Advocate Health's Hugh Chatham draws 65 applicants for 12 surgical tech seats
Hugh Chatham Health and Alleghany Health marked one year inside Advocate Health with a surgical technology program that drew 65 applicants for 12 seats. Year one also brought $11.3 million in pay and rewards, $19.3 million in capital and nearly 1,000 specialty transfers. Local training seats look like the next limit in Elkin.
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Key takeaways
In rural North Carolina, a new surgical technology program drew more than five applicants per seat, which points to training capacity, not interest, as the thing to expand.
Pay spending in the first year of a rural affiliation came to roughly 58% of the capital figure: $11.3 million in total rewards next to $19.3 million in capital.
Transfers outnumbered virtual specialty consults about 14 to 1 in year one, so the planned growth in virtual care is the year-two number worth tracking.
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Sixty-five people have applied for the first 12 seats in a surgical technology program whose classroom isn't built yet. The training space at Hugh Chatham Health in Elkin, North Carolina, which includes a mock operating room, is still under construction. The first cohort is due in January 2027.
On Monday, Advocate Health CEO Eugene A. Woods and Steve Smoot, president of the system's North Carolina and Georgia Division, toured that space to mark one year since Hugh Chatham Health and Alleghany Health joined Advocate Health. The anniversary release from Atrium Health Wake Forest Baptist, which is part of Advocate Health, lists patient transfers, a shared patient portal, virtual specialty consults and new cancer services. A large share of the list, though, is about staff: training them locally, paying them more and keeping rural physicians in place.
That mix is the useful part for anyone running the integration of a community hospital into a larger system. It shows where one large nonprofit system put its money and attention in year one, and the surgical tech numbers hint at what will hold things back next.
Five partners, 12 seats and a mock OR
The program is regional by design. Surry Community College, Wilkes Community College and Caldwell Community College & Technical Institute partner with Hugh Chatham Health and Atrium Health Wake Forest Baptist, and Hugh Chatham serves as the training site. Students spend two semesters on surgical technology skills and clinical competencies. Graduates are then eligible to sit for the Tech in Surgery, Certified examination.
Sixty-five applicants for 12 seats works out to more than five people per seat, a sign that in this corner of rural North Carolina the training slots run out long before the interest does. The structure explains why. The colleges supply the academic credential, while a working hospital supplies the clinical setting. So adding seats likely depends on how much hands-on training the hospital can host, and that's harder to expand than a lecture section.
Physician training follows the same pattern. Hugh Chatham's first Family Medicine Residency filled all four positions in its opening cohort. According to the release, it's the first rural-track family medicine residency in Advocate Health's footprint, built to teach, train and retain rural physicians. During the visit, Woods also recognized nursing supervisor Nina "Bunny" Brown, RN, who has worked at Hugh Chatham for 44 years, longer than anyone else there. That's the kind of local career these programs are trying to start.
Hugh Chatham and Alleghany, year one inside Advocate Health
Atrium Health Wake Forest Baptist
Side by side, the pay figure comes to roughly 58% of the capital figure, by MarketScale's arithmetic, or about $30.6 million combined. The rewards spending covered base-pay adjustments, market increases and higher minimum starting rates. A rural hospital HR leader should look hardest at that last item. Higher starting rates lift pay for entry-level jobs, which is where graduates of a two-semester program would be hired.
What patients saw in year one
On the clinical side, nearly 1,000 patients were connected to specialty and higher-acuity services through Atrium Health Wake Forest Baptist. The release says the affiliation also gave patients more chances to stay at Hugh Chatham when that was appropriate. More than 30,000 patients now use one digital platform to message care teams, view test results and manage appointments. The release doesn't name the platform's vendor.
New services came in smaller numbers. There were more than 70 virtual consultations and encounters across nephrology, pulmonology, infectious disease, neurology, stroke, emergency and critical care. A new Lung Cancer Screening Program at Alleghany Health has screened nearly 70 patients so far. In Elkin, Hugh Chatham opened two oncology clinical trials and a new myeloma specialty clinic.
Comparing the volumes is revealing. Nearly 1,000 transfers against just over 70 virtual encounters is a ratio of about 14 to 1, by MarketScale's arithmetic. That suggests virtual specialty care is still a young channel in year one, which fits with expanded virtual care heading the plans for year two.
Sixty-five applicants for 12 seats works out to more than five people per seat, a sign that in this corner of rural North Carolina the training slots run out long before the interest does.
Katee Hettleman, community engagement director at Hugh Chatham, gave an example of the in-person route. Earlier this year, her stepfather fell and broke his femur. He was treated at Hugh Chatham, then transferred to Atrium Health Wake Forest Baptist for surgery, rehabilitation and discharge. She described the handoff between the two organizations as well coordinated.
A comparison from western Pennsylvania
Another affiliation this year offers a reference point. In July, Healthcare Finance News reporter Eve Bender covered Allegheny Health Network, which Highmark Health owns, finalizing its affiliation with Heritage Valley Health System. The deal brought in the Beaver and Sewickley hospitals, 36 physician offices and seven multispecialty outpatient sites. Norm Mitry, president of the two hospitals, said AHN had committed roughly $285 million over 10 years for clinical services, facilities and IT. The first big project is installing Epic across every Heritage Valley inpatient and outpatient site.
The two deals make similar promises: care close to home, more virtual appointments and more specialty programs. AHN plans to track how quickly and easily patients can get primary and specialty care. The figures don't compare directly, though. Spread evenly, AHN's commitment comes to about $28.5 million a year, by MarketScale's arithmetic. But that's a 10-year pledge that includes a health record rollout, while the North Carolina numbers are first-year spending, with pay listed separately. Neither figure says one system is more committed than the other.
When comparing affiliation offers or integration plans, ask two things. Is the headline number a multiyear commitment or one year's spending? And does workforce pay sit inside it or alongside it? The Hugh Chatham report lists pay apart from capital. The Heritage Valley commitment bundles clinical services, facilities and IT.
Advocate Health's structure helps explain the training-heavy approach. HFMA reported that the system formed in December 2022 when Advocate Aurora Health and Atrium Health merged, with headquarters in Charlotte and 67 hospitals at the time. Wake Forest University School of Medicine was named the academic core. That academic arm is why an affiliated rural hospital in Elkin can run a residency and partner on clinical training.
Year two and the January cohort
For year two, the organizations plan to expand virtual care, add new tools for patients and care teams, and upgrade safety technology. Chad Brown, president of both Hugh Chatham Health and Alleghany Health, summed up the first year as more specialty care, more clinical research and better links to advanced services, giving patients more options closer to home.
The first real test comes in January 2027, when 12 students start in Elkin. System leaders weighing similar rural affiliations should watch two numbers. One is whether the program adds seats to meet the 65-applicant demand. The other is how many graduates pass the certification exam and take jobs at Hugh Chatham. Those results will say more about whether a local pipeline works than this week's anniversary did.
Sources
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