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Lauren Ruef has 10 years of professional writing and editing experience, from memoirs to financial blogs and web copy. She has collaborated with 

, a FLEETCOR Company, to write about financial technology since 2016. Nvoicepay optimizes each payment made, streamlines payment processes, and generates new sources of revenue, enabling customers to pay 100% of their invoices electronically, while realizing the financial benefits of payment optimization.

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Steve Mackin, president and CEO of Mercy, confesses that he’s still a bit astonished when he heard the commitment of Alice Walton.

“I guess I still have to wake up a little bit,” he says.

Mercy, a large nonprofit hospital system, and the Alice L. Walton Foundation last week announced a $700 million, 30-year partnership to improve access to healthcare. The foundation has pledged $350 million, with Mercy also investing $350 million into the wide-ranging initiative to improve healthcare access and outcomes.

The partnership also includes the Heartland Whole Health Institute, founded by Alice Walton, and the Cleveland Clinic, which will be contributing to the expansion of cardiovascular services.

Mackin and Walter Harris, president and CEO of Heartland, spoke with Chief Healthcare Executive® last week to talk about the effort. 

(See part of our conversation in this video. The story continues below.)

Leaders talk about the $700M initiative to improve healthcare in Arkansas and beyond

Mercy, Alice Walton Foundation team up to improve healthcare

Both Mackin and Harris lauded the commitment of Alice Walton, the philanthropist and daughter of Walmart founder Sam Walton. They say she’s driven and passionate about the need to change healthcare, both in Arkansas and nationwide. 

When Harris heard of Walton’s plan to commit $350 million to the effort, he said his initial thought was simply, “Let’s go.”

“When Alice makes her mind up and she makes a commitment, there's no turning back,” he says. “We move forward.”

Heartland Whole Health Institute hopes $700M partnership makes national impact

While Mercy and Heartland leader’s hope to produce successes that can be adopted on a larger scale, much of the focus aims on improving healthcare in northwest Arkansas. They’re aiming to develop expanded offerings in primary and specialty care, more surgical capabilities, and additional outpatient facilities.

The plans call for the development of a new cardiac care center on Mercy’s campus in Rogers, Arkansas.

Cleveland Clinic, a leader in cardiovascular care, will bring its expertise to the cardiac care center, and officials tout the potential of improved and innovative treatments. Mackin says Mercy will

“We appreciate and honor just the level of intensity that Cleveland Clinic brings specifically to cardiovascular care,” Mackin says. “When you visit their centers, there's a level of detail that they put into their patient care, their technologies and their operations, and to be able to tap into that insight and integrate that into a community-based setting is going to be a great thing for the Northwest Arkansas community.”

Harris says Cleveland Clinic’s expertise and reputation will strengthen their efforts in raising the level of cardiac care.

“Cleveland tends to be number one ranked in cardiovascular services on a regular basis,” Harris says. “And we thought, why not have a partner who's really good at cardiovascular services come in and work with a strong organization like Mercy and raise all the boats, right? And that's kind of the thinking of that. So Mercy is good at these things as well, but then we say a recognizable name helps to bring more notoriety to an issue that we can pursue.”

In addition to the cardiac center on the Mercy campus Mercy and Heartland will also be developing an outpatient center in Bentonville, Arkansas, with specialty services, including cardiovascular care.

“That's equally important, so both will start simultaneously, so we can comprehensively meet the needs of low to medium to highly complex cardiovascular patients,” Mackin says.

Harris says the efforts in cardiac care reflect the fact that many people in northwest Arkansas leave the region for specialty care. He points to an analysis that found about a billion dollars in specialty care leaves the region annually. He also notes that women in particular need more cardiovascular services.

“We thought there were a line of specialty carriers that are needed, but we thought the most impactful one to come out first would be cardiovascular,” Harris says.

Mackin points to the need to offer more care in northwest Arkansas so people wouldn’t have to travel long distances for specialty services, and he pointed to that as an area of alignment with the Alice Walton Foundation.

“There's a real need in the state of Arkansas to bring more advanced care to the community,” Mackin says. “The out-migration of care was a problem to solve.”

Tom Mihaljevic, MD, president and CEO of Cleveland Clinic, said he’s looking forward to the collaboration.

“We are pleased to be working together with the Alice L. Walton Foundation, Mercy, and Heartland Whole Health Institute to enhance access to quality cardiovascular care for the communities of Northwest Arkansas,” Mihaljevic said in a statement.

