1 00:00:00,080 --> 00:00:02,240 This is Laura Dierda with the Becker's Healthcare 2 00:00:02,240 --> 00:00:04,319 podcast. I'm thrilled today to be joined by 3 00:00:04,319 --> 00:00:05,219 Summer Klavanowalli, 4 00:00:05,599 --> 00:00:08,240 chief executive officer at Harborview Medical Center, part 5 00:00:08,240 --> 00:00:10,320 of UW Medicine. Summer, it's a pleasure to 6 00:00:10,320 --> 00:00:11,779 have you on the podcast today. 7 00:00:12,095 --> 00:00:14,575 Thank you for inviting me. Now I'm really 8 00:00:14,575 --> 00:00:16,574 excited for our discussion because I know there's 9 00:00:16,574 --> 00:00:18,175 been so much happening in health care, and 10 00:00:18,175 --> 00:00:18,675 particularly, 11 00:00:18,975 --> 00:00:20,975 Harborview Medical Center has been doing some really 12 00:00:20,975 --> 00:00:23,214 unique things as of late. And so I'm 13 00:00:23,214 --> 00:00:25,119 looking forward to hearing more about them. But 14 00:00:25,119 --> 00:00:26,719 before we dive in, can you tell us 15 00:00:26,719 --> 00:00:28,559 a little bit more about Harborview Medical Center? 16 00:00:28,559 --> 00:00:29,539 What makes it unique? 17 00:00:30,320 --> 00:00:32,960 So Harborview Medical Center is part of the 18 00:00:32,960 --> 00:00:35,119 UW Medicine System, which is part of the 19 00:00:35,119 --> 00:00:36,259 University of Washington 20 00:00:36,640 --> 00:00:38,019 here in Seattle, Washington. 21 00:00:39,045 --> 00:00:42,184 We are about a 500 bed hospital, 22 00:00:43,445 --> 00:00:45,604 that well, Harborview is about a 500 bed 23 00:00:45,604 --> 00:00:48,664 hospital, and we are a pretty complex combination 24 00:00:49,125 --> 00:00:51,304 of a very large safety net. 25 00:00:52,550 --> 00:00:54,710 At the same time, we also are a 26 00:00:54,710 --> 00:00:56,250 very quaternary level, 27 00:00:56,630 --> 00:00:57,130 facility, 28 00:00:58,229 --> 00:01:01,690 and we are the only level 1 adult 29 00:01:01,750 --> 00:01:02,570 and pediatric 30 00:01:02,870 --> 00:01:03,850 trauma center 31 00:01:04,469 --> 00:01:06,010 in a four state radius. 32 00:01:06,525 --> 00:01:09,265 So we have a pretty unique combination 33 00:01:09,725 --> 00:01:10,225 of 34 00:01:10,605 --> 00:01:13,245 a mission that is focused on those that 35 00:01:13,245 --> 00:01:14,685 are the most in need, those are the 36 00:01:14,765 --> 00:01:17,325 that are the most marginalized, very heavily focused 37 00:01:17,325 --> 00:01:19,265 on access and equity and care. 38 00:01:19,805 --> 00:01:21,905 While at the same time, we are equipped 39 00:01:22,740 --> 00:01:23,240 and, 40 00:01:23,939 --> 00:01:26,980 very much focused on providing the highest level 41 00:01:26,980 --> 00:01:28,819 of care for those that are the most, 42 00:01:29,060 --> 00:01:30,120 critically ill. 43 00:01:30,980 --> 00:01:32,740 In addition to that, we are also one 44 00:01:32,740 --> 00:01:33,560 of the largest, 45 00:01:34,260 --> 00:01:35,799 behavioral health inpatient 46 00:01:36,100 --> 00:01:37,560 providers in the state 47 00:01:37,945 --> 00:01:40,365 of Washington, and we have the only, 48 00:01:41,784 --> 00:01:42,284 psychiatric 49 00:01:42,905 --> 00:01:43,405 emergency, 50 00:01:45,784 --> 00:01:48,185 department. We have a a division within our 51 00:01:48,185 --> 00:01:50,204 emergency department that is for psychiatrically 52 00:01:50,505 --> 00:01:51,325 ill individuals 53 00:01:51,810 --> 00:01:53,269 that is staffed 247 54 00:01:53,729 --> 00:01:54,709 by psychiatrists. 55 00:01:55,649 --> 00:01:56,709 So we're pretty, 56 00:01:58,369 --> 00:01:58,869 diverse, 57 00:02:01,090 --> 00:02:03,009 hospital. No. That's great to hear, you know, 58 00:02:03,009 --> 00:02:05,250 and definitely a very, very needed resource for 59 00:02:05,250 --> 00:02:05,909 the community. 