LEWES — Weighing steep competition and a growing economic disparity in the county, Beebe Healthcare has made several changes to the organization’s management team to guide its vision of more effectively serving all — and only — Sussex County.
Beebe Healthcare President and CEO Dr. David Tam said that executive shake-ups are a result of the health care system’s path of evolution to become more effective and efficient in serving the community.
“A lot of the transformation that we’ve been doing and you’re seeing with executive changes and new departments is really a reflection of the strategic plan and some recognition that COVID-19 really changed the health care landscape,” Tam told the Delaware Business Times.
The crux of transformation
Beebe Healthcare revealed its five-year strategic plan “One Beebe” in June 2022, which highlighted goals like enhancing and expanding core clinical services, developing programs based on inclusivity as well as delivering superior access.
Notably, Tam has repeatedly gone on record to say that Beebe Healthcare’s vision is to become the premiere health care system in Sussex County — and staying solely within its borders. Sussex County continues to grow in leaps and bounds while also drawing crowds of tourists in the summer, which has drawn ChristianaCare and Bayhealth to open new facilities in the last decade. The U.S. Census Bureau estimated the county’s population at 255,956 in July 2022 — a 7.8% jump from the last review in April 2020.
The median household income rose from $57,901 in 2017 to $63,162 in 2019, but that is not indicative of all parts of the county. Beebe studied the community need index data from analytics firms in 20 zip codes in its primary service area. The index considers many factors that limit health care access such as income, language, education and insurance.
Beebe’s 2022 Community Health Needs Assessment found that Georgetown, Bridgeville and Seaford had greater needs, per the index. On the other end, Fenwick Island, Bethany Beach and Ocean View had fewer needs.
Complicating matters is that costs are rising due to staffing shortage and inflation issues, and health care reimbursement rates are not rising to match those needs. The Medical Economic Index, the government measure of the inflation rate for medical practice costs, is at 3.8%. The proposed 2024 Medicare Physician Fee Schedule has reduced the conversion factor, or a part of the formula to determine reimbursement rates for select procedures, down by 3.4%.
The question of Beebe Healthcare’s future in the face of rising costs and competition in a small state is one Tam said is at the heart of its transformation.
“The environment has changed so much that reimbursement is focused more on paying for more screening and preventative care. And to be perfectly frank, we also need to look at ourselves and understand how to do business differently to serve people in Sussex County,” he said.
Beebe’s strategic plan stresses improving access to care for all members of Sussex County, be it through Narcan training and mobile clinics that Tam said is not reimbursed through Medicare. But the plan also outlines that growth is still needed — and Beebe believes that path will be through clinical services and digital capabilities and partners.
“How we pay for [the community services] is by making sure our core businesses can be more efficient and effective so we can generate the revenue to pay for those services. And that’s the crux of our transformation,” Tam said. “It’s not that the organization was bad. It’s that so much has changed that it’s at the point we can’t keep doing things the way we’ve always done it.”
Restructuring roles
Tam’s leadership began in March 2020, when he moved up his start date at Beebe to lead the hospital system through the early months of the pandemic. Outside of the pandemic response, Beebe Healthcare has been known for a series of ribbon cuttings of new locations throughout the county.
But internally, Tam said that leadership changes began in 2021, as Beebe Healthcare changed up its board of directors. Seven people with a combined 65 years of service on the board retired, and two new directors joined. New advisory committees were formed like the Population Health Advisory Committee and the Strategic Planning Committee.
Both those moves helped pave the way for rethinking Beebe’s executive structure and roles in the organization.
In the past year, Beebe Healthcare has created new positions and renamed titles to best reflect its future. New executive roles include vice president of value-based care and operations and chief health systems design officer, while other existing positions were renamed, like chief people officer, to mirror Beebe’s values.
Other major changes included eliminating the chief operating officer role, then held by Rick Schaffner, and dividing its responsibilities between the chief nursing officer and the vice president of the continuum of care.
Also hired were new system Chief Physician Executive, Paul Sierzenski and Chief Nursing Officer Kate Bechtold.
In the past, the chief nursing officer was also responsible for continuum of care services, or those that cater to a patient through a period of time through comprehensive treatment. But that was split into a new executive role, the vice president of integrated and continuum of care, so Bechtold can focus more on facility operations and management alongside Sierzenski.
The change has been so effective that the hospital’s bed census is down considerably previous year’s average. Beebe officials said that it was comfortably away from peak capacity from the height of the pandemic.
“That effectively created more capacity even without buying or building a new hospital. Think of all the nurses who can do exactly what they need to take care of patients. That required new leadership to make that happen,” Tam said.
Beebe had created the senior vice president of value-based care and operations to explore how the organization can maximize care with a rising reimbursement model. Insurance providers are tapping into value-based purchasing contracts, where a price is set to determine the value of treatment to achieve health outcomes.
Finally, Beebe created the role of chief health system design officer this summer to examine Beebe’s existing capacity and understand what services need to be improved or added to its network. Tam said that some of the patient needs in emergency rooms across the nation are not for hospital beds, but specific treatments that could be handled outside the ER.
“It could be waiting for an inpatient rehab facility that is so specialized and the patient needs to go to Jefferson [Health],” he said. “We need to understand the continuum of care of where these patients go, and that’s the next step in our journey. And that’s why that position is so important.”
Recruitment
In filling these positions, Beebe Healthcare has recruited within. Danielle Socrates, who served as performance operations director at Beebe Medical Group for the past four years, was promoted to vice president of value-based care and operations. Dr. Bill Chasanov, who helped lead Beebe’s COVID-19 response, has since been named chief health system design officer.
Beebe has also used headhunter firms for key positions. One notable case is contracting with Witt/Kieffer to search for a new chief financial officer, as its past executive Paul Pernice retired five months ago.
“I want to make sure we don’t limit ourselves and bring people and executives with the skill set to execute the transformation journey guided by our strategic plan,” Tam said.
These leadership roles are all required to be in Sussex County, and many of the new executives have a Delaware connection. For example, Chief People Officer Ashley Foster has experience working for Fortune 100 companies but she started her studies at University of Delaware.
“I do think there is value in having people who have roots in Delaware — but what’s important is people have the open mind and sensitivity to want to serve a small community with care and a high level of experience,” Tam said.
