Health is wealth. Robust and growing medical services not only keep a community healthy, but those healthcare institutions provide jobs — and lots of them. Specifically, Mercy and EMH Healthcare employ about 4,500 people in Lorain County, providing paychecks, health insurance, career growth and, ultimately, a major source of fuel for this region’s economy.
Despite uncertainty, spurred by healthcare reform, of what’s next, one thing’s for sure: There are opportunities for employment. And in Lorain County, where old-school manufacturing has made a mass exodus during the last decade, this is news everyone can feel good about.
“We need a strong community, and the community needs a strong healthcare system — it’s a symbiotic relationship,” says Don Sheldon, M.D., president and CEO of EMH Healthcare, with main campuses in Elyria, Amherst and Avon and medical offices throughout Lorain and Cuyahoga counties. Sheldon, who assumed leadership of the hospital system in 2009, notes physician shortages across the country are projected to be in the hundreds of thousands in the next eight to 10 years. Nurse shortages are predicted to top 1 million.
According to an April 2011 U.S. Bureau of Labor Statistics report, hospitals, long-term care facilities and other ambulatory care centers are adding more jobs monthly than any other employment sector. “There are other technical clinical providers that are part of the equation as well,” Sheldon adds. “Because of those demographics, there will be a continuing opportunity for employment in the healthcare sector in Lorain County.”
But this is nothing new. Actually, healthcare has a strong legacy in Lorain County — its emergence as a leading industry is nothing new, with Mercy and EMH both having been anchored in the community for more than a century. Over time, the two organizations have adapted and grown to meet the changing needs of the population — adding facilities, meeting national quality metrics, engaging in outreach activities and eventually infiltrating the community with all of the benefits that strong healthcare systems provide.
“What we are most proud of is that we have been able to sustain through all of these changes and have always been a leader of healthcare in the community,” says Edwin Oley, president and CEO of Mercy.
Improving access has been one of Mercy’s goals, along with bolstering financials and creating evidence-based best practices in the realms of quality and safety. These days, you won’t drive more than 10 minutes to find a Mercy facility, Oley says. And EMH touts a reputation in cardiac care and orthopedics, having performed the county’s first cardiac bypass surgery and heart catheterization. Both share national rankings as top facilities in their own regard: Mercy’s parent company Catholic Health Partners (CHP) was named a Top 10 performing health system two years in a row by Thomson Reuters. EMH Elyria Medical Center ranks No. 5 in Cleveland in U.S. News & World Report’s Best Hospital Metro Area Rankings and an 11-time 100 Top Hospital by Thomson Reuters. Both institutions are making visible investments, and Mercy has acquired 33 acres at the Route 611/90 interchange, where it will expand services.
Sheldon grew up a couple of miles down the road from EMH in Elyria, and served as an emergency room physician at Mercy and then director of its emergency room before becoming the hospital’s medical director. Twelve years ago, Sheldon joined EMH Healthcare as chief medical officer/vice president of medical affairs.
“So, I have come back home — and I am proud of it,” he says, sharing that he is the first physician in Lorain County to be president and CEO of any hospital. In fact, there are few leaders in the country that share Sheldon’s climb from physician to the ranks of administrator.
That’s changing, Sheldon says. “This marriage between the business of medicine and the clinical side of medicine is important today,” he emphasizes. “As we move forward with healthcare reform legislation, it’s going to be even more critical that business leadership and physician leadership in hospitals work even closer together if we are going to achieve the kind of clinical outcomes and efficiencies to help us survive in a very challenging environment.”
Meanwhile, Oley shares a different but equally diverse perspective from beginning his career in pharmacy at St. Joseph Hospital and Lorain Community Hospital, where he held various management positions during his first 15 years of employment before being named vice president of operations in 1996. That year, the organization became a member of Catholic Health Partners, and Oley was responsible for the programming and construction of the 30,000-square-foot regional cancer center, now known as Mercy Cancer Center. In 2000, Oley was named president and CEO of Oberlin Medical Center (now Mercy Allen Hospital), saving the institution that had announced an imminent closing from financial ruin. Today, it is one of Mercy’s leaders in profitability and service metrics. Oley became president and CEO of Mercy in 2007.
Caring for the Community
Strong healthcare is crucial to the welfare of Lorain County and its people.
“There are broad needs from the community, and both facilities are critically important to the county’s well-being,” Sheldon affirms. “We are here to serve the community as a whole and, in that respect, we take care of anybody [who] is in need of medical care.”
