The most important health care decisions don't happen
in isolation.
They happen when leaders come together.
Becker's sixteenth annual meeting brings together more than
3,500
hospital and health system executives this April in
Chicago.
With 800 speakers from Ascension,
Cleveland Clinic, CommonSpirit and more, the conversations get
real. Leaders will share how their scenario planning
for policy shifts, breaking through value based care
barriers, and building clinical teams that translate
This is Laura Dirda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
doctor Soumya Viswanathan,
who's a chief physician executive at BayCare Health
System. Doctor Viswanathan, it's a pleasure to have
you on the podcast today.
Thank you so much for the invitation. Looking
forward to a great discussion.
Absolutely. Now I'm excited for our conversation because
I know there's so much happening right now
in health care, particularly.
I'm excited to learn more about what you're
doing at BayCare. I I know there's just
such a unique community that you serve down
there and a lot of innovation. You're in
growth mode. So I'm gonna be excited to
learn more about that. But before we dig
in, can you tell us a little bit
more about yourself and BayCare health system?
Absolutely.
I'm an internal medicine physician, and I spent,
the bulk of my career in Northeast. I
was in Massachusetts.
I was clinical for the longest period of
time, and then I did a whole bunch
of leadership roles.
I was with various health systems, including UMass
and
the Partners Healthcare System.
And then I was at Dartmouth Hitchcock, spent
some time with the for profit world with
Tenet Health
before I landed in BayCare health system, and
I've been here a little over three years.
It's been a wonderful journey at BayCare.
We are located
on the Gulf Coast and on the West
Coast Of Florida.
We are the largest health system in West
Central Florida with 16 hospitals.
We are building our seventeenth.
We have 34,000
employees
and more than 6,000
physicians
who are deeply engaged in some form of
relationship with us or the other, including employment
and clinically integrated network, ACO, etcetera.
We provide
all kinds of services
as an integrated health delivery model. So it's
end to end services,
hospitals,
ambulatory footprint, including ambulatory surgery center.
We have urgent care clinics. We have multiple
specialty clinics, including multi specialty and primary care
clinics.
We have imaging centers. We also have virtual
care.
We provide telehealth services.
We also have our own health plan. It's
a small health plan, but
this is where, you know, this whole spectrum
of value based care comes into play. We
kind of provide all kinds of services within
our own system,
and
we are also an academic medical center.
Absolutely. Wow. That is an incredible amount of,
services that you provide in ways that you
are integrating within the community to continue to
boost the health and access to care. Now
I'm curious. When you think back in the
last year or so, what was the most
important initiative that you led? What did you
do and what were the results?
So academics, I would say in one word,
was the biggest initiative that I have led
since I've landed here. I'll share a little
bit of the historical perspective.
BayCare as a health system came together as
a group of community hospitals that decided they
were going to become a health system
and an integrated health delivery model.
At that time, we were not heavy into
academics. When I came here,
we did not have a robust GME program.
We had, two very small residency programs in
pediatrics and psychiatry
with no plans whatsoever to enhance or expand
that. And we also had leadership change at
the same time where new leadership came on
board. Around the same time that I came
is when we had Stephanie Connors, who joined
us as CEO of BayCare.
So both of us coming from academic backgrounds
in our past,
we said, hey, you know what? For us
to really address the physician shortages
as we move forward into the next decade,
we have to look at why can't we
provide academia here. Because we have all of
the necessary
aspects of what goes into an academic medical
center in day care.
We have the infrastructure that's needed, so we
should become an AMC.
And so we went down the path of
starting up GME programs.
We have significant,
we have made significant headway in our GME
program. We went from the two small programs
of 20 resident, 29 residents total
to our plans now of having almost 650
residents graduating by 2029.
That's a robust and very aggressive goal, but
we are steadily moving forward. We have gone
from the two small programs, as I mentioned,
to establishing
16 programs currently.
We already have 300 residents who are with
us today.
In a span of two and a half
years, we have done we have made that
achieve achievement,
and we are not looking back. We are
gonna continue to enhance the GME program.
And in our attempt to really become an
AMC,
our biggest achievement was definitely
our collaboration with Northwestern,
up in Chicago.
