This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Tommy Ibrahim,
network President and Chief Executive Officer of Bassett Healthcare Network.
Tommy, it's a pleasure to have you on the podcast today.
Thank you so much, Laura. Looking forward to it.
Well, I know there's a lot happening,
and we're gonna talk through some of the big challenges and trends and rural
healthcare today. But before we dive into the broader discussion,
I was wondering if you could tell us a little bit more about yourself and your
background?
Yeah, no, happy to. Um, uh, my name is Dr. Tommy Ibrahim.
I'm an internist by background, uh, trained, uh,
greater Baltimore Medical Center, uh, in b Baltimore, Maryland. And, uh,
practice as a and internist for the first, you know,
several years of my career before getting tugged into the leadership domain.
And, um, you know,
I have been very fortunate and blessed over the past couple of decades, uh, to,
uh, advance into larger position executive roles, um, that have, uh, you know,
essentially prepared me for, um, the, uh,
incredible opportunity that I have today, uh, leading, uh,
Bassett Healthcare Network. So, delighted to, uh,
spend some time with you today.
Fantastic. Well, you know, I was wondering if we could start off with, um,
talking a little bit about some of the big challenges of rural healthcare today.
What are you really seeing on the ground floor,
and how are you navigating these challenges?
Well, thanks so much, Laura. I mean, I think the challenges are really copious.
Um, you know, we're dealing with, uh, some of the other, uh, you know, major,
um, uh,
problems that the healthcare industry in its entirety is dealing with at this
current time. Um,
but I would also say that rural healthcare in general is exponentially, uh,
you know, more affected. Uh, and that's for, uh, a variety of different reasons,
you know, most are, uh, community related, um, or, uh,
just geographically, uh, you know, uh, related. Uh, others might be, uh,
staffing, uh, you know, related or op other facets of operations, you know,
playing a key role. Um, and, and certainly, uh,
as a rural healthcare organization, we feel the brunt, um, uh,
of most of those areas. So, for example, it is, um, you know,
significantly more challenging for us to recruit, uh, to our communities. Uh,
there's a,
a general shortage across the entire industry now for both physicians as well as
nurses. Uh,
and I believe the recent statistic was actually about 200,000 or so physicians
left healthcare just last year, and about a hundred thousand nurses, uh,
decided to leave healthcare last year.
So we're all fighting for the same constrained pool of resources,
and it's exponentially harder for us in a rural environment to be able to
recruit talent to really service the, the needs of the community. Um, you know,
layering into that, the very unique social determinants of health, uh,
of rural populations in general. Uh, our communities are largely elderly. Uh,
you know, they're, uh, poorer, uh, less digitally inclined. Uh,
we might have challenges with broadband access and transportation, uh,
all of which get in the way of patients truly accessing the care that they need,
uh, in the way that they need it. And, you know,
as healthcare leaders and as a healthcare organization,
we have to really solve for those problems, uh, as we, uh,
take into account the needs of our community. And,
and we're doing a number of different things to try to address that. And, uh,
you know, as an organization, one of our, one of our major, uh,
I think strategic priorities is, uh,
to align with other partners and other affiliations, uh,
who are aligned with our mission, aligned with our vision to ensure that we are,
um, you know,
driving the strategies and the initiatives forward that really make sense for
our community. So, as an example,
we've just launched a major partnership not too long ago with Andreesen
Horowitz, uh, which is a, uh, a major venture capital firm, a major, you know,
digital, uh, innovator, uh, in the Silicon Valley. Um, and that, you know,
the premise of that partnership is to look at how we could begin to really
redesign the care delivery system to meet the needs of rural geographies in
particular, and making sure that, you know,
we're layering in solutions that make sense for our community. That's just one,
uh, you know, recent example. Uh, another is, uh,
a broadening partnership and relationship that we've built with Columbia
University, where we're bringing world class cardiovascular services, uh,
to our community through telehealth. Uh, and, uh, again,
really optimizing on, uh,
virtual and digital channels to serve the community in the best way possible.
And there's just a number of other partnerships and affiliations and other
strategies that we've put into place to make sure that, uh, you know,
we're addressing the very unique, uh, and subtle needs of overall patients.
I love that. I think that makes a lot of sense.
And it's so helpful to know how you've been redesigning that care delivery
system to match your population and the patients that you serve.
I can imagine it's so helpful within the community to have those services and
access to facet in order to, uh, have care when it's needed.
