The Jackson County Board of Supervisors announced a buyer this week following an extensive request for proposal process.
Singing River Health System (SRHS), a nonprofit health system serving the Mississippi Gulf Coast, has a buyer, the Jackson County Board of Supervisors announced this week.
The board of the county-owned health system has undergone an extensive request for proposal process with the aid of a third-party advisory firm to identify a purchaser of the three-hospital health system and chose Franciscan Missionaries of Our Lady Health System as the purchaser.
"This is an exciting day for Singing River Health System," Tiffany Murdock, CEO of SRHS said in a statement. "Our future with the Franciscan Missionaries of Our Lady Health System ensures that Singing River will be able to meet the needs of our employees, patients, and community members for years to come. Together, we will build on the strong foundation Singing River has established since we first originated as Jackson County Hospital in 1931."
Franciscan Missionaries of Our Lady Health System is a Catholic health system headquartered in Baton Rouge, Louisiana, and serves communities in Louisiana and Mississippi across ten hospitals and numerous clinics. According to a press release, the system "is committed to ensuring SRHS patients continue to receive high-quality, accessible care" locally.
"We are excited about the possibilities for healthcare in our region and believe the Franciscan Missionaries of Our Lady Health System is the right choice," Ken Taylor, president of the Board of Supervisors, said in a statement. "Fundamentally, they share our community values and have a mission to provide equal access to healthcare for all."
The announcement marks the beginning of the next phase of the buying process, the health system said, and both parties intend to complete the sale this fall.
The sale of country-owned SRHS was decided, not because of financial instability for the organization, but because of rising costs for taxpayers.
"It's not a cheap industry anymore, and for it to be put on the taxpayers in Jackson and Harrison counties, it wasn't fair," Murdock told WLOX in February. "We wanted to do it from a place of strength. We didn't want to do it when we were bankrupt or if that was a possibility. We wanted to do it because we want to grow."
Michael Slubowski talks candidly about the future of healthcare and rising costs for nonprofit health systems.
With the COVID-19 public health emergency (PHE) coming to an end in May, nonprofit hospitals and health systems, which are already facing a myriad of challenges, will have to face even more as regulations get stricter and costs continue to rise.
Among those health systems to be affected is Trinity Health, a $21.5 billion nonprofit Catholic health system that operates 88 hospitals across 26 states. Recently, the health system posted a financial loss of $298 million as the rise of expenses outpaced revenue coming in during the first six months of fiscal year 2023.
Michael A. Slubowski, who is the president and CEO of Trinity Health, spoke with HealthLeaders about the challenges the organization is facing in the wake of the PHE ending, including lost coverage for Medicare- and Medicaid-covered patients, steps already taken to reduce costs for the system, and the future of healthcare delivery and payer models.
This transcript has been edited for clarity and brevity.
HealthLeaders: What does the COVID-19 PHE coming to an end mean for Trinity Health?
Michael Slubowski: The end of the public health emergency is going to create a lot of challenges for us—it already is—because a lot of the regulatory agencies are back at full strength.
There are two big impacts. The first is with Medicaid. Nationally, 91 million people have to re-enroll in Medicaid. In our case, we're estimating 5% to 13% [of patients] could be impacted by not getting coverage. For Trinity Health, 5% would be $80 million in lost revenue, by way of example. It's an enormous number, but beyond the financial impact on us, the impact on people having coverage is a big concern that we have. Second, there was a 20% add-on for Medicare on DRG payments for COVID-positive patients and that goes away in May, as well.
We've taken some positive and proactive measures to try to help folks get re-enrolled in Medicaid. We're reaching out proactively through email or text message, we're setting up stations for re-enrollment at our sites, and we're doing our best to make people aware of what they have to do and how we can help them to reapply to keep their coverage.
HL: How has the current landscape changed the way you lead Trinity Health's operations and strategy?
Slubowski: Our labor costs have gone up over 20% with the great resignation. Our pharmaceutical expenses have gone up 24%. With two-thirds of our revenue from Medicare and Medicaid, and many of the commercial payers are unwilling to provide any kind of an increase in payment for the impact of inflation, it's put a tremendous financial strain on our health system.
Our mission hasn't changed. We always say that we're a ministry running a business, but the business is unhealthy right now. We're going through a lot of change right now on operating performance, we are not only trying to run the ministry, but evolve it. We have a $1.1 billion improvement plan and that includes some efforts on growing our patient base, but a lot of it is around cost reduction.
We have implemented a number of new care models. Before the pandemic, we created our own internal staffing agency called First Choice, so that colleagues who decide to leave the profession full-time or part time have an option to work on their terms and what works for them. So, creating flexibility for people and providing an opportunity for them to earn some income has been an important vehicle for us.
We've implemented a new care model called Together Team. We piloted it, and now we're rolling it out across all our hospitals. It's a three-person care team; it includes a floor nurse, it includes either a certified nursing assistant or LPN, and then the third member of the team is a nurse that is in a hub that can [virtually] support the patient's care needs. Those three people function together as one team for a set of patients. The floor nurses, who are generally new grads, feel supported because there's an experienced nurse at the health hub that is supporting the care and working as part of their team. We've been able to keep nurses who otherwise would have left the profession, either because the work is too much for them given physical demands, or flexibility, who still want to provide care, and they're working in these hubs that are located in our campuses. They can beam into the room, they have full access to the medical record, and the cameras are good enough now that they can look at skin conditions. The nurse assistant or LPN can practice at the top of their license as well. It's helping us with the retention of new nurses and keeping experienced nurses in the workforce.
