Welcome to the Becker's Healthcare podcast.
I'm Chris Sosa, the copy chief here at
Becker's. I am thrilled to be joined by
Dan Larson, principal and chief strategy and marketing
officer at HealthBridge Children's Hospital. Dan, thank you
for joining us today.
Thank you, Chris, for having me on.
Wonderful. Dan, for our audience members who are
not familiar with you and your work, could
you please introduce yourself and tell us a
bit about your background?
Sure. So my name is Dan Larson.
I've been in health care since, 1989,
as as a principal owner of three different
businesses. The the one that the HealthBridge Children's
Hospital is a current business.
Initially developed a partnership with my sister who's
a speech pathologist in 1989,
and we founded a company called South Coast
Rehab Services,
which contracted with skilled nursing facilities throughout the
country.
We we drew that to about 17 states
and 240
some contracts, and then we end up selling
it to one of our, actually, one of
our clients. And we became their in house,
rehab company once,
the
the Sniff business and Medicare business went to
prospective pay. So that was in 1997.
And as as part of that,
we were involved in in another takeout of
SunHealth from from Regency.
And when we were managing,
that rehab department, we had a little group
in there called Meridian NeuroCare,
which was really a kind of residential based
spinal cord and and traumatic brain injury rehab
business. We we liked it a lot. And
so when, Sun went to purchase that deal,
we asked, Rick Matros and and,
yeah, if we could go in and buy
it. He said, absolutely. So he, along with
Bruce Broussard, former Humana guy, he was our
CFO at the time.
We purchased Little Meridian NeuroCare, renamed it Care
Meridian,
and grew that to a multisite operation to
32 sites, and then we we we exited
that business as well.
In in the mean so most of my
career has been kind of in this post
acute rehab space. I did do a short
stint here in St. Louis,
where I was the CEO of Premier Care
Orthopedics, which is a kind of a roll
up strategy for practice management roll up strategy
for orthopedic surgeons.
And then we also founded a group called
Signature Health Services, which was a large which
now got large MSO.
So, again, most most of my space has
been in the in the in the rehab
post acute side of it. And, really,
the the pediatric hospital is very similar to
that. We have four levels of care. We
have, we have both, acute beds and subacute
beds. We have LTAC. We have
acute rehab.
We have subacute, and we also have outpatient
services. So I I never say never, but
I think,
after thirty five years, this will probably be
the last company I start.
Well, clearly, you've had a lot of experience
in any number of areas in in health
care, Dan. So
what exactly about
investing in starting Helpbridge Children's,
appeal to you in particular?
So I'm a I'm a huge proponent. So
take a step back.
Most of the stuff I've been involved in,
deals with especially the the care meridian phase
of it dealt with
really complex injuries that required
really long
long recoveries,
multisite kind of, you know, kind of care
model. And so understanding that the family is
going through this recovery process and there's gonna
be multiple providers involved,
I was a huge advocate for, you know,
having a coordinated care model. So we had
actually, at Care Meridian,
with,
Santa Clara Valley,
hospital, we developed a program called NeuroNet,
which was really a collection of four different,
companies
that provided that full level of care with
a common,
nurse navigator as the case manager,
from the onset of the injury all the
way to home. And so that coordinated care
model was a huge deal to to us.
We we saw,
the outcomes were much better. The client satisfaction
was much better. And so we as we
looked at this segment of of pediatric care,
most of these kids are, you know, very
fragile, medically complex kids.
It's the same it's the same problem, same
business problem. And so we are, you know,
working hard to build out that full continuum
on the post acute side, and then and
then working and coordinating that with our with
our for hospitals,
in the in our markets that like the
CHOC hospitals of the world. So it's it's
really, you know,
again, taking these kids that are medically complex
and have these long recoveries and and building,
both efficiency into it and predictability for families.
I understand. I mean, clearly, there's a lot
of work involved with that, Dan. Given all
that that you've just laid out for us,
what are your top priorities today?
So we are,
we're working with several different hospitals to, you
know, to,
put process to that coordinated care model, that
nurse navigation.
Again, think we think that is is real
key. We also are looking at at ways
where the ED boarding problem, what especially with
these kids that need,
acute beds where we can accept these these
children directly out of the EDs.
That's a that's a big push of ours.
And then,
you know, again, these kids most of these
kids are going home with some level of
permanent disability
and and ongoing medically complex issues. So there's
a, you know, high risk for these kids
to bounce back. And so we're implementing a
program called safe at home, which is a,
you know, post discharge predictive risk scoring framework
so that we can,
look at
the the the the things that basically impact
that child's life that could end up causing,
you know, a negative event like a seizure
or something else that would require rehospitalization.
