Amy B. Mansue covers a lot of geography behind the wheel of her car as she crisscrosses large chunks of New Jersey daily for her demanding work as an executive in healthcare delivery for Monmouth, Ocean, Mercer, Middlesex, and Somerset counties. In March 2016, Mansue accepted the position of President of the Southern Region of RWJBarnabas Health, the parent organization formed by the 2016 merger of Barnabas Health and Robert Wood Johnson Health System. As a person who is passionate about learning, she uses her driving time to listen to audio books and think creatively about the healthcare challenges that affect the communities she serves.
Mansue is accustomed to traveling from place to place, since as a child her family would vacation for a week camping in Maine, then visit family in Massachusetts or Florida. She grew up in a house that her parents built on two acres of a spinach field in Plainsboro. She planted trees, examined worms, and took violin lessons. As an only child, she has a close relationship with her parents, who were both educators.
Her mother was enrolled in one of the first classes at Douglass College, which encouraged women to enter college after they had children. She did this when Mansue was four years of age and shared duties with her father who oversaw care for young Amy at night. There were visits to the candy store and visits to family members. “It took a village,” Mansue observes, a concept that forms her own people-centered approach as a leading healthcare executive.
Mansue sees her job at RWJBarnabas Health as a chance to develop relationships, see people in different ways and learn from them. She applies the same principles of the village running through daily life, “whether you pick up a cup, or help somebody in a grocery store or transform healthcare in multiple counties.” She believes that we each play a role in helping others and from the small to large scales of action, that we can do it better when we do it together.
Mansue was born and raised in Plainsboro and is now a Hightstown resident who also owns a condo in Bradley Beach. Though she went south for her college years at University of Alabama, Mansue is a true New Jerseyan who has along the way fallen in love with the Shore. She draws her considerable drive and inspiration from every town and community she visits, however, as they form the roots of her faith in positive outcomes.
“I think you have to be purposeful about finding the goodness in every day, because there’s so much getting thrown at us about what is wrong or what we don’t have or what we should be aspiring to, that I think we can lose sight of what we have, and most importantly what can be done.”
A favorite book that she likes to keep close is “The Power of Moments” by Chip Heath, Dan Heath. It teaches how to focus on how to make an ordinary moment memorable. Mansue ordered 15 of the books to give to co-workers, encouraging them to find those opportunities. She also has a favorite “business” book, Five Dysfunctions of a Team by Patrick Lencioni, which presents in narrative form insights about how to tackle management issues. She turns to music – from classical to country rock to Bruce – to provide comfort in her very busy and challenging life.
As a child growing up in a household with two educator-parents, Mansue was allowed to watch only the news with Walter Cronkite and one half-hour TV show daily. It’s entirely probable that her big smile and ready laugh were inspired by nightly doses of her show of choice, I Love Lucy. Thankfully for us, that enduring sense of humor, coupled with intelligence and a wicked work ethic have this Jersey Girl in good stead as she tackles complex healthcare – and other issues – on the frontlines in New Jersey.
Living In Monmouth thanks Amy Mansue for taking the time to chat with us about her important role in shaping the present and future of healthcare in New Jersey.
LIM: The merger of Barnabas Health and Robert Wood Johnson Health System happened in 2016. How difficult was the merger process for these two major institutions?
AM: Change is always a hard thing, so any merger is difficult. But I think for the most part we’ve had a really smooth transition. We’ve had a steady opportunity to hit our goals, and that’s the first key of any merger.
We knew there would be synergies arising from strategic alignment, and there certainly have been. The need to share best practices has been wonderful throughout the system. I watched how suddenly all these people who were fierce competitors back in the community hospital days had to sit down together and share. It was definitely a process.
LIM: What institutions fall under your purview?
AM: I am responsible for the system’s service areas from the Raritan River south, including RWJ Somerset, RWJ Hamilton, Community Medical Center, Monmouth Medical Center, Monmouth Medical Center Southern Campus, and Children’s Specialized Hospital. Beyond hospitals, I have responsibility for those outpatient sites and physician practice locations in this region that work together to provide accessible service to patients.
LIM: Can you describe your main strategy for accomplishing healthcare services goals?
AM: There are established collaboratives around each of our service lines that provide the opportunity to share best practices. Using Ob/Gyn as an example, every hospital that has a program can come together and say, these are the issues we’re working on. How did you solve something similar? We pilot things and test them. There’s such dynamic energy in these systems, and it’s been really exciting to see how people love coming together.
