1 00:00:02,240 --> 00:00:05,120 The most important health care decisions don't happen 2 00:00:05,120 --> 00:00:05,779 in isolation. 3 00:00:06,240 --> 00:00:08,179 They happen when leaders come together. 4 00:00:08,800 --> 00:00:11,519 Becker's sixteenth annual meeting brings together more than 5 00:00:11,519 --> 00:00:12,559 3,500 6 00:00:12,559 --> 00:00:15,525 hospital and health system executives this April in 7 00:00:15,525 --> 00:00:16,024 Chicago. 8 00:00:16,565 --> 00:00:18,664 With 800 speakers from Ascension, 9 00:00:18,964 --> 00:00:22,164 Cleveland Clinic, CommonSpirit and more, the conversations get 10 00:00:22,164 --> 00:00:24,964 real. Leaders will share how their scenario planning 11 00:00:24,964 --> 00:00:27,605 for policy shifts, breaking through value based care 12 00:00:27,605 --> 00:00:30,000 barriers, and building clinical teams that translate 13 00:00:46,454 --> 00:00:48,534 This is Laura Dirda with the Becker's Healthcare 14 00:00:48,534 --> 00:00:50,695 podcast. I'm thrilled today to be joined by 15 00:00:50,695 --> 00:00:51,914 doctor Soumya Viswanathan, 16 00:00:52,295 --> 00:00:54,854 who's a chief physician executive at BayCare Health 17 00:00:54,854 --> 00:00:56,854 System. Doctor Viswanathan, it's a pleasure to have 18 00:00:56,854 --> 00:00:58,155 you on the podcast today. 19 00:00:59,130 --> 00:01:01,450 Thank you so much for the invitation. Looking 20 00:01:01,450 --> 00:01:02,750 forward to a great discussion. 21 00:01:03,690 --> 00:01:06,569 Absolutely. Now I'm excited for our conversation because 22 00:01:06,569 --> 00:01:08,329 I know there's so much happening right now 23 00:01:08,329 --> 00:01:09,469 in health care, particularly. 24 00:01:10,090 --> 00:01:11,609 I'm excited to learn more about what you're 25 00:01:11,609 --> 00:01:13,530 doing at BayCare. I I know there's just 26 00:01:13,530 --> 00:01:15,615 such a unique community that you serve down 27 00:01:15,615 --> 00:01:17,215 there and a lot of innovation. You're in 28 00:01:17,215 --> 00:01:20,174 growth mode. So I'm gonna be excited to 29 00:01:20,174 --> 00:01:21,855 learn more about that. But before we dig 30 00:01:21,855 --> 00:01:22,975 in, can you tell us a little bit 31 00:01:22,975 --> 00:01:25,314 more about yourself and BayCare health system? 32 00:01:26,174 --> 00:01:26,674 Absolutely. 33 00:01:27,290 --> 00:01:30,349 I'm an internal medicine physician, and I spent, 34 00:01:31,129 --> 00:01:33,450 the bulk of my career in Northeast. I 35 00:01:33,450 --> 00:01:34,510 was in Massachusetts. 36 00:01:35,290 --> 00:01:37,689 I was clinical for the longest period of 37 00:01:37,689 --> 00:01:39,369 time, and then I did a whole bunch 38 00:01:39,369 --> 00:01:40,509 of leadership roles. 39 00:01:41,375 --> 00:01:44,415 I was with various health systems, including UMass 40 00:01:44,415 --> 00:01:44,915 and 41 00:01:46,255 --> 00:01:47,954 the Partners Healthcare System. 42 00:01:48,495 --> 00:01:50,734 And then I was at Dartmouth Hitchcock, spent 43 00:01:50,734 --> 00:01:53,375 some time with the for profit world with 44 00:01:53,375 --> 00:01:54,269 Tenet Health 45 00:01:54,750 --> 00:01:57,310 before I landed in BayCare health system, and 46 00:01:57,310 --> 00:01:59,250 I've been here a little over three years. 47 00:01:59,629 --> 00:02:01,569 It's been a wonderful journey at BayCare. 48 00:02:02,030 --> 00:02:03,329 We are located 49 00:02:03,709 --> 00:02:06,429 on the Gulf Coast and on the West 50 00:02:06,429 --> 00:02:07,409 Coast Of Florida. 51 00:02:08,085 --> 00:02:10,165 We are the largest health system in West 52 00:02:10,165 --> 00:02:12,264 Central Florida with 16 hospitals. 53 00:02:13,525 --> 00:02:14,985 We are building our seventeenth. 54 00:02:15,525 --> 00:02:17,125 We have 34,000 55 00:02:17,125 --> 00:02:17,625 employees 56 00:02:17,925 --> 00:02:19,685 and more than 6,000 57 00:02:19,685 --> 00:02:20,185 physicians 58 00:02:20,849 --> 00:02:23,250 who are deeply engaged in some form of 59 00:02:23,250 --> 00:02:25,750 relationship with us or the other, including employment 60 00:02:25,969 --> 00:02:28,710 and clinically integrated network, ACO, etcetera. 61 00:02:29,569 --> 00:02:30,389 We provide 62 00:02:31,250 --> 00:02:32,550 all kinds of services 63 00:02:33,064 --> 00:02:35,625 as an integrated health delivery model. So it's 64 00:02:35,625 --> 00:02:36,685 end to end services, 65 00:02:37,465 --> 00:02:37,965 hospitals, 66 00:02:38,425 --> 00:02:41,724 ambulatory footprint, including ambulatory surgery center. 67 00:02:42,104 --> 00:02:44,685 We have urgent care clinics. We have multiple 68 00:02:44,905 --> 00:02:47,865 specialty clinics, including multi specialty and primary care 69 00:02:47,865 --> 00:02:48,365 clinics. 70 00:02:49,020 --> 00:02:51,900 We have imaging centers. We also have virtual 71 00:02:51,900 --> 00:02:52,400 care. 72 00:02:53,340 --> 00:02:54,959 We provide telehealth services. 73 00:02:55,419 --> 00:02:57,979 We also have our own health plan. It's 74 00:02:57,979 --> 00:02:59,599 a small health plan, but 75 00:03:00,300 --> 00:03:02,400 this is where, you know, this whole spectrum 76 00:03:02,459 --> 00:03:04,525 of value based care comes into play. We 77 00:03:04,525 --> 00:03:06,844 kind of provide all kinds of services within 78 00:03:06,844 --> 00:03:07,745 our own system, 79 00:03:08,364 --> 00:03:08,864 and 80 00:03:09,164 --> 00:03:11,344 we are also an academic medical center. 