Now, you know,
as you were talking through a lot around the staffing and labor issues, um,
obviously all healthcare organizations are experiencing them to some degree,
but in rural healthcare,
that recruiting people into spaces that are non-urban into spaces that,
you know, might not be as typical is an extra challenge. So, you know,
what is your strategy for recruiting and retaining great talent over the last
couple of years,
especially what's worked really well and where are you looking ahead in the
future?
Yeah, it's such an important question. And, um, you know, at Bassett,
we're really trying to take a very, um, you know, uh,
thoughtful a and comprehensive approach, um, to, uh, to this really,
uh, significant need, um, focusing predominantly on retention. Um, you know,
we found, obviously, uh, that, uh,
becoming an employer of choice and investing in our people,
investing in our culture is the single most important thing that we can do. Um,
you know, we,
we have great people already and it's really important for us to make sure that
we're putting in place processes and initiatives to,
to ensure that they're feeling valued and appreciated for the work that they do,
um, and, uh, that they're, you know, interested in staying with Bassett for the,
for the entirety of their careers. And that's, that's largely where we have, uh,
a tremendous amount of, uh, of focus right now. Um,
we've been investing into our people over the course of the past couple of
years, certainly since the pandemic has started, uh,
we've layered in about $50 million worth of investments into our workforce. And,
you know, we, we, uh, uh, very, um,
happily employ over 4,500 people across the health system. Uh, and, you know,
those, uh, investments, uh, come in the form of, you know,
salary and wage adjustments, other bonus payments that we've put into place,
tuition reimbursement programs. We've also, uh,
looked at leadership development opportunities, uh, to, to ensure, uh,
that there's a, a long-term pipeline of leaders, uh, into the organization. And,
um, have, have really, uh, just tried to again,
connect with our frontline and our leadership teams to ensure that they're
feeling appreciated for the tremendous work that they do. That's, that's,
I think our first and single most important strategy is to really hold on to the
people that we already have. Um, you know, on the recruitment side, uh, it,
it's so challenging because every single healthcare organization is dealing with
this right now, and we're all vying and sort of going after the,
the same pool of resources. And, uh, it's really about, um, you know,
who is gonna be, uh, that employer of choice. And, and, you know, I, I think,
uh, that the landscape has really shifted in, in, in workforce,
and people are looking for, uh, you know, a,
a place that they can connect to from a mission and values perspective, uh,
where they can feel fulfilled, uh,
both personally and professionally with their new employer. Um,
and I think it all goes back to, you know, creating a wonderful, uh, uh,
experience for our employees and, um, creating a,
an incredible culture that people are proud to be a part of. And, and again,
we're investing a lot of time and effort, um, you know, in that regard as well.
You know, I think on a, on a broader strategic scale, um, you know,
we have to also continue to,
to reinvent and re-engineer the care delivery model so that we could also reach
broader, uh, pools of, of people resources. And, you know, it it,
it goes back to my original thought about, uh, you know,
digital and virtual playing a key role into the future. Uh, you know,
we very much believe that we're gonna have to evolve, uh, towards a,
a virtual first model and, and key specialties and,
and really allow patients to access, uh, their care delivery, uh, uh,
system, uh, through a virtual means. And that means looking at, yeah. And, uh,
APCs and more nurse practitioners, uh,
to support virtual care delivery services, uh, looking at, uh,
virtual primary care, virtual I c U care, virtual nursing care, uh,
and other, uh, digital means, uh,
to really create a support structure that's needed for our people,
but most importantly for our communities.
Absolutely. I love that. And, and definitely that,
those two pillars of being able to have the great culture and taking care of the
workforce, really investing in them, and then at the same time,
making sure you've got those tools, the digital virtual care available.
I think that's really, um, so crucial,
especially in the rural healthcare setting. Um, from your perspective,
when you're looking at the virtual care areas, um,
what does it take to stand up a program like that? And, and are there any,
I guess,
unique considerations for the rural field as you're trying to connect more
virtually and really, um, you know, reach out to a,
a rural population with the, the virtual care?
Yeah. You know, we actually, um, uh, at Bassett we have a, a very solid, uh,
information technology, uh, backbone and infrastructure.
And we also have the electronic medical record and, um, you know,
virtual capabilities already built into, uh, the system. So we are, uh,
you know, we're an epic shop and we've been, uh, with Epic for a very long time.
There are a number of, of wonderful resources that are readily available to us.
