NEW SERIES – CEO INSIDER
Over the next several issues of the IHA quarterly newsletter, we will feature CEOs from each of the five Regions that make up our membership (i.e., Capital District, North Country, Mohawk Valley, Southern Tier, and Central New York).
This newsletter, we introduce you to our CEOs from the Capital District and North Country:
Capital Region:
- Dr. Jason Mouzakes, EVP and Hospital General Director, Albany Medical Center Hospital
- Jill VanKuren, FACHE, President and Chief Executive Officer, Saratoga Hospital
- Paul Scimeca, President and Chief Executive Officer, Glens Falls Hospital
North Country:
- Aaron Kramer, Chief Executive Officer, Adirondack Health
- Donna M. McGregor, FACHE, FHFMA, President, St. Lawrence Region, Rochester Regional Health
- Gerald Cayer, MPH, Chief Executive Officer, Lewis County Health System
- Rich Duvall, President and Chief Executive Officer, Claxton-Hepburn Medical Center & Carthage Area Hospital
We asked our Capital District & North Country CEOs the following questions:
- What are the most important issues your organization is focusing on in 2024 and beyond?
- What are the top three traits you look for in building your executive team?
- How is running a hospital in Upstate/Rural NY the same or different than elsewhere in NYS or in other States?
- When thinking about building partnerships in your community, whether with other health care providers or social care providers, what issues do you consider most important?
- As a leader in Upstate/Rural New York, what are your proudest achievements and or future goals for your organization?
- What do you think are the biggest challenges facing Upstate/Rural New York healthcare?
- If resources were plentiful, what services or programming would you prioritize in service to your patients and community?
Here’s what they had to say…
Dr. Jason Mouzakes, EVP and Hospital General Director, Albany Medical Center Hospital
In 2025, we remain focused on enhancing access for our patients and supporting our workforce, both of which are foundational to our mission. My leadership team holds fast to principles of visibility, accountability and sustainability, understanding that they are critical to quality and leadership. The Albany Med Health System underwent a significant transformation with the implementation of the Epic electronic medical record in 2024. For the first time, each of our four hospitals and 125 community locations were unified under one single platform. This has expanded our ability to efficiently connect patients with specialized, coordinated care better than ever before. Our team has grown more connected, too, with increased communication and a central source of data available at all points of care during every moment of a patient’s journey. Robust benchmarking and daily metrics have improved efforts around length of stay and patient throughput initiatives in many of our clinical areas.
The resultant drive towards accountability has been most evident in operational improvements to Emergency Department services. With a focused attention on collaborative leadership and the interconnectedness between all hospital departments and the ED, we have sustained significant improvements in wait times and EMS transfer times. Above all, experience remains a key tenet in our daily work. We appointed a respected colleague as our inaugural Chief Experience Officer, who assures positive experiences for our patients, visitors, workforce, and learners.
Sustainability remains the key ingredient to our success. Volatility in the overall workforce and disruptive change in many areas, including anesthesiology, gastroenterology, and nursing, reminds us of the importance of valuing our own workforce. Authentic engagement keeps our team performing at the highest level. At Albany Medical Center, we believe we are part of something greater!
As we traverse the second half of this year, we must prepare for ongoing challenges to health care, including potential changes to Medicaid and policy decisions that could impact some specialized services. The concept of value-based enterprises provide an opportunity to improve care for our patients while advancing the highest standards of quality and efficient care for all.
As the CEO of our campus, I approach my work in a personal way. Health care should be personal, and the work is as incredibly challenging as it is incredibly rewarding. I choose to surround myself with individuals who take this work just as seriously and personally. Health care is a basic human right and should never be viewed as a privilege.
Jill VanKuren, FACHE, President and Chief Executive Officer, Saratoga Hospital
1. What are your organization’s top priorities for 2025 and beyond?
Saratoga Hospital is adapting to support the changing demographics in our region. We are focused on developing a new model of care that will provide resources to our growing and aging community, keeping the patient and their family at the center of everything we do.
We are also working with our front-line staff to develop tools and processes that make our work more purposeful and enjoyable.
2. What three essential traits do you seek when building your executive team?
- Expertise is a given, but the respect of your peers is not. I look for people that have earned the respect of the people they lead.
- Connection to purpose and mission. A leader needs to have a strong sense of why they are called to do this work.
- The drive to get things done. We will never have enough information, resources, or time. We have to find a way to move forward.
