CEO Insider – Spring 2024 Newsletter

NEW SERIES – CEO INSIDER

Over the next several issues of the IHA quarterly newsletter, we will feature CEOs from each of the five Regions that make up our membership (i.e., Capital District, North Country, Mohawk Valley, Southern Tier, and Central New York).

Beginning with this newsletter, we are featuring our CEOs from the Capital District:

  • Dr. Jason Mouzakes – Hospital General Director at Albany Medical Center
  • Dr. Dorothy M. Urschel DNP, ACNP-BC, MBA- President and Chief Executive Officer of Columbia Health
  • Paul Scimeca – President and Chief Executive Officer of Glens Falls Hospital

We asked our Capital Region CEOs the following questions:

  1. What are the most important issues your organization is focusing on in 2024 and beyond?
  2. What are the top three traits you look for in building your executive team?
  3. How is running a hospital in Upstate/Rural NY the same or different than elsewhere in NYS or in other States?
  4. When thinking about building partnerships in your community, whether with other health care providers or social care providers, what issues do you consider most important?
  5. As a leader in Upstate/Rural New York, what are your proudest achievements and or future goals for your organization?
  6. What do you think are the biggest challenges facing Upstate/Rural New York healthcare?
  7. If resources were plentiful, what services or programming would you prioritize in service to your patients and community?

Here’s what they had to say…

Dr. Jason Mouzakes, Hospital General Director, Albany Medical Center

  1. As we continue to traverse the 2024 calendar year, our goal is to remain focused on continued recovery and stabilization. Nationally, hospital systems that post positive margins consistently demonstrate successful emphasis on three elements: reducing length of stay, reducing traveler/contract dependency in the workforce, and increasing access to ambulatory procedures. All of these priorities remain in the forefront, along with an emphasis on our most vital asset—our workforce. We remain steadfastly committed to a culture that fosters recruitment and retention for years to come, ensuring a solid foundation for future successful growth.
  2. In December 2023, when I assumed my current role, I can confidently state that I inherited one of the best executive teams ever! A strong leadership team incorporates several key attributes which include engagement, commitment to mission/vision/values/purpose, and, perhaps most importantly, integrity. As an executive, it is paramount to remain engaged and visible to the entire workforce, remaining persistently available for concerns, questions, and ever present as a “listener”. Moreover, it is equally important to always remain aligned to your institutional mission, which serves as the rudder guiding the path forward. Finally, a strong executive team must lead with integrity as the most basic foundational element towards leading the workforce.
  3. No matter where healthcare is practiced (rural / urban /upstate/downstate), patient-centered care must be an omnipresent principle. Having grown up on Long Island, my formative educational years have been spent upstate, and I truly appreciate the benefits of life in the Capital Region. Challenges to our area of New York State include an aging and slowly growing population, and a higher percentage of governmental payer representation, all of which stresses our financial status. Additionally, transportation challenges in rural communities present a growing and unfortunate burden on patient access. We must remove any and all barriers to quality health care for all.
  4. Success in building partnerships relies heavily on shared mission/vision/values and purpose. Above all, a clinical or social care partner should place a similar emphasis on evidenced-based decisions and quality care delivery, with the patient always remaining at the center of all initiatives. As a guiding principle, availing our patients to adequate access to services remains paramount, and must be guaranteed in these partnerships. In our case here at Albany Medical Center Hospital, the implementation of the Epic EMR platform has truly enhanced the interconnectedness and communication amongst critical clinical partners, allowing for a streamlining of patient care delivery across our region.
  5. Albany Medical Center proudly serves the 25 counties in northeastern New York, as its only academic medical center, Level 1 adult and pediatric Trauma Center, Level 4 neonatal ICU, and the area’s largest team of providers in a wide breadth of medical and surgical specialties. We are most proud of the willingness to serve all in need, a priority facilitated by our robust transfer center (last year, we received over 16,000 transfers), truly distinguishing ourselves as the “hospital for all hospitals”. This could not be better illustrated than during the early hours of the Covid-19 pandemic, when our newly appointed President and CEO, Dennis P. McKenna, MD, welcomed multiple downstate patients in need of critical support, in a true “Dunkirk Moment”.
  6. While excellence in healthcare in the upstate region remains a priority for our communities, we continue to struggle with workforce challenges and dependence on contract labor, coupled with physician and provider shortages in critical areas of recruitment (such as gastroenterology and anesthesiology). These factors continue to drive expenses and contribute to fiscal challenges, with many smaller hospitals finding themselves at significant risk for imminent closure. Additionally, organized labor disputes create significant stresses to healthcare delivery overall. Ultimately, this underscores the necessity for engaging the workforce in both retention and recruitment efforts, a value we hold dearly here at Albany Medical Center Hospital.
  7. Access to healthcare services must always remain at the epicenter of community priorities. If resources were plentiful, a most important health care delivery initiative would be to ensure adequate transportation for all patients (including transportation to hospitals within the health system, as well as providing the ability to receive patients from remote locations with scarce transportation services). Many of our patients suffer complex medical conditions requiring tertiary level care, and we often face challenges in patient movement throughout the region. Ultimately, the societal question to persistently consider and tenaciously pursue solutions for is the nature of adequate healthcare—whether it remains a unique privilege for a select few or a primary and foundational human right for all.

