'The FTC is concerned about the increasing use of state legislation to exempt hospital consolidation that harms patients and workers from law enforcement.'
FTC staff penned a letter to the North Carolina House Health Committee this week, sharing their opposition to Senate Bill 743, stating it would provide North Carolina Health Care System (UNC Health), and other entities it collaborates with, defense against antitrust enforcement action.
On May 1, the bill unanimously passed in a vote by the North Carolina State Senate and is now pending before the North Carolina House.
According to the FTC's Office of Policy Planning Bureau of Competition and Bureau of Economics' comments, Bill 743 "would authorize the kinds of acquisitions, marketing allocation, information sharing, and joint contract negotiations that reduce competition among healthcare providers and lead to patient harm in the form of higher healthcare costs, lower quality, reduced innovation, and reduced access to care, as well as depressed wages for hospital employees."
According to the FTC, the Bill includes a provision that "purports to extend state action "immunity" from antitrust liability to UNC Health, as well as any private and public entities with which it collaborates." The FTC staff also states they take no position at this time whether UNC Health legally qualifies as an arm of the state, or whether Bill 743 satisfies the requirements of the state action doctrine, and that both are fact-intensive inquiries that would require investigation.
"UNC Health, which was formed by a state law in 1998, operates under a mission of improving the health and wellbeing of all North Carolinians. That statue has not been updated in 25 years. In order for UNC Health to continue fulfilling its mission as the state's health system, especially in terms of serving rural areas, the statute needs to be modernized to ensure that UNC Health has the ability to adapt to today's rapidly evolving healthcare world," Alan Wolf, a UNC Health spokesperson, told HealthLeaders in an emailed statement.
"We appreciate the support of our state leaders in recognizing the need to update the law that created UNC Health. The changes will allow UNC Health to continue providing excellent care for future generations of our state’s residents. Sometimes, we are asked by the State to help a struggling hospital. In those instances, UNC Health is acting in the State’s interest to ensure care is available and delivered to all parts of North Carolina when partnering with community hospitals and health systems," he said.
According to the FTC, the agency is "concerned about the increasing use of state legislation to exempt hospital consolidation that harms patients and workers from law enforcement."
The FTC has been actively cracking down on healthcare deals that they believe do not promote competition. Among the numerous health system merger and acquisition deals that the FTC has sued to block in recent months, the FTC is also focusing on drug mergers and industry middlemen.
Recently, the FTC went after LCMC's purchase of three Tulane University Medical Center Hospitals, which they said should have gone through a federal review process, resulting in LCMC Health filing suit against the DOC and FTC, as well as the Louisiana attorney general's office accusing the FTC of unlawfully intruding on state power.
Healthcare once again remained among the top sectors experiencing monthly job growth.
The healthcare sector once again is trending up in job growth, according to the U.S. Bureau of Labor Statistics' (BLS) latest employment situation summary.
The healthcare sector added 52,000 jobs during the month of May, much in line with the job growth reported monthly so far this year. This brings the sector's average monthly job gain over the past 12 months up to 50,000.
The ambulatory sector saw experienced the most job growth during the month adding 25,000 jobs. Additionally, hospitals added 20,00 jobs, and nursing and residential care facilities experienced an addition of 9,000 jobs.
So far this year, the healthcare sector has added:
The healthcare sector joined the professional and business services, government, construction, transportation and warehousing, and social assistance sectors in experiencing the most job growth during the month.
Total nonfarm payroll employment added 339,000 jobs in May, according to the BLS. This brings the unemployment rate up to 3.7%, with a 0.3% increase this past month.
Overall, total nonfarm payroll employment has an average monthly gain of 341,000 jobs over the past 12 months.
"Baptist Health South Florida is an organization that has been, at its core, dedicated to patient-centered, outstanding care and also focused on deep employee engagement," he tells HealthLeaders. The health system instilled that same dedication and focus into the Miami Cancer Institute, he says, evolving the culture to one that has specific mechanisms for engaging all of the organization's stakeholders.