81 00:03:14,844 --> 00:03:17,644 Absolutely. Wow. That is an incredible amount of, 82 00:03:17,965 --> 00:03:20,379 services that you provide in ways that you 83 00:03:20,379 --> 00:03:23,419 are integrating within the community to continue to 84 00:03:23,419 --> 00:03:26,060 boost the health and access to care. Now 85 00:03:26,060 --> 00:03:27,580 I'm curious. When you think back in the 86 00:03:27,580 --> 00:03:29,180 last year or so, what was the most 87 00:03:29,180 --> 00:03:31,099 important initiative that you led? What did you 88 00:03:31,099 --> 00:03:32,319 do and what were the results? 89 00:03:33,525 --> 00:03:36,085 So academics, I would say in one word, 90 00:03:36,085 --> 00:03:38,564 was the biggest initiative that I have led 91 00:03:38,564 --> 00:03:40,885 since I've landed here. I'll share a little 92 00:03:40,885 --> 00:03:42,425 bit of the historical perspective. 93 00:03:43,125 --> 00:03:45,284 BayCare as a health system came together as 94 00:03:45,284 --> 00:03:48,460 a group of community hospitals that decided they 95 00:03:48,460 --> 00:03:50,159 were going to become a health system 96 00:03:50,540 --> 00:03:52,800 and an integrated health delivery model. 97 00:03:53,260 --> 00:03:55,020 At that time, we were not heavy into 98 00:03:55,020 --> 00:03:56,960 academics. When I came here, 99 00:03:57,500 --> 00:04:00,560 we did not have a robust GME program. 100 00:04:00,895 --> 00:04:04,254 We had, two very small residency programs in 101 00:04:04,254 --> 00:04:05,555 pediatrics and psychiatry 102 00:04:06,094 --> 00:04:08,974 with no plans whatsoever to enhance or expand 103 00:04:08,974 --> 00:04:12,014 that. And we also had leadership change at 104 00:04:12,014 --> 00:04:14,094 the same time where new leadership came on 105 00:04:14,094 --> 00:04:15,694 board. Around the same time that I came 106 00:04:15,694 --> 00:04:17,519 is when we had Stephanie Connors, who joined 107 00:04:17,519 --> 00:04:18,899 us as CEO of BayCare. 108 00:04:20,079 --> 00:04:22,579 So both of us coming from academic backgrounds 109 00:04:22,639 --> 00:04:23,540 in our past, 110 00:04:24,160 --> 00:04:26,160 we said, hey, you know what? For us 111 00:04:26,160 --> 00:04:28,579 to really address the physician shortages 112 00:04:28,959 --> 00:04:31,154 as we move forward into the next decade, 113 00:04:31,774 --> 00:04:33,615 we have to look at why can't we 114 00:04:33,615 --> 00:04:37,454 provide academia here. Because we have all of 115 00:04:37,454 --> 00:04:38,115 the necessary 116 00:04:39,854 --> 00:04:42,735 aspects of what goes into an academic medical 117 00:04:42,735 --> 00:04:43,740 center in day care. 118 00:04:44,220 --> 00:04:46,779 We have the infrastructure that's needed, so we 119 00:04:46,779 --> 00:04:47,919 should become an AMC. 120 00:04:48,459 --> 00:04:50,060 And so we went down the path of 121 00:04:50,060 --> 00:04:51,599 starting up GME programs. 122 00:04:52,539 --> 00:04:53,839 We have significant, 123 00:04:55,899 --> 00:04:58,300 we have made significant headway in our GME 124 00:04:58,300 --> 00:05:00,925 program. We went from the two small programs 125 00:05:00,925 --> 00:05:04,144 of 20 resident, 29 residents total 126 00:05:04,925 --> 00:05:08,524 to our plans now of having almost 650 127 00:05:08,524 --> 00:05:10,944 residents graduating by 2029. 128 00:05:11,699 --> 00:05:14,979 That's a robust and very aggressive goal, but 129 00:05:14,979 --> 00:05:18,019 we are steadily moving forward. We have gone 130 00:05:18,019 --> 00:05:20,120 from the two small programs, as I mentioned, 131 00:05:20,180 --> 00:05:21,079 to establishing 132 00:05:21,539 --> 00:05:23,160 16 programs currently. 133 00:05:23,779 --> 00:05:26,180 We already have 300 residents who are with 134 00:05:26,180 --> 00:05:26,919 us today. 135 00:05:27,404 --> 00:05:28,845 In a span of two and a half 136 00:05:28,845 --> 00:05:30,764 years, we have done we have made that 137 00:05:30,764 --> 00:05:31,745 achieve achievement, 138 00:05:32,524 --> 00:05:34,605 and we are not looking back. We are 139 00:05:34,605 --> 00:05:36,944 gonna continue to enhance the GME program. 140 00:05:37,964 --> 00:05:41,645 And in our attempt to really become an 141 00:05:41,645 --> 00:05:42,145 AMC, 142 00:05:42,990 --> 00:05:45,250 our biggest achievement was definitely 143 00:05:45,550 --> 00:05:47,009 our collaboration with Northwestern, 144 00:05:48,509 --> 00:05:49,410 up in Chicago. 145 00:05:49,790 --> 00:05:51,230 So you must have read in all of 146 00:05:51,230 --> 00:05:53,310 the news articles and the press releases that 147 00:05:53,310 --> 00:05:55,089 Northwestern collaboration with BayCare 148 00:05:55,710 --> 00:05:58,129 has been a significant milestone for us. 149 00:05:58,454 --> 00:06:00,615 Super excited about all of the work that 150 00:06:00,615 --> 00:06:01,915 we'll be doing with Northwestern, 151 00:06:02,774 --> 00:06:05,194 including research endeavors, including 152 00:06:06,134 --> 00:06:09,254 faculty development programs, and really enhancing the academic 153 00:06:09,254 --> 00:06:10,634 footprint in Florida. 