Patients and families love it. Think about it, you push your call light, and somebody comes on the screen instantly, and can attend to you, help coordinate the care, and they can do discharge planning with the patient. And spend the time with the patient and the family. Patient satisfaction is very high with this model. It's one of those transformational things that can help us with staffing as well as patient satisfaction.
We have been implementing what we call TogetherCare, powered by Epic, across all our 80-plus hospitals, and we've done it on a common platform and a common build, so our care protocols and our order sets are the same for similar conditions across the organization. Those are ways to improve care and improve efficiency.
At the same time, when I talk about operating performance, it's also about how we connect to our patients and members. Our brand promise is "we listen, we partner, and we make it easy." We have to try to live out all three of those things as we support our patients.
Running the business and evolving the business is paramount, but the third thing is about transformation. We're trying to reorganize around hospital-based services and community-based services. Community-based services, which is the growing segment of healthcare, [includes] primary care, our integrated medical groups, ambulatory surgery, diagnostic procedures, all home-based care services, and urgent care at a lower price point, because it has to be affordable to patients and members, as well as to the plans that pay us. That transformation of what we do in community-based services is critical right now and it's an area that we're moving on aggressively.
We're [also] the largest not-for-profit provider of PACE in the country. PACE is an emerging model for care for the elderly. We're at full risk for their care; this is a program where we receive total cost of care and we can integrate clinical care and social care services for seniors, and people that are dually eligible for Medicare/Medicaid. We have a great organization and the potential for growing PACE is very strong.
HL: In January, Trinity Health's chief clinical officer, Daniel Roth, spoke with HealthLeaders about the organization's urgent care growth strategy. What are some other ways the organization is doing to grow its footprint and operations?
Slubowski: We've expanded in Iowa quite a bit. We acquired CommonSpirit's [MercyOne] facilities in Iowa and we recently made another acquisition [of Genesis Health System] in Iowa to grow our footprint there.
We had a very significant [Medicare Advantage health plan] in Columbus, Ohio, and we've replicated it in some other states, like Idaho, Iowa, [Connecticut, and New York]. So those are other ways that we're growing.
The thing I would say is we're trying to do prudent growth. You have to be careful about how you expand and how you integrate that into your continuum of care because it doesn't make sense to be providing a bunch of disjointed services. Our focus is on whole-person care and connecting the care across the continuum for the people we serve. It isn't just viewed as episodic care, but as treating them as members of our health system, regardless of how they're insured.
HL: What strategies are you using to ensure the sustainability of your health system during current financial stress?
Slubowski: We are doing a lot of work in advocacy with both our local, state, and federal government contacts to support new care models, to support inflationary issues. I'm very concerned that there's been no real preparation for the next pandemic. From a public health standpoint, we're going to do this all over again if we have another pandemic because the coordination between federal, and local governments, and the role of the health systems, there were a lot of challenges and there's not a proactive plan [moving forward].
One of the other things that I'm very concerned about is, people keep talking about the growing healthcare industry. But when they say industry, they're including commercial health insurers, who are now also the biggest providers of Medicare Advantage; big pharma; medical device suppliers; big tech; and retail pharmacy companies. There's a real imbalance because most of their focus is on commercially insured patients and not public patients, and especially shying away from Medicaid. We have a social responsibility to care for folks and those companies, most of them are making double-digit margins. They're in the 20+% margin range. We're struggling to break even right now. There's an imbalance in the people who actually provide the care and add value, and the people who are the farthest from the patient.
From a public policy standpoint, there's going to have to be some recognition of change. I'm not naive enough to think that payers, and medical device suppliers, and Big Pharma are going to become charity organizations, but when you're talking about 20%-25%, margins, and zero or less, there has to be a little bit of movement towards supporting the nonprofit health system in particular. That's something that we're trying to get the attention of legislators as well as those third parties that their revenue is our cost and we cannot sustain ourselves at the levels that we're being paid for or not being paid for. We've got to work together on these solutions for healthcare in America.
We have a responsibility to prove that we're living out our tax-exempt charity goals. In the case of Trinity Health, we do $1.4 billion a year in community health and well-being. We have outreach programs, we use community health workers, we fund housing and food initiatives. And the loss on Medicaid is part of that equation because Medicaid doesn't come close to covering the cost of care. We're being very proactive in making sure that people realize that we are living out our charitable purpose, and for us being a faith-based health system, it's endemic to our mission.
How are we going to make sure that we live out what we call the common good, because the common good isn't common, right? I'm seeing a two-tier system evolving, those who can afford to pay or are well insured, and those who do not have the means and end up in public programs. How do we make sure that there's a consistent level of access and quality of care for all? That's why things like the expansion of Medicaid which appears to continue to move across the country, despite all the pushback that happened early when the Affordable Care Act was passed, is a good thing. But we have to be able to fund that appropriately, too.
A new report found that year-to-date, there was a 58% increase in CEO exits in 2023 compared to 2022.
Hospitals experienced 18 CEO exits in February 2023, according to a new Challenger, Gray & Christmas, Inc. report.
Year to date, 41 hospital CEOs have made role changes, the report found. This is a 58% increase year over year, where only 26 hospital CEOs made exits during the first two months of 2022.
"We will likely continue to see increased CEO exits in hospitals as they recover from the pandemic, consolidate, and respond to both worker shortages and increased costs," Andrew Challenger, SVP of Challenger, Gray & Christmas, Inc. said in a statement.
Hospital CEO exits have slowed down following a surge in January, where 23 hospital CEOs left their posts, leading the turnover rates for all sectors tracked by the firm for that month. But while hospitals experienced a high rate of CEO turnover in January, it's common for the first month of the year to have the highest turnover rate of the year.
