1 00:00:01,919 --> 00:00:04,500 This is where health care leadership comes together. 2 00:00:04,559 --> 00:00:07,679 Becker's sixteenth annual meeting brings more than 3,500 3 00:00:07,679 --> 00:00:10,880 hospital and health system executives and nearly 800 4 00:00:10,880 --> 00:00:12,019 speakers to Chicago 5 00:00:12,320 --> 00:00:14,259 April. 6 00:00:14,615 --> 00:00:17,335 This year's event includes keynote conversations with Dallas 7 00:00:17,335 --> 00:00:20,214 Cowboys legend Troy Aikman and former president George 8 00:00:20,214 --> 00:00:22,934 w Bush. For the agenda and event details, 9 00:00:22,934 --> 00:00:25,175 visit beckershospitalreview.com 10 00:00:25,175 --> 00:00:26,855 and click on the events tab in the 11 00:00:26,855 --> 00:00:29,494 upper right. We're looking forward to hosting you 12 00:00:29,494 --> 00:00:30,449 in Chicago. 13 00:00:31,550 --> 00:00:33,710 Hello, everyone. This is Jacob Emerson with the 14 00:00:33,710 --> 00:00:36,429 Becker's Healthcare podcast. I'm thrilled today to be 15 00:00:36,429 --> 00:00:39,390 joined by doctor Tom Shanley, who's the president 16 00:00:39,390 --> 00:00:41,090 and CEO of Lurie Children's. 17 00:00:41,469 --> 00:00:43,310 Doctor Shanley, thank you so much for taking 18 00:00:43,310 --> 00:00:44,429 the time to be with me on the 19 00:00:44,429 --> 00:00:46,674 podcast this morning. My pleasure. Thanks for having 20 00:00:46,674 --> 00:00:47,255 me, Jacob. 21 00:00:47,635 --> 00:00:49,554 Absolutely. And and, Tom, before we dive into 22 00:00:49,554 --> 00:00:51,234 everything we wanna talk with you about, can 23 00:00:51,234 --> 00:00:52,674 you first tell us a little bit more 24 00:00:52,674 --> 00:00:55,395 about yourself, your background in health care? And 25 00:00:55,395 --> 00:00:56,755 and for our listeners who might not be 26 00:00:56,755 --> 00:00:59,155 familiar, a little bit about, what you do 27 00:00:59,155 --> 00:00:59,814 at Lurie's. 28 00:01:00,899 --> 00:01:01,399 Sure. 29 00:01:01,859 --> 00:01:04,900 So, well, first, in addition to now serving 30 00:01:04,900 --> 00:01:05,959 as president and CEO, 31 00:01:06,260 --> 00:01:08,920 my professional background is as a physician. 32 00:01:09,540 --> 00:01:12,099 I'm trained as a pediatric intensive care unit 33 00:01:12,099 --> 00:01:12,599 doctor, 34 00:01:13,454 --> 00:01:15,715 and also did a number of 35 00:01:16,174 --> 00:01:18,734 research work as well, in the area of 36 00:01:18,734 --> 00:01:19,234 immunology. 37 00:01:20,495 --> 00:01:22,674 So that always tried to combine 38 00:01:23,055 --> 00:01:26,174 the discovery enterprise in advancing what we do 39 00:01:26,174 --> 00:01:27,875 in clinical care. And so certainly 40 00:01:28,290 --> 00:01:30,370 relevant in terms of opportunities to do that 41 00:01:30,370 --> 00:01:32,290 with critically ill and injured kids that I 42 00:01:32,290 --> 00:01:34,069 had the opportunity to care for. 43 00:01:35,010 --> 00:01:37,490 Fantastic. No. I appreciate the personal background, Tom. 44 00:01:37,490 --> 00:01:39,329 And can you tell us, just for anybody 45 00:01:39,329 --> 00:01:41,490 who's not familiar, a little bit about Lurie 46 00:01:41,490 --> 00:01:41,990 Children's, 47 00:01:42,385 --> 00:01:44,864 who you serve, where you're based, and just 48 00:01:44,864 --> 00:01:46,244 a little bit about your facilities. 