60 00:02:06,215 --> 00:02:08,455 So looking back on the last 12 months 61 00:02:08,455 --> 00:02:10,455 or so, what accomplishment are you most proud 62 00:02:10,455 --> 00:02:10,955 of? 63 00:02:11,574 --> 00:02:12,555 Yeah. So, 64 00:02:12,935 --> 00:02:14,775 you know, I would have to say we 65 00:02:14,775 --> 00:02:17,574 have done a lot of amazing things coming 66 00:02:17,574 --> 00:02:18,150 out of this, 67 00:02:18,709 --> 00:02:20,889 you know, out of the last several years 68 00:02:20,949 --> 00:02:23,370 with, pandemic and then with financial, 69 00:02:24,949 --> 00:02:27,289 you know, kind of disastrous financial results. 70 00:02:27,829 --> 00:02:29,269 And we've done a lot of really, you 71 00:02:29,269 --> 00:02:31,284 know, great improvements in our our quality and 72 00:02:31,284 --> 00:02:33,125 safety and patient experience, all the things that 73 00:02:33,125 --> 00:02:34,405 everybody needed to, 74 00:02:35,525 --> 00:02:37,544 get back to. But I would say that 75 00:02:38,084 --> 00:02:40,805 my my biggest achievement over the last year 76 00:02:40,805 --> 00:02:42,504 or even 18 months 77 00:02:42,890 --> 00:02:45,550 really was the financial stability of the organization. 78 00:02:46,010 --> 00:02:47,950 One of the things that Harborview 79 00:02:48,409 --> 00:02:50,650 was unique in is that even though we 80 00:02:50,650 --> 00:02:52,409 are a county hospital 81 00:02:53,210 --> 00:02:54,730 so we're owned by the, 82 00:02:55,685 --> 00:02:56,504 by King 83 00:02:56,884 --> 00:02:59,125 County, which is a large county in the 84 00:02:59,125 --> 00:03:00,025 state of Washington, 85 00:03:00,405 --> 00:03:01,144 in Seattle. 86 00:03:02,084 --> 00:03:04,965 We are operated by the University of Washington 87 00:03:04,965 --> 00:03:08,084 or UW Medicine, and we were unique in 88 00:03:08,084 --> 00:03:09,144 that up until 89 00:03:09,685 --> 00:03:10,745 or up until 90 00:03:11,069 --> 00:03:12,449 January 1 this year, 91 00:03:12,909 --> 00:03:14,430 we are the only county hospital that I've 92 00:03:14,430 --> 00:03:16,689 been able to find that did not have, 93 00:03:18,189 --> 00:03:18,689 county 94 00:03:19,229 --> 00:03:19,729 support 95 00:03:20,909 --> 00:03:21,810 for dollars 96 00:03:22,590 --> 00:03:23,330 for operations 97 00:03:23,870 --> 00:03:25,650 or maintenance or infrastructure. 98 00:03:26,564 --> 00:03:28,584 We only had money from taxpayers 99 00:03:29,044 --> 00:03:31,284 that would come about every 20 years for 100 00:03:31,284 --> 00:03:32,584 some type of a large, 101 00:03:34,084 --> 00:03:36,724 like, building expansion or something like that. But 102 00:03:36,724 --> 00:03:38,324 on a on a day to day, year 103 00:03:38,324 --> 00:03:38,985 to year 104 00:03:40,090 --> 00:03:42,750 level, we did not have operational support. So 105 00:03:43,449 --> 00:03:46,110 we were in a position where we were 106 00:03:46,810 --> 00:03:48,409 as even as a large safety net, we 107 00:03:48,409 --> 00:03:50,090 were competing with all the other, 108 00:03:50,569 --> 00:03:53,370 health systems in the area from a strictly 109 00:03:53,370 --> 00:03:55,150 patient revenue perspective alone. 110 00:03:55,655 --> 00:03:57,334 So that that has made that has put 111 00:03:57,334 --> 00:03:59,735 us into a pretty complex position over many, 112 00:03:59,735 --> 00:04:01,254 many years and put us at a very 113 00:04:01,254 --> 00:04:02,074 big disadvantage, 114 00:04:02,375 --> 00:04:03,914 particularly after the financial, 115 00:04:05,574 --> 00:04:07,814 complications that happened in in health care after 116 00:04:07,814 --> 00:04:08,474 the pandemic. 