Additionally, January 2023 was the highest hospital CEO turnover rate since August 2018, when 24 hospital CEOs left their post during the month of January. Of the 112 CEO exits tracked in January, hospital CEO exits made up 21% of the total exits.
Across all sectors, CEO exits surged 49% from the 112 tracked in January to the 167 exits tracked in February, according to the report. This is the highest monthly total tracked since January 2020, when 219 CEOs left their posts.
"The jump in CEO exits in February suggests companies are gearing up for a lot of change in the coming months," Challenger said.
James Benedict will lead Allegheny Health Network's daily operations and long-term clinical strategy in his new role.
Highmark Health, the parent company of Pittsburgh, Pennsylvania-based Allegheny Health Network (AHN), recently announced a new president for the health system.
James Benedict, JD, CPA, MAFIS, who recently served as COO of AHN, was appointed president effective immediately on March 18.
Benedict has three decades of experience in healthcare, including experience leading in hospital operations, physician practice management, and ambulatory operations.
"Jim is an exceptionally talented, highly accomplished healthcare leader with a proven track record of successfully managing complex organizations, building high-performing teams, and helping institutions develop and execute winning strategies to fulfill their mission," Bruce A Meyer, MD, MBA, EVP and Western PA market president for Highmark Health, said in a statement.
Benedict joined AHN in 2017 and is credited as being one of the "chief architects" in the organization's operational turnaround and nearly $2 billion capital investment and market expansion strategy. The campaign, to date, includes the expansion of the network's clinical footprint with the construction of AHN Wexford Hospital and four new neighborhood hospitals, six new cancer centers, and numerous multispecialty and outpatient facilities.
In 2020, he became EVP of Living Health Partnerships and Operations for Highmark Health where he led enterprise efforts in a healthcare delivery system redesign, helped develop the system's "Living Health" model, and also helped with AHN and Highmark Health's COVID-19 pandemic response strategy.
In July 2022, Benedict joined AHN, Highmark Health's western Pennsylvania provider arm, as COO again to help address the current challenges that AHN is facing as a provider organization. He will continue to report to Meyer in his new role as president and will lead the planning, direction, and coordination of the network's daily operations and long-term clinical strategy.
"As AHN's president, Jim and his team will help further transform AHN into the provider pacesetter of our Living Health model, creating and supporting the clinical infrastructure and blended payer-provider solutions that deliver better value, better experiences, and better outcomes for those we serve," Meyer said.
“It is an incredible honor and privilege to lead AHN and be part of this unique journey with Highmark Health to create a more effective, patient-centric, and economically sustainable health and wellness model for the country," Benedict said in a statement. "The challenges we face in our industry have been an inspiration to all of us who have spent the last several years building AHN's foundation, improving the health experiences of our patients, and making Western Pennsylvania a healthier place to live. We still have a lot to do, but I am extremely proud of what our clinicians and the AHN/Highmark Family has accomplished to date and look forward continuing this vital work in improving equitable access to high-quality, affordable healthcare alongside AHN's and Highmark Health's remarkable leadership and caregiving teams."
Dennis Matheis talks about workforce challenges, sustainability, and the future of consumer-focused care.
Dennis Matheis stepped into his role as president and CEO of Sentara Healthcare in September 2022 following the retirement of the nonprofit health system's previous CEO, Howard Kern.
He has more than two decades of senior leadership experience in healthcare finance and delivery and previously served as president of Sentara Health Plans and EVP at Sentara Healthcare for nearly five years, which empowers him to bring a unique leadership perspective to his role.
Matheis recently spoke with HealthLeaders about his first six months as president and CEO of the Norfolk, Virginia-based health system. He talked about topics including solutions to workforce challenges, sustainability, and the future of consumer-focused care.
This transcript has been edited for clarity and brevity.
Dennis Matheis, President and CEO, Sentara Healthcare. Photo courtesy of Sentara Healthcare.
HealthLeaders: What have you been focused on during your first six months as CEO?
Dennis Matheis: I'm enjoying the role and learning a tremendous amount. It's also very gratifying, as I've been able to get out and meet with a lot of our folks, especially on the care delivery side of our organization.
Prior to assuming the role, I got out to all of our facilities and most of our larger clinics, and the passion that our team members have for their mission of taking care of people really hit home for me.
The safety of our team members has come up again and again. We have more to do there. At the end of the day we've got to create safe environments for our team members, our patients, and our visitors in our facilities. We've done things such as piloting weapons detection systems in our EDs; [there is a] staggering number of weapons we've turned away from two of our EDs over the past six months. We're deploying [that] technology in all of our facilities, as well as we've gotten tighter in terms of our badging of our team members [and] our visitors coming into our facilities so that we know who's in our facilities at all times.
Now, we're working with the local police departments to create more of a police presence outside of our EDs as we move forward. We pushed legislation that would make it more difficult and add more stringent penalties for people to bring guns onto a hospital campus. Unfortunately, the bill didn't get through the Virginia General Assembly this year, but we'll be back at that next year.
We're in the midst of a strategic refresh for our organization. We've got a number of work efforts centered around consumerism and the notion that we need to become more consumer-oriented as an organization. We've labeled it 'One Sentara,' and it's leveraging both the healthcare financing side of our organization alongside our healthcare delivery to create more seamless, easy-to-use experiences for our patients/members. This will be a multi-year journey for us as an organization. It's about how we help drive and make healthcare simpler for our patients and customers, more accessible, ultimately more affordable, and get to a more simplified experience. The work that we're kicking off there is going to engage fairly deeply into the leadership ranks of our organization as well.