LIM: You were CEO and president of Children’s Specialized Hospital in Mountainside from 2003 to 2016. Can you talk a little about the legacy you established there?
AM: I was very excited to have been there and have a chance to work with the team to create really powerful things, such as the expansion of our services to 11 sites and the move of the inpatient hospital from Mountainside to the RWJUH academic campus in New Brunswick. We tried to serve as many kids as we possibly could, and so we invested in telemedicine and all sorts of other approaches to try to meet the need, because the need was so great. By the time I left, we were taking care of 28,000 kids, but we knew that the need was more like 300,000.
LIM: What was it like for you to leave?
AM: I don’t think anybody really leaves Children’s Specialized. I think your heart always stays there. But when the merger came, it was a wonderful opportunity to channel my skills into a whole different set of challenges.
LIM: What knowledge did you bring to your new job as President of the Southern Region of RWJBarnabas Health?
AM: The thing that I learned early on in my education in social work is that the experts are the patients and families who are on the forefront of what we do. These are the people in our communities receiving the services, living in poverty or struggling with some of the changes. They know how the system can better serve them. They know this much better than we do. And I think that’s really true for healthcare in general. I think that we’re still very driven by everyone’s needs but those of our customers. Medicare, the State, the Joint Commission have requirements for us, but we need to learn how you listen and how you respond to the people we care for as much as our regulatory structure.
LIM: What do you think is the most important metric in assessing health needs for the Southern Region?
AM: I think it’s really about the number of people we can touch. There are nine million people in the state of New Jersey, and five and a half million of them live in our service area. So, we have the chance to improve the lives of those people with our programs and our services. How we are going to help people live better lives today, and in the future, is the key issue for me.
LIM: Why are we seeing a growing number of partnerships and mergers between competing healthcare organizations?
AM: I’ll use Monmouth and Ocean counties as an example. Hackensack Meridian and RWJBarnabas, we’re well-matched competitors on the healthcare playing field. But there are places where we can and do come together around opioid addiction, health screenings, ways to improve access and quality of care that we must tackle together because the issues for people in New Jersey are too big to tackle alone.
LIM: What are some of the biggest challenges for healthcare in our area?
AM: We know that the opioid epidemic is just horrific. We go to too many funerals and see too much loss. There must be a marriage between behavioral health and physical health if we are ever going to address the most perplexing health issues of our time – such as this opioid epidemic. The drugs really are about filling holes and cravings, and we must figure out how to deal with those in a forward-thinking basis, like we would do if we found out you were diagnosed with cancer. There has to be that same understanding, and so much of it is still stuck in the stigma against raising your hand and saying I need help – and then being able to access care.
LIM: How can healthcare services help bridge this divide between behavioral and physical health?
AM: I feel like things are not where they need to be in reaching kids and families sooner, or younger. And also making it okay to say, I need to talk to somebody. Many of us were raised that you just tough those things out. Nobody would ever say to somebody with a cancer diagnosis, just “suck it up”, but for some reason you need to tough it out when you’re depressed, right? But that is still the message when there is a behavioral health issue. The challenge that I think we all have to overcome in the healthcare field is to figure out how to de-stigmatize a program, a set of services that is critical, not just for those people with mental illness, but those people who have chronic health conditions, because those chronic health conditions make you depressed. You need to be able to have the ability to move in and out of those systems and access that care. And we as a healthcare system need to make that easier.
LIM: Have you seen progress in access to care?
AM: A really important instance of a team approach to improving access is in Central Jersey, where The Robert Wood Johnson Foundation and Middlesex County funded the work that St. Peter’s University Hospital in New Brunswick and RWJ New Brunswick are doing together. We have these two super hospitals three blocks from each other, and through this partnership we’re seeing improved access to cancer screenings and behavioral health services, for example. We have been making great strides and are looking at those boots on the ground to figure out how to do that work better in Monmouth and other counties.
LIM: In January 2018, you were named chair of the Board of the New Jersey Hospital Association, the state’s oldest and largest hospital and healthcare advocacy organization. Do you feel this is a good fit for you?
AM: I am grateful for this opportunity to continue to improve wellness for both individuals and local communities. Our 2018 mission statement is to improve the health of the people across the state, and as Board Chair of NJHA I look forward to collaborating with other leaders and organizations to concentrate on the societal challenges that impact health in our communities throughout New Jersey.