Uh, we recently launched a partnership also with, uh, Optum, um,
who handles a lot of our information technology systems and has really helped
advance us, um, from a cybersecurity perspective and,
and other technology means to ensure that we're delivering, uh, the care, uh,
in, in a seamless and, and safe fashion for our community. Um,
and we've had wonderful clinicians who, over the course of the past, uh,
couple of years, particularly throughout the pandemic, have, uh, really, um,
gotten accustomed and have adopted, uh, you know,
a a virtual platform as part of our care delivery infrastructure as a whole. So,
you know, from that vein, we've been very, very pleased and,
and very happy with our progress. And, um, you know,
we're spending a lot of time right now really trying to understand what, uh,
barriers might exist, um, to, to broadband that, that, uh, you know,
potentially would get in the way of enabling our patients to access care
delivery through a virtual means.
So going back to social determinants around broadband access, um, and other,
you know,
connectivity issues that might exist that we would have to address holistically
to ensure that this is a, a valuable, successful strategy. And, you know, I,
I'm feeling more and more confident that as we look across the region, um,
and as, as new technologies emerge, like cellular and 5G and, and,
and satellite and other capabilities like that, that, uh,
broadband access will become inevitably, uh, much improved, um, and,
and will allow our patients to really be served in,
in the way that they need to be served. So I'm very optimistic, um,
as we continue to invest in infrastructure and, and, um,
partner with other regional and national players to ensure that connectivity,
uh, uh, exists for our people, um, that, uh, we will, uh,
ultimately be very successful here.
That's fantastic to hear. And you know,
one of the other things I wanted to ask you about too is value-based care.
I know that is something that has been a slow crawl in the healthcare space, um,
for the past several years, but really is becoming more crucial as resources,
um, in healthcare are diminishing to some degree of both financial challenges as
well as, uh, staffing time and, and energy. So from your perspective,
what's different about value-based care for rural facilities,
and where can rural healthcare providers start, um,
when they're thinking about moving more in that direction?
Yeah, it's absolutely, it's the right thing to do.
I'm a big proponent of value-based care. Um, I, I believe, you know,
beyond just the traditional, um, you know,
premise of improving quality and safety, uh, and reducing cost, that it's,
it's just absolutely the right thing to do for the community and for the
patient. You know, really taking a very holistic approach. Uh, you know, uh, uh,
creating a focus more on prevention and wellness and,
and really driving a long-term, uh, health agenda that's, uh,
consistent with our mission is, is the way that, that we want to go.
And I think is the way that the entire industry must, uh, really advance, uh,
in the very near future. Um, you know, for rural, uh, it's, uh,
exponentially more challenging to really get on that pathway. And it's because,
uh, you know, we operate on razor thin margins as it is. There's a,
a very low risk, uh, appetite across the board, uh,
when you're operating on,
on such thin margins if you're operating on any margins at all. And, you know,
I think the latest statistic is that 600 or so rural hospitals across the
country are at risk of closure. So, uh, it's,
it's very hard for rural organizations to be dealing with the various different
environmental and economic challenges that we're dealing with today. And,
um, you know, uh, ponder a value-based agenda, uh, whatsoever.
And that's something that I think is gonna require, uh,
some governmental intervention and,
and really close partnerships and alignments with, uh,
other payers across the country to really support, uh,
the move in this direction. Um, you know,
we are very fortunate in the fact that we have been on the value-based, uh, uh,
journey over the course of the past many years. Uh,
we operate an accountable care organization here at Bassett, um, you know,
with 18,000 lines and growing, uh, we also have partnered with regional payers,
uh, to look at, uh, Medicare Advantage and, and other, uh, uh,
value-based contracting, uh, opportunities, um,
and have performed rather well in, in those areas. Um,
and we continue to make investments in infrastructure, um, to ensure that,
you know, once we're really ready to turn on, um, you know, risk, uh,
on a large scale,
that we are resourced and we have the appropriate capabilities, uh,
in place to ensure that we can be successful. And that comes in, in,
in many forms, whether it's layering in, um, uh, digital, uh,
analytics, uh, and population health-based analytics capabilities, uh,
making sure that we have the appropriate, uh, case management,
care management and patient navigation, uh, opportunities, uh,
and infrastructure. We've recently just partnered with a,
a company that specializes in integrated continuous monitoring.