117 00:04:09,094 --> 00:04:10,394 So over the last, 118 00:04:11,069 --> 00:04:13,469 year, we were able to work with our 119 00:04:13,469 --> 00:04:14,209 state legislative, 120 00:04:14,830 --> 00:04:15,330 partners 121 00:04:16,110 --> 00:04:18,509 and then eventually with our King County Council 122 00:04:18,509 --> 00:04:19,009 members 123 00:04:19,790 --> 00:04:21,490 to, pass a councilmanic, 124 00:04:22,430 --> 00:04:22,930 tax 125 00:04:23,470 --> 00:04:23,970 that 126 00:04:24,574 --> 00:04:27,454 is the first time that a county hospital 127 00:04:27,454 --> 00:04:28,354 will receive 128 00:04:28,814 --> 00:04:29,314 operational 129 00:04:30,095 --> 00:04:33,134 maintenance and infrastructure support. So that tax will 130 00:04:33,134 --> 00:04:34,115 go into place, 131 00:04:34,495 --> 00:04:36,995 January 1 this coming year. 132 00:04:37,680 --> 00:04:40,959 And although it doesn't necessarily fix our you 133 00:04:40,959 --> 00:04:42,800 know, it's not a magic pill for all 134 00:04:42,800 --> 00:04:45,360 of our financial problems, it is a huge 135 00:04:45,360 --> 00:04:45,860 precedent 136 00:04:46,639 --> 00:04:48,160 that for the first time in all of 137 00:04:48,160 --> 00:04:50,639 its, all of its many years, Harborview has 138 00:04:50,639 --> 00:04:51,139 a 139 00:04:51,519 --> 00:04:52,740 source of income 140 00:04:53,574 --> 00:04:54,555 that is consistent 141 00:04:55,014 --> 00:04:56,395 and that is based outside 142 00:04:56,855 --> 00:04:57,355 of, 143 00:04:58,295 --> 00:05:00,694 revenue dollars or federal pull down dollars or 144 00:05:00,694 --> 00:05:01,754 things like that. So 145 00:05:02,615 --> 00:05:05,975 many, many different, leaders tried it, and, we 146 00:05:05,975 --> 00:05:07,740 were able to in the past, and we 147 00:05:07,740 --> 00:05:09,579 were able to pull it through over the 148 00:05:09,579 --> 00:05:12,079 last year in, you know, in in partnership 149 00:05:12,540 --> 00:05:16,139 with, our government relation official our government relation 150 00:05:16,139 --> 00:05:16,639 director, 151 00:05:17,419 --> 00:05:20,975 our elected official partners, and in particular, our, 152 00:05:21,214 --> 00:05:24,355 labor union partners who helped us, SEIU 1199. 153 00:05:24,895 --> 00:05:26,194 So really thrilled. 154 00:05:27,055 --> 00:05:29,455 Well, that's amazing to hear. Congratulations. And, you 155 00:05:29,455 --> 00:05:31,314 know, what a a great and unique accomplishment 156 00:05:31,455 --> 00:05:33,870 setting yourself up for success next year. I 157 00:05:33,870 --> 00:05:36,029 know as you mentioned, you know, others have 158 00:05:36,029 --> 00:05:37,889 tried it and not been able to achieve, 159 00:05:38,589 --> 00:05:40,029 achieve it. So, you know, what do you 160 00:05:40,029 --> 00:05:41,550 think gave you the edge? Was it just 161 00:05:41,550 --> 00:05:43,709 the strong partnership you you have with, 162 00:05:44,350 --> 00:05:46,990 your elected officials, labor union in in in 163 00:05:46,990 --> 00:05:48,830 your team, or were there other things too 164 00:05:48,830 --> 00:05:51,764 that really contributed to your ability, to actually 165 00:05:51,985 --> 00:05:53,125 make this come to fruition? 