So you must have read in all of
the news articles and the press releases that
Northwestern collaboration with BayCare
has been a significant milestone for us.
Super excited about all of the work that
we'll be doing with Northwestern,
including research endeavors, including
faculty development programs, and really enhancing the academic
footprint in Florida.
That's amazing to hear. And, you know, what
a a great foresight in order to be
able to start an academic program and and
have those seeds planted and foundations built for
growth. I think, as you mentioned, it is
an aggressive goal going from the the two
initial programs and 29 residents to having 650
by 2029,
but I can imagine you've got a great
plan plan to get there. What types of
resources do you need and expertise is important
when you're setting up an academic program and
trying to transform a community system into an
academic system?
So the definitely, the two aspects are the
teaching or the educational
environment
as well as research facilities. So
we were doing some amount of research. I'll
start with research. We were doing some level
of research mostly by community grants, but we
were not like
the, you know, the big AMCs up north
where there's a lot of NIH funding, a
lot of NSF funding. It was a lot
of community focused grants and state grants.
So our goal was to really in enhance
the environment in which research is being done
so that we are fostering the different aspects
of research, including
we were doing sponsored research, for example.
We need to do something which is day
care original research,
And we hadn't been doing that. So we'll
be focusing heavily on how do we start
up clinical trials. And this Northwestern collaboration is
gonna help us with that because it helps
us think differently in terms of, can we
have a multicenter trial if there is, like,
a cardiac
procedure that we are doing differently or a
new innovative
method of doing an electrophysiology
or EP study, etcetera.
So that is the aspect of research that
we are gonna enhance while we continue to
gain from the community grants.
The second piece is
teaching.
We had been dabbling a little bit in
teaching because we used to get
APPs like the physician assistant and the RN
nursing students who used to come over from
the local universities.
We also had residents and students coming over
from our local partners here,
USF and Florida State University, University of Florida.
We have engaged deeply with USF and FSU.
And,
we just needed to increase the amount of
teaching that we are doing. And what was
beautiful to see is there was significant appetite
in the physicians to really go in that
direction.
Our physicians felt, well, we have so much
talent here.
We are
some of the best in class with high
quality care. We provide clinically excellent care.
How do we continue to nurture this environment
where we groom the next generation of residents
who will be taking care of us in
the future? Because
sixty eight percent of residents who graduate from
GME programs
stay in the area where they graduated from
for at least three years after.
If that's a statistic,
then I will gain significantly from at least
three quarters of the
650
residents graduating who will become physicians at BayCare.
They'll be taking care of all of us
as we get older. And that's what we
want, is high quality residents coming from our
own programs who our physicians have taught, and
they will service the community.
So we have pretty much the infrastructure.
The system is also something that's important because
the system was committed
to making that kind of investment.
That's great to hear. And and definitely it's
so important to have that leadership and and
the executive team committed to those types of
transformations. I know Stephanie Connors is such a
dynamic leader and so inspiring and and gets
things done too. So that's incredible to to
hear, and thank you for digging a little
bit deeper there. Now looking ahead for 2026,
what are some of your big priorities as
well as headwinds that you're facing?
Well, some of the priorities are definitely
not different than many other health systems. It's
basically moving care upstream.
And I can share with you with,
having
looked at some of the other parts of
the country,
definitely
Florida, Southern states, I think, especially Florida, has
been a little bit late in moving forward
with value based care.
We have not had a lot of payment
model shifts until recently.
The payment models have been a little late
other than the federal and the regulatory
volatility that's going on,
you know, which is also influencing some of
the decisions we are making.
But let's say the central, the CMS funded,
grants that are coming our way, those we
have already started moving in similar to others.
But then it is a state payment model
shift. We haven't really moved very aggressively in
value based care. So my biggest priority will
be
to start moving physicians in that direction
where we have traditionally done so much of
fee for service type of model of care
delivery.
We now to start training, and we have
been training, but we have to start enhancing
the training
of the physicians and the whole care team
model to really deliver on, look at the
total cost of care of patients. How do
you look at utilization metrics? How do you
continue to enhance quality while you're controlling
the utilization of services? So that will be
a big focus, truly moving us in value
based care model.
Now as we do this, I mentioned to
you how BayCare is a 16 hospital system.