154 00:06:13,319 --> 00:06:15,160 That's amazing to hear. And, you know, what 155 00:06:15,160 --> 00:06:16,680 a a great foresight in order to be 156 00:06:16,680 --> 00:06:19,100 able to start an academic program and and 157 00:06:19,319 --> 00:06:21,800 have those seeds planted and foundations built for 158 00:06:21,800 --> 00:06:23,399 growth. I think, as you mentioned, it is 159 00:06:23,399 --> 00:06:25,879 an aggressive goal going from the the two 160 00:06:25,879 --> 00:06:29,264 initial programs and 29 residents to having 650 161 00:06:29,264 --> 00:06:30,305 by 2029, 162 00:06:30,305 --> 00:06:32,305 but I can imagine you've got a great 163 00:06:32,305 --> 00:06:34,625 plan plan to get there. What types of 164 00:06:34,625 --> 00:06:37,105 resources do you need and expertise is important 165 00:06:37,105 --> 00:06:39,345 when you're setting up an academic program and 166 00:06:39,345 --> 00:06:41,585 trying to transform a community system into an 167 00:06:41,585 --> 00:06:42,564 academic system? 168 00:06:43,560 --> 00:06:46,519 So the definitely, the two aspects are the 169 00:06:46,519 --> 00:06:47,819 teaching or the educational 170 00:06:48,279 --> 00:06:48,779 environment 171 00:06:49,319 --> 00:06:51,740 as well as research facilities. So 172 00:06:52,199 --> 00:06:54,360 we were doing some amount of research. I'll 173 00:06:54,360 --> 00:06:56,279 start with research. We were doing some level 174 00:06:56,279 --> 00:06:59,295 of research mostly by community grants, but we 175 00:06:59,295 --> 00:07:00,274 were not like 176 00:07:00,574 --> 00:07:02,975 the, you know, the big AMCs up north 177 00:07:02,975 --> 00:07:05,214 where there's a lot of NIH funding, a 178 00:07:05,214 --> 00:07:07,134 lot of NSF funding. It was a lot 179 00:07:07,134 --> 00:07:09,714 of community focused grants and state grants. 180 00:07:10,095 --> 00:07:12,740 So our goal was to really in enhance 181 00:07:12,740 --> 00:07:15,400 the environment in which research is being done 182 00:07:15,540 --> 00:07:18,180 so that we are fostering the different aspects 183 00:07:18,180 --> 00:07:19,319 of research, including 184 00:07:19,860 --> 00:07:22,120 we were doing sponsored research, for example. 185 00:07:22,500 --> 00:07:24,580 We need to do something which is day 186 00:07:24,580 --> 00:07:26,040 care original research, 187 00:07:26,375 --> 00:07:28,134 And we hadn't been doing that. So we'll 188 00:07:28,134 --> 00:07:31,095 be focusing heavily on how do we start 189 00:07:31,095 --> 00:07:34,134 up clinical trials. And this Northwestern collaboration is 190 00:07:34,134 --> 00:07:35,975 gonna help us with that because it helps 191 00:07:35,975 --> 00:07:38,455 us think differently in terms of, can we 192 00:07:38,455 --> 00:07:40,455 have a multicenter trial if there is, like, 193 00:07:40,455 --> 00:07:41,115 a cardiac 194 00:07:42,160 --> 00:07:44,639 procedure that we are doing differently or a 195 00:07:44,639 --> 00:07:45,539 new innovative 196 00:07:46,319 --> 00:07:48,339 method of doing an electrophysiology 197 00:07:48,800 --> 00:07:50,259 or EP study, etcetera. 198 00:07:50,800 --> 00:07:53,199 So that is the aspect of research that 199 00:07:53,199 --> 00:07:55,680 we are gonna enhance while we continue to 200 00:07:55,680 --> 00:07:57,495 gain from the community grants. 201 00:07:58,055 --> 00:07:59,595 The second piece is 202 00:08:00,055 --> 00:08:00,555 teaching. 203 00:08:01,735 --> 00:08:04,214 We had been dabbling a little bit in 204 00:08:04,214 --> 00:08:05,834 teaching because we used to get 205 00:08:06,375 --> 00:08:09,495 APPs like the physician assistant and the RN 206 00:08:09,495 --> 00:08:11,574 nursing students who used to come over from 207 00:08:11,574 --> 00:08:12,555 the local universities. 208 00:08:13,039 --> 00:08:15,600 We also had residents and students coming over 209 00:08:15,600 --> 00:08:17,939 from our local partners here, 210 00:08:18,560 --> 00:08:22,099 USF and Florida State University, University of Florida. 211 00:08:22,160 --> 00:08:24,899 We have engaged deeply with USF and FSU. 212 00:08:25,759 --> 00:08:26,240 And, 213 00:08:26,914 --> 00:08:29,475 we just needed to increase the amount of 214 00:08:29,475 --> 00:08:31,475 teaching that we are doing. And what was 215 00:08:31,475 --> 00:08:34,274 beautiful to see is there was significant appetite 216 00:08:34,274 --> 00:08:36,034 in the physicians to really go in that 217 00:08:36,034 --> 00:08:36,534 direction. 218 00:08:36,914 --> 00:08:39,075 Our physicians felt, well, we have so much 219 00:08:39,075 --> 00:08:39,975 talent here. 220 00:08:40,355 --> 00:08:41,095 We are 221 00:08:41,470 --> 00:08:43,470 some of the best in class with high 222 00:08:43,470 --> 00:08:46,289 quality care. We provide clinically excellent care. 223 00:08:46,669 --> 00:08:49,330 How do we continue to nurture this environment 224 00:08:49,470 --> 00:08:51,809 where we groom the next generation of residents 225 00:08:52,190 --> 00:08:53,950 who will be taking care of us in 226 00:08:53,950 --> 00:08:54,929 the future? Because 227 00:08:55,495 --> 00:08:57,815 sixty eight percent of residents who graduate from 228 00:08:57,815 --> 00:08:58,715 GME programs 229 00:08:59,335 --> 00:09:01,495 stay in the area where they graduated from 230 00:09:01,495 --> 00:09:03,035 for at least three years after. 