166 00:05:53,745 --> 00:05:57,365 Yeah. I think it was a magic combination 167 00:05:57,584 --> 00:06:00,305 of a very strong government relations director who 168 00:06:00,305 --> 00:06:03,365 did a an incredible amount of work 169 00:06:04,319 --> 00:06:05,779 to to educate 170 00:06:06,319 --> 00:06:08,399 the elected officials both at the state level 171 00:06:08,399 --> 00:06:10,800 and at the county level along with myself 172 00:06:10,800 --> 00:06:13,919 and chief administrative officer really getting out there 173 00:06:13,919 --> 00:06:14,659 and and 174 00:06:15,680 --> 00:06:17,120 getting to a point where we were able 175 00:06:17,120 --> 00:06:19,860 to show the burning platform of, you know, 176 00:06:20,774 --> 00:06:23,334 here's the financial status of Harborview. Here is 177 00:06:23,334 --> 00:06:25,654 how we are different because of the mission 178 00:06:25,654 --> 00:06:27,435 that we are here to provide, 179 00:06:28,214 --> 00:06:30,394 and and here is how it is 180 00:06:30,774 --> 00:06:33,649 really hard to compete in a in a 181 00:06:33,649 --> 00:06:36,709 competitive health system environment when you are committed 182 00:06:36,770 --> 00:06:39,270 to doing over 60 to 70 percent, 183 00:06:40,370 --> 00:06:43,029 of your work in a federal 184 00:06:43,330 --> 00:06:45,569 governmental, you know, whether it's federal or state 185 00:06:45,569 --> 00:06:46,069 money, 186 00:06:46,894 --> 00:06:49,535 or state payers. Right? So Medicare, Medicaid as 187 00:06:49,535 --> 00:06:50,514 opposed to commercial. 188 00:06:51,134 --> 00:06:53,455 So, you know, kinda setting that platform. And 189 00:06:53,455 --> 00:06:55,774 then I think probably more than anything, it 190 00:06:55,774 --> 00:06:57,714 was really strong partnerships 191 00:06:58,095 --> 00:07:00,274 with elected officials, but then in particular 192 00:07:00,670 --> 00:07:02,589 with our labor unions. That's a very strong 193 00:07:02,589 --> 00:07:04,689 message, particularly in the state of Washington, 194 00:07:05,870 --> 00:07:06,529 to have 195 00:07:07,069 --> 00:07:07,569 management 196 00:07:08,110 --> 00:07:11,069 and labor standing together to say this is 197 00:07:11,069 --> 00:07:14,110 absolutely what we need for this facility to 198 00:07:14,110 --> 00:07:16,270 continue to deliver on its mission. And we 199 00:07:16,270 --> 00:07:18,404 did that. And that was quite a message 200 00:07:18,404 --> 00:07:20,664 to everyone that we were absolutely aligned. 201 00:07:21,844 --> 00:07:23,925 That's amazing to hear. I know that alignment, 202 00:07:24,245 --> 00:07:26,324 doesn't exist in very many places when you 203 00:07:26,324 --> 00:07:28,805 think about the labor and management. So, really 204 00:07:28,805 --> 00:07:30,600 cool to to see that type of relationship, 205 00:07:30,819 --> 00:07:33,699 especially coming to something so important as in 206 00:07:33,699 --> 00:07:36,759 this. Now from your perspective, looking into 2025, 207 00:07:36,979 --> 00:07:38,740 what are some of the big organizational goals 208 00:07:38,740 --> 00:07:40,680 that you're focused on? Yeah. 209 00:07:41,139 --> 00:07:43,964 Achieving the ability to receive tax money was 210 00:07:44,125 --> 00:07:45,084 part of a, 211 00:07:46,845 --> 00:07:47,345 multifaceted 212 00:07:48,125 --> 00:07:49,584 financial turnaround plan. 213 00:07:49,884 --> 00:07:52,604 So other pieces of that financial turnaround plan 214 00:07:52,604 --> 00:07:55,824 are really focusing on, you know, operational efficiencies, 215 00:07:57,084 --> 00:07:58,144 revenue growth, 216 00:07:58,979 --> 00:07:59,720 and philanthropy. 217 00:08:00,339 --> 00:08:03,939 The revenue growth is highly focused on capital 218 00:08:03,939 --> 00:08:06,599 expansion. And so we are in the midst 219 00:08:06,899 --> 00:08:07,399 of, 220 00:08:08,339 --> 00:08:09,399 moving into 221 00:08:09,779 --> 00:08:10,279 a 222 00:08:11,115 --> 00:08:13,115 a period of time where we were we 223 00:08:13,115 --> 00:08:15,055 are going to be putting out a RFP 224 00:08:15,995 --> 00:08:16,475 to, 225 00:08:16,795 --> 00:08:19,194 expand a into a brand new tower to 226 00:08:19,355 --> 00:08:21,055 basically, to build a brand new tower. 