 

Dr. Dorothy M. Urschel DNP, ACNP-BC, MBA- President and Chief Executive Officer of Columbia Health

  1. What are the most important issues your organization is focusing on in 2024 and beyond? Operational and Financial stability is our key focus. Post-COVID volume fluctuations continue to cause revenue challenges on a fixed cost base. Staff recruitment and retention for clinical and non-clinical positions is a major challenge and workforce management will be an ongoing focus. Regional hospitals have smaller available labor pools which drive up labor costs and require increased utilization of agency, reduction of this will be key as we rebuild. Focus on new delivery models of care, greater focus on patient needs, access, and collaborative approaches to change management. Our hospital’s paradigm shift to transform care in our primary service area is a key strategic initiative and to continue to grow and expand the outpatient footprint to serve our rural communities.
  2. What are the top three traits you look for in building your executive team? I look for individuals with strong leadership skills; those who can lead and execute initiatives are important to the organization as well as being able to work on a team. I also look for individuals who have a vision; given the current healthcare economic landscape, it is important to be creative and be forward thinking. Lastly, executive team members must be patient-focused and empathetic, we as leaders in healthcare must have the ability to understand the needs and emotions of others as this is an essential quality to deliver excellent care.
  3. How is running a hospital in Upstate/Rural NY the same or different than elsewhere in NYS or in other States? different than elsewhere in NYS and other states. NYS Medicaid rates are incredibly challenging, and the regulatory environment adds costs to the expense profile of healthcare systems. The rural nature of the community makes providing care locally expensive and also creates transportation issues for patients to access services. In rural settings there is limited availability of staff, and it is difficult to recruit and hire. The demographic changes result in rural areas having an older population base and resulting in much greater reliance on government payers. External agencies are relied on heavily and we particularly partner with county colleagues to provide post hospitalization care.
  4. When thinking about building partnerships in your community, whether with other health care providers or social care providers, what issues do you consider most important? Willingness to be a true partner; organizations with a culture of open communication and collaboration to address community needs is of true importance. We are looking for partners who are willing to engage and support mission-driven initiatives. Geographic distance, limited range of services, cultural differences can create barriers to accessing health services. Therefore, we seek to engage in partnerships that result in creative solutions to rural healthcare challenges.
  5. As a leader in Upstate/Rural New York, what are your proudest achievements and or future goals for your organization? Recently it has been navigating the post-pandemic landscape and working to improve staff engagement, morale and wellness which has been significantly impacted by the economic and operational challenges caused by the pandemic. Increasing focus on patient, quality and access and has led to improvement of all our quality indicators and outcomes measures. We have moved the needle on Healthgrades and CMS Star ratings to the positive. Future goals would be developing a sustainable healthcare delivery model for inpatient and outpatient services that meet the needs of the rural community and continue to evolve as healthcare trends, technology and delivery mechanisms change in the coming years.
  6. What do you think are the biggest challenges facing Upstate/Rural New York healthcare? The hospital inpatient volume variance, coupled with our reliance on government payment methodology, cause significant financial challenges for our healthcare organization. Hospitals have fixed costs which make it difficult to adjust to fluctuating volumes and to meet budget. A major challenge is recruitment and retention of all staff positions including providers. Another challenge is to provide a diverse care delivery network that offers care to small towns with a limited population base. This makes it difficult to provide care across multiple healthcare disciplines in an economical and efficient way. Financial challenges also make it difficult to generate funding for capital investments, which lead to aging physical plants and obsolescence of major technology.
  7. If resources were plentiful, what services or programming would you prioritize in service to your patients and community? We would improve access to preventative healthcare by providing outpatient clinics in small rural settings and be able to offset the resulting expenses despite the challenging reimbursement and financial performance. We would improve access to behavioral health services in the communities that we serve. We would also develop new creative ways of improving access and providing care in alternate settings, for example patients’ homes and mobile care units. Finally, access to capital to modernize and upgrade our current facilities, technologies; and infrastructure along with the ability to build out net new ambulatory settings are priorities to our healthcare system.

