A better year for MetroWest Medical Center
Photo/Edd Cote
MetroWest Medical Center in Framingham
MetroWest Medical Center CEO Barbara Doyle
Denise Schepici, the hospital’s chief operating officer
Last year, MetroWest Medical Center in Framingham was in a tough spot.
Finishing the fiscal year on Dec. 31 with a $6 million loss, following several years of losses, it was hard to predict how hospital management would reverse the losses, bringing the Framingham-based community hospital back into the black.
But that work was already underway. With the opening of an expanded behavioral health unit at the hospital's Natick campus last year and a renewed focus on recruiting, executives at MetroWest Medical Center had begun to rewrite MetroWest Medical Center's fortune. By June 30 of this year, the hospital had turned a profit of $9.6 million, well ahead of the $2.75 million loss the hospital faced midway through fiscal 2014. So far this year, the hospital is the most profitable in the MetroWest region, according to state data, and that's after just six months, compared to the nine months of earnings most hospitals had reported at the end of June.
A physician infusion
Hospital CEO Barbara Doyle was hired two years ago this month. She joined the for-profit hospital as part of an effort by Dallas-based Tenet Health Care to revamp the MetroWest management team. A nurse by training, Doyle was recruited from Inova Mount Vernon Hospital in Alexandria, Va.
“We needed to get an infusion of growth, by bringing new physicians in the door, which is of course is most critical to the success of an organization,” Doyle said.
Doyle attributes the challenges MetroWest Medical Center was facing to a wave of physicians leaving the hospital and realigning with other organizations in recent years, as well as simple geography. Framingham, the site of MetroWest Medical's main campus, is just roughly 20 miles from Boston and therefore has many competitors in the city and its surrounding suburbs. Newton-Wellesley Hospital, for example, is about 15 minutes away by car and has the advantage of being owned by Partners HealthCare, the state's biggest and most powerful hospital system.
“We know Massachusetts has among the best hospitals in the country, so we feel the heat and the competition immensely,” said Denise Schepici, the hospital's chief operating officer, who was hired last year.
Assessing community needs
In the community hospital world, Doyle said the name of the game is focusing on the role you play and doing it well. That's why the management team decided to examine which health care needs weren't being met in the community and to invest in those. Behavioral health was the biggest, as a statewide shortage of in-patient psychiatric services was as big a problem in MetroWest as anywhere, according to a community assessment the hospital performed.
Tenet decided to add 16 in-patient psychiatric beds at MetroWest Medical Center's Leonard Morse Hospital campus in Natick. Those came online last fall, and the hospital is now in the process of renovating its geriatric behavioral health unit.
Tenet added capacity at its other Massachusetts hospital, Saint Vincent in Worcester, as well.
Doyle recognized that insurance reimbursements for behavioral health services aren't as high as for many other services, but there have been some changes at the state level that make it a little more profitable. The bigger obstacle, she said, is finding providers to deliver care.
“It's a complex service line,” she said.
Boosting market share
Recruitment, especially of physicians, is a challenge across most disciplines. Since MetroWest Medical Center had to expand a number of services to become more profitable this year, the hospital has had its work cut out for it.
Schepici, who formerly held a management role at Tufts Medical Center in Boston, has focused largely on that work since her arrival.
“Market share was going down here, mostly because there were physicians just realigning with different systems,” Schepici said.
Meanwhile, a physician shortage has plagued the U.S. health care industry. According to the Association of American Medical Colleges, demand for physicians could exceed supply by up to 90,000 by the year 2025. In Massachusetts, the hiring environment is slightly more challenging than the U.S. average, according to the Massachusetts Medical Society, because the cost of living is high and salaries lag national averages.
The hospital's community needs assessment prompted MetroWest Medical to focus on recruiting physicians in the areas of bariatric medicine; breast surgery; ear, nose and throat surgery; urogynecology and obstetrics. Solidifying the hospital's primary care services with new hires has been crucial as well.
“One of the keys to success is really listening to the community,” Doyle said.
Tenet's role
Of course, Tenet Healthcare's ownership of MetroWest Medical Center is an important ingredient to its success. Tenet is a huge hospital operator, with 87 hospitals in the U.S. and the United Kingdom. The organization helps MetroWest Medical Center with lean management strategies and bulk purchasing contracts, which save money.
Tenet ownership has helped make Saint Vincent among the biggest money-making hospitals in the state, with $65 million in profit for fiscal 2014.
Steven MacLauchlan, who joined St. Vincent as CEO after Tenet bought it and MetroWest from Nashville-based Vanguard Health System two years ago, said MetroWest Medical Center is in a different type of competitive market than faced by Saint Vincent Hospital, making its challenges different. He believes recruitment of specialty surgeons and investment in behavioral health services will pay off.
“They've done a really nice job, and when you see next year's data come out, I think you'll see a much different picture,” MacLauchlan said.
According to MacLauchlan, management changes have also been highly effective.
“It took some time for the team to understand the needs … and they've done an excellent job of understanding the needs of that community,” he said. n
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