227 00:08:21,514 --> 00:08:23,055 And so 2025 228 00:08:23,514 --> 00:08:25,915 is going to be filled with a lot 229 00:08:25,915 --> 00:08:27,709 of planning with 230 00:08:28,089 --> 00:08:28,589 architects, 231 00:08:29,610 --> 00:08:31,550 designers, frontline staff, physicians, 232 00:08:32,090 --> 00:08:34,350 really to kinda start looking at what 233 00:08:34,809 --> 00:08:36,970 what this new tower will look like, how 234 00:08:36,970 --> 00:08:39,549 it will help, us achieve our mission, 235 00:08:40,090 --> 00:08:40,750 how we 236 00:08:41,054 --> 00:08:42,654 design it and build it in a way 237 00:08:42,654 --> 00:08:43,375 that is very, 238 00:08:43,934 --> 00:08:47,134 patient facing, patient focused, and then provider and 239 00:08:47,134 --> 00:08:48,754 staff experience focused. 240 00:08:49,615 --> 00:08:52,174 We have a current campus that is very, 241 00:08:52,174 --> 00:08:55,490 very old. It is not, we do not 242 00:08:55,490 --> 00:08:57,409 have enough space for our patients. We still 243 00:08:57,409 --> 00:08:59,190 have many, many patients boarding, 244 00:09:00,210 --> 00:09:02,289 you know, not only in double triple rooms, 245 00:09:02,289 --> 00:09:04,690 but in hallways and conference rooms, etcetera, here 246 00:09:04,690 --> 00:09:05,990 at Harborview. So 247 00:09:06,370 --> 00:09:09,644 we are incredibly excited to design this, and 248 00:09:09,644 --> 00:09:11,884 really are are looking to, dig in in 249 00:09:11,884 --> 00:09:13,664 2025 to kick that off. 250 00:09:14,764 --> 00:09:16,445 I love that. I I think it's, you 251 00:09:16,445 --> 00:09:18,845 know, really such, an important way, as you 252 00:09:18,845 --> 00:09:21,720 mentioned, to show growth, provide the expanded access 253 00:09:21,720 --> 00:09:23,559 to care, and really make sure patients are 254 00:09:23,559 --> 00:09:26,439 able to, receive the treatment that they need 255 00:09:26,439 --> 00:09:27,259 in a timely 256 00:09:27,559 --> 00:09:28,539 fashion. So, 257 00:09:29,000 --> 00:09:30,919 it seems like a huge project and something 258 00:09:30,919 --> 00:09:33,500 that, will be really beneficial as well. 259 00:09:34,120 --> 00:09:36,034 So lots of opportunity, it sounds like, ahead, 260 00:09:36,034 --> 00:09:37,634 but I'm also wondering what are some of 261 00:09:37,634 --> 00:09:40,115 the headwinds that you're anticipating for the next 262 00:09:40,115 --> 00:09:40,855 year or 2? 263 00:09:41,714 --> 00:09:42,615 Yeah. So, 264 00:09:43,154 --> 00:09:44,855 you know, headwinds are 265 00:09:45,235 --> 00:09:46,375 going to be continued 266 00:09:46,914 --> 00:09:49,554 financial, you know, struggles as we figure out 267 00:09:49,554 --> 00:09:50,034 how to, 268 00:09:51,289 --> 00:09:53,769 increase our capacity, our space while we're waiting 269 00:09:53,769 --> 00:09:55,049 for that tower to go up to get 270 00:09:55,049 --> 00:09:57,129 creative in order to continue to enhance our 271 00:09:57,129 --> 00:09:57,629 revenue 272 00:09:58,089 --> 00:09:59,629 to, you know, be able to 273 00:10:00,089 --> 00:10:02,809 not only move ourselves into the black, but 274 00:10:02,809 --> 00:10:03,309 also, 275 00:10:03,769 --> 00:10:06,684 start to to, have enough cash to have 276 00:10:06,684 --> 00:10:07,404 a little bit of, 277 00:10:08,204 --> 00:10:10,225 have a little bit of money to reinvest 278 00:10:10,284 --> 00:10:12,125 in people and in our people and our 279 00:10:12,125 --> 00:10:12,625 programs. 