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.
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.
This is Laura Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
Tiffany Love, associate vice president of nursing at
Greater Lawrence Family Health Center in Lawrence, Massachusetts.
Tiffany is a pleasure to end the podcast
today. Oh, thank you for having me. Absolutely.
Now I'm excited for our conversation because I
know health centers are such an important part
of the broader health care ecosystem. And, you
know, it's really important that,
you are able to, you know, provide a
great service to communities and continue to, grow
and expand. And so I'm looking forward to
our conversation. But before we dig in, can
you tell us a little bit more about
yourself, your background, as well as Greater Lawrence
Family Health Center?
Yes. So I actually have two main roles.
Number one, as the associate vice president for
the, of nursing for the Greater Lawrence Family
Health Center, which is the second largest federally
qualified health center in Massachusetts.
And our catchment area is actually Massachusetts
and New Hampshire.
And what many people probably would not know
is that 80% of the people we serve
are Latinx background.
So we're talking about a a very large,
immigrant population,
predominantly
Spanish speaking.
And then my second role is the founder
and CEO of the Love Leadership Foundation where
I provide career coaching for health care executives
internationally.
So those are my two labors of love,
and I'm just so happy to have the
chance to talk to you about them today.
Well, that's fantastic. You know? What a,
great position to be in, especially being able
to train leaders in the health care space
across the spectrum. I think, you know, having
those connections and being able to shape the
future,
will be really beneficial moving forward. Now,
I'm curious, you know, first and foremost,
when you talk about your role, with the
Greater Lawrence Health Center,
what is the most important initiative you led
last year? What did you do, or what
were the results?
So I can tell you, as someone who
has
received health care in Massachusetts for many years,
because I've worked at all over New England,
and I always have had doctors in Massachusetts.
I will tell you,
now actually physically being in Massachusetts
and serving this population,
there is an emerging primary care crisis.
We literally
do not have enough primary care providers
to care for the patients that need to
be seen.
So according to the Association
of Medical Colleges,
by the year 2034,
there will be a 48,000
primary care physician
shortage.
Now that might sound like a small number,
but I can tell you for my health
care center
specifically,
we have about 2,000
unassigned
patients.
So what does this mean? Now when I
lived in Vermont,
lived in Maine, I could come see doctors
in Massachusetts no problem. But when you are
physically in Massachusetts,
you are required to have a primary care
provider
for any care,
any referrals
that you need.
And so when you have such a large
number of patients that are unassigned to a
primary care provider,
these are people
who are forced to seek their health care
through
emergency
room, urgent care visits, things that should be
going
to a primary care provider.
So with that
being in mind,
for my health care center,
I have been very focused on,
number one,
triaging the people who are trying
their best to get into the health system
coming through acute care, urgent care means,
and
using evidence based triage tools to say,
is this really urgent? Is this nonurgent?
Can this person potentially be seen by a
nurse?
Can this person potentially be seen
in telehealth?
And so really just
focusing
on creating
access
for our patients.
And when it comes to access to primary
care,
there are
approximately
a 100,000,000
Americans who are lacking
a primary care provider, and this is especially
high in rural health care. So you can
imagine Massachusetts
is not rural,
but this is definitely
a problem that we face every day. And
that's on top of workforce shortages, not just
for our primary care providers,
but also for nurses.
And then you have the lack of insurance.
You have the threat
of potentially losing
insurance for the people who are on Medicaid.
So, really,
for a federally qualified health center
that has a mission to focus on health
equity
and serving the underserved people.
It's a really big crisis for us, so
that's where my focus has been. And I'm
proud to say that we have expanded access
to
care by
being more thoughtful about who is getting that
urgent care need versus who can be seen
in a telehealth clinic. That
makes a lot of sense, and it's really
helpful to understand. I think that context you
provided, especially
on primary care and the situation you have
in Massachusetts,
but then looking at, you know, how you're
able to,
see some of the charges going down the
pipe and charges, especially in primary care is
really critical.
So from your perspective, when you talk about,
expanding access and,
providing more digital opportunities, telehealth, and those kinds
of things, what does it take to stand
up a program like that?
Oh my gosh. Well, number one, technology. Right?
Because when you think about it, I just
said that we have a large immigrant population.
So
do they have
a video the opportunity or the ability
to use a video conference calling, or can
they only speak to you over the phone?
Because we know that Medicare no longer will
reimburse for if it's only a telephone visit.
It has to be a video
telephone visit for it to actually count towards
reimbursement.
So just really making sure that our patients
actually have the technology.
Do they have Internet?
And that's especially a problem having worked in
rural health care.
Sometimes you literally don't have the infrastructure
within the state where people get good
Internet access. So imagine trying to have a
call with your provider,
but you actually don't have a good Internet
connection.
So and and I have worked with the
Department of Veterans Affairs for more than eight
years where we would actually put the technology
in the patient's home.