I'm really excited about what we've done and accomplished over the past three months, but certainly, the rubber is going to start to hit the road in the coming months and years as we continue to focus on those efforts.
HL:What is Sentara currently experiencing with workforce shortages and how do you plan on addressing that in the coming months and years?
Matheis: In the short term, we've made some extraordinary pay increases and benefit increases in 2022, especially in our clinical areas, but broadly across our enterprise. It was with an eye to help stabilize our team members, try to wean ourselves off of utilizing traveling nurses in several of our facilities, and by and large have had good success in terms of stabilizing our workforce.
We added several thousand new employees in 2022. We have, in the short run, plugged some of the challenges that we had been experiencing in '21 and in '22, not without some significant costs. But when you look at overall inflation nationally, and everything else that's going on, what we did was the right thing to do at the time for our team members and for our organization.
Longer term, as part of our strategic refresh work, we're working on putting together a 10-year workforce plan. It'll be wrong in the moment it's on paper, because the world is changing quite rapidly around us, but it will provide directional anchors in terms of the things that we need to focus on as an organization.
The notion of getting top of license for all of our team members. We as an industry [more than] a decade ago started to pivot away from non-BSNs being at the bedside in our care delivery organizations and our hospitals. We're now experimenting [with] going back to more of a team approach, and utilizing either nurses or LPNs to support our nursing staff, just to create a team approach in terms of bedside care. We've got pilots going on in several of our facilities, and if we're able to demonstrate that we're able to maintain the high-quality standards that we have as an organization, that will probably become a driver for us in terms of how we leverage staff.
Also tied to the work [of] both nurses and physicians in our organization and broadly in our industry is the data we collect in our EMRs. It's valuable in terms of our ongoing journey around driving quality as an organization, but it's also eating up a tremendous amount of time of our clinical staff. We've got to figure out how to collect the data we need to continue to drive the quality that we're trying to achieve as an organization and continue to improve upon, without sucking up time out of the workday of our nursing and clinical staff. We're looking at some nascent companies that are developing AI and machine learning to help pre-populating information into the medical records to make it easier or intuitive for documents to be generated. While there's a lot of promise there, it is going to take time for those technologies to play out, but certainly, that's on the roadmap in terms of how we leverage our existing staff more effectively as we move forward.
Pivoting on the physician side of this topic, [the] same [holds] true in terms of top of license. If you ask subspecialty physicians how much of their patient load could be handled in a different setting than in their office, about 20% to 25% of their patient volumes is the answer I consistently get. How do we rework the system? We're going to have to work and re-engineer those pieces of our care delivery model so that we can start to free up subspecialty time because there's just not going be enough of them to fill the need unless we start to think differently around how patients are able to access us.
Virtual care is going to become a bigger part of our model in terms of what we offer. That's in service to create more access for our communities that we're serving, but it also recognizes the changing use patterns and familiarity that the non-Boomer generations have withregard to virtual anything. To keep up and to be relevant to our younger generations that are becoming a bigger part of our healthcare universe and ecosystem, we're going to have to offer different modalities of access for those folks, or we run the risk of losing their use of our system and our clinical teams as we move forward.
Working with the colleges and the high schools to generate more excitement and to create more capacity in the educational institutions that we rely on to create the supply of the next-gen of our workforce. That is going to be another arm of the work that we're doing in terms of identifying the volume gap that we have and how we start to stimulate more interest in younger people to get into healthcare, and then actually have the available chairs and institutions to train them as we move forward.
We recognize we can't just chase this problem with wages because that's not going to solve the problem for our communities. It's going to have to be a multi-faceted approach in terms of how we address the workforce as we move forward.
HL: What do you have in your strategic refresh around finances?
Matheis: Sentara [is] in a better place than a lot of the industry. We ended '22 with an operating margin. While we certainly felt the headwinds, and our net margins were not what they have been historically, we fared better than most across the industry. But still, we're going to have work to make sure that we have long-term sustainability as an organization.
We're focusing on the supply chain and opportunities on the supply chain front. Pharmacy is another area; pharmacy is the fastest growing line item for healthcare costs nationally, whether it's on the plan side of our organization or the care delivery side.
I do believe we're going to have to continue to grow as a health system, probably on the plan and care delivery side of our organization. We acquired AvMed, which is a 220,000-member health plan in Florida, both commercial and Medicare, and we're bidding on the Managed Medicaid program in Florida as well. We're going to have to look at scale as a lever for us in terms of being able to generate more efficiencies as an organization.
Getting ourselves crisp from an access and experiential perspective, we're going to have to put a lot into our digital assets as an organization, and those will not be inexpensive investments Driving scale is a means for us to be able to afford those investments to make sure that we're driving towards the experiential outcomes and the efficiency outcomes.
Finally, we are looking at length of stay in our hospitals and asking ourselves the question: can we improve our throughput for our admissions in our hospitals and make ourselves more efficient that way? That is going to require some serious effort on our team members' part to go there.
The benefit of doing that is threefold.
It helps create access for us, and in some of our communities we're tight in terms of our current bed capacity compared to demand. It actually frees up capacity so that we can see more patients.
It also allows us to lever our existing cost structure in a different way, versus the alternative [of building] new bed towers in areas where we're stretched from a capacity perspective. The challenge with that is not just the capital cost involved with that, but then would we be able to find staffing given the staffing headwinds that we're facing nationally? It's another lever that we're going to be focused on in terms of trying to make sure we're creating access for our communities, but it's also a positive financial driver for us organizationally.
HL: How does your background help you in your new role as enterprise CEO?
Matheis: I've been fortunate in my career. I've worked on the provider side twice in my career, as well as on the payer side. I'm a CPA by training so I'm a non-clinician, more business-focused.