49 00:01:46,784 --> 00:01:47,284 Sure. 50 00:01:48,224 --> 00:01:50,644 Well, we we're a very unique organization 51 00:01:51,104 --> 00:01:53,825 in both the city and the and across 52 00:01:53,825 --> 00:01:54,484 the state. 53 00:01:54,864 --> 00:01:56,244 We are the only 54 00:01:57,069 --> 00:01:57,569 freestanding, 55 00:01:57,950 --> 00:01:58,450 comprehensive, 56 00:01:59,229 --> 00:02:00,930 acute care pediatric hospital, 57 00:02:01,390 --> 00:02:02,609 in the state, and 58 00:02:02,989 --> 00:02:04,670 really proud of our ranking in US News 59 00:02:04,670 --> 00:02:06,829 and World Report as the number one children's 60 00:02:06,829 --> 00:02:09,810 hospital in the state of Illinois and, among 61 00:02:09,870 --> 00:02:12,289 the leading the nation's leading children's hospitals. 62 00:02:12,965 --> 00:02:14,824 We are in the process of really 63 00:02:15,844 --> 00:02:19,125 evolving from a hospital, Lurie Children's Hospital, to 64 00:02:19,125 --> 00:02:20,645 more of a health system. I'm sure we'll 65 00:02:20,645 --> 00:02:22,585 talk a little bit more, about that. 66 00:02:22,965 --> 00:02:25,139 But in doing so, really privileged care for 67 00:02:25,139 --> 00:02:27,540 kids that come actually from just about every 68 00:02:27,540 --> 00:02:28,840 county across the state, 69 00:02:29,379 --> 00:02:31,379 as well as the Midwest Region and nationally 70 00:02:31,379 --> 00:02:32,040 and internationally. 71 00:02:33,699 --> 00:02:36,419 An aspect many people don't typically know about 72 00:02:36,419 --> 00:02:38,680 us, perhaps, is that we're also 73 00:02:39,105 --> 00:02:40,165 the top Medicaid 74 00:02:40,544 --> 00:02:43,125 the pediatric Medicaid provider in the state. 75 00:02:43,825 --> 00:02:47,425 Nearly 60% of our inpatient activity is covered 76 00:02:47,425 --> 00:02:49,985 by Medicaid. So, you know, thinking about it 77 00:02:49,985 --> 00:02:52,465 from that standpoint, we really are a bit 78 00:02:52,465 --> 00:02:54,840 of a critical safety net hospital for 79 00:02:55,379 --> 00:02:55,879 organizations. 80 00:02:56,979 --> 00:02:58,120 In addition to that, 81 00:02:58,740 --> 00:03:02,360 we have our academic partnership with Northwestern University's 82 00:03:02,419 --> 00:03:03,800 Feinberg School of Medicine 83 00:03:04,099 --> 00:03:05,240 that really embraces 84 00:03:05,620 --> 00:03:07,159 much of our training activities 85 00:03:07,625 --> 00:03:10,044 for our pediatric residents and fellowship program. 86 00:03:10,344 --> 00:03:12,284 And then, of course, our research enterprise. 87 00:03:13,544 --> 00:03:15,004 What we really, 88 00:03:16,344 --> 00:03:19,145 ground ourselves in is our multi pillar mission, 89 00:03:19,145 --> 00:03:21,870 and we describe that as care, which includes 90 00:03:21,870 --> 00:03:24,269 c for clinical care, a for advocacy, r 91 00:03:24,269 --> 00:03:26,049 for research, and e for education. 92 00:03:26,590 --> 00:03:28,669 And so each of the areas we strive 93 00:03:28,669 --> 00:03:30,129 for excellence in advancing 94 00:03:30,590 --> 00:03:32,590 the health and well-being of kids we're privileged 95 00:03:32,590 --> 00:03:33,250 to serve. 