In one of Michigan’s fastest-growing counties, Henry Ford Macomb is confronting a financial equation facing hospitals nationwide: rising costs, shifting reimbursement and consumers demanding more convenient, lower-cost care.
Macomb County is adding 11 residents a day, expanding demand for services across the Detroit-based Henry Ford Health market. But growth alone does not protect margins. Labor and supply expenses continue to rise while reimbursement lags, forcing leaders to rethink not just budgets, but the underlying care model.
Emily Moorhead, president of Henry Ford’s Macomb market, isn’t making incremental cuts or aggressive expansion. Instead, she’s focused on operational discipline.
“We really do need to do a reset in healthcare. We have a lot of burnout. There’s inconsistency,” Ms. Moorhead said.
Since stepping into the role six months ago, she has narrowed the organization’s priorities around operational and workforce sustainability. Instead of layering on new initiatives, leadership is concentrating on staffing stability, throughput, discharge efficiency and visible executive engagement with frontline teams.
“The healthcare model of the past, of the traditionalist and the baby boomers, is shifting with different expectations of our consumers, and we need to be nimble and evolve with that,” she said. “It’s a big challenge and we’re going to have to reassess constantly because driving productivity by asking to do more with less just isn’t going to work. We’re seeing that, and that’s why the high burnout and the high turnover rates that we’ve been battling for years exist.”
Instead, Henry Ford Macomb is examining care redesign. When roles open due to attrition or retirement, leaders reassess the appropriate skill mix rather than automatically replacing positions as they were. Clinical teams are also evaluating variation in testing and workflows to determine whether longstanding practices still make sense.
“It’s a wonderful time to take a step back and say instead of just replacing a position, do we need a different level? Do we need an advanced practice practitioner to replace a physician or do we need a physician to replace the advanced practice practitioner because we’re seeing different disease states or an aging population, or different disparities of care?” said Ms. Moorhead. “I really think we need to start tackling avoidable variation.”
Without a coordinated care delivery system focused on the right level and setting for patient care, health systems have evolved to include a huge amount of waste. Organizations now have the technology and strategy to become more coordinated, but they also need clinicians’ commitment to transformation.
“We need to make sure that we’re being courageous leaders in our organizations and saying, do we really need to be doing that test every day or every four hours? Are there different ways that we can utilize our resources? Is that test going to change the diagnosis or treatment plan and not just checking the boxes because we’ve always done it,” said Ms. Moorhead. “We need to be asking ourselves why we are doing this and who’s doing the work. That’s not a popular thing for a hospital president to say, but we really want to make sure people are getting care in the right location, which oftentimes, unless you’re really sick and need ICU care or surgery, or there’s been a trauma, we really need to be driving more access to the outpatient world, which is the lower cost place to be getting your care anyway.”
While the Macomb market is investing in complex services such as cardiac care, neurosurgery and spine to meet local demand, leadership is equally focused on moving appropriate care upstream into lower-cost environments. Emergency department utilization, for example, is being analyzed not simply as volume growth, but as a signal of access gaps.
“I personally am not celebrating when my ED volume is super, super high,” Ms. Moorhead said.
Shifting appropriate cases into primary care, urgent care, telehealth and home-based services is both a financial and operational imperative, preserving inpatient capacity for the sickest patients while aligning with payer and consumer expectations.
“How do we start leveraging the home environment more, leveraging technology with telehealth and mail order and people coming into the home as opposed to having a lot of expensive bricks and mortar,” said Ms. Moorhead.
For the next year, she is committed to building a culture of transparency and candid conversation as she grows in her role. The emphasis is on execution and improving performance.
“There’s nothing worse than when you think that somebody’s got the ball and is running toward some improvement opportunities. And then the next meeting comes around and everybody’s looking and saying, ‘Oh, yeah. We should do that’ and nobody actually owned it,” Ms. Moorhead said.
She’s been building relationships with small groups and unit leaders in the hospital and ambulatory environments to understand their initiatives and build the right vision for the future. She worked with her executive leadership team to establish a vision and each department also created a plan bolting back to the strategic vision, zeroing in on the most important initiatives.
“We challenged each other on making sure that there were not 500 different things on our list; that we are really focused and have measurable outcomes and metrics that are going to be looked at as both leading indicators as well as lagging indicators so we can make sure we are all aware of the things we’re working on as well as engaging our frontline staff,” said Ms. Moorhead. “It was really important to me that while we were developing our 2026 plan that staff knew what was important to leadership, but also how they show up to work every day and they’re making individual contributions, how that’s leading to the outcomes that we’re reporting out on a monthly basis on our dashboards.”
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