[Over the years] I got to understand a lot about hospital finances, how hospitals work, as well as working with physicians. When I joined Sentara five years ago on the plan side, I had no idea that I was going to end up in the role that I am in today. I firmly believe that organizing the financial healthcare and the delivery of care within the same framework is where the world is headed from a healthcare evolution perspective. We've got bigger payers that are trying to move into components of the care delivery side of the house as we speak. But it really was with this notion of aligning incentives on the care delivery side and the payer side.
In almost five years I spent as president for Optima Health, I got to learn a lot about Sentara broadly, as well as focus on the things that I needed to focus on at the time in our health plan business. Coming into this role, I had a good perspective of the history of this organization and how it works, which has been a real benefit especially in my last six months.
The perspectives I bring are a little bit different because I have spent time in the payer world and understand what our customers want from us. I bring a broader view, perhaps, to this role, and I think that's going to be beneficial for the organization in terms of how we organize ourselves and meet our customers' needs, while at the same time making sure that we're continuing to drive that journey that we've been on, while we move ourselves more toward [a] consumer-focused organization.
It really is about creating the system to allow for things to be easier for people to experience their healthcare journey. The simplest example I can give is if you come to one of our EDs, we take a bunch of information about you and then you go home and perhaps you need follow-up care. If you go back to a new physician for that follow-up care or you need a test at another one of our facilities, we will invariably ask you for the same information again. What that screams to people is that we don't know you as a patient and as a customer.
Imagine a world where you've enrolled in Optima Health Care. We've taken a bunch of information from you, you go see a doctor, we've already populated everything that the health plan had into your record. You might provide some additional information with regard to your care status when you visit that physician, and then that information gets ported wherever you go within your health journey within our system. That's one example of the world that we're going to drive toward as an organization. It is all very doable given the technologies that we have deployed today.
One of the reasons I'm really excited about this journey that we're on [is that] as we go through it, it's going to make healthcare simpler, more seamless, and more accessible for people and that ultimately should translate into healthier individuals and people being able to live healthier lives.
HL: If you could change one thing about the relationship between payers and health systems, what would it be and why?
Matheis: There's no easy answer to that because you've got a hospital industry that's under serious financial pressure [and] national payers are still recording record profits coming out of 2022. Those facts make for very contentious relationships in terms of how the plans are working together.
The notion of One Sentara is to make a family work well together in a way that perhaps we've not even done internally. We've never really harmonized and asked how do we make things better together.
I'm excited about our journey and where it will lead, and hopefully that might become a model for others to pick up on as well as things move forward. How do we create more trust within our industry and work together to solve problems rather than perhaps work at odds with each other?
I've seen it on both sides of the fence and there are proof points on either side about who could do what to improve.
Among the 135 organizations recognized are notable healthcare organizations from across the globe.
Since 2006, Ethisphere®, a nonprofit organization that defines and advances ethical business practices, has recognized organizations worldwide for their ethics and integrity. The World's Most Ethical Companies® recognition program, an annual celebration of those organizations, recently released its 2023 honoree list.
Among the 135 organizations, that operate in 19 countries and across 46 industries, that were recognized for their business integrity are notable healthcare organizations from across the globe, including five U.S. health systems that fall under the healthcare providers and integrated healthcare systems categories.
Healthcare Providers
The health systems categorized as healthcare providers on the honoree list are HCA Healthcare, Northwell Health, and University Hospitals.
HCA Healthcare, a 13-time nominee, is a for-profit healthcare provider headquartered in Nashville, Tennessee, and is comprised of 182 hospitals and more than 2,000 sites of care across 20 states and the United Kingdom. The health system employs more than 280,000 people and has an annual revenue of $60.2 billion.
Northwell Health, an eight-time nominee, is a nonprofit health system headquartered in New Hyde Park, New York, and serves patients in New York City, Long Island, and Westchester across 21 hospitals and more than 850 outpatient facilities. The health system, which employs more than 63,000 people, has an annual revenue of $16.5 billion.
University Hospitals, an 11-time nominee, is a nonprofit academic health system based in Cleveland, Ohio, serving patients in 16 counties across northern Ohio, through 21 hospitals, more than 50 health centers and outpatient facilities, and 200 physician hospitals. The health system employs more than 11,500 people and has an annual revenue of $5.3 billion.
Kaiser Permanente, a five-time nominee, is a nonprofit integrated managed care organization headquartered in Oakland, California, serving patients in eight states and the District of Columbia through 39 hospitals and more than 720 medical office buildings. The integrated health system employs more than 175,600 people and has an annual revenue of $1 billion.
UPMC, also a five-time nominee, is a nonprofit health system and insurer headquartered in Pittsburgh, Pennsylvania, and serves patients across Pennsylvania, western New York, and western Maryland, as well as global patients in Italy, Ireland, Kazakhstan, and China, across 40 hospitals and more than 800 clinics. The health system employs 92,000 people and has an annual revenue of $24 billion.
Health Insurance
Additionally, Blue Shield of California, Cambia Health Solutions, CareFirst BlueCross BlueShield, and Health Care Service Corporation were named as the world's top ethical companies in the health insurance category.
Over the past six months, on average, the healthcare sector has added 54,000 jobs.
The healthcare sector was once again among the top sectors that experienced job growth in February, according to the U.S. Bureau of Labor Statistics (BLS) employment situation summary.
In total, the healthcare sector added 44,000 jobs in February. Over the past six months, on average, the sector experienced an increase of 54,000 jobs.