3. How does hospital leadership in Upstate/Rural NY compare to other regions?
I have spent most of my career in Maryland and DC. The Upstate market differs in many ways, I find it to be more collaborative and community focused. However, the political landscape is more onerous.
4. What factors guide your approach to community partnerships?
Common vision, common purpose, and a collaborative leadership team. These are the things that we look for in community partners.
Paul Scimeca, President and Chief Executive Officer, Glens Falls Hospital
1. What are your organization’s top priorities for 2025 and beyond?
Continued financial stability and generating cash to reinvest in capital that has been deferred during the past few years.
2. What three essential traits do you seek when building your executive team?
Engagement and alignment with mission.
Cultural fit – we drive toward team goals and accomplishments with low need for individual recognition/ego validation.
3. How does hospital leadership in Upstate/Rural NY compare to other regions?
Most of our hospitals are privileged to care for populations which are largely governmental so we are use to working very frugally. I often say that we know how to be poor as we have never known anything different. We are also geared toward collaboration and supporting the other upstate/rural hospitals.
4. What factors guide your approach to community partnerships?
As the largest employer in the region, we recognize the responsibility to the financial health of our region and the need to collaborate with community partners for the overall good of the region. We need to not only be at the table but actively engaged in discussions/decisions which impact our community’s health and future.
5. What achievements are you most proud of, and what future goals have you set?
I am most proud of our organization achieving financial stability post-Covid. We are in the midst of the largest fundraising campaign in the organization’s history toward the goal of an Emergency Department renovation and expansion without incurring any additional debt. We have also completed further affiliation with the Albany Med Health System including implementation of both EMR and ERP platforms with minimal disruption to the organization. I am also very proud of our organization’s response to the increasingly complex behavioral health needs of our region, including building a 13-bed crisis stabilization unit.
6. What do you see as the greatest challenges facing Upstate/Rural NY healthcare?
Impact of federal changes at the upstate/rural level. Most specifically, threats to the Medicaid program and the 340b drug discount program.
7. If resources were unlimited, which services would you prioritize for your community?
Community-based behavioral health services, including residential settings. Expanded oncology services to meet the growing needs of an aging population.
Aaron Kramer, Chief Executive Officer, Adirondack Health
1. What are the most important issues your organization is focusing on in 2024 and beyond?
As an independent rural health system, we’re focused on strengthening the sustainability of our organization. That entails enhancing our workforce, thoughtfully advancing access to care, and exercising financial discipline, while still investing in the technology and facilities that enable us to care for the communities we serve.
The headwinds facing healthcare are strong: inflation, shrinking margins, and regulatory uncertainty jump immediately to mind. It’s a balancing act, figuring out the appropriate allocation of finite resources as we aim at moving targets.
2. What are the top three traits you look for in building your executive team?
We primarily seek to hire mission-driven individuals across the organization. Are they invested in the work they want to do here, and will they approach that work in a positive and collaborative manner? Beyond that, everyone brings their own strengths to the table and empowering people to utilize those strengths to the best of their abilities is what makes our organization successful.
3. How is running a hospital in Upstate/Rural NY the same or different than elsewhere in NYS or in other States?
It’s the same in that we’re all trying to do the best we can by our patients and our staff, amid shifting regulatory and political landscapes, against the backdrop of resource scarcity and exploding demand. As technology continues to play a larger role in overall healthcare delivery, ROI fundamentals become relatively more challenging in rural areas.
It’s hard to say quite how running a hospital is different here, because every hospital and health system is different. But there’s no doubt we are blessed to live and work in a place as beautiful as the Adirondacks. To finish a long day and walk out to your car as the sun is setting over the lake and the loons are calling, or to drive around the corner to sneak in some after-work turns at the community-run ski hill – those opportunities matter. In a world of tradeoffs, our remote, mountainous landscape is perhaps Adirondack Health’s most compelling fringe benefit.
4. When thinking about building partnerships in your community, whether with other health care providers or social care providers, what issues do you consider most important?
Building partnerships in our communities is an essential component of the work we do and requires thinking about the types of relationships we need to cultivate, maintain, or grow to further the mission of Adirondack Health.
Mission alignment is key here – if a given partnership enables us to further the mission of Adirondack Health, and enables our partners to further their own missions, and the community benefits from the shared work, then that, to me, is indicative of a successful partnership.
5. As a leader in Upstate/Rural New York, what are your proudest achievements and or future goals for your organization?
As the only full-service health system located entirely inside the Adirondack Park’s Blue Line, we bear a significant degree of responsibility for the health and wellbeing of approximately 60,000 year-round residents, 200,000 seasonal residents, and more than 12 million annual visitors.
