Mike Lauf On The State Of Cape Cod Healthcare

HYANNIS – When Mike Lauf joined Cape Cod Healthcare in 2008, he saw the makings of a top-flight healthcare system. The quality of nurses, physicians and other personnel was there, he said. What was missing was the organization to bring all of the pieces together.

“We had a system that didn’t speak to itself,” said Lauf, now in his 14th year as the network’s CEO. “All of the entities could have been just standalones. We didn’t have strong collaboration with our physicians. We didn’t have strong collaboration with our unions. We didn’t have strong collaboration with our community. We’ve worked so hard to repair that.”

Fast forward to 2024, and Cape Cod Healthcare’s efforts to strengthen and expand services locally can be seen throughout the peninsula. That includes on the Lower and Outer Cape, where medical facilities and services have historically been in shorter supply.

In July 2022, a new urgent care facility opened its doors in Orleans, the network’s sixth, helping provide a missing link to the Cape’s outermost points. The 6,500-square-foot center at 42 Route 6A offers year-round primary care as well as urgent care services from May to Columbus Day.

“Not many urgent cares, I would say none, have board certified ER physicians in them,” Lauf said of the Orleans center. “When you’re in that Orleans urgent care, you’re literally seeing the same doctor that you’re going to see in Hyannis in the ER. It’s an urgent care for 60 percent of the cost. It’s high quality, great access, low cost. That’s the differentiator for us in that space.”

Located on Route 6A, Lauf said the facility was built to help relieve the demand at nearby Fontaine Outpatient Center in Harwich, which he said was accommodating as many as 200 patients a day during the summer months. It also adds another facility within the network to help recruit and train new personnel.

With the center’s first full season in the rearview, residents and town officials have already begun to inquire as to whether the Orleans facility will eventually offer urgent care year-round. But Lauf said the demand isn’t there for such a transition, at least not yet. While the building brings in between 50 and 70 patients a day during the summer, he said those numbers fall to less than half that in the fall.

“Nobody wants to keep it open year round more than me,” he said. “But when you’re seeing 20 or 30 a day in November, it doesn’t make sense.”

But the facility may not be that far off from numbers that could make year-round urgent care sustainable. Lauf said even 40 patients per day in the offseason could be enough to consider expanding services. But while it remains to be seen how operations will change in Orleans, Lauf said Cape Cod Healthcare isn’t taking its eye off the Lower and Outer Cape as it plans for the future. That could include plans for additional facilities further down Cape.

“We’re not opposed to adding services out there,” he said. “What does it look like, and what is the need?”

New Tower, Cancer Center On Track

In the more immediate future, all eyes are on Cape Cod Healthcare’s new $215 million Barbey Patient Care Tower, which is under construction on the Cape Cod Hospital campus in Hyannis.

The first two floors of the four-story tower will house the new Davenport-Mugar Cancer Center, which Lauf said will offer “one-stop shopping for the cancer patient.” The center’s first floor will house radiation oncology services, while the second floor will have 36 private infusion bays and medical oncology exam rooms.

A new cardiac care ward with 32 patient rooms will occupy the tower’s third floor. Family counseling, nutritional support and laboratory space will also be accommodated in the new building, which Lauf said is expected to start welcoming patients in April 2025.

While plans for the facility were paused during the COVID-19 pandemic, Lauf said the stoppage offered healthcare officials the opportunity to rethink and “rightsize” the project. The end result is a project that came in $50 million less than originally planned.

“We went back with new architects, back with a new team, back with a vision. And we got everything we had in the first iteration, we just kind of scaled it back,” he said.

Cape Cod Healthcare wrapped up a capital campaign in September that raised $143 million for the project. That includes $10 million from Peter and Pamela Barbey, for whom the new tower is being named.

More Behavioral Health, Nursery Services

Calls for greater mental health services have grown on the Cape in recent years. In Orleans, for example, Police Chief Scott MacDonald has championed the need for more mental and behavioral health support for members of his department.

As Lauf sees it, the Cape isn’t short on mental health resources. Rather, many people who need them can’t readily access them.

“I would say this. Cape Cod in general does not have a lack of psychiatry and behavioral support,” he said. “There’s a lack of support for taking governmental insurances. We have enough, but most of it has become a cash-based business.”

Cape Cod Healthcare “accepts everybody,” Lauf said, including those on Medicaid. He estimated that the network’s investment in mental health services has increased by 400 percent over the past decade, and looking ahead, he said he expects that investment to continue in some form.

“In the next five years, something will be done,” he said. “Whether with us or apart from us, I think you’ll see additional meaningful investments into the space on the Cape. Because clearly the demand is here, and how do we manage that?”

Lauf also discussed the potential for increased nursery services at Cape Cod Hospital, which has continued to provide obstetric and maternity care since the closure of maternity wards at Falmouth Hospital and Tobey Hospital in Wareham. He said providing those additional nursing services for mothers and newborn children is part of the network’s mission of better serving their patients on-Cape rather than sending them over the bridge.

As for neonatal infant care, Lauf said deliveries at the hospital are not at a level that would support plans for a new NICU. He estimated that 950 newborns will be delivered at the hospital this year.

“I think what we’ve done in OB is right, and I think we’ll expand nursery services,” he said.

Working On The Pipeline

For all the talk of building for the future, none of it is possible without a capable workforce to support it. But the climate for recruiting and hiring talent has been difficult for employers in recent years, and it’s been no different for Cape Cod Healthcare.

As the local housing market continues to outpace what many working professionals are able to afford, Lauf said it’s common for candidates to turn down offers of employment with the network over issues related to securing housing on the Cape. But with the Cape’s proximity to water and plentiful natural resources, he said he also sees a desire from people to live and work in the region.

Cape Cod Healthcare has been partnering in recent years with schools and organizations to offer apprentice training for people interested in both starting a career in healthcare and doing it on Cape Cod. One of those partners is Cape Cod Community College, which Lauf said is on track to graduate 96 new nursing students this year.

On the housing front, Cape Cod Healthcare recently sold land adjacent to its Wilkens Outpatient Medical Complex in Hyannis to New England Development, which is building a 272 unit rental development consisting of affordable and market rate apartments.

“We’ve chosen not to focus on housing as a huge detriment,” Lauf said. “We know it is, but we’re focused on creating enough opportunity to provide meaningful employment, meaningful salaries and wages to people who live here.”

Today, Lauf said Cape Cod Healthcare is in a better, more cohesive place than when he arrived. There’s better synergy between staff, departments and facilities, he said, all of which has served to keep the network on its forward trajectory. But he’s also quick to note that there are many to thank for the network’s operational gains over the last 10-plus years.

“I hope that our team feels proud of the job that they did,” he said.

Email Ryan Bray at ryan@capecodchronicle.com