So and we're, you know, we'll overlay that
with AI tools to be able to look
at these trends and hopefully get to a
point where we can start predicting, okay,
if these things are happening, the risk for
this is is as acts. And so what
we wanna be able to do is support
those caregivers at home to be able to
give them a little bit of a heads
up as we start seeing trends that are
developing
that could, you know, potentially end in some
negative event that would require a rehospitalization.
Dan, I'm glad you mentioned trends. With respect
to those, whether it's the safe at home
program, which sounds like a terrific, if not
a very complicated and challenging endeavor that you
have going on. How do you think your
role is going to change, and how is
the role of your team going to change?
Well, I don't know necessarily if my role
will change that much. I I, you know,
as as an owner too, I have my
hands as you can imagine in finance and
everything else. My my primary focus though every
day is is really the the the strategy
and the payer side of the market.
So I don't really anticipate
much change to my role, but a lot
of our clinical people are are required
in in these, development meetings. And so they've
never, you know, they've never been in them
before. So it's all kind of new territory
for them,
participating in more business process than, you know,
being on the floor clinical. But we have
great experts, and
and, these different models are predicated on the
fact that, you know, again, we can we
have the clinical goods to deliver. So I
need them involved in that in that development
process.
Lastly, Dan, I have a two part question
for you. Sure.
Here's how it goes. So I would like
to know what exactly is making you nervous
about health care in general right now, whether
it's pediatrics related or not, and what are
you excited about?
Well, on on the pediatric side,
obviously,
unless you've been living in an alternate universe,
you know, we we see, you know, the
the headlines every day about the prospective
Medicaid cuts,
coming down. And so,
you know, it it depends on how that,
you know, how those end up happening and
how that would affect us. Most of the
kids that we take care of,
tend to be Medicaid
at some point.
And in California,
if you're if if you have a catastrophic
injury or illness and it goes more forty
five days, you get put in at the
into the CCS process. So,
it's a covered it's a covered actually, a
a covered level of care within the state
of California, which is unique. And so not
knowing fully how that plays out,
you know, we're we're we're watching it. We're
we're a little bit nervous. We're we're anticipating
that,
given the space that we're in and and
we're in such a cost savings,
level of care, we should be okay. But,
you know, it all depends. And and from
our perspective,
since it's pediatrics, we're not worried about, you
know, the the work requirement,
or any of that. So
we're just kind of a niche player in
that. So we're watching it carefully, but it
definitely is something that, you know, it had
has us concerned.
On the on the, you know, what makes
us excited,
you know, this level of care,
is unique. And the the reason why it's
unique is if you look at Medicare,
Medicare cut cuts across all 50 states. Right?
So you have the same you have a
well worn path to these adult continuous of
care, short stay, LTAC,
acute rehab, SNF,
assisted living, home health.
Those are all licensed,
levels of care with reimbursement.
When you look at our level of care,
it's predominantly Medicaid, so it's a state by
state effort. So there's no way really where
you can just go this business model is
gonna work in every state because there might
not be the reimbursement for it. However, we
as we see the trends, California has gone
to a % managed Medicaid.
We're seeing more and more managed products,
that growing.
That gives us the ability to negotiate deals
directly with the insurance companies and not state
itself to get the right rate structure.
So we're we we, you know, we feel
like we're in the in the early minutes
of the first quarter of the game, and
there's no 800 pound gorilla yet. And there's
a lot of organic opportunity out there. And
so and and we we know that this
business is, was founded in February.
I tried to buy it when I was
at Care Marine, and I couldn't get it
done, but we eventually did,
personally. But this this this proof time and
time again to be able to create, you
know, outstanding outcomes at a lower cost price.
And a lot of these kids would would
formally just live in the children's hospital. That's
an inappropriate level of care. So we think
estates are looking to reduce cost spend, as
the insurance companies are looking to, you know,
find alternatives to higher cost, you know, types
of settings, I think, you know, this level
of care is is is perfect.
We see it you know, health systems are
gonna, you know, want it.
Insurance companies are gonna want it. So we
we just I think this is the one
true thing where you kinda you always see
those business slides with the hockey stick. I
think this is as these states become more
managed and as we start to see this
roll out, I think you're gonna see, you
know, big growth,
if, you know, three to five years out.
That's when it's gonna take off. So, we
just wanna be we wanna be on the
front end of it.
Dan, thank you so much for all your
time and your insights today. You've been very
generous, and we can't wait to share them
with our audience soon.
I appreciate it, Chris. Thanks so much.