Coming out of the pandemic in 2022, our sustainability was threatened. We posted a loss of $14 million, which may not sound like an existential threat to a larger system, but, to us, it very much was. Our staff and stakeholders took it seriously and we made real changes. Some were difficult, while others were pretty straightforward – but everyone was all in. The following year, we turned an $800,000 profit. And last year, we posted a $2 million gain.
The impacts of that turnaround are tangible: we have made substantial investments in surgical robotics. We have successfully recruited new providers. We have enhanced our security posture to mitigate the concerning rise in violence against healthcare workers. It’s not all about the money, but it’s a lot more difficult to do these types of things on negative margins.
And while we are by no means out of the woods, we’re asking the right questions and making decisions with a constant eye to the overall sustainability of the organization.
6. What do you think are the biggest challenges facing Upstate/Rural New York healthcare?
The demographic trends confronting upstate, rural communities in New York state are very concerning, because they present workforce and fiscal challenges.
In the two counties Adirondack Health primarily serves, the total population is projected to decline by one to three percent over the next five years, while the population of individuals 65 years of age or older is projected to increase by seven to eleven percent. So, we’re going to see an increase in volumes among older patients and sicker patients, at the same time there are relatively fewer individuals of working age residing here with the qualifications to care for them in primary and acute care settings.
The vast majority of this expanding 65+ patient population are Medicare beneficiaries, with our corresponding reimbursement rates set by the federal government – which doesn’t bode well for certainty and long-term planning at the moment. And, while the jury is still out on what exactly it means for us, Medicare Advantage penetration in our primary service area has increased between eight and twelve percent in the last five years.
7. If resources were plentiful, what services or programming would you prioritize in service to your patients and community?
If resources were plentiful, we would be doing largely the same thing we are doing now, which is investing in the services, spaces, programming, and people most essential to the continued care of our fellow community members. We’d just be doing a lot more of it.
Donna M. McGregor, FACHE, FHFMA, President, St. Lawrence Region, Rochester Regional Health
1. What are the most important issues your organization is focusing on in 2025 and beyond?
Providing care across the St. Lawrence County can be incredibly challenging at times. It is the largest, most geographically isolated and most remote of all the rural counties in New York State. Furthermore, we have an aging population of modest means with unreliable transportation.
To continue meeting the challenges and unique needs of our area, we must recruit equally dynamic and talented team members to serve those we consider family. Rochester Regional Health’s St. Lawrence Region has been fortunate to expand healthcare access in our area over the past few years. Such expansions require a committed, skilled, and educated workforce. Through the support of Rochester Regional Health, we opened a satellite campus of the Isabella Graham Hart School of Practical Nursing in Potsdam, NY, allowing expanded local access to nursing education while providing enhanced career paths for some of our team members.
Equally important to workforce development, our organization remains committed to advancing innovation, improving quality of care, enhancing patient satisfaction, and leveraging technology to deliver the best possible healthcare services.
2. What are the top three traits you look for in building your executive team?
Integrity, trust, and community/patient-focused leadership. These qualities ensure our leadership team remains dedicated to our mission and continues to move forward with a meaningful impact.
3. How is running a hospital in Northern/Rural NY the same or different from elsewhere in NYS or in other States?
Having spent my entire career in NYS healthcare, primarily in downstate New York, in both suburban and urban markets, I find that leading a rural remote health system in upstate New York is very different. Local care in our Northern Region is limited with the harsh winter climate that leads to travel and transportation constraints.
Additionally, healthcare providers in rural settings often work at the top of their licenses, managing a broader scope of responsibilities with fewer support resources than their urban counterparts.
Workforce recruitment, retention challenges, and housing limitations are also factors we need to focus on.
4. When thinking about building partnerships in your community, whether with other health care providers or social care providers, what issues do you consider most important?
When building partnerships, we focus on access, alignment, and sustainability. Ensuring that patients in our rural communities have seamless access to essential healthcare and social services is our top priority. Collaboration with regional healthcare providers, social service organizations, and community stakeholders helps bridge gaps in care and address social determinants of health, such as housing, food insecurity, and transportation barriers.
Alignment of mission, values, and goals is also critical—our partners must share our commitment to improving patient outcomes and enhancing community well-being.
5. As a leader in Northern/Rural New York, what are your proudest achievements and or future goals for your organization?
