Marc Gorelick, MD, has served as CEO of Minneapolis-based Children's Minnesota since December 2017. He told Becker's that as he approaches his eighth year at the helm, he is focused on various issues. These issues include the system's Epic conversion, which will begin in 2025 and finish in 2026, as well as increasing access.
Children's Minnesota includes two hospitals — one in Minneapolis and one in St. Paul, Minn. — as well as several outpatient clinics and specialty care centers. Dr. Gorelick shared the system's strategies on capital investments, outpatient and ambulatory care, retention, and partnerships with community organizations.
Editor's note: Responses have been lightly edited for length and clarity.
Question: What do you expect to be the biggest financial challenge facing health systems in the coming year, and how are you preparing to address it?
Dr. Marc Gorelick: For pediatric health systems, where 50% or more of our patients are covered by Medicaid, it is the growing gap between Medicaid reimbursements and the cost of providing care. In Minnesota, state reimbursements currently cover less than 70% of the cost. We are working on streamlining our costs, especially non-clinical, while working with the state to maximize federal matching dollars to help boost payments to systems serving a large share of the vulnerable population that relies on Medicaid.
Q: Given the current economic climate, how are you prioritizing capital investments for the upcoming year? In what specific areas do you see the highest ROI?
MG: Capital investments are going to be, need to be targeted. And so our capital investments, which are largely going toward this Epic conversion, are aligned with our strategy. Our new strategic plan is really centered on two things. One is remaining an independent pediatric health system through sustainable reinvestment in the organization, and the second is remaining the premier provider of specialized pediatric care in the region by providing an exceptional and differentiated experience.
And so, the bulk of our capital investment over the next few years is going toward information technology and specifically our switch to Epic, because we see that allows us to modernize our tools. It allows us to take advantage of the significant AI capabilities that Epic is adding, and so we see there will be returns to that investment — financial returns through improved efficiency and revenue capture — but also returns in improved experience for patients, families and staff. So it's a very strategic investment in that sense.
Q: What strategic moves is your organization making to expand outpatient and ambulatory services, and how do you plan to balance this with maintaining inpatient care?
MG: We currently have more than a dozen ambulatory locations — primary, specialty, rehab and ambulatory surgery — throughout the 11-county Twin Cities metro area. Given the large capital investment in technology, as we continue to grow our market share, we are focused primarily on better using the ambulatory footprint we already have to increase access, while also pursuing additional opportunities to partner with other health systems in the community to expand our reach.
Before we start thinking about building new things, how do we best use what we have, and how do we partner with other organizations to be their pediatric solution? This is another way that we are looking to both expand our reach geographically as well as to expand our market share by improving access for more patients and families to our kid experts.
Q: What specific strategies will your health system deploy in the coming year to improve employee retention, particularly in critical front-line roles?
MG: Our new strategic plan calls on us to differentiate on experience, not only for patients and families but for our staff. The current EHR has been a significant source of frustration and dissatisfaction. Our Epic transition is not simply switching out one EHR for another, but using that opportunity to streamline and simplify clinical and non-clinical processes, to better support our staff in the work they do.
Q: How are strategic partnerships with community organizations and other healthcare institutions shaping your efforts to address key challenges within your health system and drive long-term success?
MG: In the past few years, we created the Collective for Community Health, which is the interface between Children's Minnesota and the wider community. This has facilitated our ability to work with a range of other community organizations to address social drivers of health, improve access to our Kid Experts, and tackle the considerable health disparities here in Minnesota.
For example, our mobile van that we use to provide immunizations out in the community, we do that through the Collective for Community Health, in partnership with schools and with other organizations like the YWCA to increase vaccination rates in the community. We work with community organizations to address social determinants of health. We've partnered with community organizations to sponsor a gun-buyback program to help remove some guns because guns are now the leading cause of death for children in the United States, and that's a big community health issue. So it really takes a variety of forms, and what we've done is, through the Collective for Community Health, we've brought that all together under one roof.