When it comes to health care, is bigger better?
Much of life’s wisdom, I learned from my mother, a German immigrant who possessed a pragmatic approach to life. As the chief strategy officer at St. Luke’s University Health Network for the last 25 years, I often reflect on her perspectives when dealing with difficult issues. In this particular instance, the question is: Is bigger truly better?
This question is particularly relevant today, especially in smaller hospitals and health systems in Pennsylvania and neighboring states, as they increasingly contemplate joining “mega” health systems. The emergence of “mega” health systems in the health care industry is a relatively recent phenomenon, and the jury is still out on whether their communities’ health will benefit in the future.
While St. Luke’s has expanded from three hospitals to 14 since 2011, this expansion was not stimulated by an objective of “bigger is better,” but by a sincere commitment to preserve struggling hospitals in our region to ensure that high quality health care services remain accessible and close to home.
Since 1995, we revitalized struggling hospitals in Quakertown, Allentown, Easton, Philipsburg and in Carbon and Schuylkill counties. This has resulted in a highly integrated network with one very high standard of patient care. Securing the future of these hospitals has also preserved family-sustaining jobs for area residents while bolstering the region’s economy — something that benefits everyone who lives here.
Another word for our growth: “organic,” by which I mean we are responsive to the needs of our patients and grow by better serving their needs. For example, in recent years, St. Luke’s has become the third largest nonprofit provider of mental/ behavioral health care in Pennsylvania. We now have over 300 overnight beds dedicated to this service. That represents nearly 1 out of 5 of our hospital beds, far more than almost any other health system in our country.
It is worth noting that much of our expansive mental/ behavioral health service line was developed during the COVID pandemic even though this was an especially challenging time in health care. In 2022, Penn Foundation, a leading organization dedicated to the care and treatment of addiction medicine, joined St. Luke’s. Additionally, St. Luke’s opened an inpatient behavioral health program for adolescents to care for their special needs and an addictions program for people suffering medical and behavioral health issues.
Over my extensive career, I have witnessed on numerous occasions nationwide health care trends that do not translate well in the Lehigh Valley and eastern Pennsylvania. Our communities are diverse, and adapting health care services to those communities’ needs requires a nuanced understanding of those communities, as I have described above. One size does not fit all.
St. Luke’s places paramount importance on delivering secondto-none, top-quality health care while consistently earning recognition as one of the premier hospital networks in America. Two key ingredients in St. Luke’s “secret sauce” for success are 1) paying attention to our communities’ health care needs while keeping access to care close to home; and 2) ensuring that our board of trustees is composed of Lehigh Valley citizens with values deeply rooted in our community, ensuring that those values are reflected in the care our patients receive.
Operating “mega” health systems comes with indisputable disadvantages including complexities, higher costs, a loss of efficiencies and the loss of the human touch as those systems expand beyond a manageable scale.
St. Luke’s, regardless of size, maintains a culture centered on respect, traditional values and a homegrown kindness — the very values instilled in me by my mother.
This is a volatile time in America, but St. Luke’s remains resilient and resolutely focused on what is important to our community, an ongoing pragmatic approach to delivering health care close to home while maintaining lower costs than anyone in the region. In the last five years, our low-cost structure and exceptional quality outcomes have saved Medicare $83 million and provided substantial savings for commercial insurers.
St. Luke’s is not preparing for the future … it is inventing the future. In my opinion, bigger is not truly better — better is better. As my mom would say, “When you are better, you are big enough.” St. Luke’s is big enough and is here to stay, and as our CEO recently stated, “St. Luke’s is not for sale.”