Q&A with Steve Lawler, President and CEO, North Carolina Healthcare Association

Q&A with Steve Lawler, President and CEO, North Carolina Healthcare Association

Recently Golden LEAF asked North Carolina Healthcare Association President and CEO Steve Lawler to share some insights on issues the healthcare industry is currently facing as well as his thoughts on opportunities for the future.

Golden LEAF supports the healthcare industry as an economic engine of growth. Not only does the industry provide quality jobs, but it also helps keep our citizens healthy and able to work. Funded projects in this area include training programs for nurses, doctors, and other medical professionals. Golden LEAF also provides funding for equipment, renovations, and construction for rural hospital systems and clinics that will provide expanded healthcare services and support new job growth. 

For more information on the North Carolina Healthcare Association, visit ncha.org.

With a global pandemic, we saw creative solutions across the board with North Carolina’s two-year and four-year colleges helping to fill the workforce gaps. In what ways did North Carolina’s hospitals pivot to handle workforce needs?

North Carolina’s health systems and hospitals know that healthcare workers are their most important asset. Throughout the pandemic, these organizations were under intense staffing and financial pressures, and they showed tremendous agility to meet rapidly changing workforce needs.

For example, when elective procedures were paused for several months, many health systems and hospitals redeployed staff to other patient care settings to do tasks that were safe and appropriate for them to do according to their licensing credentials.

In addition, the North Carolina Healthcare Association (NCHA) has a wholly owned subsidiary called NCHA Strategic Partners that helps our members get access to cost-effective services to meet their business needs. Through partnerships, we helped to identify travel nurses and other types of interim and temporary staff in high demand to help our members. We were glad to be able to offer one-source support to our members in a time- and cost-efficient way.

NCHA also advocated for various types of waivers during the pandemic in partnership with other organizations. Some of those were emergency rules permitting out-of-state or retired nurses, physicians or physician assistants to be able to apply for limited emergency licenses to provide patient care during the public health emergency.

Providing quality healthcare in rural areas has long been an issue. How did the pandemic affect rural hospitals and are there systems in place to help them recover?

Many of North Carolina’s rural hospitals faced financial strain before the pandemic. The cancelation of elective surgeries in early spring of 2020 left rural hospitals across the state without a major source of revenue.

While federal COVID relief averted an immediate crisis, rural hospitals are still not out of the woods. It is not surprising, then, to see some health systems and hospitals in rural areas announcing affiliations with larger integrated health systems. It is what some of them need to do to build the financial and staffing resources to maintain care so that they can benefit from enhanced scale and access to resources for things like strategic planning or group purchasing.

Alignment strategies are one effective strategy for developing coordinated systems of care that fuel innovation and drive value-based care. Realignment is a direct response to the changing needs of communities, continuous financial pressures to reduce costs and the drive to improve quality and outcomes for patients.

In the bigger picture post-pandemic, healthcare is rapidly changing across North Carolina and nationally to focus more on preventive care, including chronic disease management and serious illness care. The pandemic revealed important insights about underlying health issues in North Carolina’s population and needs to improve health equity. 

The state’s rural health systems and hospitals will continue to be at the forefront of addressing health issues like those in collaboration with community partners. On the macro-level, the North Carolina Healthcare Foundation is excited to be collaborating with the South Carolina Hospital Foundation and The Duke Endowment to launch a new center for innovation that will largely focus on identifying opportunities to improve serious illness care and mental health care in rural communities in both North Carolina and South Carolina.

It is an example of the two states putting a huge new, homegrown resource in place to help rural hospitals rethink their roles and opportunities to improve the health of people in the communities they serve. Rural hospitals can be economic engines for communities and are typically their area’s largest employer. It’s important to support them in continuing to reimagine and transform their business models.

We have seen an increase in using telehealth to access health providers across the state during the pandemic. Do you see telehealth playing a major role in the future of patient care?

During the pandemic, the use of telehealth grew tremendously, both because it allowed healthcare providers to respond to the needs of patients who had contracted the virus but who did not need hospitalization and because it was a safe and efficient way to patients who had other types of physical and mental health needs. For example, many patients who have chronic illnesses used teleconsultations instead of face-to-face clinic visits, saving the need to travel and minimizing risks of virus transmission to all.

In the past year, we’ve seen a surge in using telehealth for everything from outpatient behavioral health to acute-care programs where patients can be monitored at home. It is a proven technology that allows hospitals and health systems to deliver state-of-the-art medical care to every community in North Carolina.

Telehealth is here to stay, and many hospitals are already making plans to invest in and implement new programs to scale up these capabilities.

Where do you see the future of healthcare, especially in rural areas?

Though North Carolina’s cities are growing, much of the state is still very rural and I see a bright future for healthcare delivery in the state’s rural areas.

As I just mentioned, telehealth is here to stay as a component of healthcare delivery to rural communities. Expanding broadband infrastructure to the state’s rural regions should continue to be an urgent focus for the state to support delivering healthcare, education and other types of support services to rural areas.

We will also continue working with our health system and hospital members to provide equitable care for all people in our state. It’s important that we actively seek out and listen to marginalized voices, focus on systems change to meet their needs and build greater capacity in underserved areas.

I think we might see more rural hospitals and health systems signing affiliation agreements with larger integrated health systems. As I noted, that can have many benefits such as giving citizens of rural areas access to new resources like health education capabilities, access to clinical trials and timely access to specialty consults through telehealth while maintaining local jobs and a community feel to the care experience.

I am also looking forward to seeing results from the Carolinas Health Innovation Institute, the unique partnership among the foundations of the North Carolina and South Carolina healthcare association foundations with The Duke Endowment that will heavily focus on rethinking and piloting new care models to benefit rural regions in both states. We will be sharing more information about that new center with the public in July.

Thank you Steve, for your time and for all the North Carolina Healthcare Association does to support rural North Carolina.

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