Retention with Intention: Northern Light Health's 2025 Turnaround

Employee retention and strategic partnerships helped shape this system's success.

Northern Light Health, Maine's second largest healthcare system, found itself in financially tumultuous times in 2024. Through the first three questers of the year, the health system saw $100 million in operational losses and a debt of $620 million, leading to a credit downgrade.

Many of the challenges for Northern Light hung around post-pandemic, and over the last few years the system has made big steps to get back on track, including closing clinics, changing programs, selling off laboratory services and outsourcing non-medical positions.

One of the biggest steps the system took was a major administrative staff layoff in October 2024. The system eliminated three executive administration positions in order to preserve frontline medical staff.

Overseeing this from a financial standpoint was James Rohrbaugh, who was hired as Northern Light Health's executive vice president and CFO in July 2024. Rohrbaugh says the system has made a significant turnaround since then.

"We've seen significant increases in volume, specifically in the first quarter, this year compared to the first quarter of last year," he said. "That certainly is very encouraging."

Much of the challenges last year stemmed from low reimbursement, labor shortages and increased costs. Rohrbaugh says the health system has shifted its focus since then to highlight patient access, efficiency, retention and partnerships. 

Keeping Local Healthcare Accessible

The 10-hospital system, headquartered in Brewer, Maine, includes several critical access hospitals within its network, serving much of Maine's rural population. With 37 care locations, a physician-led medical group, and close to 1,000 licensed beds, Northern Light Health plays a vital role in Maine's healthcare landscape. It's also one of Maine's largest private employers, employing more than 10,000 people.

When asked if there were ever any thoughts of selling the system during its financial chaos, Rohrbaugh emphasized that it was never a part of the plan.

"Our board and our hospitals consist of community members that are devoted and focused on making sure that we're delivering services to our communities, and so we've been much more focused on what we need to do as a system to drive sustainability," he said. "To us, it's critically important to keep healthcare local."

Strategic Partnerships

Rohrbaugh says a key strategy in Northern Light Health's turnaround has been strategic partnerships. One is with local organizations such as the Maine Hospital Association. Through this partnership Northern Light Health is able to interact with "other providers together that are challenged with the same kinds of issues," he says, helping the health system to tackle challenges through a policy lens.

Joint ventures create the second category.

"For example, we have a joint venture with First Atlantic Health Care [which manages 18 nursing, rehabilitation, long-term care and assisted living centers across Maine] to manage our long- term care centers," he said. "One of the things we recognize is that it's helpful to have expertise that's focused."

Lastly, smaller partnerships play a significant role. Rohrbaugh says these types of partnerships are important for the system to leverage economies of scale, and improve efficiency and the care experience for patients.

"Over the last couple years we've put in place a number of partnerships with organizations such as Quest [Diagnostics], Optum and then most recently Compass One [Healthcare]," he said. "Partnerships show up in many ways, but they clearly are a critical part of success for us in the future."

Retention with Intention

As Northern Light Health gets back on track after last year's challenges, the spotlight on its medical staff has never dimmed.

"Maybe the most important part from our perspective is engaging the leadership and the workforce together, attacking, tackling the challenges, changing the work," Rohrbaugh said.

A couple factors the system found to be very important are the structure of job descriptions and flexible scheduling.

"[We are] being innovative around people, scheduling and making sure that we can think outside the box around how we schedule them," he said.

Engaged employees and a good organizational culture are a couple components to the health system's retention strategy. But with a labor shortage, those employees can be difficult to find. Rohrbaugh says building a robust talent pipeline, intertwined with another partnership, was vital for the system.

"Talent strategies are a critical part of the work that we do," he said. "We've been fortunate that we built strong relationships between the Maine Community College system and nursing schools across the state. So schools of nursing, for example, have clinical rotations at Northern Light Health. We also have family practice and physiatry residency programs."

Partnerships like these have shaped the system's recruitment and retention strategies. This particular collaboration includes the state's largest health system, Maine Health. 

"That's a really good example where you have two health systems that are in the same state and in [the same] markets, and we compete against each, [but are] both part of a partnership together helping fund a program through The Maine Community College [system] to grow our workforce," he said.

Rohrbaugh says partnerships highlight the opportunities in healthcare that can't be seen in isolated decision- making. Health systems work best when decisions emerge from informed groups, meshing executive leadership with outside organizations and clinical staff.

"I think it's an exciting opportunity for all of us, continuing to reinvent how we deliver healthcare, and the best way that happens is by going as close to the care as you can," he said. "I think the most important part of making those tough decisions is making sure that the workforce and the staff is part of that decision making process."