1 00:00:02,080 --> 00:00:04,660 This is where health care leadership comes together. 2 00:00:04,799 --> 00:00:07,919 Becker's sixteenth annual meeting brings more than 3,500 3 00:00:07,919 --> 00:00:11,119 hospital and health system executives and nearly 800 4 00:00:11,119 --> 00:00:14,404 speakers to Chicago, April 13 through the sixteenth. 5 00:00:14,785 --> 00:00:17,505 This year's event includes keynote conversations with Dallas 6 00:00:17,505 --> 00:00:20,385 Cowboys legend Troy Aikman and former president George 7 00:00:20,385 --> 00:00:23,105 w Bush. For the agenda and event details, 8 00:00:23,105 --> 00:00:25,440 visit beckershospitalreview.com 9 00:00:25,519 --> 00:00:27,039 and click on the events tab in the 10 00:00:27,039 --> 00:00:29,760 upper right. We're looking forward to hosting you 11 00:00:29,760 --> 00:00:30,500 in Chicago. 12 00:00:32,560 --> 00:00:34,640 This is Gracelyn Keller with the Becker's Healthcare 13 00:00:34,640 --> 00:00:36,960 podcast, and we are recording live at the 14 00:00:36,960 --> 00:00:39,780 thirteenth annual CEO and CFO roundtable. 15 00:00:40,314 --> 00:00:42,634 I'm currently joined by Josephine Wilton, who is 16 00:00:42,634 --> 00:00:45,215 the chief business development officer at CHCB. 17 00:00:45,754 --> 00:00:47,914 So Josephine, thanks for being here. I'm gonna 18 00:00:47,914 --> 00:00:50,314 have you start off by just introducing yourself 19 00:00:50,314 --> 00:00:51,835 a little bit further and telling us more 20 00:00:51,835 --> 00:00:53,429 about your background. Terrific. 21 00:00:53,890 --> 00:00:55,590 So Josephine Wilton. 22 00:00:56,210 --> 00:00:58,310 I my background is is pretty, 23 00:00:59,170 --> 00:01:01,429 it's I refer to it as, like, quilted 24 00:01:01,649 --> 00:01:03,270 in a patchwork. So 25 00:01:03,649 --> 00:01:06,290 I pride myself as being, maybe a jack 26 00:01:06,290 --> 00:01:08,069 of all trades, master of none. 27 00:01:08,685 --> 00:01:11,344 I started out my academic and professional career, 28 00:01:11,965 --> 00:01:14,045 in a legal track. Actually worked as a 29 00:01:14,045 --> 00:01:17,005 paralegal for many years, moved transitioned into legal 30 00:01:17,005 --> 00:01:17,505 operations. 31 00:01:18,765 --> 00:01:19,424 And then 32 00:01:19,805 --> 00:01:21,984 about fifteen, almost twenty years ago, 33 00:01:22,599 --> 00:01:24,200 ended up taking a job with the Blue 34 00:01:24,200 --> 00:01:26,060 Cross plan in Western New York 35 00:01:26,439 --> 00:01:26,939 and, 36 00:01:27,479 --> 00:01:30,939 started naturally the legal department, legal operations. 37 00:01:31,640 --> 00:01:32,140 And, 38 00:01:32,679 --> 00:01:34,614 once I got in there about three years, 39 00:01:34,614 --> 00:01:36,854 I realized I wanna learn more about the 40 00:01:36,854 --> 00:01:39,334 business of health care. Right? Everybody goes to 41 00:01:39,334 --> 00:01:41,655 legal when there's a problem, so you get 42 00:01:41,655 --> 00:01:43,494 a little sense of, you know, the ins 43 00:01:43,494 --> 00:01:45,414 and outs, somewhat at a very high level 44 00:01:45,414 --> 00:01:46,234 bird's eye. 45 00:01:46,854 --> 00:01:48,634 But I had tremendous support, 46 00:01:49,380 --> 00:01:51,700 from my executive and other executives throughout the 47 00:01:51,700 --> 00:01:54,280 organization and found my way into the network 48 00:01:54,659 --> 00:01:55,159 team, 49 00:01:55,620 --> 00:01:57,000 provider network, and 50 00:01:57,459 --> 00:02:00,579 ended up negotiating and doing contracting with facilities 51 00:02:00,579 --> 00:02:03,560 and ancillary providers and really learning the business, 52 00:02:03,944 --> 00:02:05,625 even sides of it that I didn't like. 53 00:02:05,625 --> 00:02:07,704 Like, we could probably do a whole podcast 54 00:02:07,704 --> 00:02:09,645 on claims issues with hospitals. 