Speaker 0: This is where health care leadership comes together. Becker's sixteenth annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13 through the sixteenth. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former president George w Bush. For the agenda and event details, visit beckershospitalreview.com and click on the events tab in the upper right. We're looking forward to hosting you in Chicago.

Speaker 1: This is Gracelyn Keller with the Becker's Healthcare podcast, and we are recording live at the thirteenth annual CEO and CFO roundtable. I'm currently joined by Josephine Wilton, who is the chief business development officer at CHCB. So Josephine, thanks for being here. I'm gonna have you start off by just introducing yourself a little bit further and telling us more about your background.

Speaker 2: Terrific. So Josephine Wilton. I my background is is pretty, it's I refer to it as, like, quilted in a patchwork. So I pride myself as being, maybe a jack of all trades, master of none. I started out my academic and professional career, in a legal track.

Actually worked as a paralegal for many years, moved transitioned into legal operations. And then about fifteen, almost twenty years ago, ended up taking a job with the Blue Cross plan in Western New York and, started naturally the legal department, legal operations. And, once I got in there about three years, I realized I wanna learn more about the business of health care. Right? Everybody goes to legal when there's a problem, so you get a little sense of, you know, the ins and outs, somewhat at a very high level bird's eye.

But I had tremendous support, from my executive and other executives throughout the organization and found my way into the network team, provider network, and ended up negotiating and doing contracting with facilities and ancillary providers and really learning the business, even sides of it that I didn't like. Like, we could probably do a whole podcast on claims issues with hospitals. From there, you know, after eight and a half year tenure with Blue Cross, I ended up transitioning to a startup, ACO, and that was awesome. Right? Because then I had the perspective of, that middle entity, that was there to bridge and support payer.

So for ACO REACH, you've got CMS as a government payer bridging with providers. And I got to go back to my old stomping ground, if you will, of doing network development recruitment. And, that ACO also established an IPA in New York, Georgia, and right here in Illinois shortly after I left, but I had an opportunity to travel and really get to see a lot of the simp similarities, with different provider types. Those claims and operational issues that I disliked and disdained on the plan side, those experiences really came into play and were helpful when I was on the ground and and working with, those provider organizations. And then I ended up, of course, where I am now, working for an FQHC, a federally qualified health center, and that was my foray into working for a provider.

I I think it's a natural fit with my background, and I'm glad that I had the opportunity to do that. So

Speaker 1: Wonderful. Well, thanks for that rundown, and I'm glad you're here with us.

Speaker 2: Yes.

Speaker 1: So let's start our conversation talking about your growth strategy in the next year or two.

Speaker 2: Yeah. So growth. Even since I've been here, at this, conference, I've been on the phone with the members of the executive team, including the CEO, and we're still strategizing. There's definitely when we talk about growth, we are, I would say, more foundationally, embarked almost two years ago on a path of renegotiating our contracts, just with the with the health plans. Like, that's just fundamental.

Right? Get the fee for service right. Make sure it aligns with your delivery of service and care, which continue should continue to evolve based off of community needs. It's not just fee for service. From there, you know, it's a building block.

Here at the conference, you're hearing people talking about fee for service is still here. I remember in my career where everybody thought it was gonna go away and value based payment arrangements were gonna take over. It's kinda been split, and I I think I agree with others that it's gonna be that way for a while. However, a lot of organizations do need to catch up to the VBP world, including especially FQHCs who can't typically take downside risk. So then we gotta get creative.

Right? And there's still a lot of opportunities. So that's been a part of our growth strategy is is kinda stabilizing, but also kinda leaning in and leveraging those different revenue opportunities, which will give us more of an advantage to expand into the community. We are opening a new brick and mortar, which the this was already, in the works through state funding. We're expanding to more southern tier of Western New York, the F Q 8 C.