 

Paul Scimeca – President and Chief Executive Officer of Glens Falls Hospital

  1. Financial sustainability in a rapidly evolving environment. Our population continues to age and we have a payor mix that is heavily and increasingly dependent on governmental payors. Our services are heavily focused on the growing needs of our population (oncology, cardiology, neurology, behavioral health) – most services we provide directly, some we ensure access to through collaboration with other providers. Maintaining a reasonable operating performance that allows us to replace/secure technology and effectively ensure an adequate skilled workforce is a major focus.
  2. Someone who…..
    – Approaches their work with a framework of solid critical thinking and problem solving – looking for solutions as challenges are encountered.
    – Professional maturity. There’s no need for unnecessary drama.
    – Ability to maintain a productive work/home balance and role model this for those they lead.
  3. In upstate NY, we are the safety net for the regions we serve. This is different than downstate where there are concentrations of providers. In our case, the next closest hospital to the north is 114 miles away – we have a huge service area with a population who relies upon us for the full spectrum of healthcare services. In NYS, different than in other parts of the country, I believe there are higher expectations of our patients as well as broad regulatory requirements which place significant burden on continuously expand what is provided to patients/resident.
  4. Collaboration based on shared values and goals and a recognition/acknowledgement of where goals do not align and/or are in conflict. A willingness for frequent and meaningful communication as we work toward shared goals.
  5. I am extraordinarily proud of the CR Wood Cancer Center at Glens Falls Hospital which provides patients in this region with access to care that is not typically found outside a rural academic medical center. In addition to state-of-the-art treatment, the supportive services provided to the patient as well as access to clinical research and genetics counseling, looks to treat the whole patient and their family. In the future, we are working to expand and revise our Emergency Department. The current facility has not been renovated since the late 1990’s and does not provide appropriate space to caring for patients. Our project is relatively modest but will allow us to best care for the growing needs of an aging region as well as the increasing behavioral health needs of those in our region.
  6. Workforce shortages. This is not unique to health care but has become an increasing challenge. We can grow our own work force to a certain degree but need support to do so. Specifically, we don’t make it easy to become a nurse in NYS. Although there are many programs and initiatives, if we consider the individual’s experience, there is a cost of entry that is prohibitive for many. We need to continue to find ways for those in our region to pursue careers in health care by showing them a path forward that is not overwhelming and burdensome.
  7. Expanded behavioral health services – there continues to be a great shortage of services in the communities we serve. There is a lot of focus institutional capacity – inpatient beds, for example, but community resources are in greater need, including residential settings and out patient care. Also, there has always been and continues to be a shortage of primary care providers. This is changing as we expand availability of advanced practitioners but access remains fairly limited.

Keep an eye out for our Summer issue where we will feature CEOs from the Mohawk Valley Region of our membership!