One of my proudest achievements is the expansion of healthcare services in our region, ensuring our patients have local access to high-quality care without having to travel long distances. Just this past fall we opened our brand new, state-of-the-art Regional Care Pavilion at Canton-Potsdam Hospital; we also opened the Wound Care Center at Massena Hospital, and created a Behavioral Health wing at Gouverneur Hospital.
Looking ahead, my goal is to continue strengthening our workforce, expanding specialized care services, and leveraging technology to improve patient access and outcomes.
6. What do you think are the biggest challenges facing Northern/Rural New York healthcare?
Patient transportation continues to be a barrier, as some may need to travel long distances for specialized services, leading to delays in diagnosis and treatment. Through Rochester’s team of experts, we are bringing specialized care to our region; which will, undoubtedly, help reduce the patients’ burden and enhance population health across our county. Additionally, rural healthcare continues to face significant workforce shortages, making recruitment and retention a continuous priority.
7. If resources were plentiful, what services or programming would you prioritize in service to your patients and community?
Should that day ever come, I would:
- Improve community-based health & wellness programs for the betterment of our overall community health
- Develop transportation solutions to assist our patients in receiving healthcare services more easily
- Expand primary and specialty care to reduce travel burdens and wait times
- Enhance telehealth & digital health expansion to improve access to specialists and reduce travel barriers
- Strengthen workforce development & housing initiatives by offering competitive incentives, housing assistance, and educational opportunities to attract and retain top talent
Gerald Cayer, MPH, Chief Executive Officer, Lewis County Health System
1. What are the most important issues your organization is focusing on in 2025 and beyond?
- Safety & Quality: Celebrating the board’s engagement and focus on safety and quality, and supporting and enhancing the culture of safety and quality as evidenced by the identified key focus areas across the health system.
- Access: Maintaining, modifying, and improving access to care for those services appropriate for a small rural health system. Access means being affordable, available, and easily accessible (transportation) to the clinic or service.
- Workforce: Recruiting, retaining, training (pipeline and career ladders), with a particular focus on those who call Lewis County home, with a specific emphasis on CNAs, LPNs, and RNs.
- Maximizing the CAH and Rural Health Designation: A strategic and compliant focus on enhancing and maximizing these critical reimbursement resources.
- Maternity: The reopening of maternity and the expansion of women’s health services. To beat the national trend of rural maternity and women’s health services closures.
- Fort Drum: The re-engagement with and commitment to the soldiers and their families.
- 10/1 Capital Budget Process: The continued evolution/growth of the 10-year capital budget and the full funding of the 1-year capital budget.
2. What are the top three traits you look for in building your executive team?
- The capacity to lead by rolling up the sleeves and being comfortable engaging with the dietary staff, EVS, nurses, and physicians.
- Someone who is a listener, collaborator, and problem solver with a healthy sense of humor.
- Someone who is a creative thinker who demonstrates a commitment to safety, quality, compliance, and transparency.
- Someone who consistently demonstrates a desire to be part of our organization and serve our community.
- Lastly, they are a Red Sox, Celtics, Patriots, and Bruins fan!
3. How is running a hospital in Upstate/Rural NY the same or different than elsewhere in NYS or in other States?
My point of reference is the State of Maine. The two states demonstrate a shared commitment to access, safety, quality, and collaboration. There is a shared understanding of who we serve: our families, friends, neighbors, coworkers, summer and winter visitors, and agricultural and recreational workers.
What’s challengingly different: the New York State bureaucracy, the unions, and the Department of Health.
4. When thinking about building partnerships in your community, whether with other health care providers or social care providers, what issues do you consider most important?
Community partnerships are critical. There must be mission alignment and shared commitment to the goal, as evidenced by a sharing of staff and resources. It is vital to demonstrate that the partnership is a collaborative relationship!
5. As a leader in Upstate/Rural New York, what are your proudest achievements and or future goals for your organization?
The team has:
- Driven improvements in our culture, enhancing safety, quality, patient satisfaction, and access
- Improved Days Cash on Hand to 116 days
- Developed a very strong relationship with the Board of Managers, the Board of Legislators, and the five school superintendents
- Facilitated the rebirth of maternity
- Implemented a 10-year capital budget process
- Completed an internal revitalization project with a complete rebuild of M/S and the CCU
- Constructed a 4 OR Surgical Pavilion
- Invested in technology enhancements in the lab and radiology
- Enhanced several service lines
6. What do you think are the biggest challenges facing Upstate/Rural New York healthcare?
- Financial Sustainability
- Workforce
- Programs and services for those aging in place
- Transportation
- Dysfunctional Government
7. If resources were plentiful, what services or programming would you prioritize in service to your patients and community?