"This is what the Miami Cancer Institute, part of Baptist Health South Florida, did with its Breast Clinic Pilot," he says.
The first step was engaging with relevant stakeholders who collectively identified key issues to improve scheduling, then by flipping the org chart, the breast clinic pilot learned key information and solutions from the frontline staff that then translated into better patient care, he says.
"After five months, patient satisfaction increased to 98.3%, employee engagement to 79%, and the lead time for obtaining authorizations for clinic visits ahead of the date of services doubled," he adds.
Mark A. Davis, MD, MS. COO of Miami Cancer Institute and Baptist Health Cancer Care. Photo courtesy of Miami Cancer Institute.
Flipping the org chart "is an intentional, structural, and sustainable strategic management change that equips frontline team members as leaders, informing and implementing necessary advancements," he says
Following the success of that pilot program, the idea was introduced across the system.
"It is critical to create reproducible structures in the operational levels that allow for this type of engagement," he says.
Enacting organizational transformation needs to be thoughtful, deliberate, and goal-oriented, Davis says.
"To advance healthcare, we must move from reactive iteration to proactive imagination," he says. "As healthcare leaders, we need to facilitate a structural change that can achieve our strategic goals."
Davis shares three steps that have helped Baptist Health South Florida and the Miami Cancer Institute flip the org chart to create better outcomes for patients and employees, combat operational challenges, and create a stronger and more collaborative culture.
1: Advance Organizational Culture by Breaking Down Silos
"When we talk about flipping the org chart, it really is about breaking those silos," Davis says.
"Structurally, what that means is evolving the org chart from independent reporting. One of the things you'll see in many organizations is the business office goes up one line, the nurses go up another line, doctors … and so forth. Breaking down that and having people work together is really key."
Using the breast clinic as an example, Davis explains that each clinic has a variety of staff. Schedulers, frontline registration, business office, doctors, nurses, and medical assistants all have different job responsibilities that are sometimes sequestered from each other. The goal is to create a mechanism for them all to work together and share opportunities and feedback, breaking down the silos between their positions to create a stronger teamwork culture.
"The second part in flipping that org chart, once you get the verticals aligned in a more horizontal structure, is to empower and embrace the voices which are often unheard, which is those members of our team that are on the front line," he adds.
Taking simple actions can achieve impactful cultural shifts, including active communication and then taking action, he says.
"Leaders should consistently communicate their intentions to build a collaborative culture where all voices are valued and issues are addressed as systems opportunities," he says. "Pair that structure with a true sense of appreciation for all who work at your organization, demonstrated through your day-to-day interactions by an enthusiasm for understanding their experience."
He also suggests practicing genuine gratitude to help the teams feel appreciated.
"If it's genuine, and we show genuine gratitude and appreciation for all of our teammates, there's interesting literature that suggests it makes us as individuals happier and it certainly makes those receiving it," he says. "That's part of the cultural emphasis engagement that's part of Baptist Health and MCI, and part of what we focused on in our transformation."
2: Establish the Current State and Plan for the Future State
Once you have a more aligned and horizontal structure, you can bring that staff together to map the organization's current and desired future state, Davis says.
"Where to begin is a primary challenge organizations face when considering change," he says.
The goal is to start simple. Davis suggests listing the details of the clinic's current processes, then listing desired future processes.
"This requires a clearly delineated mission and margin objectives, so that each internal group can align," he says. "From that structure, engage the team in the quest for data and input. Hold moderated ,multi-stakeholder groups with leads, who have authority and accountability. Ensure diversity of voices in the process and think broadly about who is impacted and who can advance the objectives. There is deep insight within our front-line team members; as well as great capacity to implement change."
At the breast clinic "we created the structure for each of these groups to come together [and] look at transformation," he adds. "That disciplined approach is one of getting the group together to spend time together with the current state of operations in the clinic, then decide together what the best future state would be."
Having those silos broken down allows for each position to learn about the challenges another position faces that they may not have understood.
