin across more than 500 sites of care and 27 hospitals. Advocate Aurora is engaged in hundreds of clinical trials and research studies and is nationally recognized for its expertise in cardiology, neurosciences, oncology, and pediatrics. The organization also contributed two billion dollars in charitable care and services to its communities in 2016.

For several years, Advocate has been a sponsor of the Chicago Cubs, Bulls, and Bears, thus enhancing Sacks’s opportunities to attend games, including Cubs’ playoff and World Series games. Sacks was pictured with the World Series trophy after the Cubs’ 2016 title.

Some of Sacks’s health-care accomplishments were highlighted in an August 2018 article in Modern Healthcare (“Retiring Advocate Aurora Health CMO Dr. Lee Sacks leaves legacy of advanced-care models” by Steven Ross Johnson).

Sacks is credited with developing and implementing concepts of coordinating care or managing a population’s health, ideas that were off the radar of the majority of hospitals and systems in 1995 when Advocate Health Care was formed, according the article.

“That courage for him to take the steps to organize care delivery at Advocate toward value was really something that was unconventional at the time,” said Dr. Jay Bhatt, senior vice president and chief medical officer for the American Hospital Association. “It’s allowed them to be ahead of the curve as more and more are moving toward value now.”

Sacks’s leadership over the past few decades has come in the tumultuous context of major challenges in health care, including costs, access, delivery, quality, price, safety, structure, and technology. He has been a force in developing creative approaches to address these issues while becoming a national leader.

In his new book Tailspin: The People and Forces Behind America’s Fifty-Year Fall—and Those Fighting to Reverse It, Steven Brill points out that despite spending more on health care and K-12 education per capita than any developed country, health-care outcomes and student achievement rank in the middle or worse internationally; the U.S. has the highest infant mortality rate and lowest life expectancy among its peer countries.

Brill explains that health-care reform in America has always been about two issues: the high cost of health care compared to other countries that produce as good or better results, and the fact that, unlike most other countries, large numbers of American families did not have protection against those costs through insurance or some other mechanism such as government-provided health care.

Colleagues credit Sacks for making a mark as one of the architects of Advocate’s formation in 1995 when Evangelical Health System Corp. and Lutheran General Health System merged to become Advocate, according to the Modern Healthcare article. Advocate grew from having net patient revenue of $1.4 billion in 1996 to $4.5 billion in 2017.

Sacks, of Glenview, Illinois, earned a bachelor’s of science degree in chemical engineering at the University of Pennsylvania and a medical degree from the University of Illinois College of Medicine. He completed his family practice residency at Lutheran General and served as chief resident before joining the Lutheran General medical staff in 1980. He practiced family medicine for thirteen years in suburban Chicago from 1980 to 1992. In 1992, his practice joined the Lutheran General Medical Group where he served in a variety of leadership roles leading to the merger that created Advocate.

Under the merged system, in l997, Sacks became executive vice president and chief medical officer with responsibilities for health outcomes, patient safety, managed care contracting, PHO (physician-hospital organization)  operations, research, medical education, risk management, and insurance. These responsibilities were part of his dual role as chief executive of Advocate Physician Partners.

“He pulled together hospitals and doctors who didn’t before see themselves as being part of an organization,” said Dr. Thomas Lee, chief medical officer for Press Ganey Associates, in the Modern Healthcare article.

Sacks’s ability to bring different parties together was part of his recipe for success when Advocate Physician Partners in 2004 moved to form a clinical- integration program designed to improve outcomes and lower care costs, according to the article. Today, Advocate Physician Partners is recognized as one of the largest accountable health- care organizations in the country with more than 5,000 physicians serving one million patients.

Clinical integration is a structured collaboration among APP physicians and hospitals on an active and ongoing program designed to improve the quality and efficiency of health care.

“Our healthcare ministry owes Lee Sacks a debt of gratitude and one we’ll never quite be able to repay,” said Jim Skogsbergh, co-CEO of Advocate Aurora Health.

Skogsbergh highlights Sacks’s legacy in his “relentless pursuit” of safety. “As an organization with a rich history of safety initiatives, in 2014 we launched our journey to zero harm that fundamentally changed the culture of Advocate,” Skogsbergh said. “From daily safety huddles to serious safety event reporting, Lee has left a lasting impact on our safety-first focus.”

Sacks led Advocate’s initiative to eliminate the system’s clinical serious safety events by 2020. By 2017, the health system was halfway to its goal, reducing serious safety events by 55 percent by the end of that year, according to Modern Healthcare.

Sacks told Modern Healthcare that talks about improving safety began after the 1999 release of a key national report, which led to the system to create a new strategic plan. Sacks said a culture change was required in the clinical environment that encouraged staff to become more transparent about reporting events. “I think we can confidently say that we truly have changed the culture and created one that more embraces safety,” Sacks said.

Under Sacks’s leadership, Skogsbergh said, Advocate earned a reputation as a pioneer in clinical integration. “His visionary approach positioned Advocate as a national leader in population health and the shift from fee-for-service to fee-for-value,” Skogsbergh said. “Today, Advocate is noted as one of the largest Accountable Care Organizations in the country, and Lee’s schedule could easily be filled on the national speaking circuit as others seek to learn from our journey.”

Population health means coordinating or managing medical care delivery to improve clinical outcomes at a lower total cost of care. The goals are to improve the patient experience, to improve health outcomes, and to reduce the total cost of care. Accountable care occurs when an organized delivery system of care like Advocate takes the responsibility of managing care of a specific population with incentives or financial risk for the total cost of care and the quality.

Skogsbergh said Sacks had a national impact on health care because he was promoting population health management at a time when few providers were engaged in such practices. Skogsbergh told Modern Healthcare that Sacks understood the importance of interventions that focused on better disease management, targeting high-risk user groups and addressing social needs for socioeconomically vulnerable patients as part of the organization’s fiscal strategy as Advocate shifted to value-based payment contracts.

For years, Sacks has been visible as a key source in national newspaper articles, trade publications, and professional publications. He has testified before Congressional committees and other governmental bodies, and he frequently speaks at health- care conferences.

In July 2018, Sacks received the 2018 TRUST Award from the Health Research & Educational Trust (HRET). HRET established the TRUST award in 2003 to honor visionary leaders who symbolize HRET’s mission of leveraging research and education to make a lasting impact in policy and practice. HRET is the not-for-profit affiliate of the American Hospital Association (AHA).

“Lee’s leadership in the field to promote value and meet the challenge of affordability in health care has been courageous and impactful,” said Jay Bhatt, president of HRET and chief medical officer at AHA. “His work on clinical integration, physician engagement, and health care delivery innovation has been tremendous and supports the AHA’s commitment to quality, safety, value, and affordability.”

Besides his health-care accomplishments, Sacks has succeeded in converting my sister into a sports fan. I don’t recall her being interested in sports. Besides watching the Chicago teams, the couple cheers for their favorite college teams, University of Michigan and Northwestern University; my sister and her children attended these colleges. Both Lee and Joan attended the 2018 Super Bowl in Minneapolis.

With a passion for family and health care, Sacks will continue to be busy in retirement. And he will continue to fly the W as a Cubs’ fan forever.