The Hard Thing About Hard Things

By the time this is published, most or all of you will have heard or been affected by the recent reduction in force. Across Mercy about 350 individuals, more than 100 in the Springfield Communities, have had their positions eliminated. Another 100 have kept their jobs but had their management positions reduced. Many of you have heard the reasons for these actions. Continued implementation of cuts in the Affordable Care Act, cuts in Medicare reimbursement, a switch to value-based payments, and lack of Medicaid expansion in Missouri are among many reasons that the Springfield Communities will see at least $30 million less revenue in the coming year, despite taking care of more patients.

Less revenue forces us to find ways to reduce our costs if we are going to maintain the quality and breadth of service our community expects from us. Given that approximately 60 percent of all our costs are wages and benefits, it is no surprise that part of that cost reduction results in a loss of co-workers.

As this financial reality became clearer and it became apparent what actions we would need to take, our priority became placing the brunt of the reduction in force on management and doing everything we could to augment salaries and additional manpower to front-line positions – to the ER, hospital floors and clinics where patients are cared for. Thus the jobs affected in the Springfield Communities have primarily been vice presidents, directors, managers and supervisors. Some of these individuals have been with Mercy for many years and dedicated their entire professional careers to our organization, which makes it disheartening for all of us. That, of course, is the hard thing.

Decisions about cutting costs and making our organization sustainable start on pieces of paper, analyzing numbers, reviewing metrics…and then that time ends. Numbers turn into positions which turn in to people. People we know and work with and care about. People who have families that rely on them, with bills that have to be paid, and dreams that now have to be reimagined. That’s when it gets real. That’s when the emotions of the moment become our reality and the numbers and metrics that led to them seem distant and hollow.

For those who have not been directly affected by the reduction in force, I suspect some will continue to have fears. Perhaps some will fear they could be next. Perhaps some question our commitment or ability to sustain the organization. I cannot quiet all those fears. The fact remains that these are challenging times for health care. But while this moment may be difficult, we will face these moments together and overcome our challenges. Perhaps it is comforting to know when times get hard that there have always been hard times. Through each of those times we have gotten better, learned how to work smarter and remembered how we were resilient. One day when we inevitably face another difficult time, we will no doubt look back on this moment and recall the sadness of what it is like to do hard things. Yet as we recall the sadness, we will also know that when we had to, we were able to do hard things – the hard things that allowed us to continue in the service of others. We will be mindful to let our hopes, not our hurts, shape our future.

I thank each one of you for your continuing service and resilience in this moment. If you have questions about the reduction in force or want to express your thoughts to me directly, please email me at Alan.Scarrow@mercy.net.