In February, hospitals experienced the most growth in the sector, adding 19,000 jobs. Nursing and residential care facilities added 14,000 jobs, and the ambulatory gained 11,000 jobs.
Healthcare continues its steady job growth, starting the year off strong, adding 58,000 jobs in January, with significant growth experienced in the ambulatory healthcare sector (+30,000).
In 2022, healthcare added an average of 47,000 jobs per month in the sector.
Along with healthcare, notable job gains occurred in leisure and hospitality, retail trade, and government, according to the BLS. Total nonfarm employment rose by 311,000 in February, bringing the unemployment rate up to 3.6%.
Lori Herndon, who began her career as a critical care nurse within the system, became president and CEO of the New Jersey health system in 2016.
AtlantiCare has announced that its president and CEO intends to retire, ending her 40-year career with the New Jersey health system.
Lori Herndon first joined the health system as a critical care staff nurse in 1983. She has held several leadership roles within the system, including as hospital administrator, COO, and president and CEO, a role she has held since 2016.
"While we will miss her deeply, we respect her decision to cap her career on this milestone anniversary," David Goddard, AtlantiCare's board chair said in a statement. "On behalf of AtlantiCare and our entire community, the Board wants to sincerely thank Lori for dedicating her career to our organization and wish her all the best in her well-earned retirement. We will share plans for honoring her soon."
The health system's board has begun a search for Herndon's successor, who they are looking to "build upon AtlantiCare's success as an independent health system." The board said it will consider qualified candidates both internal and external of the health system.
"AtlantiCare has a strong and seasoned executive leadership team, and dedicated team members across the organization, to ensure a smooth transition to a new CEO with the right vision for our health system and the communities we serve," Goddard said. "We will seek a new leader to define and execute our strategic priorities for the future, with the same commitment to personalized health, healing, and wellness services that people expect from AtlantiCare."
Herndon will transition her responsibilities to her successor on May 31, and will support a smooth leadership transition until her retirement on June 30.
"Lori’s impact on AtlantiCare and her leadership in the hospital has been far-reaching. She has provided steady and solid leadership through the unprecedented challenges of the COVID-19 pandemic while expanding clinical services and programs in our region," Goddard said.
Over the course of the COVID-19 pandemic, Herndon was a voice of leadership and guidance for the healthcare industry, the state of New Jersey, and the state department of health to "[make] sure that our workforce is safe and [make] sure that we are advocating for things that they need to do; their important work has been critical," Herndon told HealthLeaders in 2022.
In January 2022, Herndon was appointed as chair of the New Jersey Hospital Association, where over the past year she has worked to protect healthcare workers, redesign care delivery, and develop the workforce. She also introduced the Consider Kindness campaign, a campaign focusing on supporting healthcare providers.
"As many of you know, I began my career as a critical care nurse and enjoyed every opportunity to learn and grow over 40 years at AtlantiCare," Herndon said in a note to team members, according to a press release. "I care deeply about our AtlantiCare team, our patients, and our community. Our impact on the community and our patients we serve has been immeasurable and I will always be proud of working with our AtlantiCare team through some of healthcare’s most challenging times."
Tiffany Miller, DBA, MHA, became CEO of Yoakum Community Hospital following Karen Barber's retirement in January 2023.
Editor's note: This conversation is a transcript from an episode of the HealthLeaders Podcast. Audio of the full interview can be found here and below.
In December 2022, Yoakum Community Hospital (YCH), a 100-year-old, rural, 23-bed critical access hospital in Yoakum, Texas, announced that Karen Barber was retiring after serving as CEO for 30 years.
YCH, which is managed by the Community Hospital Corporation in Plano Texas, chose Tiffany Miller, DBA, MHA, as Barber's successor.
Miller, who has a decade's worth of executive healthcare experience, joined YCA as CEO in January 2023, hitting the ground running in her new role. In her previous role, she served as CEO of Encompass Health Rehabilitation Hospital of Humble, a 90-bed inpatient rehabilitation hospital in Houston, Texas.
During the podcast interview, Miller talks about transitioning into her new role as CEO and strategies she's looking forward to implementing in her first year, and she gives advice for aspiring healthcare leaders.
This transcript has been edited for clarity and brevity.
HealthLeaders: What have the past few months been like as you settle into your role as CEO?
Tiffany Miller: Anytime I have started in a new role, I like to compare it to drinking from a firehose. One thing that holds true in healthcare is that you can expect things to change and change can be hard, and the transition can be even harder. While these constants seem to be universal truisms in the healthcare industry, I do have to say that this experience onboarding at Yoakum Community Hospital has been quite different. The board and the team extended me the warmest welcome. I immediately felt at home and like I was truly a part of the team, even though I was obviously the newest person on the team and a big change given the tenure of Karen Barber being at the hospital [before me]. Yoakum Community Hospital [has] strong community support and it's truly what I've felt since I was onboarded in such a short amount of time.
HL: In a recent press release, the Community Hospital Corporation's president and CEO, Jim Kendrick, is quoted saying: "Rural hospitals should develop and implement strategies that will help them successfully navigate a challenging healthcare environment this year." What pain points are you focused on developing strategies for during your first year as CEO?
Miller: One of the biggest focus areas for Yoakum is the recruitment and retention of qualified staff; that starts with the culture of our hospital, especially given the current environment of higher labor costs. It's about creating an environment where people not only want to be, but they also want to stay.
The pain point is overcoming those extremely high salary rates that make it hard to compete with larger institutions that are in closer proximity or contract travel gigs.
As a leader, I believe it's important to be transparent with your team and being able to make that connection—that purpose—and help bridge that gap between action and the why behind it. I've already started having those conversations with team members to help make the connection that underscores that importance of fiscal stewardship and being able to get creative on how do you create an environment where people want to work and that they want to stay?