231 00:09:03,894 --> 00:09:05,035 If that's a statistic, 232 00:09:05,654 --> 00:09:08,695 then I will gain significantly from at least 233 00:09:08,695 --> 00:09:10,075 three quarters of the 234 00:09:10,600 --> 00:09:11,480 650 235 00:09:11,480 --> 00:09:14,220 residents graduating who will become physicians at BayCare. 236 00:09:14,279 --> 00:09:15,799 They'll be taking care of all of us 237 00:09:15,799 --> 00:09:17,879 as we get older. And that's what we 238 00:09:17,879 --> 00:09:20,440 want, is high quality residents coming from our 239 00:09:20,440 --> 00:09:23,054 own programs who our physicians have taught, and 240 00:09:23,054 --> 00:09:24,434 they will service the community. 241 00:09:24,815 --> 00:09:26,914 So we have pretty much the infrastructure. 242 00:09:27,774 --> 00:09:31,134 The system is also something that's important because 243 00:09:31,134 --> 00:09:32,514 the system was committed 244 00:09:32,894 --> 00:09:34,595 to making that kind of investment. 245 00:09:37,620 --> 00:09:39,539 That's great to hear. And and definitely it's 246 00:09:39,539 --> 00:09:42,120 so important to have that leadership and and 247 00:09:42,179 --> 00:09:44,980 the executive team committed to those types of 248 00:09:44,980 --> 00:09:47,539 transformations. I know Stephanie Connors is such a 249 00:09:47,539 --> 00:09:49,860 dynamic leader and so inspiring and and gets 250 00:09:49,860 --> 00:09:52,605 things done too. So that's incredible to to 251 00:09:52,605 --> 00:09:53,884 hear, and thank you for digging a little 252 00:09:53,884 --> 00:09:56,285 bit deeper there. Now looking ahead for 2026, 253 00:09:56,285 --> 00:09:57,805 what are some of your big priorities as 254 00:09:57,805 --> 00:09:59,345 well as headwinds that you're facing? 255 00:10:00,285 --> 00:10:02,465 Well, some of the priorities are definitely 256 00:10:02,845 --> 00:10:05,565 not different than many other health systems. It's 257 00:10:05,565 --> 00:10:07,264 basically moving care upstream. 258 00:10:07,700 --> 00:10:09,559 And I can share with you with, 259 00:10:10,100 --> 00:10:10,600 having 260 00:10:11,460 --> 00:10:12,980 looked at some of the other parts of 261 00:10:12,980 --> 00:10:13,639 the country, 262 00:10:14,100 --> 00:10:14,600 definitely 263 00:10:15,139 --> 00:10:17,779 Florida, Southern states, I think, especially Florida, has 264 00:10:17,779 --> 00:10:20,340 been a little bit late in moving forward 265 00:10:20,340 --> 00:10:21,639 with value based care. 266 00:10:22,095 --> 00:10:25,134 We have not had a lot of payment 267 00:10:25,134 --> 00:10:27,235 model shifts until recently. 268 00:10:27,695 --> 00:10:29,375 The payment models have been a little late 269 00:10:29,375 --> 00:10:31,475 other than the federal and the regulatory 270 00:10:31,934 --> 00:10:33,554 volatility that's going on, 271 00:10:34,095 --> 00:10:35,934 you know, which is also influencing some of 272 00:10:35,934 --> 00:10:37,235 the decisions we are making. 273 00:10:37,799 --> 00:10:41,100 But let's say the central, the CMS funded, 274 00:10:42,360 --> 00:10:44,600 grants that are coming our way, those we 275 00:10:44,600 --> 00:10:47,179 have already started moving in similar to others. 276 00:10:47,320 --> 00:10:49,960 But then it is a state payment model 277 00:10:49,960 --> 00:10:52,745 shift. We haven't really moved very aggressively in 278 00:10:52,745 --> 00:10:55,225 value based care. So my biggest priority will 279 00:10:55,225 --> 00:10:55,725 be 280 00:10:56,264 --> 00:10:58,764 to start moving physicians in that direction 281 00:10:59,225 --> 00:11:01,304 where we have traditionally done so much of 282 00:11:01,304 --> 00:11:03,669 fee for service type of model of care 283 00:11:03,669 --> 00:11:04,169 delivery. 284 00:11:04,790 --> 00:11:07,190 We now to start training, and we have 285 00:11:07,190 --> 00:11:09,269 been training, but we have to start enhancing 286 00:11:09,269 --> 00:11:09,929 the training 287 00:11:10,389 --> 00:11:12,710 of the physicians and the whole care team 288 00:11:12,710 --> 00:11:15,750 model to really deliver on, look at the 289 00:11:15,750 --> 00:11:17,669 total cost of care of patients. How do 290 00:11:17,669 --> 00:11:20,084 you look at utilization metrics? How do you 291 00:11:20,084 --> 00:11:22,745 continue to enhance quality while you're controlling 292 00:11:23,205 --> 00:11:26,004 the utilization of services? So that will be 293 00:11:26,004 --> 00:11:28,325 a big focus, truly moving us in value 294 00:11:28,325 --> 00:11:29,304 based care model. 295 00:11:29,684 --> 00:11:31,845 Now as we do this, I mentioned to 296 00:11:31,845 --> 00:11:34,504 you how BayCare is a 16 hospital system. 297 00:11:35,179 --> 00:11:36,720 We have large facilities 298 00:11:37,100 --> 00:11:40,299 that cannot have empty beds. We need heads 299 00:11:40,299 --> 00:11:42,779 in beds because that's the way we sustain 300 00:11:42,779 --> 00:11:44,879 our whole integrated health system. 