Weeks into his new role as president and CEO of Bryn Mawr, Pa.-based Main Line Health, Edward Jimenez told Becker’s the five-hospital system — with more than 13,000 employees — is taking steps to stay financially resilient while also hiring more physicians and planning new care sites to improve access.
Mr. Jimenez assumed the top leadership role in June and brings nearly 30 years of healthcare leadership experience. He joined Main Line from University Hospital in Newark, N.J., where he served as president and CEO for the past two years. Before that, he spent eight years at the helm of UF Health Shands Hospital in Gainesville, Fla.
Mr. Jimenez said he is now leaning into his new role as Main Line Health remains focused on financial resiliency, workforce retention, access, and digital and clinical innovation.
Editor’s note: Responses have been lightly edited for length and clarity.
Question: What steps is Main Line Health taking to stay financially resilient amid rising labor costs and today’s payer dynamics?
Edward Jimenez: Main Line hired a consulting company, BCG, to assess what was going on with a deteriorating financial situation and to offer some recommendations. So BCG spent about a year doing some very deep analytical work and then provided a report.
BCG pointed out that Main Line needed to go through a right-sizing of the employee base, and earlier this year, we did have a reduction of force. The other thing that BCG pointed out is that our expenses keep growing. Every year we pay more for staff. Every year we pay more for medications. Every year we pay more for supplies.
Additionally, BCG pointed to some areas in the broader supply chain process that we could do better on, that we could get more organized, that we could standardize, that we could manage it better. So the health system has been doing that as well.
And naturally, any time we get the chance, we convey the realities of Medicare and Medicaid to payers and others. At Main Line, the Medicaid dollar is about 50% of our cost. The Medicare dollar is about 75% of our cost. So for every Medicaid patient, we’re underwater — 50% on cost alone. And then on Medicare, we’re underwater by, again, 25%.
Q: What changes is the system exploring to make care more accessible and convenient for patients?
EJ: Over the last few years, Main Line has really expanded its reach by opening either physician practices or ambulatory care centers closer to where our patients live, and we’re going to be on an accelerated pace of that.
We are going to hire well over 150 physicians, and, in this next year, we’re going to break ground on multiple sites. One of the things we’re going to do is bring care closer. The other thing we’re going to do, especially by the locations and the hiring, is improve access times pretty dramatically. For us at Main Line, we know of patients that live in our area that experience extraordinarily long wait times trying to go into the metropolitan urban centers.
So by bringing care closer, by bringing more physicians and nurses, and by bringing more services, we’re going to be able to dramatically impact access and convenience in a big way.
Q: What are you doing to strengthen employee engagement and retention at a time when workforce challenges remain high?
EJ: Our reliance on traveling nurses is almost completely gone, and our nurse vacancy rate lives just under 2%. And then when you look across all the clinical disciplines, we have very low vacancy rates. Still, we have some areas of turnover. The emerging areas over the last year that we’ve had to pay a lot of attention to are in imaging and in the central supply space.
We’re not in a very challenged situation yet, but we see what’s going on around us. We, for several years, aligned ourselves with all the schools as it relates to imaging, and we’re trying to do more. And then for the sterile supply crew — about a year ago, we opened up our own training program to get ahead of it before we got ourselves in a spot where we’re getting agency.
Main Line just has a rich tradition of being very interactive with our employees. So we take a lot of feedback, so we hear about things before they emerge as significant problems. We work super hard at creating dialogue — from surveys, or through 360-degree feedback.
We also have a total rewards package. That is part of our benefits plan, which includes tuition reimbursement and childcare assistance. But in that, we also create things that employees find nice, like discounts of popular services. We have ways that they can decrease out-of-pocket costs, like making available pet insurance. So our total rewards package really looks at trying to bring additional added value to the employees.
Lastly, Main Line is very intentional about professional development. It is very intentional about finding out what somebody would like to aspire to, and then trying to figure out how we can help them.
You have a workforce that believes that your employer truly cares about you — you have the possibility of having a long tenure. And, in the weeks that I’ve been here, I cannot tell you the number of people that have said, ‘I’ve been here 20, 30 years. My mom works here. My daughter works here.’ I wish I kept track, because the list feels super long.
So when you put that all together, you can create a situation where there’s stability in the workforce, and where there are early warning signals that get put on your radar before they’re problems.
Q: Which areas of digital or clinical innovation are most critical for Main Line Health to prioritize right now, and how are you approaching them?
EJ: The continued connectivity between equipment and the medical record is important to us and everybody else. Main Line has a robust pathway toward continuing to do that. All of our pieces of equipment effectively collect data, and putting it into a record in a way that becomes useful in one compiled way is extraordinary.
There’s a world of wearables that begins to take shape that’s a little different. I’m sure my colleagues have shared that with you across the country, and I think we’re all trying to figure out: What does that really mean? And what data are you getting from wearables that add to the clinical picture?
And then the third piece is this focus on storage. All of these devices and wearables and medical records and information we get from outside of hospitals needs to be accessible somewhere, and it’s almost an insatiable growth of data. And so we’re paying a lot of attention to the storage of that data, the accessibility of that data, the redundancy of that data.
We want to be prepared so that it’s there for us to make decisions, which is what they’re supposed to be there for. But it’s also available to us in a way — if there’s ever a need for redundancy or having issues — that we’re nimble about it.
Those are three big areas that are at our fingertips right now. We want to get really good at those before we start thinking these sort of really big thoughts that are next generation.
My approach is: Let’s do what we’re supposed to do really, really well before we convince ourselves that we need to focus on the coolest thing for the next generation.