280 00:10:13,324 --> 00:10:15,404 But most I I would say the biggest 281 00:10:15,404 --> 00:10:18,304 headwind we are facing is our incredible worry 282 00:10:18,605 --> 00:10:19,105 about, 283 00:10:19,970 --> 00:10:21,909 new administration at the federal level 284 00:10:22,370 --> 00:10:24,230 and what that will mean for Medicaid 285 00:10:24,690 --> 00:10:27,169 in particular in the state of Washington. We 286 00:10:27,169 --> 00:10:29,429 are a huge Medicaid expansion state, 287 00:10:29,809 --> 00:10:32,309 and we are also very dependent on our 288 00:10:33,134 --> 00:10:36,415 directed payment systems from our, from our federally 289 00:10:36,415 --> 00:10:37,715 directed payment programs. 290 00:10:38,254 --> 00:10:40,115 And so any changes 291 00:10:40,815 --> 00:10:42,894 to that type of funding those types of 292 00:10:42,894 --> 00:10:44,514 funding sources that would 293 00:10:45,069 --> 00:10:45,569 limit 294 00:10:45,870 --> 00:10:49,069 access and limit ability to, get reimbursed for 295 00:10:49,069 --> 00:10:52,269 those for that Medicaid population, which is one 296 00:10:52,269 --> 00:10:54,110 of our, you know, really our the core 297 00:10:54,110 --> 00:10:54,850 of our mission 298 00:10:55,549 --> 00:10:56,610 is incredibly, 299 00:10:57,549 --> 00:11:00,049 concerning and and and would be quite devastating 300 00:11:00,190 --> 00:11:01,595 for a facility like Harborview. 301 00:11:03,174 --> 00:11:05,735 Absolutely. I can imagine just the uncertainty of 302 00:11:05,735 --> 00:11:07,894 exactly what will happen and and how, you 303 00:11:07,894 --> 00:11:10,475 know, the the next few years unfold. Certainly, 304 00:11:10,774 --> 00:11:12,629 it's unnerving, especially given, 305 00:11:13,190 --> 00:11:15,509 how reliant folks are on, you know, the 306 00:11:15,509 --> 00:11:18,309 Medicaid and being able to provide care to 307 00:11:18,309 --> 00:11:19,850 that population is so critical. 308 00:11:20,549 --> 00:11:22,710 Yeah. When you're working with your team through 309 00:11:22,710 --> 00:11:24,649 this and and knowing, you know, the possibilities 310 00:11:24,950 --> 00:11:25,450 that 311 00:11:25,764 --> 00:11:27,524 could occur over the next few years in 312 00:11:27,524 --> 00:11:29,365 Medicaid, is there anything that you're doing to 313 00:11:29,365 --> 00:11:30,105 try to 314 00:11:30,725 --> 00:11:33,704 just protect yourself against the the that potential? 315 00:11:33,764 --> 00:11:35,444 Or or Right. Right. 316 00:11:35,924 --> 00:11:38,730 Navigating some of those waters, I guess. Yeah. 317 00:11:38,730 --> 00:11:40,169 I think I mean, first of all, we're 318 00:11:40,169 --> 00:11:41,230 just trying to understand, 319 00:11:41,529 --> 00:11:44,110 you know, and anticipate what could be coming. 320 00:11:44,169 --> 00:11:46,409 Right? Just trying to follow really closely with 321 00:11:46,409 --> 00:11:48,429 our with our federal government relations, 322 00:11:48,889 --> 00:11:49,389 individuals 323 00:11:50,009 --> 00:11:52,350 back in DC and just trying to understand, 324 00:11:52,915 --> 00:11:54,274 the lay of the land as it as 325 00:11:54,274 --> 00:11:55,495 it will evolve. 326 00:11:56,195 --> 00:11:58,355 But I think, you know, from our perspective 327 00:11:58,355 --> 00:12:01,075 right now, we're really trying to that that 328 00:12:01,075 --> 00:12:03,335 is why it's so important for us to, 329 00:12:04,274 --> 00:12:07,554 figure out additional sources of revenue that it's 330 00:12:07,554 --> 00:12:08,539 not just, 331 00:12:09,159 --> 00:12:11,720 those those Medicaid federal dollars. We're also you 332 00:12:11,720 --> 00:12:13,259 know, the tax was so important. 