301 00:11:45,500 --> 00:11:47,740 So for that to happen, as we move 302 00:11:47,740 --> 00:11:48,879 care into ambulatory, 303 00:11:49,554 --> 00:11:51,235 we need to ramp up the types of 304 00:11:51,235 --> 00:11:52,535 services in the hospitals. 305 00:11:53,075 --> 00:11:55,394 Right now, we provide a lot of primary 306 00:11:55,394 --> 00:11:57,955 and secondary level of care. We provide some 307 00:11:57,955 --> 00:11:58,934 tertiary care. 308 00:11:59,315 --> 00:12:01,075 Our goal for 2026 309 00:12:01,075 --> 00:12:03,475 is to move the entire health system forward 310 00:12:03,475 --> 00:12:05,970 to provide high end tertiary care 311 00:12:06,350 --> 00:12:08,509 as well as start working on quaternary care 312 00:12:08,509 --> 00:12:10,049 services, which is gonna be 313 00:12:10,509 --> 00:12:12,289 big amount, big ticket items, 314 00:12:12,829 --> 00:12:13,649 high acuity, 315 00:12:14,750 --> 00:12:15,570 severe cases, 316 00:12:15,950 --> 00:12:19,089 very complex cases, including looking at transplants. 317 00:12:19,654 --> 00:12:21,174 So that will be a big driver for 318 00:12:21,174 --> 00:12:22,634 us in 2026. 319 00:12:23,174 --> 00:12:25,174 The other big thing that we are working 320 00:12:25,174 --> 00:12:25,674 on 321 00:12:26,455 --> 00:12:29,495 is recruitment of specialties. As you know, private 322 00:12:29,495 --> 00:12:31,115 equity firms had 323 00:12:31,815 --> 00:12:34,134 nationally had looked at health care. They had 324 00:12:34,134 --> 00:12:35,039 invested in health 325 00:12:35,839 --> 00:12:37,600 care. But now as some of the PE 326 00:12:37,600 --> 00:12:40,399 firms are backing off from some of these 327 00:12:40,399 --> 00:12:40,899 specialties, 328 00:12:41,519 --> 00:12:44,799 we're struggling because these specialties are coming to 329 00:12:44,799 --> 00:12:47,360 us and saying, well, we're going under or 330 00:12:47,360 --> 00:12:49,220 we are going to be collapsing and 331 00:12:49,704 --> 00:12:51,384 we are no longer going to have a 332 00:12:51,384 --> 00:12:52,904 job. So we don't know whether we'll be 333 00:12:52,904 --> 00:12:53,644 in the area. 334 00:12:54,105 --> 00:12:55,964 It started last year with anesthesiology, 335 00:12:57,065 --> 00:12:58,524 where we had anesthesiologists 336 00:12:59,065 --> 00:13:01,544 in the market because we were contracted with 337 00:13:01,544 --> 00:13:03,485 them. They were not employed by us. 338 00:13:04,169 --> 00:13:06,009 They came to us and they said, well, 339 00:13:06,009 --> 00:13:07,129 we are not sure if they're going to 340 00:13:07,129 --> 00:13:08,889 stay in the state and we may have 341 00:13:08,889 --> 00:13:10,250 to move somewhere. We may have to go 342 00:13:10,250 --> 00:13:11,070 to an AMC. 343 00:13:11,610 --> 00:13:14,190 So we started looking at a nontraditional 344 00:13:14,970 --> 00:13:15,470 methodology 345 00:13:16,090 --> 00:13:16,830 of employing 346 00:13:17,634 --> 00:13:18,134 specialties, 347 00:13:18,754 --> 00:13:21,315 which usually are not employed unless you're an 348 00:13:21,315 --> 00:13:22,695 academic medical system. 349 00:13:23,235 --> 00:13:25,174 So anesthesia, for example, 350 00:13:25,554 --> 00:13:27,634 usually because they don't have their own panel 351 00:13:27,634 --> 00:13:30,034 of patients, many health systems don't employ them 352 00:13:30,034 --> 00:13:31,334 if they are not an AMC. 353 00:13:32,059 --> 00:13:33,659 So we have gone down the path since 354 00:13:33,659 --> 00:13:35,199 we're already becoming an AMC. 355 00:13:35,659 --> 00:13:37,419 We said, well, this is time for us 356 00:13:37,419 --> 00:13:39,339 to look at that specialty and say, we 357 00:13:39,339 --> 00:13:41,839 need to employ anesthesiologist. So that's a big 358 00:13:42,059 --> 00:13:43,980 headwind for us that we were able to 359 00:13:43,980 --> 00:13:47,034 walk into last year. We have done tremendous, 360 00:13:47,034 --> 00:13:49,774 had great progress in that and employing anesthesiology, 361 00:13:50,075 --> 00:13:50,575 and 362 00:13:51,034 --> 00:13:53,294 we're making a lot of headway there. 363 00:13:54,394 --> 00:13:55,774 The third aspect, 364 00:13:56,475 --> 00:13:57,294 is population. 365 00:13:58,379 --> 00:14:01,679 Population has grown tremendously in the Florida market. 366 00:14:02,700 --> 00:14:05,179 As you know, through COVID, many people who 367 00:14:05,179 --> 00:14:06,240 could work remotely, 368 00:14:06,940 --> 00:14:08,799 they migrated from 369 00:14:09,340 --> 00:14:11,835 the northern colder states and they came and 370 00:14:11,835 --> 00:14:13,855 settled down in the Southern states. 371 00:14:14,235 --> 00:14:16,634 So Tampa and Austin, Texas, I think, were 372 00:14:16,634 --> 00:14:18,495 the fastest growing cities in the country. 373 00:14:19,195 --> 00:14:21,695 That said, when the people moved down here, 374 00:14:22,409 --> 00:14:24,190 the types of generations, 375 00:14:24,730 --> 00:14:26,809 the types of people, the demographics of the 376 00:14:26,809 --> 00:14:29,549 people who came here were the younger generation. 