Converting the Currency of Patient Access Into Organizational Growth and Economic Development


By E.W. Tibbs

The best way to provide exemplary patient access is to go to where the patients are. It seems like a simple approach, but healthcare tends to invest in communities by population density usually defined by home address. My team at Centra Health, a four-hospital, not-for-profit integrated healthcare delivery system in Virginia, took a different approach, and it paid off in ways we could not imagine. In addition to providing unparalleled patient access to services in our community that were previously inaccessible, we were able to increase job growth, create economic development and provide organizational growth. Towns that were once places to drive through became robust and thriving communities. 

We wanted to grow in all four geographic directions, and in order to do so knowing that we had to build and implement an innovative strategy that would allow us to compete with big-name healthcare institutions in our area. Our methods were unconventional at a minimum; we invested $100M to place six outpatient facilities throughout the community. Population density was a consideration, but we decided where to build after studying travel patterns and where our patients worked. One of our facilities was constructed in a hay field! We built six facilities in three years, and every single facility exceeded volume by all estimations. 

The ambulatory growth fueled the hospital growth, which seems contrary, but healthcare is all about relationship building. Our amazing healthcare providers and teams at the ambulatory facilities were building relationships and earning outpatient loyalty with the patients, so when the patients were sick, they already trusted our health system and selected our hospitals for their acute care needs. 

Patient testimonials indicated how much the new facilities positively affected their lives. There was an elderly couple in their 80s who had mobility and transportation challenges. They thanked us for believing in them and their community. Prior to the new facilities, they had limited to no access to primary and preventative care; they had no timely access to emergency care. The couple said the ambulatory outreach was a lifesaver for them and everyone in the area. Experiences like this confirm how important patient access and quality healthcare services are to not just a person, or the community, but to the region at large.

With the rise in patients in all locations, we were able to recruit the best and brightest to join our healthcare team. Employees are the lifeblood of an organization, and hospitals and healthcare facilities are often the largest employers in their regions. From 2013 – 2018, our workforce grew exponentially. Centra’s total employees (full time equivalents – FTE’s) in 2013 was 6,000; in 2018, there were 8,508 total employees (FTE’s) with most of the new roles being full-time with benefits including retirement plans. 

Improved patient access also drove organizational growth.  In 2013, Centra Health was an approximately $680M annual net revenue organization and was largely hospital and Lynchburg centric.  In 2018, annual net revenues were projected at $1.3 billion and Centra had become a regional integrated delivery system serving a geography of more than 9,000 square miles.

Bringing new jobs to rural central and southern Virginia was an important part of our growth strategy. One example was the construction and opening of a new 50,000 square foot facility housing a free-standing emergency room, patient-centered medical home, ancillaries and other services. This facility was located about 40 miles from larger communities where people had previously had to travel to work. About 75 new jobs in this area meant nurses, physicians, receptionists, environmental services and other professionals could work close to home caring for their friends, families and neighbors.

With an average annual income of approximately $50,000, employees were incentivized to stay at our healthcare facilities and our region. With the influx of people earning a higher salary, industry moved into the area, and quiet towns were revitalized with new places to eat, shop and stay. Patient access is the currency to a thriving community, and I am blessed to have played a part in the betterment of so many lives for generations to come. 

An experienced healthcare system CEO who began his career as a registered nurse, EW Tibbs is a proactive, determined leader with a passion for building lasting, collaborative relationships. He writes about healthcare leadership and community impact at