Like many rural community hospitals, St. Mary’s Healthcare faced challenges to its sustainability, including financial pressures, workforce shortages, and regulatory demands. While consolidation or significant cuts can seem like the only options to struggling hospitals, St. Mary’s chose a different path. After leaving a larger health system to re-establish its independence, the Amsterdam, New York, hospital launched a strategic turnaround plan in 2023 to strengthen its organization and secure its future.
The plan began with one question: “What do we need to become today to ensure we’re still serving this community 20 years from now?” That vision continues to guide St. Mary’s strategy, centered on five priorities: financial and operational resilience, clinical excellence, workforce growth and culture, digital health innovation, and organizational autonomy.
“The results of our transformation are earning attention and accolades locally, regionally, and nationally,” said St. Mary’s Healthcare President and CEO Jeff Methven. “St. Mary’s is demonstrating that this community hospital can successfully adapt to the changing healthcare landscape while remaining financially strong, clinically excellent, and deeply connected to the community we serve.”
Independence
St. Mary’s is among the roughly 30% of US community hospitals that remain independent, and preserving that independence has been a strategic priority. It gives St. Mary’s the flexibility to respond quickly, collaborate effectively, and direct resources where they have the greatest community impact.
“From an innovation perspective, agility is a tremendous advantage,” said St. Mary’s Vice President and Chief Technology and Digital Innovation Officer Julie Demaree. “We can identify an opportunity, bring the right people together, and move from idea to implementation quickly. That ability to innovate, adapt, and continuously improve has been an important part of our transformation.”
Fiscal Sustainability
Strengthening financial operations has been central to the transformation, with a focus on improving processes, eliminating waste, and creating greater accountability.
A key part of St. Mary’s strategic turnaround plan was to modernize its revenue cycle. By optimizing its Expanse Revenue Cycle solution, St. Mary’s was able to streamline workflows and leverage automation, enhance patient communication, reduce administrative burden, and improve operational efficiency. Previously, many revenue cycle processes were manual, fragmented, and difficult to navigate. Measurable outcomes included a 26% reduction in A/R days, a 40% increase in self-pay collections, and improved cash flow.
By adopting standardized, automated workflows within Expanse, St. Mary’s has created more consistent financial results while allowing the organization to reinvest resources in patient care and community health.
Quality and Safety
St. Mary’s transformation strategy has also prioritized an organization-wide commitment to improving care quality and safety. The hospital has fostered a culture where patient safety is everyone’s responsibility. To achieve this, the leadership team strengthened governance structures, increased transparency around quality metrics, standardized clinical practices, and empowered frontline teams to identify and address opportunities for improvement.
St. Mary’s also utilized MEDITECH Expanse to create a more connected clinical environment, using timely insights, standardized workflows, and analytics to monitor quality measures, reduce variations in care, and support more consistent decision-making.
As a result of its efforts, St. Mary’s advanced in The Leapfrog Group’s Safety Grade from a “D” to an “A” for Patient Safety in just 18 months.
“Our Leapfrog ‘A’ is the result of thousands of decisions made every day by caregivers who are committed to doing what’s right for patients,” said St. Mary’s Chief Nursing Executive and Executive Director, Quality and Performance Excellence Meredith Borak. “It reflects a culture where quality, safety, and continuous improvement are embedded in everything we do.”
Workforce Culture
St. Mary’s recognizes that its people are the organization’s greatest asset, focusing on creating an environment where talented people want to build their careers and have the tools needed to provide exceptional care.
To support its staff, St. Mary’s has invested in compensation, benefits, professional development, and more. Equally important, the organization strengthened internal communication and transparency.
Over the past two years, St. Mary’s has added more than 90 providers and 130 associates, reopened previously closed facilities, introduced critical medical specialties, and increased investment in both staff and equipment. As a result of its commitment to workplace culture, St. Mary’s has earned recognition as a Times Union “Top Workplace” in 2025 and 2026.
Strength Through Strategy
St. Mary’s commitment to its transformation plan demonstrates that community hospitals can survive—and thrive—by aligning leadership, culture, and technology around a clear mission. The results position the hospital for long-term sustainability while preserving its independence and advancing community health.
