The interim chief executive for Cleveland-based MetroHealth Medical Center envisions running a hospital under two systems: one that attracts more patients who can afford healthcare and another that offers a streamlined, cost-effective method of delivering care to the poor. Mark Moran's proposal includes new screenings and other measures to guide non-emergency cases away from its emergency room; an expansion of certain services and more community health centers; "upgrades" that would allow MetroHealth to collect more of the money it bills; and possible partnerships with other hospitals.