"It allows that interchange that informs a much better future state," he says. "If you work together to determine the current state [and] the future state, then you [can] agree what the next steps will be with metrics that are predefined."
"It's very important that we recognize that most challenges and failures that we have persistent problems—they're not individual," he adds. "People … come to work, particularly in healthcare, because they're dedicated to helping patients and being good colleagues. That means that when we have a challenge, we have to look at the system-based solution together with an organized structuring group, so that we can learn from the challenges that we face. That means evolving our cultures to be just open and to celebrate and emphasize our desire to learn from everyone in a very psychologically safe manner."
3. Use Metrics to Guide Operational Success
Metrics are an important tool to help team members understand, support, and enact operational success, Davis says. So once the desired future state is determined and tactics are identified to advance, the group, with an insightful leader, is ready to implement the strategy, he says.
"When addressing operational challenges, organizations must move from the common 'whack-a-mole' approach to one that includes a detailed understanding of [the] desired future state, with clearly identified tactical interventions and metrics," he says. "Be structured, inclusive, and data-driven, but also nimble to pivot when data and team members suggest the need to reevaluate."
In the case of Baptist Health South Florida, the Miami Cancer Institute, and Baptist Health Cancer Care, the organization's true north is patient satisfaction and outstanding patient care, Davis says.
"Everything revolves around that with other critically important areas, which is our employee engagement [and] employee satisfaction."
This also helps with other responsibilities during times of financial challenges, he says. It's important to "make sure that we have appropriate margins and that operationally, we're able to move things forward in a very effective way using things like Lean Six Sigma and the like."
In the case of the breast clinic, the staff were getting authorizations so close to the appointment times that sometimes it was hard to keep those appointments aligned, Davis explains. Another success was moving those authorizations many days out, which helped release the burden from staff and kept patients happy.
"The future of healthcare is bright. We have tremendous opportunity and many of my colleagues and fellow leaders are beginning to look at things a little differently," he concludes. "Flipping the org chart is one of those opportunities for us. Our teammate colleagues on the front line— they're seeing patients directly, they're the ones … who see the problems firsthand, they hear the problems firsthand—and to be able to create a structure and culture that empowers their voices is not only great for helping improve burnout and engagement. It's also extraordinarily important for us to be better as healthcare institutions and leaders."
While exits are up compared to last year, they continue to trend downward during 2023.
The exits of hospital CEOs are trending downward so far this year, according to a new CEO turnover report from Challenger, Gray, & Christmas, Inc.
Eight hospital CEOs left their positions in April, according to the report, the smallest number of exits recorded so far this year. Last year, during the month of April, there were seven hospital CEO exits reported.
During the first quarter of 2023, the number of exits reported was:
Exits include retirement, switching to a different role within the organization, being let go, and leaving the organization to lead a different one.
While hospital CEO exits appear to be slowing down since the beginning of the year, there is a 72% increase in exits when comparing year-over-year exits. 62 CEOs reportedly made exits through the end of April 2023, compared to only 36 who made exits through April 2022.
"Companies are undergoing a significant amount of change as they respond to economic challenges, higher costs, and talent management issues," Andrew Challenger, leadership expert and SVP of Challenger, Gray & Christmas, Inc., said in a previous statement.
The firm noted that the amount of CEO changes across the sectors they track is up 6% from the 139 exits tracked in March to the 147 exits tracked in April. Last month is the highest total for exits during the month of April since the firm began tracking CEO exits in 2022, according to the report. This is the third consecutive month where that has been the case.
"Companies have a lot to consider as we head to the second half of the year, as recession and inflation concerns continue. Many sectors are letting go of workers, and new technologies, like AI, are forcing conversations about use cases. This environment is conducive to new leadership," Challenger said.
Indeed, the looming recession and rising hospital expenses will continue to play roles in current workforce and operational challenges for healthcare organizations, undoubtedly having an impact on hospital and health system leaders across the C-suite.