55 00:02:11,625 --> 00:02:13,064 From there, you know, after eight and a 56 00:02:13,064 --> 00:02:14,044 half year tenure 57 00:02:14,344 --> 00:02:15,245 with Blue Cross, 58 00:02:15,705 --> 00:02:18,525 I ended up transitioning to a startup, ACO, 59 00:02:19,269 --> 00:02:21,430 and that was awesome. Right? Because then I 60 00:02:21,430 --> 00:02:23,049 had the perspective of, 61 00:02:23,509 --> 00:02:25,049 that middle entity, 62 00:02:25,989 --> 00:02:28,969 that was there to bridge and support payer. 63 00:02:29,269 --> 00:02:31,909 So for ACO REACH, you've got CMS as 64 00:02:31,909 --> 00:02:34,169 a government payer bridging with providers. 65 00:02:34,625 --> 00:02:36,224 And I got to go back to my 66 00:02:36,224 --> 00:02:36,724 old 67 00:02:37,185 --> 00:02:39,264 stomping ground, if you will, of doing network 68 00:02:39,264 --> 00:02:40,324 development recruitment. 69 00:02:40,864 --> 00:02:44,145 And, that ACO also established an IPA in 70 00:02:44,145 --> 00:02:46,965 New York, Georgia, and right here in Illinois 71 00:02:47,025 --> 00:02:49,099 shortly after I left, but I had an 72 00:02:49,099 --> 00:02:51,520 opportunity to travel and really get to see 73 00:02:51,659 --> 00:02:53,019 a lot of the simp 74 00:02:53,500 --> 00:02:53,979 similarities, 75 00:02:54,300 --> 00:02:56,000 with different provider types. 76 00:02:56,939 --> 00:02:59,919 Those claims and operational issues that I disliked 77 00:03:00,379 --> 00:03:02,479 and disdained on the plan side, 78 00:03:03,025 --> 00:03:03,844 those experiences 79 00:03:04,865 --> 00:03:06,944 really came into play and were helpful when 80 00:03:06,944 --> 00:03:08,865 I was on the ground and and working 81 00:03:08,865 --> 00:03:10,965 with, those provider organizations. 82 00:03:11,824 --> 00:03:13,664 And then I ended up, of course, where 83 00:03:13,664 --> 00:03:14,485 I am now, 84 00:03:15,185 --> 00:03:17,905 working for an FQHC, a federally qualified health 85 00:03:17,905 --> 00:03:18,405 center, 86 00:03:18,840 --> 00:03:21,159 and that was my foray into working for 87 00:03:21,159 --> 00:03:21,740 a provider. 88 00:03:22,599 --> 00:03:24,360 I I think it's a natural fit with 89 00:03:24,360 --> 00:03:26,200 my background, and I'm glad that I had 90 00:03:26,200 --> 00:03:27,879 the opportunity to do that. So 91 00:03:28,439 --> 00:03:30,520 Wonderful. Well, thanks for that rundown, and I'm 92 00:03:30,520 --> 00:03:33,064 glad you're here with us. Yes. So let's 93 00:03:33,064 --> 00:03:35,305 start our conversation talking about your growth strategy 94 00:03:35,305 --> 00:03:36,604 in the next year or two. 95 00:03:37,305 --> 00:03:38,664 Yeah. So growth. 96 00:03:39,384 --> 00:03:40,905 Even since I've been here, 97 00:03:41,864 --> 00:03:44,185 at this, conference, I've been on the phone 98 00:03:44,185 --> 00:03:44,685 with 99 00:03:45,849 --> 00:03:47,849 the members of the executive team, including the 100 00:03:47,849 --> 00:03:49,550 CEO, and we're still strategizing. 