One more reason to appreciate locally managed, not-for-profit healthcare

By Del. Terry Austin

terry austin
Del. Terry Austin

It’s hard to believe there was ever a chance it wouldn’t turn out this way.

Fourteen years ago, members of Carilion Health System’s board had an existential decision in front of them. The healthcare industry faced an upheaval, and trends for traditional hospital systems were not favorable. One thing was clear: Proceeding with the status quo would not serve the community or the health of its members.

Should they get out of the business altogether, and sell the health system to a corporate buyer or go “all in” on a different model of medicine?

We know how this story ends. The board didn’t like the prospect of someone else, somewhere else managing our community’s health. Not only did they say “no” to a sale, they said “yes” to a significant investment in the community’s future. Weighing the pros and cons took true discernment, a lot of time and a lot of courage. What, in retrospect, looks like the obvious choice involved a lot of risk back then.

That decision led to what we know today as Carilion Clinic. The board invested tens of millions of dollars in more specialists, more services and a medical school and research institute. In 2007, Carilion offered a few dozen specialties. Now, it offers nearly 80. With Virginia Tech, they opened the nation’s first allopathic medical school in several decades. Now it’s one of the most competitive schools nationwide.

The work is far from over. More specialties are on the way – especially those associated with cancer and cardiac care – and Carilion is always pushing to continuously improve. This type of growth means patients won’t have to leave the area for the expert, high-quality care they want, need and deserve.

Regarding education, Carilion and other partners are addressing a persistent shortage in health professionals by establishing a regional health sciences program. This program will provide students with the opportunity to acquire credentials, starting in high school, and continuing through community college or a four-year institution. Thanks to the support of many, I was successful in securing $2 million for this pilot, with the hope that it will be used statewide.

The benefits of the board’s decision all those years ago are many, and they have had a tremendous impact on our region.

Money you spend on healthcare in our region stays in our region in the form of salaries, construction projects, tax dollars and more. Any surplus revenue – usually between 1 and 5% of Carilion’s gross revenue annually – is reinvested in the community as well. Like every business, Carilion is accountable to shareholders. Only in Carilion’s case, its shareholders are the people of this region. As a not-for-profit, locally managed health system, Carilion delivers “dividends” through improved community health.

Carilion’s community health assessment process, conducted every three years, engages community members to determine their health needs. The results help Carilion prioritize business plans to meet those needs. For example, it’s why a VelocityCare now exists in Lexington, where the community identified a need for urgent care. And it’s why Carilion is partnering with others to support southeast Roanoke City residents by establishing the new Local Impact For Tomorrow (LIFT) community clinic at Fallon Park Elementary School.

Now after the year we had in 2020, we can list one more benefit of that board decision in 2007. Being an integrated health system meant that Carilion was well-suited to manage the needs associated with a global pandemic. Think about it.

Some rural hospitals in areas like ours did not survive the pandemic. Carilion’s smaller hospitals kept operating in the face of the harsh financial impact of the virus. Having a locally managed health system, whose mission is to improve the health of OUR community, doesn’t just advance the physical health of our residents. It advances our economic health as well.

Integrated health systems were able to respond rapidly to the evolving crisis, expanding telemedicine services, developing and enhancing testing, and igniting innovations that improved care delivery and advanced other clinical services for patients.

Carilion was able to shift staff between its hospitals and practices to address surges of patients and evolving testing needs. And most recently, more than 1,000 Carilion staff helped the Commonwealth of Virginia administer more than 120,000 vaccines in more than 50 mass vaccination clinics.

I’m grateful to the healthcare professionals who have been our lifeline during this pandemic. I’m equally grateful for the foresight of the Carilion board. In 2007, there was no guarantee of this success, just an unwavering commitment to our community.

Elected in 2014, Del. Terry Austin (R) represents Alleghany County and parts of Bedford and Botetourt Counties as well as the City of Covington. He has been a member of the Carilion Clinic Board of Directors since 2019.


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