Becker's ASC Review

26 HEALTHCARE NEWS 26 The next health system C-suite obsession By Laura Dyrda H ealth system executives spent the last few years building financial stability aer the pandemic and adjusting to workforce shis. ose areas will remain important in 2025, but a new obsession for C-suite executives is emerging. Or, more accurately, re-emerging. Solving capacity issues and becoming more efficient with patient throughput is a top priority for next year, several CEOs and top health system executives recently told Becker's. Many are operating at or near capacity, especially with workforce challenges persisting, and leadership teams are looking for immediate solutions. "Our major headwinds are related to capacity, both inaptent and ambulatory," said Robert Corona, DO, CEO of SUNY Upstate Medical University Hospital in Syracuse, N.Y. "We are struggling to recruit specialists in anesthesia, radiology and pediatric subspecialties. We continue to turn away approximately 7,500 transfer requests per year [due to capacity]." SUNY Upstate operates all hospitals, including the children's hospital, at 110% capacity most days, reaching 120% capacity during peak times. Emergency department volume and ambulance visits are also steadily rising. "We oen have 35 to 40 admitted 'boarders' in our ED at any one time," said Dr. Corona. "We are working to manage through by growing our ambulatory access, telehealth and mobile health offerings. We are also using new technologies to improve our throughput and operating room efficiencies." Dr. Corona is hardly alone. A recent survey from Vizient shows 52.8% of hospital and health system leaders see patient access, throughput and capacity as top focus areas for 2025. Volumes are still elevated compared to pre-pandemic levels, according to Kaufman Hall's "National Hospital Flash Report," and while growth has slowed this year, leaders are still contending with big capacity issues. "e industry's competitive landscape has irrevocably shied, and the performance gap between the best and worst has widened. Health systems must chart this new territory with less capital, which makes strategy – from both a financial and operational lens – essential," according to Vizient. Marty Sargeant, CEO of Keck Medical Center of USC, cited the cost of capacity as one of the biggest challenges to growth next year. He also has his eye on changing regulations and shis to at-home care eroding hospital margins. Nationally, nonprofit operating margins are around 4%, and projected to stay low next year, which could hinder a system's ability to fund technology purchases that would make patient throughput more efficient. "Reimbursement increases are not keeping pace with increases in labor and supply costs," Mr. Sargeant said. "Finding resources for strategic investments, especially in technology, has become increasingly difficult and isn't likely to ease in 2025. Despite these challenges, the medical center has remained financially strong and is investing strategically in resources for our tertiary/quaternary patients, who comprise the majority of our patient population." Cherie Smith, PhD, RN, president of Dublin Methodist and Grady Memorial Hospitals in Columbus, Ohio, part of OhioHealth, said her top priority over the next two to three years is improving patient throughput to ensure inpatient beds are available for patients in need. "It is deeply concerning when we are unable to accommodate the volume of patients requiring inpatient care in a timely manner, resulting in patients held in the emergency department while they wait on a bed to become available in the hospital," she said. "e challenge is not unique to our hospitals, but is a common issue, especially during peak periods and winter months to many hospitals across the country." Dr. Smith's teams are dedicated to safe discharges and connecting patients with resources and follow-up care when needed, but the resources are limited and it can be challenging to find available post- acute care beds. As a result, the hospital is expanding to accommodate the needs of the community. Hospital charges spike post-merger By Laura Dyrda C onsolidation in healthcare pushes up charges without improving quality of care, according to a new study published in the Journal of the American College of Surgeons. Study authors reviewed 37 studies published over the last 14 years for charge and quality data. Almost 77% of the 26 studies measuring quality showed no change or lower quality after the merger, and 93% of the 14 studies examining charges revealed increased charges after integration. "Proponents of healthcare integration have claimed it controls costs and enhances care quality," said Bhagwan Satiani, MD, lead study author and professor of surgery emeritus at The Ohio State University Wexner Medical Center in Columbus. "But we found that evidence is lacking that integration alone is an effective strategy for improving the value of healthcare delivery." Nearly 70% of hospitals are now affiliated with systems, according to the report, and transactions could become more common during President-elect Donald Trump's second term. Hospitals and systems will need to search for increased value in consolidation. The report also found in 54% of the studies, consolidation had a negative net impact on hospitals and 81% of the studies on healthcare spending showed no change or higher costs post-transaction. n

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