101 00:03:50,010 --> 00:03:52,409 There's definitely when we talk about growth, 102 00:03:53,530 --> 00:03:54,030 we 103 00:03:54,409 --> 00:03:56,430 are, I would say, more foundationally, 104 00:03:57,930 --> 00:04:00,044 embarked almost two years ago 105 00:04:00,344 --> 00:04:01,965 on a path of renegotiating 106 00:04:02,264 --> 00:04:03,004 our contracts, 107 00:04:04,264 --> 00:04:06,344 just with the with the health plans. Like, 108 00:04:06,344 --> 00:04:08,504 that's just fundamental. Right? Get the fee for 109 00:04:08,504 --> 00:04:10,665 service right. Make sure it aligns with your 110 00:04:10,665 --> 00:04:12,444 delivery of service and care, 111 00:04:13,250 --> 00:04:16,129 which continue should continue to evolve based off 112 00:04:16,129 --> 00:04:17,269 of community needs. 113 00:04:17,810 --> 00:04:19,569 It's not just fee for service. From there, 114 00:04:19,569 --> 00:04:21,009 you know, it's a building block. 115 00:04:21,490 --> 00:04:23,730 Here at the conference, you're hearing people talking 116 00:04:23,730 --> 00:04:25,490 about fee for service is still here. I 117 00:04:25,490 --> 00:04:27,330 remember in my career where everybody thought it 118 00:04:27,330 --> 00:04:29,404 was gonna go away and value 119 00:04:29,785 --> 00:04:31,865 based payment arrangements were gonna take over. It's 120 00:04:31,865 --> 00:04:34,504 kinda been split, and I I think I 121 00:04:34,504 --> 00:04:36,504 agree with others that it's gonna be that 122 00:04:36,504 --> 00:04:37,485 way for a while. 123 00:04:37,944 --> 00:04:40,504 However, a lot of organizations do need to 124 00:04:40,504 --> 00:04:42,285 catch up to the VBP world, 125 00:04:42,689 --> 00:04:46,050 including especially FQHCs who can't typically take downside 126 00:04:46,050 --> 00:04:48,310 risk. So then we gotta get creative. Right? 127 00:04:48,610 --> 00:04:50,790 And there's still a lot of opportunities. So 128 00:04:51,090 --> 00:04:53,090 that's been a part of our growth strategy 129 00:04:53,090 --> 00:04:54,389 is is kinda stabilizing, 130 00:04:54,770 --> 00:04:55,509 but also 131 00:04:56,134 --> 00:04:58,954 kinda leaning in and leveraging those different revenue 132 00:04:59,014 --> 00:05:01,574 opportunities, which will give us more of an 133 00:05:01,574 --> 00:05:03,754 advantage to expand into the community. 134 00:05:04,294 --> 00:05:06,935 We are opening a new brick and mortar, 135 00:05:06,935 --> 00:05:08,714 which the this was already, 136 00:05:09,490 --> 00:05:11,189 in the works through state funding. 137 00:05:11,649 --> 00:05:14,449 We're expanding to more southern tier of Western 138 00:05:14,449 --> 00:05:16,129 New York, the F Q 8 C. We 139 00:05:16,129 --> 00:05:18,129 have five locations right now in a mobile 140 00:05:18,129 --> 00:05:18,629 unit, 141 00:05:19,250 --> 00:05:21,329 but access is still an issue. When we 142 00:05:21,329 --> 00:05:23,595 talk about access, folks could be, like, five 143 00:05:23,595 --> 00:05:25,595 blocks away from a hospital or provider. That 144 00:05:25,595 --> 00:05:27,675 doesn't mean they're able to get there for 145 00:05:27,675 --> 00:05:28,814 many different reasons. 