Cliff Megerian, MD, has served as CEO of Cleveland-based University Hospitals for nearly five years, overseeing a $6.4 billion health system that spans 21 hospitals across 22 counties in Northeast Ohio. Under his leadership, the system has prioritized growth, culture and a redefined patient experience rooted in hospitality — a differentiator he sees as critical in today’s consumer-driven healthcare environment.

Dr. Megerian recently joined the “Becker’s Healthcare Podcast” to discuss how University Hospitals is reimagining patient experience, navigating demographic and financial shifts and fostering a culture of agility and innovation.

Editor’s note: Responses are lightly edited for length and clarity. Click here to listen to the full episode of the podcast.

Question: Is there one initiative you’re particularly proud of at University Hospitals?

Dr. Megerian: We really want to be true to our differentiation, which is the way people feel they’re treated. We’ve supercharged our customer and patient experience initiative to create the notion that the best hospital is one that embodies hospitality as one of its principal differentiators.

To do so, we’ve embraced the idea that our patients are not just patients — they’re customers, guests, friends lodging in our home. We rolled out a robust training program focused on communication skills, emotional intelligence and service recovery, in case we fall short. We have close to 33,000 full-time employees, and many more when including part-time and PRN.

We’re already seeing significant impact. This affects not only the bedside, but also the call experience. When a sick patient calls for an appointment, their healing begins with how they’re treated and how quickly they can get in. If the agent can detect anxiety in the patient’s voice, they’ll work even harder to get them in quickly. This is especially visible in our central scheduling departments, where we’ve implemented personalized greetings and more intentional listening. It’s led to a 6-point improvement in caller sentiment over just a few months.

We’re also making it easier for patients to access care — something we know they deeply value. Nearly 70% of our patients have activated their UH MyChart accounts, and we’ve seen a 39% year-over-year increase in appointments scheduled online. We’re seeing similar momentum at the point of care — when patients finish a visit, we ensure follow-ups are scheduled before they leave. It helps manage all their concerns in one seamless interaction.

Q: I know you’re an avid reader, and your comments remind me of Unreasonable Hospitality by Will Guidara. How do you view the role of hospitality in today’s healthcare environment, particularly when it comes to the patient and consumer experience?

CM: Today, patients have tremendous choices. The narrow networks we used to see in the ’80s and ’90s are largely gone. Patients can go anywhere — and more importantly, they want to feel connected to their doctor, nurse practitioner or hospital. It’s about how they feel.

There’s that Maya Angelou quote we reference often: people don’t necessarily remember what you said, but they remember how you made them feel. We’ve adopted many tried-and-true mechanisms to improve that engagement and build trust.

One example is our 10-5 rule, championed by Lisa Griffin, University Hospitals’ chief consumer officer. If you’re 10 feet from someone — a patient, guest or fellow employee — you engage them with your eyes. At five feet, you say, “Hello. May I help you?” Physicians are also encouraged to sit down with patients at the bedside to help create a caring, welcoming environment.

These may seem like small gestures, but they build trust. And when patients trust their caregivers, they’re more likely to follow treatment plans or dietary changes. Compassionomics illustrates that trust improves outcomes. From a business perspective, it also leads to more “stickiness” — patients share their positive experiences and encourage their families to return.

Q: In your market and with your patient population, what is the most pressing challenge, and how are you preparing to address it?

CM: Cleveland is a fantastic city. Northeast Ohio is a beautiful place to live. Demographically, though, we’re seeing an aging population in some areas, meaning a growing number of our patients are on Medicare. Meanwhile, commercial payer growth isn’t keeping the same pace in those sectors.

As hospitals, we’re price takers — not price makers. Commercial contracts allow for some negotiation, but increases are relatively standard. With Medicare and Medicaid, the increases are minimal. That means we have to be strategic — focusing on efficiency, throughput, length of stay and closely examining our operations to remove waste and redundancy.

We’ve stood up weekly revenue and expense “cabinets” to help us grow smart revenue and reduce unnecessary costs. That can mean consolidating vendors, optimizing billing or maximizing our value equation.

We define value as quality divided by cost — and it’s measurable. One of our best decisions was joining the Medicare Shared Savings Program (MSSP) six years ago. It gave us real-time feedback on quality and per-member-per-year costs. We’ve dropped that cost from $12,200 to $9,870, while maintaining a 95.6% quality score.

This matters because if you’re in a risk-based MSSP model, you can retain up to 75% of the savings compared to your baseline. We’ve also established similar arrangements on the Medicare Advantage side.

We believe the future of healthcare is a deliberate blend of fee-for-service and value-based models. And it’s paying off — financially last year, and even more so this year. Of course, many changes are still on the horizon, and we’re working hard to make sure we have a seat at the table when decisions are made that could affect our future.

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