96 00:03:34,264 --> 00:03:36,025 And, Tom, let's dive into some of the 97 00:03:36,025 --> 00:03:38,665 things you just mentioned, evolving into more of 98 00:03:38,665 --> 00:03:39,564 a health system, 99 00:03:40,025 --> 00:03:41,944 the the Medicaid piece of what you mentioned. 100 00:03:41,944 --> 00:03:43,384 We'll talk about that in just a little 101 00:03:43,384 --> 00:03:43,884 bit. 102 00:03:44,425 --> 00:03:46,344 But but, obviously, as you know, Lurie just 103 00:03:46,344 --> 00:03:49,165 opened a new outpatient facility out in Schaumburg. 104 00:03:49,469 --> 00:03:51,949 You're planning a new inpatient facility in Downers 105 00:03:51,949 --> 00:03:52,449 Grove. 106 00:03:53,069 --> 00:03:54,669 So so talk to our audience about what's 107 00:03:54,669 --> 00:03:57,409 driving the strategy here for these suburban facilities 108 00:03:57,949 --> 00:04:00,210 and how you're really thinking about which services 109 00:04:00,270 --> 00:04:01,009 can move 110 00:04:01,310 --> 00:04:04,594 into these communities versus what needs to remain 111 00:04:04,594 --> 00:04:06,915 concentrated at the flagship hospital here in the 112 00:04:06,915 --> 00:04:07,415 city. 113 00:04:07,794 --> 00:04:08,294 Sure. 114 00:04:08,675 --> 00:04:09,415 Well, I think, 115 00:04:10,435 --> 00:04:11,335 first and foremost, 116 00:04:11,875 --> 00:04:14,915 the principal driver of the strategy is a 117 00:04:14,915 --> 00:04:17,795 focus on the kids and the access that 118 00:04:17,795 --> 00:04:18,449 they need 119 00:04:18,930 --> 00:04:19,410 for, 120 00:04:19,889 --> 00:04:21,350 excellent and high quality 121 00:04:21,650 --> 00:04:22,150 specialty 122 00:04:22,529 --> 00:04:24,150 and primary care. And 123 00:04:24,610 --> 00:04:25,270 what we, 124 00:04:25,810 --> 00:04:29,250 recognize as we look across both our market 125 00:04:29,250 --> 00:04:31,509 in Chicagoland as well as the national market, 126 00:04:32,074 --> 00:04:34,334 there's an increasing recognition that what 127 00:04:34,875 --> 00:04:36,875 we do here at Lurie Children's and many 128 00:04:36,875 --> 00:04:38,334 of our national leading peers 129 00:04:38,634 --> 00:04:40,014 do is not easy, 130 00:04:40,475 --> 00:04:42,175 to put together comprehensive 131 00:04:42,475 --> 00:04:42,975 multidisciplinary 132 00:04:43,514 --> 00:04:45,834 programs with a plethora of faculty that are 133 00:04:45,834 --> 00:04:48,189 expert at that and to have that the 134 00:04:48,189 --> 00:04:51,490 degree of patient volume to drive the experience 135 00:04:51,709 --> 00:04:53,789 that re that results in the high quality 136 00:04:53,789 --> 00:04:54,449 of care. 137 00:04:54,829 --> 00:04:57,870 And when you think about the systems that 138 00:04:57,870 --> 00:04:58,689 aren't necessarily 139 00:04:58,990 --> 00:05:00,849 laser focused just on kids, 140 00:05:01,194 --> 00:05:03,754 it's very challenging for them to provide that 141 00:05:03,754 --> 00:05:06,314 kind of service line. And so we're seeing 142 00:05:06,314 --> 00:05:08,875 across our market and others, people getting out 143 00:05:08,875 --> 00:05:10,654 of the pediatric service business. 