146 00:05:29,595 --> 00:05:31,274 Western New York community has gone through a 147 00:05:31,274 --> 00:05:32,095 lot of trauma, 148 00:05:32,875 --> 00:05:34,634 because of a lot of events. You know, 149 00:05:34,634 --> 00:05:37,694 winter storm, we had, unfortunately, a Tops massacre. 150 00:05:38,839 --> 00:05:41,480 The the community at large was impacted, and 151 00:05:41,480 --> 00:05:43,160 a lot of folks are dealing with behavioral 152 00:05:43,160 --> 00:05:45,399 health issues. So when we talk about growth 153 00:05:45,399 --> 00:05:48,139 and expansion, it's it's access to care. 154 00:05:48,519 --> 00:05:49,339 In particular, 155 00:05:49,959 --> 00:05:52,300 there's behavioral health, but also dental. 156 00:05:53,105 --> 00:05:54,324 There's a great need. 157 00:05:54,944 --> 00:05:57,605 A lot of avoidable hospital visits are due 158 00:05:57,745 --> 00:05:58,965 to dental issues, 159 00:05:59,425 --> 00:06:00,725 and you really can't 160 00:06:01,105 --> 00:06:02,865 there's not much they can do unless it's, 161 00:06:03,105 --> 00:06:06,384 trauma related. So we're looking into expanding our 162 00:06:06,384 --> 00:06:07,285 dental delivery 163 00:06:07,789 --> 00:06:09,250 of care. Absolutely. 164 00:06:10,430 --> 00:06:12,589 And tell us about the most exciting or 165 00:06:12,589 --> 00:06:15,229 impactful initiative or project that you're currently working 166 00:06:15,229 --> 00:06:16,449 on. Oh, wow. 167 00:06:16,910 --> 00:06:17,649 So many. 168 00:06:18,029 --> 00:06:18,529 So 169 00:06:19,069 --> 00:06:21,310 I would say something that kinda hits home 170 00:06:21,310 --> 00:06:23,490 at a personal level is maternal health. 171 00:06:24,564 --> 00:06:26,725 Obviously, there's there's a lot of focus on 172 00:06:26,725 --> 00:06:27,125 that, 173 00:06:27,605 --> 00:06:29,685 in our country. I mean, even globally, but 174 00:06:29,685 --> 00:06:32,084 certainly we'll talk we'll stay with The US. 175 00:06:32,084 --> 00:06:34,105 We got enough to deal with here. 176 00:06:34,964 --> 00:06:37,625 And certainly the health disparities around that. 177 00:06:38,319 --> 00:06:40,000 I through the health center, we had an 178 00:06:40,000 --> 00:06:40,500 opportunity 179 00:06:40,800 --> 00:06:41,300 to, 180 00:06:41,920 --> 00:06:42,420 request, 181 00:06:43,279 --> 00:06:44,100 some funding 182 00:06:44,480 --> 00:06:47,060 to expand access to maternal care. 183 00:06:47,439 --> 00:06:49,779 There's a lot of great statistics out there 184 00:06:50,080 --> 00:06:52,560 within each state county level. They're gathering all 185 00:06:52,560 --> 00:06:53,620 sorts of statistics, 186 00:06:54,134 --> 00:06:55,435 But there's still a shortage, 187 00:06:56,454 --> 00:06:58,694 at a at a more micro level and 188 00:06:58,694 --> 00:06:59,194 certainly 189 00:06:59,814 --> 00:07:02,875 incorporating social determinants of health. Like, what's happening 190 00:07:03,574 --> 00:07:04,055 to, 191 00:07:04,615 --> 00:07:06,314 those individuals, those persons, 192 00:07:06,694 --> 00:07:09,569 birthing persons who are and also their support 193 00:07:09,569 --> 00:07:11,490 system. Right? It's not just them. It's their 194 00:07:11,490 --> 00:07:11,990 partners, 195 00:07:13,009 --> 00:07:16,129 family. What are they experiencing that's causing them 196 00:07:16,129 --> 00:07:16,629 to 197 00:07:17,169 --> 00:07:18,949 end up at at risk, 198 00:07:19,250 --> 00:07:22,449 potentially losing