377 00:14:30,329 --> 00:14:32,809 So what ended up happening is Florida being 378 00:14:32,809 --> 00:14:35,289 usually a state of, like, retirees, you know, 379 00:14:35,289 --> 00:14:36,589 it's a haven for retirees. 380 00:14:37,815 --> 00:14:40,695 Our health system was not prepared for the 381 00:14:40,695 --> 00:14:43,674 number of young people settling in Tampa market. 382 00:14:44,215 --> 00:14:47,894 So the whole this BayCare market is now 383 00:14:47,894 --> 00:14:48,394 having 384 00:14:49,095 --> 00:14:52,554 huge numbers of young population settling here. 385 00:14:52,910 --> 00:14:55,470 The need for those specialties has gone up, 386 00:14:55,470 --> 00:14:56,450 which is pediatrics 387 00:14:56,910 --> 00:14:57,730 for children 388 00:14:58,110 --> 00:15:00,290 and women's care, OB GYN, 389 00:15:00,750 --> 00:15:02,590 to take care of all the pregnancies and, 390 00:15:02,590 --> 00:15:04,269 you know, taking care of the women who 391 00:15:04,269 --> 00:15:05,330 are settling here. 392 00:15:05,654 --> 00:15:07,894 So these are some of the big priorities 393 00:15:07,894 --> 00:15:10,074 that we'll be working on from a population 394 00:15:10,134 --> 00:15:13,355 and specialty perspective, peds and women's care. 395 00:15:14,054 --> 00:15:16,615 Anesthesia is a specialty that we'll continue to 396 00:15:16,615 --> 00:15:17,355 work on. 397 00:15:18,009 --> 00:15:21,129 And just moving care upstream with payment models 398 00:15:21,129 --> 00:15:21,629 and 399 00:15:22,089 --> 00:15:24,509 enhancing tertiary care in the hospital while 400 00:15:24,809 --> 00:15:28,329 moving towards value based care aggressively in our 401 00:15:28,329 --> 00:15:29,470 outpatient centers. 402 00:15:33,375 --> 00:15:35,695 Okay. Wow. That's fascinating. That's a lot to 403 00:15:35,695 --> 00:15:37,375 to think about and a lot of transitions 404 00:15:37,375 --> 00:15:39,134 that are happening all at the same time, 405 00:15:39,134 --> 00:15:41,534 but also really, you know, fascinating to think 406 00:15:41,534 --> 00:15:43,774 about the the puzzle complexity of how you're 407 00:15:43,774 --> 00:15:46,595 running health care system, making these transformations into 408 00:15:46,730 --> 00:15:49,050 an academic center, and then really changing with 409 00:15:49,050 --> 00:15:52,029 how the market's changing, the economics, the demographics 410 00:15:52,250 --> 00:15:54,649 even of of what's coming into the Tampa 411 00:15:54,649 --> 00:15:57,129 market and and around in that region of 412 00:15:57,129 --> 00:15:59,149 Florida. So, that's fascinating. 413 00:15:59,644 --> 00:16:00,924 What do you think, out of all of 414 00:16:00,924 --> 00:16:02,524 these things, will be the hardest thing you 415 00:16:02,524 --> 00:16:03,825 have to do in the coming year? 416 00:16:05,085 --> 00:16:08,125 The hardest thing, probably the most work will 417 00:16:08,125 --> 00:16:10,705 be around the value based care movement, 418 00:16:12,284 --> 00:16:13,424 ramping up our 419 00:16:13,850 --> 00:16:16,590 physicians to understand total cost of care 420 00:16:17,050 --> 00:16:19,210 because we have to amplify what we are 421 00:16:19,210 --> 00:16:20,910 doing in the ambulatory setting. 422 00:16:21,290 --> 00:16:22,509 We need to enhance 423 00:16:23,050 --> 00:16:23,610 the work, 424 00:16:24,410 --> 00:16:25,930 not just the brick and mortar, but the 425 00:16:25,930 --> 00:16:29,625 availability of services in ambulatory care. So we 426 00:16:29,625 --> 00:16:31,544 need more virtual care. We need to be 427 00:16:31,544 --> 00:16:34,365 able to support more telehealth services, more technology 428 00:16:34,424 --> 00:16:35,085 and innovation 429 00:16:35,625 --> 00:16:37,884 so that the physicians feel they can offload 430 00:16:37,945 --> 00:16:40,044 to the ambulatory footprint for 431 00:16:40,504 --> 00:16:42,904 doing this value based care model. And, of 432 00:16:42,904 --> 00:16:43,965 course, enhancing 433 00:16:44,620 --> 00:16:46,700 the tertiary and quaternary care on the back 434 00:16:46,700 --> 00:16:48,960 end. Because if you don't do that, financially, 435 00:16:49,019 --> 00:16:49,679 the sustainability 436 00:16:49,980 --> 00:16:50,879 is not there. 437 00:16:51,340 --> 00:16:52,399 One of the 438 00:16:52,940 --> 00:16:55,100 aspects of this movement that we are doing 439 00:16:55,100 --> 00:16:56,080 to help physicians 440 00:16:56,460 --> 00:16:56,960 and 441 00:16:57,324 --> 00:16:59,504 prevent burnout of any cause is 442 00:16:59,964 --> 00:17:00,945 because physicians 443 00:17:01,404 --> 00:17:03,824 need to be available to provide that access. 444 00:17:04,444 --> 00:17:04,924 And, 445 00:17:06,125 --> 00:17:08,944 our health system has traditionally not 446 00:17:09,484 --> 00:17:11,644 done a lot of work with APP integration 447 00:17:11,644 --> 00:17:12,464 into practices. 448 00:17:13,220 --> 00:17:15,480 We are moving in that direction this year. 449 00:17:15,539 --> 00:17:18,519 There'll be heavy integration of allied health professionals 450 00:17:19,059 --> 00:17:19,799 and providers, 451 00:17:21,059 --> 00:17:24,259 who will be supporting both PAs and NPs, 452 00:17:24,259 --> 00:17:26,440 who will be supporting our physicians and practices, 453 00:17:26,820 --> 00:17:28,200 as well as in the hospitals. 