144 00:05:11,035 --> 00:05:13,274 And that leaves a dearth of where these 145 00:05:13,274 --> 00:05:16,230 kids, particularly in the Far Northwest Region, that's 146 00:05:16,389 --> 00:05:18,389 that explains why we wanted to get more 147 00:05:18,389 --> 00:05:20,730 proximal in the Schaumburg outpatient facility, 148 00:05:21,110 --> 00:05:23,689 and then the Western Suburban Region as well. 149 00:05:24,550 --> 00:05:27,589 It it also, you know, makes strategic sense 150 00:05:27,589 --> 00:05:29,990 for us as an organization because we do 151 00:05:29,990 --> 00:05:30,810 believe that 152 00:05:31,404 --> 00:05:32,704 we have the opportunity, 153 00:05:33,485 --> 00:05:37,004 to develop sustainable clinical service programs with this 154 00:05:37,004 --> 00:05:37,504 expansion. 155 00:05:37,964 --> 00:05:39,564 And I'll talk a little bit about what 156 00:05:39,564 --> 00:05:42,464 that looks like both from the ambulatory standpoint 157 00:05:42,604 --> 00:05:44,524 in terms of casting a broader net for 158 00:05:44,524 --> 00:05:45,185 our subspecialty, 159 00:05:45,680 --> 00:05:47,439 But also as well, you asked the question 160 00:05:47,439 --> 00:05:49,600 about the differential of care, if you will, 161 00:05:49,600 --> 00:05:52,240 for example, in our in our, plan Downers 162 00:05:52,240 --> 00:05:53,139 Grove initiative. 163 00:05:54,080 --> 00:05:55,939 So as we think about, 164 00:05:56,560 --> 00:05:59,115 that particular market, first of all, we've had 165 00:05:59,115 --> 00:06:01,194 services there, for a number of years in 166 00:06:01,194 --> 00:06:04,475 our Westchester site where we provide ambulatory surgical 167 00:06:04,475 --> 00:06:07,774 care as well as some ambulatory subspecialty care. 168 00:06:07,995 --> 00:06:10,074 We were, we knew over time we were 169 00:06:10,074 --> 00:06:12,475 outpacing our capacity there, and we're looking at 170 00:06:12,475 --> 00:06:13,050 how to 171 00:06:13,610 --> 00:06:16,649 phase our next replacement strategy there. As we 172 00:06:16,649 --> 00:06:18,669 did so, we looked very closely across 173 00:06:18,970 --> 00:06:21,129 all the types of pediatric services that are 174 00:06:21,129 --> 00:06:23,689 requested by patients and families in that region 175 00:06:23,689 --> 00:06:25,689 and how they may or may not be 176 00:06:25,689 --> 00:06:28,714 adequately met and delivered. And so we recognized 177 00:06:28,774 --> 00:06:31,254 it provides us an opportunity not just to 178 00:06:31,254 --> 00:06:31,754 expand 179 00:06:32,214 --> 00:06:36,074 those services, ambulatory surgical care and ambulatory subspecialty 180 00:06:36,455 --> 00:06:40,235 access, but also provide both inpatient and emergency 181 00:06:40,375 --> 00:06:40,875 care. 182 00:06:41,439 --> 00:06:43,360 We recognize that about half of the kids 183 00:06:43,360 --> 00:06:45,920 in that region leave that region to get 184 00:06:45,920 --> 00:06:48,480 inpatient care. And so we felt that being 185 00:06:48,480 --> 00:06:50,959 able to keep kids closer to home where 186 00:06:50,959 --> 00:06:53,295 they where they play, where they learn, 187 00:06:53,694 --> 00:06:56,014 and where they study is a much makes 188 00:06:56,014 --> 00:06:57,475 much more sense for them. 189 00:06:57,775 --> 00:07:00,254 And it it enables us to not have 190 00:07:00,254 --> 00:07:00,915 to make, 191 00:07:01,615 --> 00:07:02,115 parents, 192 00:07:03,215 --> 00:07:04,835 make a differential chain 193 00:07:05,254 --> 00:07:07,634 a a choice between