Another focus area, especially as a critical access hospital, is service-line growth. We are the health lifeline in the community. We are the reason our patients can receive care close to home. Think about a time when you were sick, or maybe something was just not quite right with your health. The last thing that you would probably want to be doing is travel; you're not going to want to travel a long distance to receive care to address the underlying health concern. Yoakum has a robust family practice clinic and outpatient offerings, so now that focus is how do we further develop our service line offerings based on that community need? Cardiac services is a big one in our community.
Along those lines is the opportunity for medical staff succession planning. One thing I've quickly grasped, even during the interview process, is the tenure here. It's pretty unheard of. It will be important to ensure we have providers available to continue providing care in our community for another 100-plus years.
Tiffany Miller, DBA, MHA, President and CEO of Yoakum Community Hospital. Photo courtesy of Yoakum Community Hospital.
HL: What initially drew you to work in healthcare? Can you walk me through your healthcare career journey?
Miller: I attended undergrad at Texas Lutheran University in Seguin, Texas, and [during] the fall of my junior year, my advisor asked me what I wanted to do with my business degree. I quickly realized I had no clue. I grew up in a home where "I don't know" was not an acceptable answer, so I had asked for time to consider my response to his question. A week passed and I still had no clue. Fast forward from that conversation, my advisor, who was on the board at the local hospital in Sydney at Guadeloupe Regional Medical Center, set up a meeting for me to have a conversation about completing an administrative internship for independent study credit. And once I started, I was bitten by the healthcare bug.
I'm a purpose-driven individual and I knew I wanted to make a difference. I knew I wanted to be a good steward of my skills and abilities, and I wanted to make an impact in the lives of those whom I was serving. I knew that I ultimately wanted to become a hospital CEO and I knew I would need to obtain my Masters. After undergrad, I was working full time and I was going through the full-time Master's in Healthcare Administration Program at Trinity in San Antonio.
I started in a regional acute care setting in Victoria, and while I was there, I took a slight detour when I started my full-time Doctoral program. I shifted over into an administrator role for emergency medicine at a hospitalist medicine group. Fast forward a little bit more to the point of my life when I was writing my dissertation, I shifted [to] working in population health.
When I made that initial pivot out of the hospital setting, I knew I always wanted to get back to the hospital setting. I started working in the post-acute industry, I was running a long-term acute care hospital. Unfortunately, Houston was over-bedded with LTAC beds, so I closed down that LTAC right before the pandemic hit and transitioned into an inpatient rehab setting, running an inpatient rehab hospital, which I absolutely loved.
One of the things that parallels between the size of Yoakum Community Hospital and being in a critical access setting is you're afforded the opportunity to get to know your staff. You know something about every single staff member. And so when this opportunity became available, I threw my hat in the ring.
I grew up in a small community about this size, and I was ready to be back in that kind of place. I've got a really great team of amazing community support, and I'm looking forward to carrying on the hospital's legacy.
HL: What advice do you have for women and others who aspire to be leaders in healthcare?
Miller: You have to be willing to work hard. There is absolutely no substitute for sweat equity. If you are willing to persevere through any kind of circumstance or any odds that are stacked against you, the likelihood that you achieve a goal that you set for yourself is much greater. Be willing to bet on yourself. Relentlessly believe in yourself and affirm that you're both capable and able.
Expand your circle of influence to include people who will hold you accountable to the standards you set for yourself and who will empower you and encourage you along the way.
Specifically for women, I would say to be confident in who you are, and don't ever apologize for it. I think as women, we have a tendency of minimizing who we are, so we don't get labeled a certain way. Give yourself permission to take up space and play to your strengths. Take time to understand your strengths, understand what drives you, and then go for it.
Along those same lines, it's so important to understand the strengths of your team and those who support you. I jokingly will tell my team—and it's really not a joke—"I'm a generalist, and I know enough to be dangerous." There's a reason why there are key leadership positions within the hospital in those roles. They serve a purpose, and it's understanding the strength of your subject matter experts, being able to tap into that, take time to understand what motivates them and what inspires that shared vision.
Have fun while you're doing it. What we do is hard. Being in the healthcare industry is a business and we're dealing with human lives. Enjoy what you're doing, because while it is hard, it's also extremely rewarding. And it's important to celebrate those successes no matter how big or small.
Finally, I would say embrace the notion that every experience is a learning opportunity. Whether the outcome is either what you intended or maybe not what you intended, it's about what you do with that learned experience that determines what comes next for you. Having an open mind and choosing to have a growth mindset allows you to capitalize on those learning gains and move forward from that experience.
Celebrate Women Healthcare Leaders During International Women's Day 2023.
March 8 is International Women's Day (IWD), a day to celebrate women's achievements, raise awareness on gender discrimination, and drive gender parity initiatives. This year's theme is embracing equity, an important topic in healthcare when it comes to patient and community care, and when it comes to leadership in healthcare.
HealthLeaders is proud to recognize women leaders in the healthcare sector around the nation who have achieved so much for themselves and their organizations, lifting up others in the process, and making healthcare a better industry.
In celebration of IWD, we've highlighted recent interviews with women executives who are making a difference in their organizations and the healthcare sector.
The coronavirus pandemic and related issues are still a leading concern for healthcare providers, the chief clinical officer of Banner Health says.
Marjorie Bessel, MD, has been with Banner Health for more than a decade. She has held many physician leadership roles at the health system, including serving as chief medical officer for several hospitals and working as chief medical officer of Banner Health's Arizona Division. Before taking on the chief clinical officer role, she served as vice president and chief medical officer of community delivery.
