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October 16, 2023 / 2023 Power 25 Health Care

2023 Power 25 Health Care: James Shmerling

Superhero day has been an annual tradition for the last decade at Connecticut Children’s medical center. This April, the hospital was able to combine it with a groundbreaking for the most significant expansion in the hospital’s 27-year history.

CEO Jim Shmerling got in on the act, donning a red superhero cape for the accompanying press conference.

The $280 million new tower, adjacent to the hospital’s current Hartford premises, will house several ambitious new programs, including a fetal surgery center that is expected to make Hartford a national leader in the discipline; a NICU unit with 50 private rooms; and state-of-the-art facilities for bone marrow transplant work and gene therapy.

The new patient tower is the highest-profile piece of a broader turnaround effort that’s been underway at Connecticut Children’s since Shmerling, a Tennessee native, arrived eight years ago.

At that time, the hospital had run multimillion-dollar deficits in two of the previous three years.

The legacy financial issues revolved around the hospital’s size and core patient population, he said.

“We’re comparatively small … to other children’s hospitals, so we don’t have the same kind of scale,” Shmerling told HBJ in April. “We have a lot of children who are enrolled in the Medicaid program, and Medicaid does not pay the cost for the care.”

His approach to fixing those two problems included supporting the hospital’s mission in underserved communities by expanding its overall reach, and thereby tilting its revenue mix toward more sustainable private insurance payments. This strategy was partly achieved by building more outpatient facilities.

Where previously the hospital counted 750,000 children in Connecticut as its core patient population, it has now extended into western Massachusetts and eastern New York, encompassing a potential patient population of 1.2 million children.

And, as it has moved south in Connecticut toward communities in Fairfield County, it has begun to serve more families with access to private insurance, improving the payer mix. The southern Connecticut expansion, not incidentally, also builds Connecticut Children’s brand in part of the state with potential wealthy donors.

Shmerling has also partnered with peer institutions. Connecticut Children’s now runs the neonatal intensive care units at eight other hospitals in the region, and for some, their pediatric units as well.

Shmerling, who joined Connecticut Children’s in late 2015, is not new to major expansions. He previously oversaw hospital construction at Vanderbilt Children’s Hospital and the Children’s Hospital of Colorado.

The Nashville native is well-known in the industry, having held management roles at children’s hospitals in five states since 1979. He also chaired the board of the national Children’s Hospital Association in 2014.

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