convenience versus 194 00:07:08,039 --> 00:07:10,919 competence and excellence. And so rather than saying 195 00:07:10,919 --> 00:07:11,899 we're gonna go 196 00:07:12,279 --> 00:07:13,259 somewhere different, 197 00:07:14,039 --> 00:07:15,959 because it's closer and don't have to come 198 00:07:15,959 --> 00:07:18,360 downtown, we wanna make sure that we're bringing 199 00:07:18,360 --> 00:07:21,399 that service capability much closer so families aren't 200 00:07:21,399 --> 00:07:23,180 sort of forced to make that decision. 201 00:07:23,764 --> 00:07:25,845 So excited. The other asset that will be 202 00:07:25,845 --> 00:07:28,985 out there is the pediatric emergency department. And 203 00:07:29,285 --> 00:07:31,845 right now we we, staff with our partnership 204 00:07:31,845 --> 00:07:33,145 with Northwestern Medicine, 205 00:07:34,404 --> 00:07:36,564 most of the day at Central DuPage Hospital 206 00:07:36,564 --> 00:07:39,460 with pediatric emergency medicine trained physicians. That's really 207 00:07:39,460 --> 00:07:40,199 the only 208 00:07:40,660 --> 00:07:43,139 service that's out in that entire region that 209 00:07:43,139 --> 00:07:46,020 is focused on pediatric emergency care, which is 210 00:07:46,020 --> 00:07:49,060 very different and requires very different expertise than 211 00:07:49,060 --> 00:07:51,875 adult emergency care. So we believe that too 212 00:07:51,875 --> 00:07:53,334 is going to be an enormous, 213 00:07:54,035 --> 00:07:56,754 enormous asset for this region to be able 214 00:07:56,754 --> 00:07:58,694 to provide stability for kids. 215 00:07:59,475 --> 00:08:01,714 I'll just touch briefly, Jacob, that you asked 216 00:08:01,714 --> 00:08:03,735 about sort of that level of care and, 217 00:08:05,250 --> 00:08:05,990 this institution, 218 00:08:06,850 --> 00:08:09,889 in Streeterville, the flagship hospital will always be 219 00:08:09,889 --> 00:08:12,550 the place where we provide that high quality, 220 00:08:13,329 --> 00:08:14,790 and high tertiary 221 00:08:15,169 --> 00:08:18,225 so called coronary care. So kids with heart 222 00:08:18,225 --> 00:08:20,865 failure that may need a cardiac transplant, kids 223 00:08:20,865 --> 00:08:21,365 with, 224 00:08:21,745 --> 00:08:23,125 cancer that may need, 225 00:08:23,504 --> 00:08:24,884 a bone marrow transplant. 226 00:08:25,264 --> 00:08:27,264 Though that type of care will always be 227 00:08:27,264 --> 00:08:29,685 anchored here at this facility because it requires 228 00:08:29,904 --> 00:08:32,644 a a unique environment and a unique workforce. 229 00:08:33,179 --> 00:08:34,540 What we will be placing out in the 230 00:08:34,540 --> 00:08:37,419 Downers Grove is a a slightly lower level 231 00:08:37,419 --> 00:08:38,399 of care capability. 232 00:08:39,899 --> 00:08:42,299 So for example, today, we we have a 233 00:08:42,299 --> 00:08:43,679 number of kids in our hospital 234 00:08:44,620 --> 00:08:45,519 impacted by 235 00:08:46,264 --> 00:08:50,264 lung viral infections where their oxygen level in 236 00:08:50,264 --> 00:08:52,504 in normal room air is not sufficient. And 237 00:08:52,504 --> 00:08:54,184 they need a little bit of oxygen to 238 00:08:54,184 --> 00:08:57,144 recover, but they don't need extensive services beyond 239 00:08:57,144 --> 00:08:59,065 