Dear Community Partners,
Across LMH Health, our clinics are the front door to care for our community and the foundation of our healthcare system. They are also where we are experiencing some of our greatest operational and financial challenges. 

Earlier this year, we launched a Clinic Enterprise transformation project to make thoughtful, system-wide changes to improve access, reduce delays, and use every available appointment more effectively. Our goal is to help patients get the care they need when they need it, while ensuring our health system remains strong for the future.

Protecting our mission

While LMH Health has never sought to acquire any independent practice, we have agreed to assume ownership when asked, if it means preserving community access to care. Our Clinic Enterprise practitioners are vital to our community, and we are proud to invest in the care they provide. However, we must ensure these investments remain sustainable. With guidance from an experienced healthcare advisory partner, we’ve identified that our Clinic Enterprise currently requires an annual investment that’s 60-90% higher than similar health systems. 

Closing the gap is not about making clinics profitable – it is about protecting our mission and our ability to serve this community. Last year, LMH Health provided approximately $54 million in financial assistance and charitable care to more than 20,000 people. Sustaining that level of support requires long-term financial stability, which allows us to reinvest in people, technology, and care models that improve patient care.

Improving access to care

As many of you have experienced firsthand, access remains one of our biggest challenges. There are a number of factors at play here: 

• Many practitioners are part-time but have full-time staff supporting them, creating financial strain. This creates access issues for patients as well. We value flexibility and work-life balance. The reality is that clinic costs for staffing, facilities, and infrastructure remain largely fixed regardless of practitioner schedules. Our goal is to balance flexibility with a more sustainable model.
• Last year, we experienced approximately 26,000 missed appointments—unused time when valuable care could have been delivered to patients who need an appointment. Even small reductions in no-shows would significantly improve both access and financial performance. Although we have a policy to charge for late cancellations and no-shows, its application has been inconsistent. Improving consistency, communication and accountability around this policy is one way to help address the impact of missed appointments.
• Lengthy wait times for an appointment also contribute to no-shows. When patients schedule appointments months in advance, many find alternative care in the interim and simply forget to cancel their appointment.
• Simultaneously, same-day appointment availability in primary care is significantly below national averages, something we must work to improve. 

Improving access is vital to both patient experience and organizational health, and we are already seeing progress. For example, the LMH Health Heart Center has already reduced wait times by six weeks over the past two months due to improvements to process. Standardizing processes and procedures will also help improve efficiency, reduce duplication, and enhance experience for patients, employees and practitioners alike.

Looking ahead

Our Clinic Enterprise transformation will be thoughtful, collaborative and gradual. Four multidisciplinary workgroups are meeting weekly, allowing physicians, advanced practice providers, nurses, technicians, clinical staff, leaders and executives to come together to identify solutions. Our Board of Trustees and the senior leadership team are providing guidance along the way.

Closing a gap of this magnitude cannot happen in a single year. We are committed to thoughtful, steady progress, and we have the resources to make these changes responsibly and collaboratively. Over the next two to three years, we believe we can strengthen our operations, improve access, and enhance the experiences of our patients and team members. Together, we can ensure LMH Health remains a thriving community health system for at least another 100 years.

Warmly,
Dr. Shelly Kortkamp