And essentially what that is, is, is remote patient monitoring,
where we're able to, uh, track in real time, uh, patients, uh,
physiological data and be able to respond with early interventions if,
if needed, and,
and to try to keep those patients outta the hospital and keep them at home
where, where they wanna be. So we're, um, you know,
we're a little bit further along and I think we're very well set up, um,
you know, as an organization across this geography to,
to really take care o of a very large population, um, that, uh,
very much wants to be, uh, kept outta the hospital and kept healthy and well, I.
Love that. I think that makes so much sense. And,
and certainly it's helpful to understand the investment that it takes,
not only on the infrastructure side, but also, um,
within the culture and the teams that you're working with,
and then your partners across the line, whether it's the vendors or the payers,
uh, to really get yourself set up and ready to go, um,
with the value-based care. And in the aco. Two, from your perspective,
when you're having these conversations with especially payers,
have they changed much over the last few years? Is there additional urgency,
I guess, around them now, or has it really been a continued, uh,
kind of evolution o of where these value-based contracts could go?
I mean, I think, uh, there's definitely an increasing willingness on,
on both sides of the equation to come to the table and align around common
objectives. And I think certainly the payers wanna move in that direction and,
and we as a health system, as I mentioned,
believe that it's the right thing to do. Um, it, it usually is just about,
you know, how do we, uh, you know, find a sort of a common platform to,
to work on these strategies and these initiatives together. Uh, you know,
are there ways to jointly collaborate or potentially even jointly venture, uh,
with our payer partners, uh, in, um, uh, you know,
making capital infrastructure investments so that we can mutually be successful.
Um, and, uh, you know, I think moving a little bit away from the traditional,
uh, you know, payer provider negotiation, uh, um, you know,
uh, discussions to more of a collaborative and, and, um, you know,
jointly aligned, um, discussion that, uh, serves a broader purpose.
And I'm seeing a lot more, uh, certainly a willingness on,
on the health systems part,
but also payers to really come together and strategize, uh,
for what makes the most sense for our communities. And that's really refreshing.
Absolutely. I love that. Thank you so much for sharing. Now,
before we wrap up our conversation, I was wondering,
could you talk through the best opportunities that you're seeing for growth and
development in the future?
Yeah, I mean, we're constantly thinking about how we grow our footprint and,
and reach more lives and, and create a, a, a broader impact across the region.
Um, you know, we believe, uh, you know,
making continued critical investments in ambulatory infrastructure and
ambulatory services is certainly the way to go.
And that's something that we're very interested in. Uh, you know,
we're looking at, uh, adjacent communities and, um, trying to identify,
uh, areas where we might be seeing out migration or leakage, uh, out of the,
outta the area. And, and, uh, you know, considering key investments to, uh,
provide primary care and specialty care services and other ancillary, uh,
support, uh, services that, uh,
would be meaningful and beneficial to the community,
and always sort of evaluating that opportunity. Uh, we believe, um,
you know, making critical investments in the digital, uh,
space is gonna be very important to ensure that we're not only reaching, uh,
people across our region,
but that we're potentially even penetrating broader markets. Uh, you know,
with the advent of telehealth, uh, we can, uh, we can reach, uh,
patients all over the country and we think that that is a exciting growth
opportunity for the organization as well, that we continue to explore. Uh,
we're always looking at, uh, how we partner with other employers, uh,
across the region and creating those connections.
And certainly as we continue to evolve, um,
the infrastructure that I mentioned around our population and, and value-based,
um, health initiatives, uh, continuing to make those investments and,
and broadening our value-based risk contracts, um, will ultimately create,
uh, you know, uh,
a longer term growth for the organization that we're very excited about. So, uh,
without divulging too much information, we have a lot going on,
and we're very excited about the future here at Bassett.
Absolutely. Fantastic. Well, it sounds like you know,
a future is definitely bright there at Bassett, and,
and looking forward to catching up with you, um,
down the road here and just seeing how this has all played out. So Tommy,
thank you so much for joining us on the podcast today.
This has been a really fun and insightful conversation,
and I look forward to connecting with you again soon.
I'm honored to have been on. Thank you so much, Lori.
It's so important for leaders at the top of organizations to keep learning,
stay sharp, grow their networks,
help our audience better do this in a more simplified, personalized,
and meaningful way. Becker's Healthcare has launched my bhc,
it's your trusted Becker's healthcare experience and more with content,
connections, events and learning opportunities.
Join the community free of charge@www.my dot becker's hospital
review.com and we'll see you there.