We have five locations right now in a mobile unit, but access is still an issue. When we talk about access, folks could be, like, five blocks away from a hospital or provider. That doesn't mean they're able to get there for many different reasons. Western New York community has gone through a lot of trauma, because of a lot of events. You know, winter storm, we had, unfortunately, a Tops massacre.

The the community at large was impacted, and a lot of folks are dealing with behavioral health issues. So when we talk about growth and expansion, it's it's access to care. In particular, there's behavioral health, but also dental. There's a great need. A lot of avoidable hospital visits are due to dental issues, and you really can't there's not much they can do unless it's, trauma related.

So we're looking into expanding our dental delivery of care.

Speaker 1: Absolutely. And tell us about the most exciting or impactful initiative or project that you're currently working on.

Speaker 2: Oh, wow. So many. So I would say something that kinda hits home at a personal level is maternal health. Obviously, there's there's a lot of focus on that, in our country. I mean, even globally, but certainly we'll talk we'll stay with The US.

We got enough to deal with here. And certainly the health disparities around that. I through the health center, we had an opportunity to, request, some funding to expand access to maternal care. There's a lot of great statistics out there within each state county level. They're gathering all sorts of statistics, But there's still a shortage, at a at a more micro level and certainly incorporating social determinants of health.

Like, what's happening to, those individuals, those persons, birthing persons who are and also their support system. Right? It's not just them. It's their partners, family. What are they experiencing that's causing them to end up at at risk, potentially losing their lives, their, you know, their child's life?

So we went to the state, and I was personally involved in that and was able to give personal testimony as to how it, you know, I was impacted through the health care system, negatively, but could have been a whole lot worse. And just to, speak and be a voice and a face. You know? Oftentimes, we're working with people right next to them, and we don't know how they've been impacted in their lives. And so, hopefully, if anything, I was able to make it real and relatable, in the ass.

So we're looking forward to getting that going. It's gonna be a complete, I guess, infrastructure build that we will augment our current care delivery system workflows and process to expand this maternal health. And we're gonna leverage our ACO, which also is an IPA partner, to do that work. So I'm excited. It it's like we're in the infancy planning stage, but and it's not a ton of money.

And our goal is to keep it going. But I'm really excited about that work because I think it's it's just so meaningful, as well as all the work that we do at the health center. But we gotta make a difference somehow, and it's just incremental wherever we

Speaker 1: can. Absolutely. And then finally, what is the most important thing you think health care executives should be doing right now to make sure their organizations are successful in the future?

Speaker 2: Infrastructure. So I heard I I was very pleased to hear some of your panelists in different sessions, some value based sessions, others not so not exactly that, but there was, a little bit of a theme in focusing on operations and execution. And so I think that's exactly where executives should be. The the entire c suite boards need to be focused on operations and execution. I've done contracting for a living negotiations.

It's great. I have a legal background. My I'm excited by redlining and making sure the contract is fully executed. But then what happens after that? Right?

We sit in meetings, internal meetings with our partners, others, and, health plans, etcetera. And we're talking about moving the needle, and we're staring at scorecards, metrics, and data. And everybody's frustrated on all sides because things are just not progressing, as expected. And I'll speak for f q eight c's in particular. They're incredibly nimble.

One of your most flexible provider types in a community, they have to be resilient inherently because of all what they endure despite whatever administration we have, just in the landscape of health care. However, one of your panelists also mentioned the first thing before you even start to talk about operationalizing and execution is get getting that deep understanding on both sides. And I've experienced that through negotiations where people say, yes. We understand your organization and your care delivery model, but usually there's a wide gap in the in that understanding. So starting there first on both sides.

Certainly, there are a lot of myths from the providers based off of health plans. And then moving into operational planning and execution and proper tracking and monitoring, to ensure that all the great activities that are occurring are getting the parties, moving them along some sort of pathway to success.

Speaker 1: Absolutely. Well, Josephine, thanks so much for being here today and joining me on the Becker's Healthcare Podcast. Again, we are recording live at the thirteenth annual CEO and CFO roundtable.

Speaker 2: Thank you so much.