When people talk about hospital mergers and acquisitions, the narrative is often negative: larger systems becoming more fragmented and expensive, less efficient and more difficult for patients to navigate, resulting in worse access and less coordinated care. 

A smiling man wearing a doctor's smock.
Dr. David C. Miller is the CEO of Michigan Medicine and executive vice president of medical affairs at University of Michigan. (Courtesy photo)

But at Michigan Medicine we are writing a different story. Our goal has always been to build a more connected statewide academic health system that expands access to high-quality care, strengthens local communities, improves outcomes and delivers greater value for patients across Michigan.

Three years ago, we integrated the six-hospital Sparrow Health System into our clinical enterprise, University of Michigan-Health, which also includes our academic medical center and UM Health-West on the state’s west side. And in that short time, we’ve achieved a number of clinical and financial performance goals that other mergers have not.

In fact, we are demonstrating that growth and value can go hand in hand. As we expand, we are strengthening quality, improving access, enhancing services within local communities and delivering more coordinated, patient-centered care. 

We recently detailed this work in NEJM Catalyst, the prestigious peer-reviewed publication of the New England Journal of Medicine where we reported measurable proof of this progress at UM Health-Sparrow:

  • A new neurosurgical program expanded access to advanced, patient-centered care closer to home, eliminating long travel for high-acuity patients. At the same time, quality scores in the Michigan Spine Surgery Improvement Collaborative also increased from 63% in 2022 to 91% in 2024.
  • Registered nurse turnover declined from 17.4% in 2022 to 7.7% in 2024, while employee workplace satisfaction rose from just over 3.5 on a scale of 1 to 5 In 2002 to nearly 3.9 in 2024.
  • Supply chain integration generated more than $23 million in savings through new sourcing strategies and aligned system vendor contracts without significant reductions in workforce
  • Operating performance improved from a $158 million deficit to a $28 million surplus in less than a year.

This has not been easy, and changes like this don’t happen overnight. Meaningful integration requires sustained operational discipline, clinical coordination, cultural alignment and long-term investment. But when done thoughtfully, integration can strengthen local health care systems, improve patient outcomes, expand access and create long-term value for communities across Michigan.

One of the clearest examples is patient safety and quality performance. Even as we expanded and integrated operations across a larger and more complex health system, U-M Health and UM Health-West both improved their Leapfrog Hospital Safety Grades to an A from a B. UM Health-Sparrow achieved a B, but was just a slim margin away from an A grade.

Expansion and value do not have to be mutually exclusive. Health care organizations should not have to choose between growth and quality, or between operational sustainability and patient-centered care. In fact, when integration is done well, those goals can strengthen one another.

Patients are increasingly benefiting from more coordinated care, improved access to specialists, and expanded services closer to home. Services in areas such as pediatrics, maternal fetal medicine, neurosurgery, cardiovascular care, oncology and gastroenterology are becoming more connected across our statewide network, reducing unnecessary travel and improving continuity of care for patients and families.

Academic health systems bring capabilities that are uniquely important to Michigan’s future. Michigan Medicine is not only a provider of care. We are also a major engine for research, innovation, education, workforce development, and economic growth across the state. 

We train future physicians, nurses, pharmacists and health care professionals. We advance scientific discovery and clinical innovation. We care for some of the most medically complex patients in Michigan. And increasingly, we are working to ensure that patients across the state can benefit from those capabilities without always needing to travel to Ann Arbor.

That matters not only for health care, but for Michigan’s long-term economic competitiveness and quality of life. As health care continues to evolve, academic health systems have an opportunity, and a responsibility, to help build more connected, sustainable models of care that better serve patients, communities, employers, and the state.

We know there is still more work ahead. Integration is complex, and no organization gets everything right the first time. But we remain committed to transparency, continuous improvement and long-term stewardship of the communities we are privileged to serve.

Michigan deserves health care that is innovative, accessible, high-quality and affordable. Our delivery systems must expand opportunity and access without compromising quality; and we must strengthen communities while advancing discovery and education.

University of Michigan Health is ready to meet these challenges.

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