Over the past several years, EMH Healthcare’s level of uncompensated care, which includes bad debt and charity care, has increased significantly. This year, Sheldon estimates $35 million of EMH’s total $250 million operation is spent on uncompensated care. “As people lose employment, they lose healthcare coverage,” Sheldon relates.
While healthcare reform will provide coverage for some of those who are currently uncompensated, Sheldon estimates 5 percent of today’s estimated 15 percent of people without healthcare insurance still will not have coverage to pay for medical services. He says the hospital systems need to prepare for change and managing people who need charity care.
At Mercy, the estimated community benefit provided on an annual basis totals more than $21.8 million, according to the 2010 Mercy Community Benefit Report. Its mission: to extend the healing ministry of Jesus by improving the health of our communities with emphasis on people who are poor and underserved.
When Oley took over Mercy three and a half years ago, his charge was to make the institution financially viable. But Mercy has also extended its outreach to the community by developing its medical staff. In a few years, the organization has increased its roll of primary-care physicians from 33 to 65.
To continue serving those in need and the community at large, Oley emphasizes the role quality metrics will play in keeping hospitals on track to adapt as healthcare legislation is put into place. Mercy was selected by the Institute of Health Improvement (IHI) to participate in a three-year project geared toward improving quality performance. Mercy was one of seven chosen from the country’s 34 Catholic Health Partners hospitals for this IHI project.
Responding to Reform
The big question mark in the future of healthcare is what new reform legislation rules will mean for patients and medical institutions. Preparing to succeed in a rapidly changing industry means gearing up for precision.
“Where healthcare reform is going to take us is a model where the incentive is around value, not volume,” Oley says, explaining how the current system incentivizes physicians and hospitals to conduct more procedures. “In 10 years, the successful healthcare organizations will have empty beds, and we will be incentivized to keep people healthy, to keep them out of hospitals — to do less rather than more.”
But Oley and Sheldon agree this does not mean the healthcare jobs will disappear like some in other industries have. As a matter of fact, Oley says the hospital needs more people to manage change.
“In our model, we have actually added staff in many areas so we can be more efficient and effective,” he says.
Sheldon reiterates the growing demand for physicians, nurses and clinical technicians. There are — and will continue to be — more jobs than professionals qualified to fill them. To that end, Lorain County Community College offers a range of nursing and healthcare degree opportunities.
Meanwhile, healthcare institutions will prepare to meet tomorrow’s challenges by raising the bar in all facets of their operations, Oley says. “Identifying and adopting evidence-based best practices will allow us to best respond to healthcare as we see it in the future, which will be very different than the healthcare we know of today,” he says.
But he adds no one really knows what tomorrow’s healthcare will actually look like. “There is no clear roadmap of how we will move through this morass of where we are today and where we are headed tomorrow,” Oley says. “The greatest challenge will be the ability to react to the regulatory changes in a prompt manner.”
A Healthier Tomorrow
Hospital systems and medical/wellness organizations throughout the region are working together to ensure Lorain County’s people stay healthy and the community thrives. “As we look forward to healthcare reform, you are going to see a need for more collaboration and consolidation within the industry — we can no longer compete with other healthcare systems,” Sheldon says. “We need to work together as much as possible, and there are a variety of ways to do that.”
For one, EMH, Mercy and Grace Hospital together operate a 25-bed acute long-term care facility in Amherst called the Specialty Hospital of Lorain. Mercy partners with Walgreens’ Pharmacy to help individuals who can’t afford prescriptions pay for medications, including footing the bill for cab rides from hospital facilities to pharmacies.
In addition, Sheldon suggests hospitals can share clinical services and consolidate programs. “Not every hospital does everything, so by collaborating with different entities you appreciate the efficiencies and advantages of size,” Sheldon says.
This spirit extends to individual talent: encouraging leaders within the hospital systems to reach out and share their abilities with Lorain County. “The way we lead is by example, and we work very hard to integrate ourselves as much as we can into the community,” Sheldon says, himself serving as a volunteer physician at the Lorain County Free Clinic since its inception 25 years ago. He also serves as its volunteer medical director and is a board member.
Oley concurs that having an “engaged workforce” will give the healthcare industry and community at large the ability to manage change. Oley chaired the 2011 United Way of Lorain County campaign and is a Team Lorain County trustee and board member of REACHigher, an organization dedicated to improving educational outcomes in Lorain County. He is also a board member and treasurer of the Lorain County Chamber of Commerce.
“There is probably no community anywhere in the United States that has access to the quality of healthcare that the people in Lorain do, whether that be services that we provide at a community level or those more tertiary services provided by larger facilities in Cleveland,” Oley points out. “Healthcare is a tremendous benefit to this community.”