We have large facilities
that cannot have empty beds. We need heads
in beds because that's the way we sustain
our whole integrated health system.
So for that to happen, as we move
care into ambulatory,
we need to ramp up the types of
services in the hospitals.
Right now, we provide a lot of primary
and secondary level of care. We provide some
tertiary care.
Our goal for 2026
is to move the entire health system forward
to provide high end tertiary care
as well as start working on quaternary care
services, which is gonna be
big amount, big ticket items,
high acuity,
severe cases,
very complex cases, including looking at transplants.
So that will be a big driver for
us in 2026.
The other big thing that we are working
on
is recruitment of specialties. As you know, private
equity firms had
nationally had looked at health care. They had
invested in health
care. But now as some of the PE
firms are backing off from some of these
specialties,
we're struggling because these specialties are coming to
us and saying, well, we're going under or
we are going to be collapsing and
we are no longer going to have a
job. So we don't know whether we'll be
in the area.
It started last year with anesthesiology,
where we had anesthesiologists
in the market because we were contracted with
them. They were not employed by us.
They came to us and they said, well,
we are not sure if they're going to
stay in the state and we may have
to move somewhere. We may have to go
to an AMC.
So we started looking at a nontraditional
methodology
of employing
specialties,
which usually are not employed unless you're an
academic medical system.
So anesthesia, for example,
usually because they don't have their own panel
of patients, many health systems don't employ them
if they are not an AMC.
So we have gone down the path since
we're already becoming an AMC.
We said, well, this is time for us
to look at that specialty and say, we
need to employ anesthesiologist. So that's a big
headwind for us that we were able to
walk into last year. We have done tremendous,
had great progress in that and employing anesthesiology,
and
we're making a lot of headway there.
The third aspect,
is population.
Population has grown tremendously in the Florida market.
As you know, through COVID, many people who
could work remotely,
they migrated from
the northern colder states and they came and
settled down in the Southern states.
So Tampa and Austin, Texas, I think, were
the fastest growing cities in the country.
That said, when the people moved down here,
the types of generations,
the types of people, the demographics of the
people who came here were the younger generation.
So what ended up happening is Florida being
usually a state of, like, retirees, you know,
it's a haven for retirees.
Our health system was not prepared for the
number of young people settling in Tampa market.
So the whole this BayCare market is now
having
huge numbers of young population settling here.
The need for those specialties has gone up,
which is pediatrics
for children
and women's care, OB GYN,
to take care of all the pregnancies and,
you know, taking care of the women who
are settling here.
So these are some of the big priorities
that we'll be working on from a population
and specialty perspective, peds and women's care.
Anesthesia is a specialty that we'll continue to
work on.
And just moving care upstream with payment models
and
enhancing tertiary care in the hospital while
moving towards value based care aggressively in our
outpatient centers.
Okay. Wow. That's fascinating. That's a lot to
to think about and a lot of transitions
that are happening all at the same time,
but also really, you know, fascinating to think
about the the puzzle complexity of how you're
running health care system, making these transformations into
an academic center, and then really changing with
how the market's changing, the economics, the demographics
even of of what's coming into the Tampa
market and and around in that region of
Florida. So, that's fascinating.
What do you think, out of all of
these things, will be the hardest thing you
have to do in the coming year?
The hardest thing, probably the most work will
be around the value based care movement,
ramping up our
physicians to understand total cost of care
because we have to amplify what we are
doing in the ambulatory setting.
We need to enhance
the work,
not just the brick and mortar, but the
availability of services in ambulatory care. So we
need more virtual care. We need to be
able to support more telehealth services, more technology
and innovation
so that the physicians feel they can offload
to the ambulatory footprint for
doing this value based care model. And, of
course, enhancing
the tertiary and quaternary care on the back
end. Because if you don't do that, financially,
the sustainability
is not there.
One of the
aspects of this movement that we are doing
to help physicians
and
prevent burnout of any cause is
because physicians
need to be available to provide that access.
And,
our health system has traditionally not
done a lot of work with APP integration
into practices.
We are moving in that direction this year.
There'll be heavy integration of allied health professionals
and providers,
who will be supporting both PAs and NPs,
who will be supporting our physicians and practices,
as well as in the hospitals.