The independent brand consultancy, which surveyed 25,000 healthcare consumers and analyzed 200 healthcare brands across the country, shared their learnings and offer steps that healthcare marketers can take right now to better consumer engagement.
So, how do consumers engage with healthcare and manage their own health?
According to the survey:
89% of consumers said they go to the doctor's, a hospital, or medical facility
42% practice "self care" where they do their own research and self-diagnose to manage their own care
29% utilize virtual care to connect remotely with a doctor or other medical professional
5% use home-care services, or receive care right in their home
But while there are high volumes of consumers visiting their doctor's office, hospitals, or medical facilities, their healthcare experience isn't bringing in 5-star reviews.
In 2023, Monigle's healthcare engagement index scored 101, the same score released in 2022. In 2021, the score was 100, compared to 108 in 2020. The index score is based on consumer survey answers around how they feel about healthcare.
The report also found that consumers' distrust in providers has grown by 4% between 2022 to 2023. In 2023, 33% of consumers said that they do not always trust their healthcare provider to make the best decision for them as a patient. Across all age groups, there has been an increase in distrust from 2022 to 2023.
Staffing shortages, which are plaguing healthcare institutions all over the country, are also being noticed by consumers. 54% of consumers said that they believe it's harder to get an appointment for their healthcare because of the staffing shortages. Additionally, 52% of consumers believe that the quality of care they are receiving is worsening because of the shortages.
But it's not all bleak. The survey also found that:
73% of consumers said they "feel peace of mind after receiving healthcare services or treatment"
65% of consumers said that extra cost is worth it to go to the best healthcare provider or facility
44% of consumers surveyed said they always trust their healthcare provider to provide the correct decisions for them as a patient
Steps healthcare marketers can take right now to better engage their consumers:
Collaborate. Collaboration across your organization is key to better consumer engagement.
Rebalance. Equally ground your brand strategy internally and externally to focus on consumer engagement with patients and staff.
Focus. Create a clearer "why" around your organization's "systemness" or vision and let that guide the organization to maximize growth.
Evolve. Update your content and content channels to keep up with your consumers' wants and needs.
Elevate. Take on the role of "chief customer officer" to successfully lead your organization's brand and culture to become a more impactful organization.
LuAnn Brady, MSPH, discusses the system's growth plans and the creation of a new regional medical center.
LuAnn Brady, MSPH joined the University of Maryland Shore Regional Health (UM Shore Regional Health) in February as the organization's COO and now oversees hospital and outpatient facility operations throughout the five-county region the system serves.
UM Shore Regional Health is a nonprofit health network that serves the mid-shore region of Maryland, which includes Caroline, Dorchester, Kent, Queen Anne's, and Talbot counties. It operates two hospitals, University of Maryland Shore Medical Center at Easton, and The University of Maryland Shore Medical Center at Chestertown, the state's first critical access hospital, recently created by the system and the state. The system also has two free-standing emergency centers, five medical pavilions, numerous inpatient and outpatient services, and urgent care centers across the mid-shore region.
LuAnn Brady, COO, UM Shore Regional Health. Photo courtesy of UM Shore Regional Health.
In a recent interview with HealthLeaders, Brady shared how she hit the ground running in her new role and talked about UM Shore Regional Health's growth plans and the creation of the system's new regional medical center.
This transcript has been edited for clarity and brevity.
HealthLeaders: How has everything been going as you settle into your role?
LuAnn Brady: It's like any new role where there are lots of people to meet, especially in this health system, because of the large geographic area that makes up the Shore Regional Health network across the five counties. In the early days, it was important to go to those places, meet people, listen to the things that they're doing, that they find challenging, that they're most proud of. It's about getting to know the place and the people.
But as with any job, there are always things that come up that you need to deal with. For example, working with some areas where we're securing some of our physician providers for the next few years, things that we have to do from a regulatory and compliance perspective that are on the calendar, equipment that breaks that you have to get in and help the leaders work through the processes. For me, that's a good learning, too, because it forces you sooner to understand the processes around emergency capital or equipment or, unfortunately in the day and time we live in, getting a lot more familiar with what we have in place around our workplace violence events and learning those processes. It's important that I'm out there and I'm meeting people and seeing where they work and what they're doing, because at some point, if you wait too late for that, you've lost that window and you've also lost your credibility as a leader.