that. We have kids that often come in 240 00:08:59,065 --> 00:09:02,330 with, significant vomiting and and diarrhea that might 241 00:09:02,330 --> 00:09:03,070 be dehydrated 242 00:09:03,610 --> 00:09:05,129 and can't do that on their own, but 243 00:09:05,129 --> 00:09:07,690 need intravenous fluid therapy for a period of 244 00:09:07,690 --> 00:09:09,610 time. Those are the kinds of kids that 245 00:09:09,610 --> 00:09:10,269 we anticipate, 246 00:09:11,210 --> 00:09:12,110 often leave 247 00:09:12,485 --> 00:09:14,804 that their region, to get that kind of 248 00:09:14,804 --> 00:09:16,804 inpatient care that we'll now be able to 249 00:09:16,804 --> 00:09:18,804 provide for them and keep them local for 250 00:09:18,804 --> 00:09:20,884 that aspect of it. And we've had a 251 00:09:20,884 --> 00:09:24,024 number of, you know, we we've had experience 252 00:09:24,245 --> 00:09:24,985 in managing 253 00:09:25,449 --> 00:09:28,169 how to triage that level of care. So 254 00:09:28,169 --> 00:09:30,089 I think it's something very familiar to our 255 00:09:30,089 --> 00:09:33,049 providers that we'll do safely and effectively with 256 00:09:33,049 --> 00:09:33,870 our new site. 257 00:09:34,809 --> 00:09:36,730 Understood. So these new sites, they're gonna be 258 00:09:36,730 --> 00:09:39,709 working in tandem with the flagship hospital downtown, 259 00:09:40,365 --> 00:09:41,965 but this is all really to meet the 260 00:09:41,965 --> 00:09:44,304 access demands that you are seeing and hearing, 261 00:09:45,164 --> 00:09:47,804 from patients out in in, out in the 262 00:09:47,804 --> 00:09:48,304 suburbs. 263 00:09:48,764 --> 00:09:51,965 Staying on this topic, Tom, Lurie is opening 264 00:09:51,965 --> 00:09:54,709 the Austin Hope Center on the West Side 265 00:09:54,709 --> 00:09:56,569 Of Chicago later this year. 266 00:09:56,870 --> 00:09:58,309 Can you tell us a little bit more 267 00:09:58,309 --> 00:10:00,089 about this project and 268 00:10:00,470 --> 00:10:03,509 more contextually how you think other children's hospitals 269 00:10:03,509 --> 00:10:05,884 should be thinking about meeting the needs of 270 00:10:05,884 --> 00:10:06,945 more underserved 271 00:10:07,404 --> 00:10:08,945 populations across the country? 272 00:10:09,804 --> 00:10:11,165 For sure. I think it's such an such 273 00:10:11,165 --> 00:10:12,865 an important area today, Jacob. 274 00:10:13,725 --> 00:10:16,524 The the high level summary I I would 275 00:10:16,524 --> 00:10:19,360 put on this is that, you know, two 276 00:10:19,360 --> 00:10:21,379 things kinda come to mind. One, 277 00:10:22,320 --> 00:10:23,059 too often, 278 00:10:23,600 --> 00:10:26,720 a child's ZIP code has a much higher 279 00:10:26,720 --> 00:10:29,460 impact on their health outcomes than their 280 00:10:29,840 --> 00:10:33,085 genetic code. And that's because of all what 281 00:10:33,085 --> 00:10:35,725 we describe as social influencers of health. It's 282 00:10:35,725 --> 00:10:38,065 often described as the determinants of health, 283 00:10:38,605 --> 00:10:41,345 that that conveys a deterministic 284 00:10:41,884 --> 00:10:44,845 factor from those, situations, and we believe they 285 00:10:44,845 --> 00:10:46,799 can just be influential and that we can 286 00:10:46,799 --> 00:10:49,379 help