ICYMI: In a two-hour Fluence Forum on WCCO Radio, Minnesota hospital and health system leaders, policymakers, and experts came together to examine the growing strain on the state’s health care system — and what it will take to stabilize and strengthen it.
Across four conversations, a clear message emerged: the health care crisis is statewide and rooted in structural challenges that require both short-term action and long-term reform.
Hospitals in crisis – how did we get here
Rahul Koranne, Minnesota Hospital Association President and CEO
Jan Malcolm, Senior advisor to the Governor on hospitals and health systems
In the first segment, Rahul Koranne and Jan Malcolm outlined how Minnesota hospitals reached a crisis point, pointing to rising costs and reimbursement rates that fail to keep pace, particularly from Medicaid and Medicare. They said the result is a growing financial gap that is forcing difficult decisions across the state.
Takeaways:
- Hospitals are facing a systemwide financial crisis, not isolated challenges
- Government payers reimburse significantly below the cost of care
- Rising costs, especially workforce and pharmaceuticals, continue to accelerate
- Service closures, including labor and delivery, are increasing
“Because so many hospitals — both metro and rural — are having the financial crisis at the same time, this is a full-blown fire that is burning, and frankly, we’ve been ringing the alarm bell with our lawmakers for at least the last year and a half to two years on this,” Koranne said.
Urgent short-term fixes are needed
Rick Ash, United Hospital District CEO
Rick Breuer, Community Memorial Hospital CEO
John Cumming, Hennepin Healthcare CEO
Health care leaders from across the state described for listeners a shift from long-term planning to near-term survival, saying financial pressures are impacting daily operations and patient access to care.
They said hospitals are being forced to scale back services and delay investment while trying to maintain access for their communities.
Takeaways:
- Many hospitals are operating in survival mode
- Service cuts are affecting entire care ecosystems, not just hospitals
- Rural access gaps are growing, even in high-demand areas
- Hennepin Healthcare’s stability is critical to the broader system
“This is the most challenging operating environment I’ve seen — and that includes the pandemic years.” Breuer said. “We have had to pare back or shut down services. We have had to delay, defer maintenance needs … it’s a number of short-term and immediate-term strategies that you have to do just to keep the doors open.”
Stabilizing health care delivery in Minnesota
Rachelle Schultz, Winona Health CEO
Greg Ruberg, Aspirus Lake View Hospital President
James Hereford, Fairview CEO
Beyond immediate pressures, three health care leaders pointed to deeper structural challenges shaping the future of care delivery in Minnesota during the forum’s third segment.
They said rising fixed costs, workforce shortages and reimbursement gaps are converging in ways that make long-term sustainability difficult under the current model.
Takeaways:
- The system is structurally strained, not just temporarily stressed
- Rural hospitals face growing limits on what services they can sustain
- Hospitals have limited control over major cost drivers
- Incremental fixes alone are unlikely to resolve the issue
“We’re trying to find ways to stabilize out hospital and health system … we’re trying to innovate, we’re trying to be creative, we’re trying to transform, but I would say more importantly, we’re trying to survive,” Ruberg said. “And you have to be able to survive to be able to do those other things.”
Legislators on Minnesota's hospital crisis
Representative Robert Bierman, DFL-Apple Valley
Senator Paul Utke, R-Park Rapids
Lawmakers from both parties reinforced for listeners the urgency of stabilizing hospitals in the near term. While perspectives varied, the conversation pointed to the need for longer-term policy changes.
Takeaways:
- Stabilizing Hennepin Healthcare is a top immediate priority
- Medicaid continues to be a major financial pressure point
- Workforce shortages remain a statewide challenge
- Policymakers are calling for greater transparency in system costs
“Our top priority is structural reform of our system … the long-term structural problems or our system will not be addressed in the next few weeks and we need to think long and hard about how to solve for the American health care problem,” Rep. Bierman said.
