Save for his morning routine, few things are consistent in the average workday of MultiCare Health System CEO Bill Robertson.

“I start the day by repeating to myself, as I’m getting into the car and driving, the mission of the organization: partnering for healing and a healthy future; the vision: MultiCare will be the Pacific Northwest’s highest value system of health; and our values: respect, integrity, stewardship, excellence, collaboration, (and) kindness,” said Robertson. “And the reason I do that is that should be the frame for my day. No matter what I’m doing that day, I need to do it in a way that it is consistent with all those ideas.”

Robertson has worked in health care since 1986, when he took a job as director of accounting for a hospital near Tampa, Florida, four years after earning a bachelor’s degree in finance and accounting from Southern Adventist University. Growing up, he always had imagined himself as a physician, but changed that career trajectory while in college. Yet, in the end, he still circled back to health care. For 10 years after that first finance job in a hospital, Robertson made his way up the corporate ladder at various hospitals and became CEO of Shawnee Mission Medical Center in Kansas in 1996. Four years later, he was leading Adventist HealthCare in Maryland. In 2014, he moved to the South Sound to head MultiCare.

Why has he spent his career in health care?

“I like working with people who are doing something that’s worthwhile, and that’s what health care is,” he said.

MultiCare is a nonprofit organization, which Robertson said bolsters its goal of remaining a staple institution in every community it serves. “For-profit organizations or other businesses are not necessarily so centered on staying in a community over time,” he said. “If you look at some of the organizations that have been around the longest in the United States, there are hardly any big for-profit corporations that were started 135 years ago.”

We sat down with Robertson to learn more about the economic impact of Pierce County’s second-largest employer, important shifts in the nonprofit under Robertson’s leadership, and the logistics of prioritizing the interests of multiple communities.

Q: MultiCare is the second-biggest employer in Pierce County (after Joint Base Lewis-McChord), with about 16,000 employees. Has it always been such a giant in the local health care industry?
A: MultiCare got its start as something really small in 1882. It wasn’t the biggest in the community then, but it has grown over time with lots of good leaders trying to make sure that they took care of the community well. When you put the community first and ask yourself what the community needs in order to be cared for, you create great opportunities to grow because there’s always a need for health care in communities.

Q: Since you’ve started at MultiCare in 2014, what has putting the community’s needs first looked like from your position as CEO?
A: The first thing that the team and I took on was the lack of access to mental health care in this community. We worked with our board and with others in the community to focus our efforts on that, and we’ve seen positive community engagement and success in that area.

The services we operate directly have grown dramatically in behavioral health and moved to different communities that we serve. We have a great partnership developed with the (CHI) Franciscan (Health) organization around building a 120-bed inpatient psychiatric hospital that will open in 2019, which will be the first free-standing psychiatric hospital in the area.

In 2016, we opened an adolescent behavioral health psychiatric hospital, which was something that Pierce County had never had access to before. Those are a couple examples of times when we notice a need, see that no one has focused on that need, and find the right partners to help create a reality where we are meeting those needs.

Q: Besides the greater focus on providing access to mental health, what else has changed at MultiCare since (you arrived in) 2014?
A: We have dramatically shifted our focus toward enhancing access to urgent care centers, retail clinics, and virtual medicine because we think that people want to access health care as close to home as possible.

We moved to Spokane, so now we have a very large presence there. We built the Pulse Heart Institute, which is an innovative partnership between community-based cardiologists and MultiCare coming together to create world-class cardiac and vascular services.

And we have become more efficient in many of the services we provide.

Q: How do you improve people’s access to health care?
A: About three years ago, we reworked our uncompensated care policy and now have a generous way of helping people who can’t normally afford health care to have access to it without becoming financially burdened. That’s an access issue even though it doesn’t include new buildings or new services.

We’ve also expanded to have new services. For example, we’re developing a unit at Good Samaritan Hospital that will help women who are pregnant and using opioids or other substances have a successful pregnancy and get off those drugs. That service will open next year, and it provides access to something that did not previously exist in the community.

A similar case is the adolescent behavioral health psychiatric hospital: Before, there wasn’t access to inpatient mental health services specifically for adolescents. Now, there is.

Q: What is the economic impact of the work that MultiCare does for the different communities it serves?
A: There are a lot of different ways that you could look at that.

One is to look at how much uncompensated care we provide, and that’s probably hundreds of millions of dollars. But I would suggest that a better way to think about economic impact is to consider how many people we employ in the community, which is about 16,000. We’re about a $3 billion organization with a payroll of about $1.5 billion dollars. We make a fairly substantial contribution to the area’s economy because we are such a large employer, and because we buy our goods and services — like our utilities — from the same place that everyone else in the community does.

Q: How do you measure health needs, and how do you then respond to them?
A: Every three years, we do something called a Community Health Needs Assessment for each hospital in our network. We identify what the health status is, and then what the health needs are.

For example, a need might be that there are disparities between infant mortality based on race and ethnicity. Unfortunately, our African-American community tends to have a higher rate of infant mortality. So, there’s an opportunity for us to be a partner and provide support and access to prenatal care for that community.

One of the things we’re doing is to become more educated about cultural competence so that we can better understand the many ways that different communities see health and health care. For the last three years, we have put a lot of time and energy into making sure that our team members and our organizations are as adept as possible at delivering the care that needs to be provided in the context of an individual’s culture and the way they see the world.

Q: In your opinion, what makes MultiCare a successful health care provider?
A: I think that our ability as an organization to remain connected to the people we serve is very substantially driven by the fact that we have a highly engaged community board, as well as people in the community who are willing to raise money around issues that are important to them.

For example, there were over 70 community leaders who came together from all walks of life to help support the development of the new behavioral health hospital. They facilitated raising $18 million for that project, which was $44 million in total.

When our community is helping make a difference, that’s when we can really be successful and make the impact we want to.