For patients that
need chronic disease management,
we would actually
give them equipment to keep in their home
so that when they needed to have an
interaction with a provider,
we would be able to connect with them
directly with the equipment that we provided for
them.
And I think a lot of systems just
really haven't gotten that advanced where
if the patient doesn't have the equipment that's
required,
that we supply it for them. And so,
hopefully,
in the future,
we will think about that as we're trying
to expand telehealth and expand access to care,
especially for people in rural rural America.
That makes a lot of sense. You know,
it it sounds like a, important solution especially
to make sure they have access to that
type of technology. Now looking ahead, what are
some of the big priorities and kind of
ones you're focused on for 2026?
So for me, working in a federally qualified
health center, and I know a lot of
safety net hospitals are probably focused on this
as well, There are two major threats for
us. So the first is the threat of
the cut to Medicaid.
With the recent legislation with the one big
beautiful bill,
we are expecting that there are gonna be
about a trillion dollars in Medicaid cuts.
And so for
a federally qualified health center that relies heavily
on Medicaid,
that relies heavily on grant funding,
if these cuts come to fruition,
there are a lot of patients
who are suddenly gonna be uninsured.
And
suddenly, we will be in a position where
we're trying to provide care for people who
absolutely cannot pay for it. This is the
same position with most
safety net hospitals as well who heavily depend
on Medicaid, rural health care as well. And
so you have to think about how destabilizing
this can be to these health care systems.
Not only that, but think about the impact
that it's gonna have on private
insurance
and our our
as a organization,
trying to get that highest level reimbursement
from the sources that we can be reimbursed
for,
but also thinking about the people
who may simply give up and not seek
care.
So Medicare Medicaid cuts are one threat.
And then the second threat that a lot
of people might not be thinking of
is the threat of the loss of the
current three forty b program.
The three forty b program
is a program where a lot of organizations
are receive they're able to buy
their medications at a discounted rate.
And so for a community health center like
ours, that is hugely
important because a lot of our patients meet
the criteria to get those three forty b
meds.
And here's the thing.
Being the second largest
health center in federally qualified health center in
Massachusetts,
for us,
if we were to lose this program,
it would equate to millions,
many millions of dollars. So just imagine
larger safety net hospitals,
larger health systems,
and it really
creates a situation where
the vulnerable populations
might not be able to get services.
Those services might be cut.
And so
the proposal,
as I understand it, is that they might
change their program
where we pay for the medications upfront,
and then they reimburse us the discount.
Again, that would be millions of dollars
that we would be paying upfront
that we haven't historically
had to pay for.
So think about the higher cost drugs that
we might not be able to provide anymore
and just the financial strain that it's gonna
put on organizations.
And for some
organizations,
this might be
enough of a financial impact
that at least them to close their doors.
Between these two threats,
it literally could lead to
health core health care organizations
closing because they simply cannot overcome
the financial strain
of these two
new changes.
Absolutely. That, you know, is huge and definitely,
a sobering future when you think about those
programs, those cuts to Medicaid and, three forty
b and other funding programs that are really
critical to FUHCs
and other hospitals and systems and safety net
hospitals,
across the country. And so,
you know, that is definitely a a huge,
challenge. And, you know, when you think about
all of these things that are potentially coming
down the pipe, how do you prepare for
them, while also, you know, keeping yourself and
your teams focused on continuing to deliver care
to patients
today? Well,
so I will tell you that, number one,
because our organization
heavily relies on grant funding, we're trying to
take advantage
of the grant funding that is there. There
have already been cuts that we have seen,
but we're trying to do our best to
take advantage of what is still currently there.
And it's almost impossible
to prepare
for
if there's gonna be Medicaid cuts? Like, how
do you prepare for that? It's really
challenging because there really aren't
any other funding sources unless you look to
philanthropy
and, you know, big donors that are willing
to provide that support for our underserved communities,
which is usually not the case. I mean,
usually, philanthropy, you think about
big donors wanting their name on a new
building or something glamorous. And, really, the work
that we do isn't glamorous. We're just
serving the underserved people.
And so for us,
I would say the biggest challenge is going
to be
if those cuts come to fruition,
do we need to cut services? How are
we going to remain financially
stable?
How are we going to manage the wait
list that are increasing,
especially for people
who cannot afford to pay for the services.
Because we still have to pay for the
doctors. We have to pay for the nurses.
And so that's when organizations
start to think about, do we need to
cut services?
Do we need to
just try and
provide the care for the people that we
can?
Got it. That makes a lot of sense,
you know, and and is a helpful context
to dig a little bit deeper there. Thank
you.
What do you think the hardest thing you'll
have to do in the coming year will
be?
I would say,
number one, caring for the people who are
just not coming into the health care system
because they know they can't they can't pay
for it.
And then when they do come in,
they're very, very sick.