their lives, their, you know, their 199 00:07:22,449 --> 00:07:23,295 child's life? 200 00:07:25,055 --> 00:07:25,715 So we 201 00:07:26,175 --> 00:07:27,235 went to the state, 202 00:07:27,694 --> 00:07:30,415 and I was personally involved in that and 203 00:07:30,415 --> 00:07:32,895 was able to give personal testimony as to 204 00:07:32,895 --> 00:07:35,550 how it, you know, I was impacted through 205 00:07:35,550 --> 00:07:36,689 the health care system, 206 00:07:37,470 --> 00:07:39,389 negatively, but could have been a whole lot 207 00:07:39,389 --> 00:07:41,949 worse. And just to, speak and be a 208 00:07:41,949 --> 00:07:44,370 voice and a face. You know? Oftentimes, 209 00:07:44,910 --> 00:07:46,829 we're working with people right next to them, 210 00:07:46,829 --> 00:07:49,089 and we don't know how they've been impacted 211 00:07:49,534 --> 00:07:51,774 in their lives. And so, hopefully, if anything, 212 00:07:51,774 --> 00:07:53,694 I was able to make it real and 213 00:07:53,694 --> 00:07:54,194 relatable, 214 00:07:55,134 --> 00:07:57,375 in the ass. So we're looking forward to 215 00:07:57,375 --> 00:07:59,634 getting that going. It's gonna be a complete, 216 00:08:00,254 --> 00:08:01,394 I guess, infrastructure 217 00:08:01,774 --> 00:08:04,735 build that we will augment our current care 218 00:08:04,735 --> 00:08:05,235 delivery 219 00:08:05,910 --> 00:08:09,430 system workflows and process to expand this maternal 220 00:08:09,430 --> 00:08:13,050 health. And we're gonna leverage our ACO, 221 00:08:13,350 --> 00:08:15,289 which also is an IPA partner, 222 00:08:16,069 --> 00:08:18,675 to do that work. So I'm excited. It 223 00:08:18,754 --> 00:08:21,154 it's like we're in the infancy planning stage, 224 00:08:21,154 --> 00:08:23,014 but and it's not a ton of money. 225 00:08:24,115 --> 00:08:25,975 And our goal is to keep it going. 226 00:08:26,675 --> 00:08:28,514 But I'm really excited about that work because 227 00:08:28,514 --> 00:08:30,294 I think it's it's just so meaningful, 228 00:08:31,459 --> 00:08:32,660 as well as all the work that we 229 00:08:32,660 --> 00:08:34,580 do at the health center. But we gotta 230 00:08:34,580 --> 00:08:37,000 make a difference somehow, and it's just incremental 231 00:08:37,059 --> 00:08:40,340 wherever we can. Absolutely. And then finally, what 232 00:08:40,340 --> 00:08:42,019 is the most important thing you think health 233 00:08:42,019 --> 00:08:44,019 care executives should be doing right now to 234 00:08:44,019 --> 00:08:45,000 make sure their organizations 235 00:08:45,379 --> 00:08:46,840 are successful in the future? 236 00:08:47,985 --> 00:08:48,485 Infrastructure. 237 00:08:49,024 --> 00:08:50,245 So I heard 238 00:08:50,545 --> 00:08:52,545 I I was very pleased to hear some 239 00:08:52,545 --> 00:08:55,504 of your panelists in different sessions, some value 240 00:08:55,504 --> 00:08:57,605 based sessions, others not so 241 00:08:57,985 --> 00:09:00,165 not exactly that, but there was, 242 00:09:00,945 --> 00:09:02,245 a little bit of a theme 243 00:09:02,759 --> 00:09:06,040 in focusing on operations and execution. And so 244 00:09:06,040 --> 00:09:09,080 I think that's exactly where executives should be. 245 00:09:09,080 --> 00:09:11,639 The the entire c suite boards need to 246 00:09:11,639 --> 00:09:13,820 be focused on operations and execution. 