Ascension could shift away from hospital focus, Modern Healthcare finds

https://www.healthcaredive.com/news/ascension-restructuring-modern/519850/

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Dive Brief:

  • Ascension is restructuring to adapt a new strategic direction. President and CEO Anthony Tersigni hinted that direction would put a larger emphasis on outpatient access points and telemedicine, according to a video obtained by Modern Healthcare. The effort could move Ascension away from being a hospital-focused business.
  • The board of directors has endorsed the new direction and the company expects to save $57 million a year by streamlining its pay practices, Tersigni reportedly said in the video.
  • The 151-hospital system has realigned leadership and organizational efforts, including limiting business travel and holding virtual meetings as Tersigni and his direct reports take pay cuts. Such efforts are expected to save $61 million in fiscal 2019, Modern Healthcare’s Alex Kacik reported.

Dive Insight:

The news comes as the industry is questioning whether the days of large hospital-based health systems are numbered.

Tenet Healthcare and Community Health Systems are both shedding hospitals as they seek to reduce debt loads that were $15 billion at their peaks. Tenet, also in restructuring mode, raised its number of layoffs to 2,000 to help reduce its debt.

Ascension recently laid off 500 workers in Michigan and more could be on the way. It’s restructuring shouldn’t be a surprise. The company’s operating income dropped 93% in Q1 2018 to $11.5 million, compared to $172.6 million the previous year. The operating revenue dropped $122.1 million over the last half of 2017.

Admissions for many health systems have been trending downward as expenses have risen. In efforts to make numbers work, health systems are exploring outpatient access points while focusing on geographic areas they believe they can become market leaders in and where higher-revenue-yield services are more in demand.

This has led to large systems questioning whether they want to still be large.

However, no one is waving the white flag just yet and pivoting away from a “strength by numbers” system approach. The restructuring news comes as Ascension and Presence Health signed a definitive agreement for Presence to join Ascension and become part of AMITA Health, a joint venture between Ascension’s Alexian Brothers Health System and Adventist Midwest Health.

The system is also rumored to be in merger talks with Providence St. Joseph Health that surfaced in December.

HCA, which is bullish on inpatient facilities and saw rising admissions last year, is exploring a possible acquisition of Mission Health.

The industry is in a state of change, and it’s yet to be seen how the multiple restructurings shake out. But smaller, regional-focused systems look to be one option as the large systems sell parts of themselves off.

http://www.modernhealthcare.com/article/20180322/NEWS/180329953/ascension-amid-major-restructuring-hinting-at-smaller-hospital

 

NYC Health + Hospitals cuts 476 positions amid financial pressure

http://www.healthcaredive.com/news/nyc-health-hospitals-cuts-476-positions-amid-financial-pressure/444136/

Dive Brief:

  • NYC Health + Hospitals on Friday cut 476 management positions, which will reduce the current six layers of managers to four and is expected to save the health system $60 million, several news outlets reported.
  • The largest U.S. public health system cut 396 managers and eliminated 80 unfilled positions.
  • The system expects the job cuts to lead to $60 million in savings in fiscal year 2018.

Dive Insight:

The announcement of the health system’s massive restructuring day came after a $673 million loss was posted for Q3 2017. H+H interim President and CEO Stanley Brezenoff said in a statement the restructuring will reduce “unnecessary layers of management.” The health system will now be able to “better direct resources where we need them most —  at the front line of patient care.” It also cut 70 employees in February.

Revenue increased by 1.8% to $6.7 billion during the third quarter. Yet system officials said net patient service revenues dropped by 9%. The reasons behind the drop were “lower payments from the disproportionate share hospital (DSH) and upper payment limit programs,” according to the healthcare system of 11 hospitals.

At that time, H+H predicted that it would cut its $779 million budget gap this year and end with $185 million cash in hand. In April, the health system announced a redesign of its management structure after losing $776 million for the first half of FY 17, but said at that time that they did not expect layoffs.

Hospitals are facing financial issues across the country. Safety net hospitals like H+H may soon face even more difficulties. H+H has a large Medicaid population and potential cuts in President Donald Trump’s budget and the American Health Care Act – the GOP’s proposed bill to replace the Affordable Care Act – could send millions off of Medicaid. This would mean a system like H+H may soon face more uncompensated care.

H+H is looking for ways to improve its finances. One way is through a new Epic revenue cycle system that officials in May said will “improve efficiency and ensure that the health system is collecting the maximum amount of revenue for the services it delivers.” They expect it will improve clinical documentation, reduce claims denials and accelerate reimbursements.

Hedge fund-backed Bay Area health system sees C-suite shake up

http://www.bizjournals.com/sanfrancisco/news/2016/08/02/hedge-fund-healthcare-verity-health-system-c-suite.html

Less than eight months after becoming CEO of Verity Health System, the successor to the former Daughters of Charity Health System, Mitchell Creem, has been demoted to chief administrative officer. Verity also hired a new COO, B. Joseph Badalian, it disclosed today.

The Redwood City-based system’s board of directors replaced Creem as CEO late last week with Andrei Soran, who was initially hired in April as president and COO.

Verity disclosed the “restructuring of the system’s executive team” on July 28. Board chairman Jack Krouskup said the new CEO “will continue to lead the efforts to revitalize our Verity hospitals to ensure that they continue to serve our communities across California for generations to come.”

Badalian, most recently CEO at Fountain Valley Regional Hospital and Medical Center in Southern California, a for-profit Tenet Healthcare Corp. (NYSE: THC) hospital, is set to start in the new job Sept. 1.

Why revamp the leadership team less than eight months in? “A turnaround is all hands on deck,” Soran told the Business Times late last week. “It’s a major effort, a fairly major turnaround.”

Scripps begins to stabilize as it undertakes restructuring

http://www.modernhealthcare.com/article/20160512/NEWS/160519961?utm_campaign=CHL:%20Daily%20Edition&utm_source=hs_email&utm_medium=email&utm_content=29563951&_hsenc=p2ANqtz-8S0JEN1pYYD1RlEuEWC_RBCOQjz3nx1AsWEDjHcEdbWOoj2NM01wGgkDiM2gRZmY6y6O5E09Aosdas2afAwMdUsgpj0Q&_hsmi=29563951

Scripps Health

Scripps Health’s operating performance is starting to stabilize as the San Diego-based system takes steps to get its costs under control. The four-hospital group is restructuring and plans to eliminate about 100 jobs.  Scripps CEO Chris Van Gorder notified employees in a memo earlier this year that the job cuts will come mostly from management and administration. The system spent nearly $2.4 million on restructuring costs in the quarter ended March 31, according to its quarterly earnings report.

UC Medical Center CEO to depart amid management shakeup at UC Health

http://www.bizjournals.com/cincinnati/news/2015/11/17/uc-medical-center-ceo-to-depart-amid-management.html?ana=e_cinci_hc&s=newsletter&ed=2015-11-24&u=FAuoHGaGEPdmk4X6khnaiw045b16af&t=1448395233

UC Health in Cincinnati