Ryan Lilly '97 is second-in-command at the nation's oldest veterans hospital, Maine's Togus VA Medical Center

Story and photo by Marc Glass (Spring 2008 issue)

Ryan Lilly ’97 wants people to understand the priority he places on patient care from the moment they connect with the nation’s first and oldest veterans hospital. And that’s why they hear his congenial voice upon calling: “Hello. This is Ryan Lilly, associate medical center director, welcoming you to the Togus Division of the VA New England Health Care System.”

Administratively, Lilly is second-in-command at Togus, with responsibility for managing all non-clinical aspects of the 1,000-acre campus and its more than 150 beds for acute and long-term care. In addition to the in- and outpatient specialty services at the main Togus campus, Lilly also has oversight of six community-based outpatient clinics that provide a variety of primary and specialty care services in areas closer to veterans homes throughout Maine. In total, the system serves nearly 40,000 Maine veterans through more than 325,000 outpatient visits.

“No two days are the same,” said Lilly, who majored in history and political science—and now rides herd on all matters relating to finance, contracting, human resources, facilities and engineering, food service, medical records and benefits eligibility. “At 8:30 in the morning, I could be dealing with a concern from a patient that breakfast was served cold, and at 9:30 I could be working on a contract to get a mobile magnetic resonance imaging unit on site to expand our diagnostic capacity.”

Reporting directly to Lilly is a legion of “chiefs”—for contracting, finance, nutrition and human resources, among others. It’s a job, he said, that requires being a “generalist” rather than technical expert in each area. “My philosophy is that the people at the front lines are the ones who have the right answers,” he said. “I ask the right questions and provide the support to achieve solutions.”

Opened in 1859 with a $250,000 investment from Rockland granite merchant Horace Beals, Togus Springs was envisioned as a second Saratoga Springs, complete with a hotel, stables, a bowling alley, bathing house and race track. (Locally, the resort gained notoriety as “Beals’ Folly,” when a lack of business during the Civil War forced the short-lived venture to fold in 1863.) Selected for its serene, therapeutic environs (not to mention its fire-sale price), the site was purchased by federal government for $50,000, and Togus welcomed its first veteran in 1866.

While the history major in Lilly delights in Togus’s first-in-the-nation status within the VA Healthcare System, the senior hospital administrator in him sees formidable challenges. With a mid-century vintage, the average VA medical center building is a good 40 years older than its private-sector counterpart. And that means retrofitting for 21st-century medicine is a constant entry on Lilly’s to-do list (as evinced by the two construction crews working opposite ends of the campus on the day of the interview).

Although never-ending, the job of maintaining Togus buildings has been easier since 2007, when the conditions at Walter Reed Army Medical Center garnered headlines and congressional hearings. Although Lilly said the VA Healthcare System has no formal relationship with the military hospital system, being “painted by the same brush” had an unexpected benefit. “The positive result of the President’s blue ribbon commission is the greater recognition that the facilities and infrastructure in the VA system need to be upgraded if we are to achieve our desire to provide the best health care in the country.”

After graduating from UMF, Lilly earned a master’s in public administration at West Virginia University and then joined the VA Healthcare System in Denver as one of 400 graduate students nationwide selected for the Presidential Management Intern Program. And after serving one year as a budget analyst, Lilly, at 24, was appointed Chief Fiscal Officer at Denver’s VA Health Administration Center.

“It was kind of unusual,” said Lilly of his rapid rise through the VA medical center ranks. “Most CFOs come from a strictly accounting background, and I wasn’t a green-eye-shade accountant who talked about funding in terms of line items. Clinicians want to know how much money they have to bring another doctor on staff. Everyone on some level, even at home, has a budget, so I spoke in budgeting language that people can more easily understand.”

After three years in Denver, Lilly and his late wife, Tara (Hayes)’97, relocated to White River Junction, Vt., where he served as CFO of the state’s VA medical center. For the North Berwick native, accepting the Togus position in 2006 was a chance to scale the next-highest rung on the VA medical center career ladder and rejoin family in Maine.

Despite the success and opportunity afforded by graduate study, Lilly insists the path to his lofty perch at Togus began at UMF with his study of political science, history and economics: “Farmington was the foundation for everything that came after,” he said. “That’s what a liberal arts education does.”

Barely more than a decade out of college, Lilly is taking what he learned at UMF and putting theory to practice.

“I remember back in ’94-’95 sitting in poli-sci classes, debating what role government should play in the health care system,” he said. “Now that I’m in a federal system, I see the dynamics first-hand.”

And even though the VA takes “guidance and counsel” from the executive branch of government, Lilly said former Speaker of the House Tip O’Neill’s sage words—“all politics is local”—resonate every minute of every day on the job.

“That’s true for my work even though the VA is the largest national health care system in the U.S.,” Lilly said. “I still walk through the in-patient wards and nursing homes and ask ‘How are things going? Are you getting what you need? Are people explaining things to you in a language you understand?’ The patients here are my constituents.”