Mercy and Heartland leaders both stress that they are especially concerned with reaching those in northern Arkansas who have limited access to care. And as Harris notes, the lack of access is a problem for many in the region.

As Harris notes, “There are certain counties in Arkansas that don't even have doctors in it.”

As a nonprofit Catholic system, Mercy has long worked to care for those with lower incomes, and he says the system’s board annually examines the success of efforts in eliminating disparities in care and outcomes, Mackin says.

Still, he acknowledges that there are persistent gaps in care in Arkansas.

“The state of Arkansas is very low in many of the national healthcare rankings, in part because of healthcare disparities,” Mackin says.

Both Mackin and Harris say the organizations will work to expand telehealth options for those who can’t easily get to a doctor or clinic.

“We believe extending virtual care options, and extending primary care and bringing more access to specialty services will start to address some of those solutions,” Mackin says. “But we've got to take a holistic approach to engage … those populations.”

He says thinking more comprehensively includes reaching out to those who have no insurance and getting them on Medicaid, and ensuring they have access to care both virtually and in person.

Harris also discusses the value of virtual care to offer primary care and preventive services.

“There are many folks who don't even know what their conditions are,” Harris says. “We give them the modality and the access to it, and that changes things. And many people don't know that chronic conditions are reversible. We give them the information they need in the teaching and the learning, so that they can take control of their own healthcare.”

And Harris says such efforts reduce stress on the healthcare system for cardiovascular services and other critical services.

“So the message really is, if we start doing preventive care, because we don't do enough of that, that helps to really reduce the cost of healthcare and grows access in some exponential ways,” Harris says.

In addition to expanding primary and specialty care options, both Mackin and Harris say their goal is changing the way northwest Arkansas views healthcare.

They’re looking to engage residents to help improve their own health. They also are looking to get employers to take a more active role in helping to ensure their workers stay healthy.

“There's an opportunity to engage employers to manage their populations more effectively with more comprehensive solutions,” Mackin says. “Locally, there was a need to expand primary care to more parts of northwest Arkansas so people have easy access and low-cost access.”

Ultimately, Mackin says they want to help people get more involved in their healthcare.

“We want it to look and feel very different than it historically has been,” Mackin says.

“We don't want hospitals in these locations and these investments we're making to be where people go just in emergency situations,” he adds. “Of course, we'll be there for that, but we want to engage the community in a fundamentally different healthcare experience that can meet their needs at 10 o'clock at night from their couch, as well as when they're in a moment of understanding their long-term needs and trajectory that we can impact. So that's the key aspect of the vision.”

The partnership includes the Heartland Whole Health Institute and the Cleveland Clinic. Steve Mackin of Mercy and Walter Harris of Heartland talk about the ambitious plans.

Topic

A $700M mission: Mercy and Alice Walton Foundation want to change healthcare

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Florida hospitals are bracing for Hurricane Helene, and some systems have transferred patients, closed clinics, and in a few cases, evacuated facilities.

Hospitals and health systems have been tracking the storm for days, and the 

 is projecting Helene will hit Florida’s “Big Bend” region late Thursday. The center said Helene could be a Category 4 hurricane, with winds of at least 130 miles per hour, when it strikes Florida.

“Helene is expected to be a major hurricane when it reaches the Florida Big Bend coast Thursday evening,” the center said.

In addition to catastrophic winds, the center also warned of “life threatening” storm surges along much of Florida’s west coast.

At least six Florida hospitals had evacuated as of Wednesday night, said Mary Mayhew, president and CEO of the Florida Hospital Association.

Mayhew told Chief Healthcare Executive® Wednesday night that she’s very concerned about the storm’s potential damage to such a wide swath of the state.

“It really is the sheer size, and given the concern about the wind speed, the prolonged loss of power, combined with the flooding … we just haven't experienced anything of that nature in a long time,” Mayhew said. “That is a little unpredictable given the sheer scope of the storm and how much of Florida may be impacted. Combined with the wind and the flooding, that's my biggest concern.”

Hospitals and health systems in Florida are accustomed to dealing with hurricanes, but the size of Helene poses added difficulties, Mayhew said.

“When you've got nearly the entire state under some kind of a warning, either a tropical storm warning or a hurricane warning, that just compounds the situation,” Mayhew said. “You can't move patients from the west coast of Florida now to necessarily the east coast, if the entire state is at risk.”