HL: Is there anything you're hearing from staff that may have caught you off guard or that is interesting to you?
Brady: The things that every health system is struggling with post-COVID are certainly things that we're seeing here at Shore Regional as well. Those are the challenges related to our staffing and our workforce shortages, the burnout that our staff and our physicians feel. The different landscape for me is listening to those challenges now on top of our rural healthcare environment that we're in, and how significant the Chesapeake Bay Bridge is in terms of creating a significant barrier between the western shore of our state and the eastern shore, and what that means in terms of being able to recruit and [partner with schools.]
[What] I continue to find incredibly refreshing about Shore Regional is the culture and the people. I noticed, upon walking into the hospital the first day, a lot of smiling faces, people saying hello. And that's not always your experience when you walk into a hospital or into any medical complex.
HL:In your role as COO, how will you lead the hospital's operations and outpatient facilities?
Brady: As the operational leader for Shore Regional, to be successful, no one does that in a vacuum. The importance of all my team members that are part of the Shore executive leadership team is critical. Partnerships with the chief nursing officer and the chief medical officer are critical, because when you think about that trifecta relationship of operations and clinical leadership, those three roles are important in leading the level of quality and safety and operationally efficient programs that we need to lead in these times. The relationship with our chief financial officer and our human resources executive, all of those come into play because no one can know everything about what it takes to operate a complex system like we do in hospitals, ambulatory facilities, home care, and post-acute [facilities].
The University of Maryland Medical System is on that journey [of becoming a highly reliable organization (HRO)]. We started the executive academy for our most senior leaders in January, and even though I wasn't with the organization formally at that time, I started to participate in the weekly executive academies to learn about the framework and the operational characteristics of being an HRO.
One of the critical points of the HRO model is that you're always deferring to expertise. That's important for us as a senior leadership team, deferring to one another's expertise, but it's also critical in deferring to the expertise of our department directors and managers and frontline workers, because they're the people that are closest to the work every day and are teaching us where are the pain points, where are the things that aren't working. Our job in the leadership role is to help them frame those problems and make sure that we're supporting them and how they problem solve. We're looking toward the future in terms of where we need to go to continue to create that access and safe care, and right care at the right time, but doing that in a collaborative way with your team.
HL: Part of your role will be managing the construction of the new Regional Medical Center. Can you talk about the project and how you'll be involved?
Brady: The new Regional Medical Center is, in some ways, the cherry on the sundae of what has been over a decade of work that folks from both University of Maryland Medical System and the Shore Regional Health team have been doing to build out a network of healthcare facilities across the five county areas. That includes the two hospitals, two freestanding emergency centers, a number of medical office buildings and pavilions, and several urgent care facilities. All of those things have come to be over the last 10 years along with the robust primary care physician medical group, UM Shore Medical Group, along with some key subspecialties that have now created this opportunity for the Regional Medical Center.
What's exciting is that for me, I get to join the journey that many of my team members have been on for a number of years. We are looking at about 330 acres of land on Ocean Highway, where there will be about a 380,000-square-foot building. That will be both a hospital and a medical office building with about 147 licensed beds.
Where I came from at the University of Pennsylvania Health System, I had the opportunity to be part of a team to build and open a 504-bed hospital pavilion that created a large academic medical center. One of the exciting things about building a new building is how you go about engaging the teams, the staff, to be part of the design concept with you. Going back to high reliability, if we think about deferring to the experts, the people who know how to take care of the patients and the people who are doing it every day, then we want their input because we're going to be talking about new space, [and] we're talking about changing workflows.