What began as an innovative way to monitor and care for COVID-19 patients at the height of the pandemic is evolving into a growing virtual nursing program at Atrium Health.
The North Carolina-based health system, now part of Advocate Health, launched its virtual nursing program in March 2021 when, like other health systems, nurses struggled to meet staffing demands.
Nurses loved it, patients loved it, and the health system noticed positive outcomes: decreased medication errors, decreased falls, increased patient satisfaction, and more, says Patricia Mook, MSN, RN, NEA-BC, CAHIMS, FAONL, vice president of nursing operations, professional development and practice.
At the end of December 2022, Advocate Aurora Health and Atrium Health completed their merger to create Advocate Health, a nonprofit health system serving patients across Alabama, Georgia, Illinois, North Carolina, South Carolina, and Wisconsin. The combined system, headquartered in Charlotte, North Carolina, has 67 hospitals and more than a thousand sites of care and is the fifth largest nonprofit health system in the country.
Carol Lovin, MHSA, MN, executive vice president, chief of staff, and chief integration officer for Advocate Health, recently connected with HealthLeaders to talk about the integration that will be done in 2023 to bring the health system together, while the legacy providers continue to deliver care under their consumer-facing brands.
Airica Steed, EdD, MBA, RN, is breaking the glass ceiling in her new role as CEO of Cleveland, Ohio-based MetroHealth. She is the first woman, Black person, and nurse to lead the four-hospital nonprofit health system.
She previously served as COO of the Sinai Chicago Health System and president of Mount Sinai and Sinai Children's Hospital. She began her role on December 5, 2022, during a turbulent time for the organization, after the previous President and CEO, Akram Boutros, MD, was fired by the board of directors for allegedly authorizing himself bonuses without disclosing them to the board.
Earlier this year St. Jude Children's Research Hospital appointed Catherine Corbin the health system's first chief business innovation officer.
An expert in human-centered design, Corbin is charged with working with CEO James Downing, MD, and other senior leaders to guide the health system's $12.9 billion, six-year strategic plan, the largest and most ambitious investment in St Jude's 60-year history. This includes roughly $3 billion in planned construction projects.
Prior to joining St. Jude, she spent four years at the San Francisco-based global design and innovation firm IDEO, where she helped St. Jude develop programs like Family Commons and the St. Jude Global Alliance. She was also a principal at the architectural and engineering firm CannonDesign and was administrative director of orthopedic surgery and neurosurgery at a Chicago health system.
To Michelle Stansbury, innovation is a necessity at Houston Methodist. It certainly involves thinking outside the box, and now it also means thinking outside of the hospital.
"We're either going to disrupt ourselves or somebody's going to do it for us," says the hospital's vice president of innovation and information technology applications, noting the large number of healthcare organizations in the Houston area and the growing threat of competition from telehealth companies, payers, and retail giants like Amazon.
More than half—57%—of caregivers quit within the first 90 days of working for an agency, according to a report by MissionCare and the National Association for Home Care and Hospice. They're also seven times more likely to live at or below the poverty line.
Healthcare’s dire staffing shortages extend to unskilled workers, which means private duty agencies also are struggling to recruit and retain caregivers.
Aishling Dalton-Kelly is a private duty consultant, as well as president and CEO of Aishling Care Academy. Having previously owned an agency, Dalton-Kelly understands the importance and necessity of setting caregivers up for success and helping them see a future for themselves within an agency.
In part two, Aishling Dalton-Kelly reiterates the need to equip caregivers with the tools and knowledge they need, as well as what should be done so potential employees will see a fruitful career path in the sector.
Carol Campbell joined Ascension, a nonprofit Catholic health system headquartered in St. Louis, Missouri, at the beginning of this year as the system's inaugural senior vice president of consumer experience. She now serves as senior vice president and chief experience officer for the health system, which serves 19 states through more than 140 hospitals, where she continues to lead the organization's consumer experience work.
Campbell recently connected with HealthLeaders to share what the first year in her role has looked like so far, what she's looking forward to leading, and how health systems can learn from other sectors when it comes to patient and consumer experience. She also shares the importance of the consumer experience in healthcare and ministry-driven organizations.
As Dana Erickson approaches her one-year mark as president and CEO of Blue Cross and Blue Shield of Minnesota (Blue Cross MN), she shared with HealthLeaders her vision for better healthcare in Minnesota and the just-minted strategy that is designed to deliver place, plan, and industry-based solutions against healthcare's most persistent problems.
"Was it always my goal? No, I don't think so."
Erickson wasn't gunning to be CEO, but a combination of service, experience, and opportunity—and positions with Optum Health—positioned her for the role.
"I think it was something that did emerge over time," says Erickson, who served in four prior roles with Blue Cross MN before taking the top position.
Sabrina Martucci Johnson never planned on being a founder and CEO of a women’s healthcare company, but after identifying gaps in women's healthcare, she asked herself, “If not me, then who?"
"I'm not one of those people who always wanted to be a CEO," she says. "But I had a light bulb moment: if I don't do this, it's not going to happen."
Over the years, Johnson had always championed for women in her volunteer and charity work, supporting philanthropic activities surrounding STEM education for women, domestic violence awareness, and women's healthcare issues.
On the professional side, Johnson spent her entire career in the drug development industry, in a variety of roles. She began as a research scientist with Baxter Healthcare and went on to hold marketing and sales positions there.
To stay up to date with the amazing work that women healthcare leaders are up to, be sure to read HealthLeaders' Women in Leadership quarterly profiles. The next profiles report will be released on March 27.
