Health system CEOs strive for sustained growth. Marlon Levy, MD, a career transplant surgeon who stepped into the CEO role at Richmond, Va.-based VCU Health four years ago, has been able to achieve it. But that doesn’t mean the health system is problem-free.
“We’re in our fifth, almost sixth year now of a year-over-year growth, both on the inpatient and outpatient side,” Dr. Levy said during a recent “Becker’s Healthcare Podcast” episode. “That’s, of course, very affirming. It presents interesting challenges which we have to meet.”
The challenges Dr. Levy describes are supply-side: inpatient bed constraints, specialty clinic capacity limitations and the ongoing difficulty of recruiting the right clinicians to care for a population that increasingly seeks VCU Health out for the work other systems can’t or won’t do.
“Having very strong demand is incredible as I’ve mentioned. But we have to be able to supply that demand,” he said. “Understanding how to meet the demand — the supply side of things — is really critical.”
A core piece of that supply-side strategy is the same one reshaping academic health systems nationally: determining which services can safely and affordably move out of the inpatient environment. Dr. Levy frames the question in terms of both clinical integrity and financial stewardship: can the system deliver the same level of complex care in a lower-cost setting, and can it do so in a way that makes that care more accessible to the patients and payers it serves?
“We’re continually assessing: does a particular therapy need to be on the inpatient side? Can it be moved to the outpatient side? If the answer is yes, can it be done as safely on the outpatient side as the inpatient side?” he said. “Can we deliver the kind of complex care that we deliver in a lower-cost environment, so that we make what we do as affordable as possible to patients, to payers, to governmental funders, to everybody.”
The financial pressures compounding that question are familiar across the industry. Rising costs of labor and medicinals, reimbursement pressure from federal and state governments and private payers, and the imperative to remain competitive on compensation and benefits for the people doing the work. Dr. Levy describes it as one interconnected problem that shifts in shape from day to day.
“On any given day, one problem is bigger than the others. But in the end, they’re all issues that we really have to pay attention to,” he said.
Running through Dr. Levy’s growth strategy is a patient experience standard that doubles as an organizational accountability tool. He and his leadership team ask a single orienting question when evaluating any aspect of care delivery: if it were me, or my family member, what would the experience need to look like?
“From the seemingly simplest things to the most complex — how is the communication? How is physical access to our facilities? Parking? How is the cleanliness of the environment? How’s the food that we serve? How timely are we with making the appointments that need to be made? Making sure that people understand discharge instructions, access to meds when they need prescription meds filled,” he said. “It really goes back to trying to put ourselves in the shoes of the patient or the patient’s loved one and making sure that the experience we deliver is the experience that we would expect if we were the ones in those shoes.”
For a system defined by its willingness to care for Virginia’s most complex and vulnerable patients, that standard — applied across everything from parking to discharge instructions — is how Dr. Levy keeps the organization’s growth from outpacing its purpose.
