Health equity is a big challenge for health system CEOs as the gap between the insured and uninsured population widens. Access to care is an issue in communities across the U.S. and will likely become more challenging over the next few years as ACA subsidies disappear, premiums increase and Medicaid cuts come to fruition.
Many hospitals already had thin margins to begin the year, and likely the challenge will remain for the next few years. How can hospitals meet the increased demand for care and improve their communities while remaining financially stable?
“Now more than ever it’s important to follow a true north,” said Omar Lateef, MD, president and CEO of Rush University System for Health and Rush University Medical Center in Chicago during an interview at the Becker’s CEO+CFO Roundtable in early November. “The Rush true north is to reverse the death gap. We believe, and it’s written on the side of the building, that all people deserve to be healthy. We believe at Rush that healthcare is a human right. We have to balance that by staying in business. That is reality. We get that and we’ll stay in business, but we’ll stay in business while taking care of the community.”
The tension between sustaining the margin and fulfilling the mission of academic health systems is top of mind for many CEOs. Systems are taking steps to cut wasteful spending, tighten investments and collaborate with community organizations for improved access to care.
“If everything you do is in partnership with the community and you find other community leaders to invest in these programs, and the other hospitals who are amazing, including UIC and all the hospitals in the medical district, Mount Sinai Hospital and Lurie Children’s Hospital, they are our partners and we do this work together, not our competitors,” said Dr. Lateef. “What I see in the future is for all of us to leverage our collective weight as employers, to leverage our weight as inspirational leaders, to change our neighborhoods so everybody gets healthy.”
Rush and its partners formed a collaborative called West Side United, a collection of mission-driven organizations investing in the community.
“It was an idea, and part of the idea was to go as big as you can,” said Dr. Lateef. “One of the leaders, Larry Goodman, said, ‘You know, the challenge is not to be afraid to go big. It’s to not go big enough.’ What we were thinking was, if we found partners in the community that had a shared vision in other companies, not necessarily healthcare, and then use those partners to co-invest in the community, and we changed the neighborhood, we could make it safer, we could bring jobs and we could change the dynamic.”
One prime example of the impact is Rush’s commitment to keeping linen laundered locally. When Dr. Lateef joined Rush, his team identified a medical linen laundering company in Wisconsin that could do Rush’s laundry for the best price. So, Rush shipped their linens across state lines for washing.
But, what if there was a better option?
There wasn’t a local commercial linen facility, so Rush decided to develop one. The health system partnered with a foundation that loaned money to create the commercial laundry facility on the West Side of Chicago, in one of the most violent zip codes in the U.S. They brought on community members to own the business with the caveat that everyone they hired would live in the neighborhood and all employees needed to have a retirement plan. Then, Rush provided the company owners with the business to pay back the initial loan.
“It turns out that’s profitable,” said Dr. Lateef. “It was built in a decrepit neighborhood where we bulldozed homes and built a beautiful state-of-the-art facility which physically changes the neighborhood. We hired people locally and the CEOs don’t work for Rush. They’re their own leaders in their own neighborhood, and Rush is doing laundry there, and it’s actually cheaper than sending it to Wisconsin. What we found was we invested in the neighborhood and there’s over 300 jobs we created. Everybody who works there is donating to the community and now we’ll crowdsource the other hospitals to do the same thing.”
When organizations work together on uplifting communities, healthcare can improve and access to care becomes easier. When more people have access to clinicians and healthcare services, they’re healthier overall. Dr. Lateef hopes more communities adopt the collaborative mindset of West Side United.
“Access is one of the biggest problems not only in urban America, but in rural America,” he said. “We collectively have to take the programs like West Side United, which are creating wealth in the communities, and expand those in all other communities in America. We have to do it. It’s not about getting credit and if it’s synergistic, everybody wins. What we have to do is find out what those programs and health center needs are, what programs they need and then how do we expand and build them.”