address them. And so the other component 287 00:10:49,440 --> 00:10:52,160 is that health is, not just about health 288 00:10:52,160 --> 00:10:55,059 care, but it's the broader environment. And, 289 00:10:55,519 --> 00:10:57,840 we believe that we need to be a 290 00:10:57,840 --> 00:10:58,340 component 291 00:10:58,960 --> 00:10:59,475 of the 292 00:10:59,954 --> 00:11:00,454 comprehensive 293 00:11:00,754 --> 00:11:02,375 health and well-being of kids. 294 00:11:03,074 --> 00:11:03,554 So, 295 00:11:03,954 --> 00:11:06,855 we have a number of initiatives that progress 296 00:11:06,995 --> 00:11:09,315 in that area through what we call our 297 00:11:09,315 --> 00:11:11,254 Magoon Institute for Healthy Communities. 298 00:11:12,434 --> 00:11:16,129 My privilege to to succeed, Patrick Magoon, who 299 00:11:16,129 --> 00:11:18,129 was the CEO for twenty two years here 300 00:11:18,129 --> 00:11:21,170 at Lurie Children's and, with his retirement took 301 00:11:21,170 --> 00:11:22,790 the opportunity to name, 302 00:11:23,170 --> 00:11:25,250 this area, which was such a high priority 303 00:11:25,250 --> 00:11:27,330 and focus for him that we're extremely proud 304 00:11:27,330 --> 00:11:28,309 to carry on. 305 00:11:28,690 --> 00:11:30,125 And in Austin, 306 00:11:31,065 --> 00:11:32,524 as we work through, 307 00:11:33,384 --> 00:11:34,125 an opportunity 308 00:11:35,225 --> 00:11:37,225 to enter into the neighborhood in partnership with 309 00:11:37,225 --> 00:11:37,884 the Stone, 310 00:11:38,665 --> 00:11:39,165 church, 311 00:11:40,105 --> 00:11:42,665 to develop this, it's an effort for us 312 00:11:42,665 --> 00:11:43,325 to be 313 00:11:43,870 --> 00:11:46,689 a component of a holistic approach to what 314 00:11:46,829 --> 00:11:48,750 our our real vision is, and that's to 315 00:11:48,750 --> 00:11:49,569 be a transformational 316 00:11:49,870 --> 00:11:52,110 force for health and well-being to achieve the 317 00:11:52,110 --> 00:11:54,990 healthier future for every child. And that's every 318 00:11:54,990 --> 00:11:57,705 child regardless of where they they live. We 319 00:11:57,705 --> 00:12:00,024 know that this particular area of the West 320 00:12:00,024 --> 00:12:02,504 Side Of Chicago has been under resourced for 321 00:12:02,504 --> 00:12:03,485 a number of years, 322 00:12:04,264 --> 00:12:05,805 and we have an opportunity 323 00:12:06,504 --> 00:12:08,425 to come in at what I would describe 324 00:12:08,425 --> 00:12:10,524 as the generational ground level. 325 00:12:10,850 --> 00:12:13,090 Because one of the most important challenges we 326 00:12:13,090 --> 00:12:15,730 have in Chicago in many urban sites is 327 00:12:15,730 --> 00:12:17,950 the differential in terms of, 328 00:12:18,370 --> 00:12:18,870 longevity 329 00:12:19,250 --> 00:12:19,990 of health. 330 00:12:20,290 --> 00:12:22,290 And we have too too much of an 331 00:12:22,290 --> 00:12:24,610 adult disparity in terms of health outcomes here 332 00:12:24,610 --> 00:12:26,550 in Chicago and in other urban sites. 