333 00:12:14,919 --> 00:12:17,080 However, I also think it's really a time 334 00:12:17,080 --> 00:12:19,100 for for us in health care 335 00:12:19,559 --> 00:12:22,039 in large safety nets like Harborview to really 336 00:12:22,039 --> 00:12:24,945 think about what the how we can how 337 00:12:24,945 --> 00:12:26,644 we can partner a little bit differently 338 00:12:27,345 --> 00:12:28,964 with our states around, 339 00:12:30,065 --> 00:12:32,544 how we manage our Medicaid populations and how 340 00:12:32,544 --> 00:12:34,325 we can think differently about, 341 00:12:35,264 --> 00:12:38,225 partnerships with managed Medicaid plans, trying to have 342 00:12:38,225 --> 00:12:41,019 a much more population health focus even though, 343 00:12:41,240 --> 00:12:41,899 you know, 344 00:12:42,519 --> 00:12:45,179 patients that are on Medicaid plans can be 345 00:12:45,480 --> 00:12:47,639 can have a lot of complications that make 346 00:12:47,639 --> 00:12:50,299 it difficult for population health to be successful. 347 00:12:50,759 --> 00:12:52,279 But I think that we have to start 348 00:12:52,279 --> 00:12:55,285 to get much more creative in the space 349 00:12:55,504 --> 00:12:56,004 of, 350 00:12:56,865 --> 00:12:58,945 of how we deliver health care to those 351 00:12:58,945 --> 00:13:00,325 that are the most in need. 352 00:13:01,105 --> 00:13:03,904 And because there is a a real world 353 00:13:03,904 --> 00:13:06,245 in which we will continue to be squeezed 354 00:13:06,625 --> 00:13:08,865 and limited in in money that will be 355 00:13:08,865 --> 00:13:09,365 given, 356 00:13:09,990 --> 00:13:11,929 in order to deliver these types of services. 357 00:13:12,149 --> 00:13:14,309 So we have to think differently just like 358 00:13:14,309 --> 00:13:15,990 we are, you know, at the at the 359 00:13:15,990 --> 00:13:18,730 federal level with Medicare with making care primary 360 00:13:18,790 --> 00:13:20,649 and and things like that. Those types of 361 00:13:21,029 --> 00:13:23,225 pilots need to move to what can you 362 00:13:23,225 --> 00:13:24,205 learn about 363 00:13:24,664 --> 00:13:27,384 managing the most complicated of our individuals, the 364 00:13:27,384 --> 00:13:30,284 most sick, the most, socially and behaviorally complex, 365 00:13:31,144 --> 00:13:32,985 and how we better our how we're better 366 00:13:32,985 --> 00:13:35,004 stewards of the resources we are given. 367 00:13:36,110 --> 00:13:37,549 That makes a lot of sense. Thank you 368 00:13:37,549 --> 00:13:39,309 so much for digging a bit deeper there 369 00:13:39,309 --> 00:13:41,389 with me. Now before we wrap up, I 370 00:13:41,389 --> 00:13:42,129 wanted to, 371 00:13:42,909 --> 00:13:45,309 talk for just a moment on leadership. How 372 00:13:45,309 --> 00:13:47,629 are you evolving as a leader, especially given 373 00:13:47,629 --> 00:13:49,870 some of the opportunities ahead, but but also 374 00:13:49,870 --> 00:13:50,690 clear challenges? 375 00:13:51,684 --> 00:13:52,184 Yeah. 376 00:13:53,044 --> 00:13:54,884 Boy, have I learned you know, I I 377 00:13:54,884 --> 00:13:58,084 came into the CEO position in December of 378 00:13:58,084 --> 00:14:00,644 2020 after after being at Harborview for a 379 00:14:00,644 --> 00:14:02,664 very long time in a in a very, 380 00:14:02,964 --> 00:14:05,850 you know, various operations roles. I I would 381 00:14:05,850 --> 00:14:06,990 say I'm evolving 382 00:14:08,330 --> 00:14:10,490 very quickly in well, I don't know 4 383 00:14:10,490 --> 00:14:12,889 years as quickly, so that was probably way 384 00:14:12,889 --> 00:14:14,410 too much credit for me. But I am 385 00:14:14,410 --> 00:14:14,910 evolving 386 00:14:15,289 --> 00:14:18,190 in my ability to better understand 387 00:14:19,825 --> 00:14:22,225 how I'm going to have to navigate this 388 00:14:22,225 --> 00:14:24,245 facility and set it up for the future. 