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Improving the Community Health of Brevard

Collaboration is Key to Unlocking Patient-Centered Healthcare By Lyle Smith As Brevard County’s only integrated delivery network, Health First uses its network of hospitals, insurance plans, medical group and outpatient services to meet the community’s needs.

Collaboration is Key to Unlocking Patient-Centered Healthcare

By Lyle Smith

Dr. Jeffrey Stalnaker, Health First Medical Group CEO and Travis Douglass, Health First Medical Group President

As Brevard County’s only integrated delivery network, Health First uses its network of hospitals, insurance plans, medical group and outpatient services to meet the community’s needs. But beyond any of this, and foremost in the minds and efforts of its leaders, Health First is a group of dedicated and experienced medical practitioners committed to maintaining and improving the health of where they work and live.

“We are vested in our mission, to work for the benefit of the community,” Health First Medical Group President, Travis Douglass said.

Perhaps the biggest challenge to managing an organization of this scale and complexity is identifying the most effective leadership business model to sustain a customer-centered system.

Healthcare and hospital organizations across the nation have wrestled for decades with the dual roles required in leading their business structures successfully. On one side is the medical focus with patient needs at the center and the development of culture and quality supported by the front-line services from physicians, research, technical and support staff. On the other side is the business operation, which includes everything from administration, finance, budget, billing, insurance, facilities, and logistics with a focus on cost benefit.


Health First has chosen to create a collaborative leadership structure between clinicians and operations where both sides are built on a foundation of equal footing and accountability.

This structure is trending nationally in the healthcare industry and Health First is successfully utilizing it in Brevard to provide improved outcomes.

For Health First’s Chief Physician Executive, Dr. Jeffrey Stalnaker and Health First Medical Group President, Travis Douglass, this collaboration creates equal positions of responsibility, but utilizes their unique talents and backgrounds to improve outcomes for both the medical and operational sides of the business. As a result, the pair is able to perpetuate a culture of collaboration across the entire organization.

They work closely together with a mutual respect for their backgrounds and talents. Decisions stemming from or affecting medical providers are reviewed by Dr. Stalnaker while those impacting business operations are led by Douglass. Inevitably, some choices require both leaders to consult with each other in order to find the best, most effective solution or strategy to benefit the patient first.

“There is a division of duties,” Douglass said, “but it’s more important how we work together.”


While the two men come from divergent backgrounds and outwardly project quite different personalities, the combination actually enables an energizing team leadership dynamic.

Together, they pair to organize and manage a system of almost 400 providers in 24 specialties, extensive lines of service, and a large number of staff and facilities across the county to efficiently and effectively serve the health of the community. And as a large part of a not-for-profit enterprise, that sense of community is what drives them both to make the organization succeed.

Dr. Stalnaker’s light-hearted personality is clearly a holdover from 36 years of an effective bedside manner he carried as a successful internal and emergency medicine specialist. Douglass, on the other hand, carries himself with the steady demeanor of his former role as a Marine Corps captain and combat veteran.

But as they chat and describe what they are trying to achieve at Health First, the dynamic cooperation between the two men shines through. Clearly, the structure is working.


Health First is a not-for-profit community healthcare system. Beyond a vague idea that not-for-profit equals “good,” it’s sometimes easy to lose focus on what it actually means from a community perspective.

A for-profit medical system, like any for-profit endeavor, uses the revenue it receives from fees and payments from insurance companies to generate a profit that is paid out to shareholders over time in the form of dividends. These organizations are subject to the direction of a management structure with a responsibility to shareholders.

In the not-for-profit model, any profit realized from the work of the system can be used for other purposes, like to provide charitable support to the community. Also, it can be used to reinvest into the system to enhance quality, add services, personnel or build and refurbish facilities. Last year, for example, Health First as an organization provided for more than $129 million of direct benefit into the community.

“You don’t see that from the for-profits, or other smaller systems.” Dr. Stalnaker said. Some of that benefit took the form of what’s called “uncompensated care” or “direct charity care.”

Part of that funding went into joint efforts with the Brevard Health Alliance (BHA), a federally qualified health center providing extensive primary healthcare services to Brevard County residents regardless of their ability to pay. Health First, as part of its mission, partners with BHA to deliver health and wellness services to the underserved. Additionally, Health First serves the community by working closely with the Space Coast Health Foundation and many other community based organizations that share the vision of improving the health of Brevard County.


Health First Pro-Health & Fitness Centers

The notion of reinvestment into the system is another fundamental part of Health First’s mission. As a result of these efforts, this year, Health First became the first in Brevard to offer 3D mammography, known as tomosynthesis.

Through the support of the community and the Health First Foundation, the newest addition to the Health First system, a state-of-the-art, fully integrated breast cancer center in Melbourne, opened in April.

At the Health First Breast Center, specialists manage every phase of care. This, both Dr. Stalnaker and Douglass agree, is a cornerstone of the Health First approach and the latest way healthcare systems across the country are working to realize efficiencies and effectiveness in the full continuum of patient care.

In the past, patients would consult multiple sources for services, which often led to them receiving care at various facilities across a large geographical area.

At this new facility, designed with patients at the center, they are not only diagnosed and directed, but guided through the complicated maze of treatment options, insurance questions and physical locations required to realize a positive outcome. All resources are under one roof.

And this is one of the visions for the future for Douglass and Dr.Stalnaker. The Health First Medical Group is currently taking this approach with cancer, heart and vascular, and orthopedics.

The next possible areas he noted will likely be in neurology and mother/baby. Another area that’s already growing across Health First is wellness. There were more than 1.2 million visits to Health First Pro-Health & Fitness centers in Viera, Palm Bay, Melbourne and Merritt Island.

“As the market evolves with the need for comprehensive care, approaches like this arise,” Douglass says, “we’ll work to evolve with that need.”

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