MaineHealth CEO sees challenges, opportunities for vision of 'healthiest communities in America'

BIDDEFORD, Maine — Andrew Mueller, MD, the new chief executive officer of MaineHealth, says his vision for the region’s largest health care system is the same one the organization has had all along.

“Working together so that our communities are the healthiest in America,” said Mueller.

To achieve that shared vision, Mueller said there are a number of things that must be done by MaineHealth, which comprises nine hospitals, including Southern Maine Health Care in Biddeford and Sanford.

Continuing to deliver “really high-quality, safe, effective” care is one of the tasks, Mueller said during a recent interview at SMHC’s campus in Biddeford. Focusing on ways to improve health outcomes by resolving equity issues in communities is another, he added.

Yet another task involves economics, according to Mueller. That involves recognizing that “the health of the community is tied directly to the health of the economy of the community.” As one of the state’s largest private employers, MaineHealth has the opportunity to consider ways to “meaningfully and sensibly” affect the economics of the region it serves, Mueller said.

“We have a greater chance to accomplish all of those things at MaineHealth than just about anywhere else,” Mueller said.

Pursuing these goals has its fair share of challenges, given factors in the health care industry today. Chief among them, according to Mueller, is the issue of workforce shortages. Wherever you go these days, all kinds of businesses are wrestling with not having enough employees on staff, and hospitals are right there with them.

“We’re going to continue to have workforce challenges for the foreseeable future,” Mueller said. “Like so many industries, health care has really been hit by that.”

This includes Southern Maine Health Care. According to SMHC President Nate Howell, the hospital employs about 2,200 people at its facilities on both its campuses in Biddeford and Sanford. Approximately 1,700 of them are caregivers, he said. These figures represent a shortage, with janitorial and nursing vacancies high among those that need filling, Howell added.

“In our nursing staffing, we’ve brought in traveling nurses to offset that,” Howell said.

In fact, Howell said, traveling nurses comprise almost a quarter of SMHC’s nursing staff – a situation that creates its own challenges, and not only ones financial in nature.

“We prefer, long term, to employ folks who live in the communities (we serve) because we’re a community-based hospital,” Howell said.

Mueller said MaineHealth is doing many things to recruit and retain talented health care workers. The competition with other health care systems is as broad as it has ever been, he added.

“Historically, we probably would have had a perspective that we need to make sure that we’re competing effectively for talent against other health systems in the state and some in the region,” Mueller said. “But the reality is, today, given the workplace shortages, we’re competing nationally for talent.”

Part of the effort involves staying very competitive when it comes to wages, according to Mueller.

“We’ve invested, with benefits, nearly $200 million in wage increases over the last 18 months,” Mueller said.

Mueller acknowledged that such an investment impacts the assorted costs MaineHealth’s hospitals face. He said the organization recognizes that it has to “play a large role” in managing those expenses – in making sure hospitals are effective in how they are delivering care, how they are operating, and how they are managing costs that continue to rise.

“We can’t expect our communities to bear all of that,” Mueller said.

In a typical health care system, 60% of a hospital’s costs are associated with its workforce. Mueller said the average rate of inflation for labor in health care – from what MaineHealth has experienced – has been roughly 15% in the last year.

“It’s a pretty staggering increase,” he said.

Howell praised the staff at SMHC, describing caregivers in particular as dedicated but exhausted after helping patients through the COVID-19 pandemic.

“There are realities of COVID for our work teams – our care teams – that will be here for a long period of time,” he said. “People have worked really hard and are a little tired from that work. They’ve borne well the stresses.”

Mueller also praised the SMHC staff for what he described as the innovation and commitment they have showed while delivering care throughout the pandemic. A lot of their effort, he said, entailed being flexible and acting “on the fly” to meet demands “as they presented themselves in the moment.”

“I think we learned a lot from that experience here that we were able to apply throughout the rest of MaineHealth to help us deliver better care,” Mueller said. “We’re very grateful for the contributions that Nate and the team made that helped us do that.”

The status of the virus is transitioning from a pandemic to an endemic, but this does not mean the pace and demands of providing care have decreased as COVID cases have. Beds once occupied by COVID patients are now filled with individuals contending with heart attacks, strokes, and other health concerns and crises that commonly occur.

According to Mueller, there could be at least two reasons for the shift. One is the impact of stress on people’s minds and bodies as they lived through the pandemic. Another involves deferred care – matters patients held off on addressing with their doctors during the pandemic.

“There’s a largely unprecedented demand for services at all of our facilities right now, including the ones at Southern Maine Health Care,” Mueller said.

Such is part of the picture of where MaineHealth and its hospitals stands now. Where would Mueller like to see MaineHealth, say, five years from now?

“My hope is that we’re more accessible, more affordable, and that we’ve made real inroads to solve some health equity challenges that face us in the community today,” he said. “We know that we’ve got to really think about how we can help and serve the most vulnerable in our communities and do that more proactively than we’ve historically done.”

That goes for not just MaineHealth, Mueller said, but for the entire industry across the nation, as well.

“We see that now, as a result of the pandemic, with increasing numbers of patients who are hospitalized for conditions where we potentially had the opportunity to intervene earlier to have an impact so they don’t ultimately end up in the emergency rooms or hospitals,” Mueller said.

Being proactive with the most vulnerable among us is important for a couple of reasons, he added.

“If we can do that, not only are we providing better care, we’re reducing the cost of care,” Mueller said. “We’re creating a greater capacity for other patients who need care.”

The effort will require MaineHealth to partner with agencies in communities to identify vulnerable people and to figure out how best to intercede in an effective way, early on, Mueller said. Also, he added, it will require MaineHealth to work internally on its awareness about and its involvement in issues of diversity, equity and inclusion.

“It’s really going to be a multi-pronged approach in thinking about how we can be most effective for those who are most vulnerable in our communities,” Mueller said.

Mueller began serving as MaineHealth CEO in the spring of 2021, succeeding retiring Bill Caron in the position.

According to the MaineHealth website, he earned his medical degree from the University of North Carolina School of Medicine in 1996. Mueller then joined the Air Force and completed his residency at the Malcolm Grow Medical Center at Andrews Air Force Base in Maryland, where he was later chief resident in family medicine. From 1999 through 2003, he was a staff family physician and flight surgeon with the 437th Medical Group at Charleston Air Force Base in South Carolina. Upon leaving the Air Force, he practiced as a family physician in South Carolina for three years.

While he remained a practicing physician, Mueller began his career as a physician-executive with Novant Health, a large health care system that spans four states and is based in North Carolina. In May of 2019, he became the president and chief executive of Centra Health.

Mueller said he is “thrilled” to be in Maine.

“It’s an honor and a privilege to be a part of the Maine health care team and to be a part of the good work that’s been going on for a long time,” he said.

This article originally appeared on Portsmouth Herald: MaineHealth CEO pursuing shared vision of 'healthiest communities'