LIM: Are you looking to community partners outside the healthcare arena?
AM: I’m seeing that RWJBarnabas has really moved outside of the traditional healthcare realm very successfully. We view ourselves broadly in the social service business, not solely in the healthcare business. Whether you’re talking about developing jobs and work opportunities or looking at food insecurity and safe housing, you know, you’re really looking at these holes that need to be plugged to really have total wellness for people in a community.
LIM: Can you give an example of a community-outreach initiative?
AM: One of our major initiatives in Ocean County was the partnership with the schools and the naming of the RWJBarnabas Health Arena, which is in Toms River. It’s right on the campus of the high school. The school uses it for all of its activities, and it’s also the center for the community.
A primary driver for that naming opportunity was partnering with families and educators and really looking at creating those healthy lifestyles right up front because, you know, the older we get, the harder it is to change our behaviors, right? We want to look at how to start those healthy behaviors early, and also identify this next generation of healthcare leaders.
We’ve also started aligning RWJBarnabas Health with Rutgers’ education, research and clinical activities, including those at the Rutgers Cancer Institute of New Jersey and Rutgers University Behavioral Health Care.
This summer we will mark the first Rutgers Robert Wood Johnson Medical School class that will begin at Monmouth Medical Center in Long Branch. We’re very excited about that opportunity.
LIM: Can you identify any major shifts in our healthcare services model?
AM: We know we’re moving from a fee for service, inpatient model to an outpatient model, a value- based model that really looks at health outcomes. A priority is making sure that we use our universities and our health professionals to help ensure that we’re protecting people as we move to that value- based model. That is going to be critical. LIM: You seem to take a boots-on-the-ground approach to community healthcare. Why?
AM: The responsibility of ensuring the public good is one that you don’t always understand until you’re inside of Federal and State government.
I could never tell you the hours and challenges and things that I saw from the DYFS worker who would go into the most difficult situations, to the individual who’s making, you know, just barely minimum wage caring for our most fragile elderly and children. Those are really important jobs and we need to make sure that there is talent to be able to do them. When you’ve been privileged to see that whole range of challenges people face, it forms who you are. When you see the dedication of people who are passionate about helping their neighbors, it’s humbling. What matters is what you’re doing on the ground every single day for each person. And I think that it’s easy in this time of great competition to lose sight of that.
LIM: Does healthcare advocacy necessarily involve politics?
AM: I’ve always been interested in how laws get made and in how they impact people on the frontline, but I don’t see healthcare as a partisan issue. At the end of the day, whether you’re a Democrat or Republican or Independent, you want to make sure that when a patient walks into a facility, they receive the highest quality of care, a relationship with the practitioner that is respectful, and the ability to make important decisions together.
LIM: You’ve had experience in the public sector at both the federal and state level. Can you give us some highlights?
AM I had two tours of duty in State government under Governor Florio and then again under Governor McGreevey. My most memorable experiences came from the dedicated staff, advocates and families I got to meet along the way. Caring for the most vulnerable among us is both a huge responsibility and a tremendous honor. We must strive to find the best in each other and the institutions that help us provide these critical services.
LIM: You served as Co-Chair of the Budget Transition Advisory Committee for current Governor Phil Murphy. Do you think his administration will be proactive on healthcare issues?
AM: The thing that I like most about Governor Murphy is that he’s not afraid to take on a tough issue. He has been very clear about his desire to address the major issues we have in New Jersey, and it doesn’t matter whether it’s healthcare or education or transportation. They are all important issues that are going to require critical partnerships. I think we’re in for a very dramatic time in New Jersey as one of the states that has been on the forefront of Medicaid expansion, ensuring that people have access to services. There is no calculation under any federal block grant proposal or any entitlement reform that doesn’t end up hurting New Jersey. I think Governor Murphy has a clear vision about that. He’s been out front in reference to the out-of-network legislation, saying that people should not have surprise medical bills. He looks for a partnership between the hospitals and the doctors to really address those issues.
LIM: Any chance you might run for public office yourself?
AM: I never say never, except I know I won’t ever run for office. I can say never to that! Mr. Ostrowsky [Barry H. Ostrowsky, President and Chief Executive Officer at RWJBarnabas Health] has given me more work than I could even imagine. I can’t be thinking about another job right now. I’ve got to do well with the one I have.