454 00:17:28,845 --> 00:17:31,404 That is a big movement that I'm really 455 00:17:31,404 --> 00:17:33,644 looking forward to. It took a lot of 456 00:17:33,644 --> 00:17:36,765 education and continuous education of physicians to see 457 00:17:36,765 --> 00:17:38,944 how they can embrace APPs in the practices. 458 00:17:39,804 --> 00:17:41,565 So this is gonna be a beautiful journey 459 00:17:41,565 --> 00:17:43,549 as we build the teams to support that 460 00:17:43,549 --> 00:17:46,130 movement in value based care and improving access. 461 00:17:51,950 --> 00:17:54,029 That's helpful to understand. And I think, you 462 00:17:54,029 --> 00:17:55,994 know, it's so fascinating to see how you're 463 00:17:55,994 --> 00:17:57,835 looking at value based care and where some 464 00:17:57,835 --> 00:17:59,595 of the holes are. I think when you're 465 00:17:59,595 --> 00:18:01,275 looking at the clinical side as well as 466 00:18:01,275 --> 00:18:02,634 the financial side, I mean, there's a lot 467 00:18:02,634 --> 00:18:03,455 of big changes 468 00:18:03,835 --> 00:18:06,154 overall. But for the clinical team, for the 469 00:18:06,154 --> 00:18:08,669 physicians and nurses already on board, what types 470 00:18:08,669 --> 00:18:10,950 of things are are they having to adjust 471 00:18:10,950 --> 00:18:13,349 about the way they think about practices or 472 00:18:13,349 --> 00:18:14,649 their standards or protocols? 473 00:18:14,950 --> 00:18:17,509 How are they being affected by the transition 474 00:18:17,509 --> 00:18:19,029 of value based care, and what are you 475 00:18:19,029 --> 00:18:21,190 doing to make it as strict seamless as 476 00:18:21,190 --> 00:18:21,690 possible? 477 00:18:22,644 --> 00:18:24,825 Yeah. Absolutely. So we are, 478 00:18:26,005 --> 00:18:28,805 changing the model to support the value based 479 00:18:28,805 --> 00:18:31,625 care model. One is along team based care. 480 00:18:32,005 --> 00:18:35,339 So really looking at services, we have, for 481 00:18:35,339 --> 00:18:37,740 example, a value based care team that has 482 00:18:37,740 --> 00:18:39,680 a population health services division. 483 00:18:40,619 --> 00:18:44,079 The team of care coordinators, clinical pharmacists, quality 484 00:18:44,140 --> 00:18:47,039 folks, they all sit in one location. 485 00:18:47,855 --> 00:18:49,795 Now what we are looking at doing is 486 00:18:49,855 --> 00:18:52,894 enhancing and embedding them in the practices so 487 00:18:52,894 --> 00:18:54,835 they are there in real time for physicians 488 00:18:55,295 --> 00:18:57,215 so that they are part of the team 489 00:18:57,215 --> 00:18:59,934 that's providing that team based care. Because that's 490 00:18:59,934 --> 00:19:02,255 how you move towards value is when you're 491 00:19:02,255 --> 00:19:03,740 able to get the physician, 492 00:19:04,119 --> 00:19:07,079 get the patient, the physician, and their patients, 493 00:19:07,079 --> 00:19:09,079 caretakers all involved in the care of the 494 00:19:09,079 --> 00:19:09,579 patient, 495 00:19:09,960 --> 00:19:12,200 then you can reduce the readmission rate. You're 496 00:19:12,200 --> 00:19:14,200 able to better care for them in the 497 00:19:14,200 --> 00:19:15,019 home environment. 498 00:19:15,734 --> 00:19:18,055 We have also involved in hospital at home 499 00:19:18,055 --> 00:19:19,835 programs. So for all that to happen, 500 00:19:20,295 --> 00:19:22,295 we really need to enhance the services at 501 00:19:22,295 --> 00:19:24,555 the ground level, which is in the practices. 502 00:19:25,335 --> 00:19:27,335 The second thing that we are doing is 503 00:19:27,335 --> 00:19:29,835 a lot of work around AI innovation. 504 00:19:30,509 --> 00:19:32,670 I know AI and tech is like a 505 00:19:32,670 --> 00:19:35,869 big buzzword these days. We're actually looking at 506 00:19:35,869 --> 00:19:36,930 all of the practical 507 00:19:37,630 --> 00:19:38,130 implications 508 00:19:38,670 --> 00:19:39,170 of 509 00:19:39,789 --> 00:19:42,450 inputting these AI tools in our practices. 510 00:19:42,910 --> 00:19:44,690 If it's going to help the patient, 511 00:19:45,055 --> 00:19:47,214 if it's going to help with delivery models 512 00:19:47,214 --> 00:19:48,815 that's going to take care of the patient 513 00:19:48,815 --> 00:19:49,955 when they are at home, 514 00:19:50,335 --> 00:19:52,734 we are definitely evaluating all of those tools. 515 00:19:52,734 --> 00:19:55,474 And we have we have looked at multiple 516 00:19:55,615 --> 00:19:57,875 platforms that's going to help the patients 517 00:19:58,240 --> 00:20:00,740 with not just the patient navigation into practices, 518 00:20:01,200 --> 00:20:03,359 but taking care of them in their homes 519 00:20:03,359 --> 00:20:05,200 so that they are not heading back into 520 00:20:05,200 --> 00:20:07,619 the hospital and increasing the 521 00:20:07,960 --> 00:20:08,460 the 522 00:20:08,799 --> 00:20:09,460 the complexity 523 00:20:09,759 --> 00:20:13,125 of their problems by delaying care. So we 524 00:20:13,125 --> 00:20:15,705 really want them to have the best available 525 00:20:15,845 --> 00:20:16,345 services. 