While many areas of Florida are facing the threat of storm surge or powerful winds, Mayhew said she’s worried about the Big Bend, which is where Helene is expected to make landfall.

The Big Bend area has endured a number of storms over the past 18 months, Mayhew noted.

“They're just recovering from some of the more recent storms,” she said. “This is just adding insult to injury.”

Much of the ground along Florida’s coast is already saturated, and some of the state’s rivers are prone to significant flooding, Mayhew says.

Extended power outages could pose another challenge for Florida’s hospitals, Mayhew noted. A number of ports along Florida’s coast are being closed due to the storm, so fuel shipments could be delayed. Hospitals have been working to ensure they have enough fuel for their generators.

Flooding and storm damage could also impede the delivery of drugs and other essential supplies, she said.

, which supplies blood to many of Florida’s hospitals, made an urgent call for blood donations before Hurricane Helene’s arrival. OneBlood has reached out to hospitals to make sure they are aware of inventory levels, Mayhew said.

Mayhew credits Florida state emergency officials for their work in coordinating with hospitals and health systems. She’s been on a number of calls with state officials updating plans for more than 300 Florida hospitals.

“I couldn't be more pleased with the engagement and the support from the state,” Mayhew said.

Florida hospitals have also been working with state and local emergency officials to ensure that patients who rely on medical equipment in their homes are transferred to safe places. 

"They also have been very focused on that to make sure that those individuals have not just a shelter to go to, but a shelter that can accommodate the acuity of their medical needs," Mayhew said. "Now there are hospitals around the state that also help to support some of that sheltering where it is possible."

Many communities and counties have ordered residents to evacuate, and Mayhew said she is encouraged that residents are heeding that advice. 

"Our understanding is that people have seen enough over the last couple of years, and the risks that are not worth taking," she said.

Pinellas County, which includes St. Petersburg and Clearwater, ordered the evacuation of two hospitals, along with several nursing homes and assisted living facilities, in portions of the county especially vulnerable to strong storms.

Tampa General Hospital said it was closing many of its clinics and outpatient facilities on Thursday. The system said it was going to transfer some patients from one hospital, TGH Crystal River, in Citrus County.

 around its main campus to help protect the facility from flooding. The fence is designed to protect the 1,000-bed hospital from storm surges of up to 15 feet above sea level. Mayhew pointed to Tampa General’s fence as one of a number of new flood mitigation efforts hospitals have developed in the past few years.

“The positive news is that there's been such incredible investment in some relatively new flood mitigation efforts, at least in terms of a number of the hospitals,” Mayhew said.

HCA Florida, which operates 46 hospital campuses in the state, said some of its hospitals were transferring patients to other facilities. HCA Florida West Tampa Hospital was among the facilities transferring patients; the hospital closed Wednesday night.

HCA Florida established a patient reunification hotline (844-482-4821), which is available 24/7.

Tallahassee Memorial Healthcare closed some urgent care centers Wednesday night, and all of TMH Physician Partners practices and urgent care centers were to be closed Thursday.

Hospitals will also be focusing on ensuring their employees can get to their facilities, and also meeting the needs of their workers who may see damage to their own properties.

“They depend on and need their staff to be there to take care of the patients and the individuals that we may be admitting to the hospital as a result of injuries from the storm,” Mayhew said.

 hit Florida two years ago, some hospital employees lost cars and even their homes, she said.

“Hospitals are going to be looking at all the contingency planning around supporting their staff so that they will be ready to support the needs of their patients,” she says.

For the clinicians and other staff working at Florida hospitals, Hurricane Helene represents the latest in what feels like a constant series of crises.

“It feels like it's been a long time since the pandemic, but it really hasn't been,” Mayhew said. “We're just barely two years out. You know, our staff are still kind of battle weary coming out from that, and then we have had a number of major storms over the last several years. So it is such a combined impact that is having a psychological toll.”

Still, Mayhew marvels at the resilience and commitment of hospital staff during Florida’s severe storms.

“They're rushing into the crisis to be there for their patients, for their communities,” Mayhew said. “We just need to do everything we can to support them.”

Some systems have closed clinics and a few hospitals have evacuated. Mary Mayhew, president of the Florida Hospital Association, worries that the storm may impact much of the state.

Lauren Ruef

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