That is a big movement that I'm really
looking forward to. It took a lot of
education and continuous education of physicians to see
how they can embrace APPs in the practices.
So this is gonna be a beautiful journey
as we build the teams to support that
movement in value based care and improving access.
That's helpful to understand. And I think, you
know, it's so fascinating to see how you're
looking at value based care and where some
of the holes are. I think when you're
looking at the clinical side as well as
the financial side, I mean, there's a lot
of big changes
overall. But for the clinical team, for the
physicians and nurses already on board, what types
of things are are they having to adjust
about the way they think about practices or
their standards or protocols?
How are they being affected by the transition
of value based care, and what are you
doing to make it as strict seamless as
possible?
Yeah. Absolutely. So we are,
changing the model to support the value based
care model. One is along team based care.
So really looking at services, we have, for
example, a value based care team that has
a population health services division.
The team of care coordinators, clinical pharmacists, quality
folks, they all sit in one location.
Now what we are looking at doing is
enhancing and embedding them in the practices so
they are there in real time for physicians
so that they are part of the team
that's providing that team based care. Because that's
how you move towards value is when you're
able to get the physician,
get the patient, the physician, and their patients,
caretakers all involved in the care of the
patient,
then you can reduce the readmission rate. You're
able to better care for them in the
home environment.
We have also involved in hospital at home
programs. So for all that to happen,
we really need to enhance the services at
the ground level, which is in the practices.
The second thing that we are doing is
a lot of work around AI innovation.
I know AI and tech is like a
big buzzword these days. We're actually looking at
all of the practical
implications
of
inputting these AI tools in our practices.
If it's going to help the patient,
if it's going to help with delivery models
that's going to take care of the patient
when they are at home,
we are definitely evaluating all of those tools.
And we have we have looked at multiple
platforms that's going to help the patients
with not just the patient navigation into practices,
but taking care of them in their homes
so that they are not heading back into
the hospital and increasing the
the
the complexity
of their problems by delaying care. So we
really want them to have the best available
services.
Access is critical,
whether in the form of physicians and APPs.
Having access to the teams,
so the value based care team will provide
all of those support services.
And with technology, we feel like we can
improve the operational efficiency and effectiveness
of the care that we are delivering.
So a lot of great work that's going
on in in this tremendous growth mode.
Got it. That that's super helpful. Thank you
so much for digging a bit deeper. Before
we wrap up, I wanna talk about growth
as well. Where do you see some of
the best opportunities for organizational growth?
For us, specifically, I had mentioned some of
the services, which is growing much more rapidly
than others, which is women's care services and
pediatric growth. And to help with that, we
are not only just looking at the ambulatory
footprint.
We're actually building our own freestanding children's hospital.
We already have a children's hospital. We're building
a freestanding children's hospital that's going to be,
it's slated for in the next three years.
So that is the timeline where we need
to enhance the services we are providing. It'll
provide every aspect of pediatric care that's possible
from end to end,
whether it's going to be early stages of
primary pediatric services to end stages of
transplants for pediatrics, BMT, CAR T and all
of that.
Then we are looking at
the APP integration. As I said, that's where
the organizational growth will occur because it's the
types of people we have in our team.
We need more, not just physicians who are
providing the care. We need more nurses. We
need more allied health professionals. We need more
techs.
And we need more PCLs who are on
the ground level providing the care for these
patients.
So along with the growth of the population,
we are matching the growth
with the types of people who can provide
that level of care. These are two big
areas we are focusing on. But as every
other health system is doing,
we are not doing this without or ignoring
the enhancements in technology and innovation we need
to input. We are integrating that into the
practices as well.
Fascinating.
Thank you so much for joining us on
the podcast today. This has been such a
fantastic conversation. I'm really excited to learn more
about what you're doing at BayCare and,
you know, continue to dig deeper at the
annual meeting. I know you'll be speaking on
a panel and really truly,
you know, sharing some of these great insights
and and learnings that you've had. So I'm
looking forward to that, and, it'll be a
great opportunity to grow and and, connect with
others. So, thank you so much for your
time today, and looking forward to April. Thank
you. And when you come, thank you so
much, Laura. Really looking forward to it.