526 00:20:17,045 --> 00:20:18,184 Access is critical, 527 00:20:18,565 --> 00:20:20,984 whether in the form of physicians and APPs. 528 00:20:21,684 --> 00:20:23,545 Having access to the teams, 529 00:20:23,924 --> 00:20:25,924 so the value based care team will provide 530 00:20:25,924 --> 00:20:27,305 all of those support services. 531 00:20:27,820 --> 00:20:30,299 And with technology, we feel like we can 532 00:20:30,299 --> 00:20:32,640 improve the operational efficiency and effectiveness 533 00:20:32,940 --> 00:20:34,799 of the care that we are delivering. 534 00:20:35,660 --> 00:20:37,420 So a lot of great work that's going 535 00:20:37,420 --> 00:20:39,680 on in in this tremendous growth mode. 536 00:20:41,494 --> 00:20:43,654 Got it. That that's super helpful. Thank you 537 00:20:43,654 --> 00:20:45,335 so much for digging a bit deeper. Before 538 00:20:45,335 --> 00:20:46,934 we wrap up, I wanna talk about growth 539 00:20:46,934 --> 00:20:48,454 as well. Where do you see some of 540 00:20:48,454 --> 00:20:50,794 the best opportunities for organizational growth? 541 00:20:52,615 --> 00:20:55,000 For us, specifically, I had mentioned some of 542 00:20:55,000 --> 00:20:57,720 the services, which is growing much more rapidly 543 00:20:57,720 --> 00:20:59,960 than others, which is women's care services and 544 00:20:59,960 --> 00:21:02,920 pediatric growth. And to help with that, we 545 00:21:02,920 --> 00:21:04,700 are not only just looking at the ambulatory 546 00:21:04,840 --> 00:21:05,340 footprint. 547 00:21:05,755 --> 00:21:08,394 We're actually building our own freestanding children's hospital. 548 00:21:08,394 --> 00:21:11,375 We already have a children's hospital. We're building 549 00:21:11,434 --> 00:21:14,095 a freestanding children's hospital that's going to be, 550 00:21:14,954 --> 00:21:17,454 it's slated for in the next three years. 551 00:21:17,750 --> 00:21:19,830 So that is the timeline where we need 552 00:21:19,830 --> 00:21:21,670 to enhance the services we are providing. It'll 553 00:21:21,670 --> 00:21:25,289 provide every aspect of pediatric care that's possible 554 00:21:25,350 --> 00:21:26,410 from end to end, 555 00:21:26,710 --> 00:21:28,710 whether it's going to be early stages of 556 00:21:28,710 --> 00:21:31,529 primary pediatric services to end stages of 557 00:21:32,244 --> 00:21:34,804 transplants for pediatrics, BMT, CAR T and all 558 00:21:34,804 --> 00:21:35,384 of that. 559 00:21:35,765 --> 00:21:37,144 Then we are looking at 560 00:21:37,924 --> 00:21:40,244 the APP integration. As I said, that's where 561 00:21:40,244 --> 00:21:43,204 the organizational growth will occur because it's the 562 00:21:43,204 --> 00:21:45,599 types of people we have in our team. 563 00:21:45,819 --> 00:21:48,140 We need more, not just physicians who are 564 00:21:48,140 --> 00:21:50,460 providing the care. We need more nurses. We 565 00:21:50,460 --> 00:21:52,859 need more allied health professionals. We need more 566 00:21:52,859 --> 00:21:53,359 techs. 567 00:21:53,660 --> 00:21:55,900 And we need more PCLs who are on 568 00:21:55,900 --> 00:21:58,059 the ground level providing the care for these 569 00:21:58,059 --> 00:21:58,559 patients. 570 00:21:58,954 --> 00:22:01,115 So along with the growth of the population, 571 00:22:01,115 --> 00:22:02,575 we are matching the growth 572 00:22:02,875 --> 00:22:04,714 with the types of people who can provide 573 00:22:04,714 --> 00:22:06,875 that level of care. These are two big 574 00:22:06,875 --> 00:22:09,115 areas we are focusing on. But as every 575 00:22:09,115 --> 00:22:10,575 other health system is doing, 576 00:22:10,875 --> 00:22:13,615 we are not doing this without or ignoring 577 00:22:14,200 --> 00:22:16,840 the enhancements in technology and innovation we need 578 00:22:16,840 --> 00:22:19,000 to input. We are integrating that into the 579 00:22:19,000 --> 00:22:20,220 practices as well. 580 00:22:23,640 --> 00:22:24,140 Fascinating. 581 00:22:24,680 --> 00:22:26,119 Thank you so much for joining us on 582 00:22:26,119 --> 00:22:28,140 the podcast today. This has been such a 583 00:22:28,815 --> 00:22:31,294 fantastic conversation. I'm really excited to learn more 584 00:22:31,294 --> 00:22:32,914 about what you're doing at BayCare and, 585 00:22:33,214 --> 00:22:35,294 you know, continue to dig deeper at the 586 00:22:35,294 --> 00:22:36,734 annual meeting. I know you'll be speaking on 587 00:22:36,734 --> 00:22:38,434 a panel and really truly, 588 00:22:38,894 --> 00:22:41,054 you know, sharing some of these great insights 589 00:22:41,054 --> 00:22:42,654 and and learnings that you've had. So I'm 590 00:22:42,654 --> 00:22:44,619 looking forward to that, and, it'll be a 591 00:22:44,619 --> 00:22:47,099 great opportunity to grow and and, connect with 592 00:22:47,099 --> 00:22:48,700 others. So, thank you so much for your 593 00:22:48,700 --> 00:22:50,940 time today, and looking forward to April. Thank 594 00:22:50,940 --> 00:22:52,619 you. And when you come, thank you so 595 00:22:52,619 --> 00:22:54,720 much, Laura. Really looking forward to it.