When I was at the University of Pennsylvania, a design-and-build company helped us with these rooms made out of Styrofoam that people could walk through and provide input on where things were in the room. I think we'll have the opportunity to do that with the new Regional Medical Center. We're just kicking off our relationship with our design-and-build partners who are going to be helping us with that. It is an exciting time for people to think about ways to do their job in new and different ways and what they need to do that.
I never thought I'd have the opportunity to be a part of two new hospitals in my career. But now I have the second opportunity. I live here on the mid-shore so it's exciting for me to be part of this on a personal level because it's where I live, and to know that I'll be part of helping to design what the future of the healthcare platform will look like here on the mid-shore.
HL: Are there other things you're looking forward to in your role?
Brady: Maryland is a very unique state, and I've had the opportunity to work at the University of Maryland before. About 13 years ago, I was at the downtown Medical Center, and it was my first experience in academic medicine. It was the place where I first appreciated how much I loved academic medicine because every day you came to work and everyone was focused on the delivery of excellent care. There were all kinds of inventions, and the first this and the first that, that were happening, and so it's an exciting place to be part of. I was happy to be able to come back 13 years later.
I see Maryland as a progressive state when it comes to healthcare, and everything that they've done since the 1970s in terms of being a waiver state, and having one payer, and how that in fact benefits the ability to not pass cost from one payer to another but support the needs of uncompensated care. The state has stayed progressive in looking at the global budgeting, but also the work that they're doing around population health and population management.
To me, it makes the work that we need to do around ensuring access and making sure that people have the care that they need, where they need it, a little bit easier, because when you're operating in a state where the payers aren't paying you for that, it's almost like you don't have that burning platform to be able to accomplish what you know is the right thing to do for the patient. But in Maryland, the state has created the environment for us to be able to do that. To me, it's a real plus. It can be challenging, and people can speak to the challenges of what that is, but I see it as a real positive when we're talking about access and when we're talking about population health and population management, which is really what healthcare is all about.
HL: What has your experience been as a woman leader in healthcare?
Brady: I came into healthcare in the mid-1980s, and so I have experienced a lot as a woman in terms of how we're perceived in leadership roles. It's really encouraged me to—and I have done a lot of this work in the last five years—be a mentor and a role model to women in healthcare and women who express interest in advancing and becoming leaders. I had a boss one time who said to me that it all comes back to our behavior and how we behave as a leader. That really is so critical in the work that we do, and I've never forgotten that. I try to share that with not only other women leaders, but just people in general, who want to grow and develop.
But as much as I have people that I look to and admire, I've also learned just as much from behaviors that you see that you think that's not something I would want to adopt. That's not a model that I would want to take on for others to see. And so, you learn from both sides. I still learn every day about sitting back and reflecting on how did I handle that, could I have handled that better? And that's something we all have to do because that's how we make sure that we're keeping our awareness right at the sharp edge.
The deal, which would integrate Flagler Health+ into UF Health, is expected to be completed by the end of September.
Just three months after first announcing plans to merge, Florida-based Flagler Health+ and the University of Florida's academic health center, UF Health, have reached a definitive agreement.
The deal, following regulatory approval, would integrate Flagler Health+ into UF Health. The process is expected to be completed by the end of September 2023.
The two health systems signed a non-binding letter of intent in February after Flagler Health+ chose UF Health as a "like-minded organization" to focus on and share a commitment to patient-centric care, a community-first approach, team member support, building physician relationships, and creating a welcoming culture.
The idea behind the merger is to expand access to care and enhance local healthcare services in northeast Florida communities. Flagler Health+ serves St. Johns County, Florida, located in the northeastern part of the Sunshine State. UF Health has two academic hospitals, one in Gainesville and one in Jacksonville, Florida, as well as other clinical locations in the northeastern part of the state. The combined system would serve Flagler, St. Johns, Putnam, Clay, and Duval counties.
Further developments, such as an updated organization mission and vision, as well as a future name and logo for Flagler Health+, are being discussed but have not been made yet.
According to an FAQ page, no significant changes to Flagler Health+'s organizational structure are planned. Patient-physician relationships and existing services are also expected to stay the same.