389 00:14:24,304 --> 00:14:26,304 I think when I first came into this 390 00:14:26,304 --> 00:14:29,044 position, I was very much focused on 391 00:14:29,745 --> 00:14:33,684 a, you know, worldwide pandemic, keeping patients safe, 392 00:14:34,700 --> 00:14:36,320 you know, kind of in the moment 393 00:14:36,700 --> 00:14:38,080 type crisis management 394 00:14:39,019 --> 00:14:41,100 where the last couple years I've had to 395 00:14:41,100 --> 00:14:43,600 pivot more to a traditional CEO role, 396 00:14:45,019 --> 00:14:47,115 and really start to think about, you know, 397 00:14:47,115 --> 00:14:47,855 this is a 398 00:14:48,634 --> 00:14:49,294 complex institution 399 00:14:50,475 --> 00:14:52,095 that has not had 400 00:14:52,715 --> 00:14:55,434 a good way to ensure its viability into 401 00:14:55,434 --> 00:14:57,115 the future. And so a lot of what 402 00:14:57,115 --> 00:14:59,215 I'm doing as a leader is thinking about, 403 00:14:59,595 --> 00:15:01,514 okay. When I'm gone, what is the legacy 404 00:15:01,514 --> 00:15:03,169 I wanna I wanna leave here? Here? What 405 00:15:03,169 --> 00:15:04,690 do what do I want the leader, the 406 00:15:04,690 --> 00:15:07,169 person sitting in this seat 20 years from 407 00:15:07,169 --> 00:15:07,990 now to say 408 00:15:08,529 --> 00:15:10,370 about the time I spent as CEO? And 409 00:15:10,370 --> 00:15:11,569 I want them to be able to say, 410 00:15:11,569 --> 00:15:12,069 well, 411 00:15:12,449 --> 00:15:15,190 that that particular CEO set us up for, 412 00:15:15,809 --> 00:15:18,370 for the future. She ensured we had, you 413 00:15:18,370 --> 00:15:21,785 know, sufficient buildings built and sufficient space built 414 00:15:21,785 --> 00:15:22,285 to 415 00:15:22,665 --> 00:15:23,644 to accommodate 416 00:15:24,105 --> 00:15:26,904 growth, both organic and strategic, up, you know, 417 00:15:26,904 --> 00:15:27,644 well into 418 00:15:28,105 --> 00:15:30,825 the 20 forties, 20 fifties, not just, you 419 00:15:30,825 --> 00:15:32,205 know, what we need right now. 420 00:15:32,610 --> 00:15:34,929 She looked at creative ways to ensure we 421 00:15:34,929 --> 00:15:36,870 had revenue coming in for Harborview. 422 00:15:37,569 --> 00:15:38,789 You know, just 423 00:15:39,649 --> 00:15:41,409 really look at how I set up the 424 00:15:41,409 --> 00:15:43,730 future of this place. Harborview has been such 425 00:15:43,730 --> 00:15:46,549 an iconic institution in the state of Washington 426 00:15:47,425 --> 00:15:49,205 for for so long, and 427 00:15:49,985 --> 00:15:51,205 things were so precarious, 428 00:15:51,985 --> 00:15:54,225 during COVID that I really set my mind 429 00:15:54,225 --> 00:15:56,865 to my job as a CEO or as 430 00:15:56,865 --> 00:15:58,565 a CEO during this time frame 431 00:15:58,865 --> 00:16:01,540 is to ensure Harborview is here, you know, 432 00:16:01,540 --> 00:16:04,100 20, 30, 40, 50, 60, 70 years from 433 00:16:04,100 --> 00:16:07,059 now and being able to deliver the same 434 00:16:07,059 --> 00:16:08,920 exact mission we deliver right now. 435 00:16:10,660 --> 00:16:12,580 That's amazing to hear. Summer, thank you so 436 00:16:12,580 --> 00:16:14,179 much for joining us on the podcast today. 437 00:16:14,179 --> 00:16:16,075 This has been such a fun and inspiring 438 00:16:16,075 --> 00:16:17,674 conversation, and I look forward to connecting with 439 00:16:17,674 --> 00:16:18,575 you again soon. 440 00:16:19,115 --> 00:16:21,195 Thank you so much, Lauren. I really enjoyed 441 00:16:21,195 --> 00:16:22,735 myself. Thanks for having me.