247 00:09:14,759 --> 00:09:16,940 I've done contracting for a living negotiations. 248 00:09:17,595 --> 00:09:19,595 It's great. I have a legal background. My 249 00:09:19,674 --> 00:09:22,154 I'm excited by redlining and making sure the 250 00:09:22,154 --> 00:09:24,954 contract is fully executed. But then what happens 251 00:09:24,954 --> 00:09:27,134 after that? Right? We sit in meetings, 252 00:09:27,514 --> 00:09:29,214 internal meetings with our partners, 253 00:09:29,769 --> 00:09:30,269 others, 254 00:09:30,889 --> 00:09:31,389 and, 255 00:09:31,850 --> 00:09:34,970 health plans, etcetera. And we're talking about moving 256 00:09:34,970 --> 00:09:37,230 the needle, and we're staring at scorecards, 257 00:09:37,850 --> 00:09:39,149 metrics, and data. 258 00:09:39,529 --> 00:09:42,649 And everybody's frustrated on all sides because things 259 00:09:42,649 --> 00:09:43,789 are just not progressing, 260 00:09:44,654 --> 00:09:46,815 as expected. And I'll speak for f q 261 00:09:46,815 --> 00:09:47,875 eight c's in particular. 262 00:09:48,735 --> 00:09:49,475 They're incredibly 263 00:09:50,174 --> 00:09:50,674 nimble. 264 00:09:51,054 --> 00:09:53,615 One of your most flexible provider types in 265 00:09:53,615 --> 00:09:56,355 a community, they have to be resilient inherently 266 00:09:56,414 --> 00:09:59,075 because of all what they endure despite whatever 267 00:09:59,740 --> 00:10:01,200 administration we have, 268 00:10:01,899 --> 00:10:03,840 just in the landscape of health care. 269 00:10:04,220 --> 00:10:04,720 However, 270 00:10:05,420 --> 00:10:07,279 one of your panelists also mentioned 271 00:10:07,820 --> 00:10:09,980 the first thing before you even start to 272 00:10:09,980 --> 00:10:13,660 talk about operationalizing and execution is get getting 273 00:10:13,660 --> 00:10:14,800 that deep understanding 274 00:10:15,475 --> 00:10:16,294 on both sides. 275 00:10:17,154 --> 00:10:19,634 And I've experienced that through negotiations where people 276 00:10:19,634 --> 00:10:22,115 say, yes. We understand your organization and your 277 00:10:22,115 --> 00:10:24,674 care delivery model, but usually there's a wide 278 00:10:24,674 --> 00:10:26,215 gap in the in that understanding. 279 00:10:26,995 --> 00:10:29,070 So starting there first on both sides. 280 00:10:29,789 --> 00:10:31,230 Certainly, there are a lot of myths from 281 00:10:31,230 --> 00:10:31,809 the providers 282 00:10:32,429 --> 00:10:33,809 based off of health plans. 283 00:10:34,429 --> 00:10:37,570 And then moving into operational planning and execution 284 00:10:37,710 --> 00:10:39,649 and proper tracking and monitoring, 285 00:10:40,509 --> 00:10:42,750 to ensure that all the great activities that 286 00:10:42,750 --> 00:10:44,129 are occurring are 287 00:10:44,654 --> 00:10:45,154 getting 288 00:10:45,774 --> 00:10:46,514 the parties, 289 00:10:47,134 --> 00:10:49,454 moving them along some sort of pathway to 290 00:10:49,454 --> 00:10:49,954 success. 291 00:10:50,815 --> 00:10:53,294 Absolutely. Well, Josephine, thanks so much for being 292 00:10:53,294 --> 00:10:55,054 here today and joining me on the Becker's 293 00:10:55,054 --> 00:10:57,375 Healthcare Podcast. Again, we are recording live at 294 00:10:57,375 --> 00:10:58,434 the thirteenth annual 295 00:10:58,786 --> 00:11:01,606 CEO and CFO roundtable. Thank you so much.