If resources were plentiful, I would hold community meetings within each of the 10 districts that make up Lewis County, ensuring that the district legislator, county manager, county treasurer, and county attorney were all invited. I would seek a facilitated discussion with community members to determine what services or programming would be most essential for us, at the Lewis County Health System, to invest our time and resources in. We would aim to create a top 10 list of services and programs that the community would like to see in Lewis County!
Rich Duvall, President and Chief Executive Officer, Claxton-Hepburn Medical Center & Carthage Area Hospital
1. What are your organization’s top priorities for 2025 and beyond?
North Star Health Alliance (NSHA)’s top priority is preserving rural healthcare in our region while transforming how care is delivered. A major step has been transitioning acute care operations in Ogdensburg to be managed by Carthage Area Hospital, with Critical Access Hospital designation pending. Behavioral health services continue under Claxton-Hepburn Medical Center as a certified Article 31 hospital. This co-location model expands access and supports long-term sustainability.
Looking ahead, we’re focused on integrating care across our system, these efforts will be led and coordinated by our recently established centralized operations center, and forming new partnerships that align with our mission. These efforts aim to reduce barriers, improve outcomes, and ensure local, resilient, and high-quality healthcare for the communities we serve.
2. What three essential traits do you seek when building your executive team?
First and foremost, I look for mission alignment—leaders who are deeply committed to rural healthcare and understand the importance of community trust. Second, resilience and adaptability are critical, especially in environments where resource constraints and regulatory complexities are daily realities. Finally, I value collaborative visionaries—those who can bridge disciplines, facilities, and county lines to innovate and unify under a shared strategy, as we’ve done across the North Star Health Alliance.
3. How does hospital leadership in Upstate/Rural NY compare to other regions?
I believe we all face similar challenges; however, Hospital leadership in rural Upstate New York is grounded in proximity, purpose, and persistence. We are not just administrators—we are neighbors, caregivers, and advocates. Our decisions impact people we know by name, which raises the stakes and deepens our commitment.
Unlike in larger, urban systems, rural leaders must be more hands-on, resourceful, and community-driven. We manage challenges like workforce shortages, geographic isolation, and limited resources with creativity and collaboration. It’s a leadership model defined by connection, accountability, and a relentless focus on meeting the needs of the people right in front of us.
4. What factors guide your approach to community partnerships?
At North Star Health Alliance, we prioritize partnerships that align with our mission, strengthen local care delivery, and support long-term community health. Guided by our strategic plan, we focus on collaboration that enhances access, addresses system gaps, and builds trust across sectors. Whether it’s working with independent providers, local leaders, or state agencies, we view partnerships as long-term commitments that drive meaningful, sustainable impact for the people we serve.
5. What achievements are you most proud of, and what future goals have you set?
We’re proud of the progress we’ve made transforming care across the region, and especially of the recognition our teams have earned—Claxton-Hepburn Medical Center’s 4-star CMS rating, the only in our region, and Carthage Area Hospital’s swing bed program receiving Exemplary Provider® certification from The Compliance Team.
We’ve also launched ambulette services to improve access and continue to advocate for a paramedic-level ambulance service, following a denied CON application. Looking ahead, our priorities include expanding shared clinical programs, improving system coordination, advancing emergency medical services, and deepening our commitment to recruiting and retaining a skilled, community-connected workforce.
6. What do you see as the greatest challenges facing Upstate/Rural NY healthcare?
The greatest challenge facing Upstate and rural New York is ensuring consistent, timely access to local care. Geographic isolation, limited transportation options, and long travel distances often prevent patients from getting the care they need when they need it.
This challenge is compounded by severe workforce shortages, particularly in behavioral health, primary care, and specialty services. Financial pressures—including reimbursement models that don’t reflect the realities of rural healthcare delivery—further strain the system. Together, these barriers create a fragile environment where even small disruptions can have serious consequences for patients and communities.
7. If resources were unlimited, which services would you prioritize for your community?
With unlimited resources, I would continue to prioritize expanding access to primary care, behavioral health, and core support specialties like gastroenterology and general surgery. These services are essential to meeting the day-to-day health needs of our communities and reducing the burden of travel for patients.
At the same time, we recognize that highly complex or specialized care will always require strong coordination with tertiary care centers. Our focus would be on building a robust, local foundation of services that keeps as much care as possible close to home—where it’s most accessible and effective. Just as importantly, we would ensure that patients have reliable transportation when they do need to access care beyond our region.