What the leaders are saying
"At the time we made our initial selection, we were confident that UF Health matched our longstanding commitment to our community and our dedication to our team members, providers, and patients. Our discussions in reaching this definitive agreement have cemented our initial impressions. We look forward to joining the UF Health family." — Carlton DeVooght, CEO, Flagler Health+
"Throughout our discussions, a constant has been the desire to deliver outstanding health care to the people in the area. UF Health will bring its unique capabilities as an academic health system, with technologically advanced care focused on world-class outcomes, research opportunities including clinical trials, and training programs for the next generation of care providers, to build upon the Flagler Health+ legacy of meeting the health care needs of the residents of Flagler, St. Johns, Putnam, Clay and Duval counties." — David R. Nelson, MD, SVP for health affairs at UF, President of UF Health
"UF Health is uniquely positioned to bring much-needed top-flight service to Northeast Florida and to ensure that all of the region’s residents have access to the very best health care available. Florida’s population growth is remarkable, and Flagler and St. Johns are among the state's 10 fastest-growing counties. This agreement builds on Flagler's long tradition of caring for the community and positions UF to offer the latest breakthroughs in pursuit of ensuring Floridians can enjoy the quality of life they deserve." —Ben Sasse, President, University of Florida
Sheri Shapiro will serve as senior executive vice president and chief strategy officer effective June 5.
CommonSpirit Health recently announced it has appointed a new senior executive vice president and chief strategy officer for the nonprofit Catholic health system.
Sheri Shapiro currently serves as executive vice president and CSO for Trinity Health, which is a part of CommonSpirit Health. Effective June 5, she will become CSO of CommonSpirit and will report to CommonSpirit's CEO, Wright Lassiter, III.
"Sheri is an inspirational and transformational leader, whose experience guiding strategic initiatives across a broad range of health systems and health care clients makes her an outstanding addition to CommonSpirit's executive leadership team," Lassiter said in a press release. "She shares our values, encourages critical thinking, intellectual curiosity, and data-driven decisions. Sheri will help us propel our vision and mission and bring a new, fresh way of thinking as we close the gap between today and what is possible."
Shapiro will lead market strategy and development, growth and partnerships, strategy transformation, innovation, marketing and communications, brand management, the international division, sales, and payer strategy for the $33.9 billion nonprofit health system, which operates 138 hospitals across 22 states.
According to her LinkedIn profile, Shapiro joined Trinity Health in 2016, where she has since served as the chief strategy officer. She led strategy, growth, business development, mergers, acquisitions, and partnership development for the $21.5 billion nonprofit health system, which operates 88 hospitals across 26 states. She also led the system's innovation program, which invests in advancements that can be used and scaled for health systems.
Prior to joining Trinity Health, she served as a partner and strategic advisor at The Chartis Group, where advised C-suite level health system executives on enterprise strategy, growth, physician alignment, partnerships, and value-based care initiatives. Prior to that, she worked as a consultant for CSC Healthcare.
Shapiro also has experience in brand and product management. From 2001 to 2005 she worked at Ford Motor Company where she managed marketing and market strategy for the Ford Escape and Escape Hybrid SUV product lines.
This past week, CommonSpirit reported operating revenues of $8.57 billion and operating expenses of $9.08 billion for the quarter. The provider posted a normalized operating loss of $508 million and EBITDA of -$38 million.
Elmouchi details his first orders of business for the newly integrated health system, including the alignment of operational and clinical strategies.
Corewell Health launched in February 2022 when Spectrum Health and Beaumont Health merged to create a $14 billion, 22-hospital system serving patients in Michigan.
Over a year later, the system is gaining momentum as the organizations continue to integrate. To help in those efforts, the system recently announced the appointment of Darryl Elmouchi, MD, MBA, who previously served as president of Corewell Health West, to oversee the whole system's operations as chief operations officer.