And I can tell you,
even though
I work at a federally qualified health center,
people walk in having strokes, having heart attacks
almost every day.
And so
how how can we reach out to this
community?
What are what other
financial resources can we tap into
to make sure that people literally
aren't
dying because they can't afford health care.
And so I would say the coming year,
really
trying to figure out how to recover if
they do cut Medicaid,
trying to figure out how we do provide
medications
for those who might be cut off from
three forty b. I have to say our
organization
is really awesome when it comes to fundraising
so that we can for those people who
cannot cover the cost of their medications or
other medical needs,
we do have a fund that
our employees actually contribute heavily to
where we provide money so that we can
hopefully
help out those people who just don't have
the means.
So I would say, you know, just
trying to reach out and help as many
people as we can is really gonna be
the hardest thing in the coming year.
Got it. Well, that's incredible. And we definitely
have a bad service oriented mindset,
to the team and and, you know, having
so many resources focused on ensuring people have
the care they need is,
incredible.
And and can I add before we move
on, can I add that I didn't even
mention the rising cost
of care of all of the services that
we use every day? All the costs are
increasing.
And we also have that that
staffing
that the shortage of staffing. You know?
Maybe more people to go to school to
be a nurse, maybe more people to go
to school to be a medical assistant.
And,
the shortage that I mentioned earlier about primary
care providers,
especially now that,
we know that if you go to school
to be a nurse practitioner,
you're not necessarily gonna get the financial support
that you have in the past.
Got it. That's helpful to know and, you
know, definitely a huge, huge challenge to overcome
for health care providers and, you know, especially
those trying to get into the profession. So
I know,
you know, you with your background, and leadership
and in coaching,
to you know, what do you say to,
young professionals who are trying to get into
the physicians or nurses or a clinician,
any way, shape, or form,
within the health care space today trying to
build a career and and be a leader
within those space. What is your advice for
them, and how do you,
position them to be a leader and champion
of change?
Mhmm.
So a lot of people who get into
health care leadership start out as clinicians. We
have our nonclinical folks that have the MHA
and the MBA, but we also have a
large number of people who go from being
a clinician
to being an administrator.
And so for both,
my advice is diversify your skill set. Make
sure that you have
advanced degrees, especially
when you're living in large cities because it's
very competitive.
Make sure that you get those certifications
in lean management,
as a health care executive,
project management,
things that will help you stand out, things
that will make you an asset to an
organization,
especially
now
with leaders having to constantly
be dealing with change management.
You have to be very agile.
So making sure that every single year, you
are investing in your education
and your skills
to
be,
that leader can that can deal with adaptive
leadership changes. Because
we would like to think that problems have
a straightforward answer,
but a lot of times,
especially
in today's health care organizations,
there's not always a straightforward
solution
to the problem. So you have to be
very creative.
You have to make sure you're using evidence
based leadership skills.
And so I would say at every opportunity,
please
invest
in your skill set and making sure that
every year you're learning something new.
And I will say,
I'm on the Harvard Business Review Advisory Council,
and,
we just had
our voting on the top four
HBR articles of the year.
And every single article
had something to do with artificial
intelligence.
So as health care leaders,
you cannot avoid it. You cannot run from
it. Embrace it. Learn it. Learn how to
use it.
AI is everywhere,
and we need to use it to our
benefit.
I love that. Thank you so much, Tiffany,
for joining us on the podcast today. I
think just before we wrap up here, we've
talked a lot about some of the different
challenges,
upcoming and, you know, ways that you're navigating
around it. But, you know, where do you
see some of the actual opportunities for organizational
growth in the future as well?
Yeah. So,
you know, I will say that
I have been in the private sector since
2018,
and one of the things that I think
we don't do well enough is telehealth.
I think that now that we know that
it can be fully reimbursed,
we really need to
expand
our growth in telehealth.
And, honestly,
I would I would challenge our country
to not
restrict telehealth to state lines.
I would encourage because health care is health
care. Health care in Massachusetts
should not be different from Vermont, should not
be different from Maine.
So why cannot
we,
have telehealth
a telehealth provider
in Maine
taking care of someone in Massachusetts
or vice versa?
Thinking about the shortage in primary care providers
and behavioral health providers,
couldn't we potentially
expand
access to care
if we allow telehealth across state lines? So
I see that as a huge opportunity,
and I would I would love to have
the discussion further at the federal level.
Absolutely. I think you and many others,
that that is absolutely makes a lot of
sense and, you know, would be great to
hopefully see some more movement, on policy in
that in that direction. So,
Tiffany, thank you again for your time today.
It's been a lot of fun speaking with
you and learning,
from you and your perspective at the FQHC,
and I look forward to connecting with you
again soon. And I I know you'll be
speaking at our annual meeting upcoming in April,
so it'll be great to connect there in
person and catch up and and just continue
this conversation.
I'm looking forward to it, Laura. Thank you
so much. I'll see you in April.