ROCKPORT — MaineHealth President and Chief Executive Officer Dr. Andrew T. Mueller has been with the health system for a little over a year and sat down last week to discuss where the system is in general and where our local hospitals, specifically Pen Bay Medical Center in Rockport and Waldo County General Hospital are especially following the COVID-19 pandemic.

Mueller took over as president and CEO of MaineHealth last spring during the height of the pandemic. He said during the pandemic both Pen Bay Medical Center and Waldo County General Hospital played an incredibly important role in helping provide care for patients, not only those suffering from COVID, but also patients that required increasingly high acuity care. He said one of the things that the system learned during the pandemic is that the system would be sorely ineffective if its goal is to take as many patients as it can.

Currently, Mueller said the COVID situation in the state is improving.

“We are seeing the (COVID) numbers come down across all of our hospitals,” Mueller said. “Fewer patients require intensive care or ventilator care.”

With those improvements, he said, no one can predict what the COVID situation is going to do next.

“COVID left a lot of debris in its wake,” he said, noting that one of the major aspects of debris is the industry is seeing significant labor challenges that have emerged. Mueller said some of that is due partially to the large wave of retiring baby boomers, which was in part accelerated by the challenges presented by COVID.

“COVID took a huge toll on our workforce, people are tired and have worked exceedingly hard and have been heroic in every way you can measure the word,” he said.

One of the labor challenges Mueller referenced is traveling labor.

“We typically see 10 to 15% of the nursing work force is travel labor,” he said. “In some ways this is good because it prevents us from growing too big in some cases and allows us to flex labor in a seasonal manner when it is appropriate.”

Mueller said when COVID hit, the demand for travel labor exploded and the health system saw itself in a situation where costs for travel nurses increased to four to five times the rate they normally would see.

In response to the tight labor market, Mueller said the system has worked hard to remain competitive. The system has recently made investments of $200 million, including salary increases for staff, in order to retain and attract a skilled workforce. This has resulted in a 15% rise in labor costs over the last 18 months, he said.

“While we have been able to weather the storm relatively well as a health care system and in many cases weather the storm better than most, we’ve got some real challenges ahead in the next couple of years,” Mueller said.

He also noted that payments from Medicaid and Medicare will not increase, which will put an additional burden on area employers in the community, as well.

Mueller said the system had a strong year financially last year, in part due to funds available as part of the federal CARES act funding. He said he expects this year will be more of a struggle and that the system will be closer to breaking even. Mueller said generally a healthy margin for the system is 3%, which is something the system restricts itself to in order to ensure it is investing its dollars in an appropriate way with the communities it serves and with its staff members.

He said with the 15% increase in wages, it will be a real challenge financially over the next couple of years. He said the system will also see increased drug costs and an increase in other medical supplies such as personal protective equipment.

Mueller said that while 60% of MaineHealth’s expense is its workforce, the system has no plans to reduce its workforce. He said a reduction in workforce would mean the system would have to reduce its services, which is something they are not willing to do. In fact, Mueller and Mark Fourre, president of MaineHealth’s Coastal Healthcare Alliance, which includes Pen Bay Medical Center and Waldo County General Hospital, said the system is actually looking to expand the services they provide to the public.

Pen Bay is currently in the middle of an expansion of its emergency services, which will double the current size of the ER at the hospital, and the system has made some major investments to expand primary care offerings and specialty services to local residents.

Fourre specifically touted the $14 million invested in the Charlotte and Christopher Beebe Health Center in Rockport, which he said allowed Pen Bay to increase the overall quality of its primary care.

Fourre said the inclusion of Pen Bay and Waldo in a larger hospital group also allows significant sharing of resources. He said this has been beneficial in several areas, including cardiology resources, gastroenterology and ear, nose and throat specialties. He said the addition of specialists has allowed the two local hospitals to keep more patients locally.

Mueller said another area that has seen growth locally is oncology services, which he said is an area that is experiencing increased need across the state. He said the system has actively recruited medical oncologists, which again allows patients to receive services closer to home.

“We are really excited to figure out how we can deliver more care for our patients,” he said.

Mueller said that even though COVID numbers are decreasing, MaineHealth is seeing increasing numbers for other medical needs to a point that the numbers are higher than anything they have seen before.

Mueller attributed the increase in non-COVID-related services to an aging population and the fact that a lot of care was deferred during the pandemic. He also felt a lot of issues were developing in patients because of the stress people have been under the last couple of years. With respect to the stresses MaineHealth staffers have been under, Mueller specifically referred to a $2.5 million investment in Talkspace, a virtual behavioral health provider, which the system offers to health care teams and their families.

With respect to other financial issues the system faces, Mueller referred to MaineHealth’s ongoing issues with Anthem Inc.

“We have had a challenging relationship with Anthem,” he said, noting that Anthem has recently been fined in Indiana, Georgia and California for practices similar to those experienced by MaineHealth. He said Anthem is creating a huge backlog of payments ($70 million) and is doing things, from a policy perspective, that are incredibly problematic, such as paying only for one surgery if more than one is performed at the same time or on the same day.

“We have let them (Anthem) know unless we can get these issues resolved, we intend to take Maine Medical Center hospital services out of their network,” Mueller said.

Mueller did note, however, that patients with Pen Bay and Waldo would not be affected by this.

With all the challenges MaineHealth is facing, Mueller offered some positive signs for the future. He said one of the things that originally attracted him to MaineHealth is its vision statement, which is working together so our communities are the healthiest in America. He said he believes MaineHealth has the opportunity to authentically achieve that vision more than anywhere else in the country because of the combination of the system’s incredible care team and the fact the organization has a history of making big investments and really trying to improve health outcomes.