Elmouchi, who has a background as a cardiac electrophysiologist and in numerous leadership roles including president of the Spectrum Health Medical Group and chief medical officer of Spectrum Health, will lead strategy, operations, clinical care delivery, and financial performance for Corewell's entire clinical enterprise and work to further integrate the system clinically.
In a recent interview with HealthLeaders, Elmouchi shares insights into his new role and the system's integration efforts so far. This transcript has been edited for clarity and brevity.
HealthLeaders:How will your new role as health system COO differ from serving as president of Corewell Health West?
Darryl Elmouchi: It'll be much more on how we work together across the state to ensure we're providing the highest quality care and at the most affordable prices. To do that, it requires a lot of teamwork. My prior role, which also required teamwork, was much more focused on local operations. It's a much bigger scope when you start thinking of the whole state.
HL: What will be your first order of business as COO?
Elmouchi: Even though I'm very familiar with the organization, it's going to be to listen and learn. As much as I might know about the west, I want to learn a whole lot more about both the east and the south, we call it, which is down near the St. Joseph/Benton Harbor area, to make sure that I make the best and most informed decisions working with the teams.
HL:How does your background as a physician define the way you lead in the C-suite?
Elmouchi: I practiced as a cardiologist for many years [and] became increasingly good at complaining about what didn't seem like it was working well within healthcare. My wife, who is also a physician, one night said to me, 'Have you done everything you can to try to make it better?' More or less reminding me that complaint doesn't really solve a problem. That really kind of knocked me over and made me realize that looking for solutions was key, not just picking out the problems.
I firmly believe that having spent so many years at the frontlines caring for patients—seeing what it's like for our nurses, technicians, for everybody working here—informs every decision I make and grounds me to what our true mission is. And that's probably different than those who have not been clinical before.
One of the things about being a practicing physician for so many years, that has weighed on me, is it's really important to have the 'why' of a decision. As a physician, as a nurse, you know why you're doing something to help someone. You've seen the data, you understand. I've often found, dating back many years ago, that decisions were often made where I never knew the why, and so I questioned them. One of my firm beliefs [is to be] incredibly transparent in communication, and trying to explain the why as best I can. So even if someone doesn't always agree with every decision, they can understand how we got to it.
HL:How has the integration of Beaumont and Spectrum into Corewell Health been going so far? How will your appointment help in that integration?
Elmouchi: We've hit all the internal targets we set. But in most integrations, that kind of easier part of working together is in the kind of corporate functions, like finance, and HR, and IT, [and] so forth. What I really hope to help achieve is to have our clinical teams and our operational teams work more closely together. That is going to be front and center as we work toward being on one electronic health record, which is our very aggressive and important plan to do that by the middle of next year.
HL: What pain points are you looking forward to addressing as COO?
Elmouchi: Ultimately, every healthcare organization in the country all the way down to a private practitioner's office has their way of doing something that worked for them over time. And I'd like to help bring us together to our way of doing something. The pain points to get there are going to be breaking through some of those historical norms that might have worked in the past but won't work as well in the future. It's tough because that's convincing people that there might be a better way to do things together.
Healthcare remained among the top sectors trending up in job growth for the month.
The healthcare sector trended up in job growth last month, according to the U.S. Bureau of Labor Statistics' (BLS) latest employment situation summary.
The healthcare sector, which was among the top sectors experiencing job growth last month, added 40,000 jobs in April.
The ambulatory sector led the gains with 24,000 jobs, while nursing and residential care facilities added 9,000 jobs, and hospitals added 7,000 jobs.
Over the past six months, the average monthly job gain has decreased from previous highs but is still at 47,000 jobs.
The healthcare sector joined the professional and business services, leisure and hospitality, and social assistance sectors as the top sectors continuing to trend up in job growth.
So far this year, the healthcare sector added 58,000 jobs in January, 44,000 jobs in February, and 34,000 jobs in March.
Total nonfarm payroll enrollment saw an increase of 253,000 in April, according to the BLS. This left the unemployment rate changed little at 3.4%.