333 00:12:27,225 --> 00:12:29,304 You can try to address that at the 334 00:12:29,304 --> 00:12:30,205 adult level, 335 00:12:30,585 --> 00:12:33,325 but we believe that this requires a generational 336 00:12:33,544 --> 00:12:34,845 investment in kids. 337 00:12:35,144 --> 00:12:36,825 And that if we can elevate the health 338 00:12:36,825 --> 00:12:38,365 and the well-being and the education 339 00:12:38,825 --> 00:12:41,519 of kids, they can be that next generation 340 00:12:41,579 --> 00:12:44,379 of adults that continues to remain healthy and 341 00:12:44,379 --> 00:12:46,860 to remain productive and to really drive the 342 00:12:46,860 --> 00:12:47,360 future 343 00:12:47,740 --> 00:12:48,559 of our city. 344 00:12:49,100 --> 00:12:50,779 So you can't do that just with health 345 00:12:50,779 --> 00:12:52,699 care. And so this is an effort where 346 00:12:52,699 --> 00:12:55,144 we're bringing both our clinical services 347 00:12:55,845 --> 00:12:59,225 that the community has identified as needing most, 348 00:12:59,445 --> 00:13:01,764 and that's the key component of this. You 349 00:13:01,764 --> 00:13:03,605 can't go in as a system and say, 350 00:13:03,605 --> 00:13:06,080 we believe we know what you need. You 351 00:13:06,080 --> 00:13:08,399 need to go in and understand from them 352 00:13:08,399 --> 00:13:11,040 and from the community based organizations, from the 353 00:13:11,040 --> 00:13:13,779 patients and the families, and from other providers 354 00:13:13,840 --> 00:13:15,860 that are already existing in that community 355 00:13:16,240 --> 00:13:18,320 to not duplicate what they do well already, 356 00:13:18,320 --> 00:13:21,345 but to complement that. So we're very excited 357 00:13:21,345 --> 00:13:23,665 to have an integration of the primary care 358 00:13:23,665 --> 00:13:26,785 services, bring some behavioral health and social support 359 00:13:26,785 --> 00:13:27,285 structures 360 00:13:27,665 --> 00:13:31,504 along with access to subspecialty care that too 361 00:13:31,504 --> 00:13:34,750 often is not provided and results in unnecessary 362 00:13:34,970 --> 00:13:35,470 hospitalizations, 363 00:13:36,410 --> 00:13:38,809 and too often is not being taken care 364 00:13:38,809 --> 00:13:41,129 of in the community and necessitates them coming 365 00:13:41,129 --> 00:13:44,190 in to the emergency department really unnecessarily. 366 00:13:45,665 --> 00:13:46,804 So I will just say 367 00:13:47,264 --> 00:13:50,065 parenthetically to keep in mind, this is certainly 368 00:13:50,065 --> 00:13:52,565 first and foremost an investment in the kids. 369 00:13:52,785 --> 00:13:54,545 That it is going to make a tangible 370 00:13:54,545 --> 00:13:55,524 difference in them. 371 00:13:55,904 --> 00:13:58,325 But in the long run, this is also 372 00:13:58,465 --> 00:13:59,125 an investment 373 00:13:59,425 --> 00:14:01,960 in reducing the cost of care. And so 374 00:14:01,960 --> 00:14:03,639 when we think about the challenges, I'm sure 375 00:14:03,639 --> 00:14:04,779 we'll talk about the Medicaid 376 00:14:05,080 --> 00:14:06,860 funding challenges that we have coming. 377 00:14:07,320 --> 00:14:10,279 This is a way to overall reduce the 378 00:14:10,279 --> 00:14:13,399 the cost of care by significantly elevating the 379 00:14:13,399 --> 00:14:14,220 health outcomes. 380 00:14:14,534 --> 00:14:16,214 So we believe not only is this the 381 00:14:16,214 --> 00:14:17,975 right thing to do for kids, but, honestly, 382 00:14:17,975 --> 00:14:19,495 in the long term, we think it's the 383 00:14:19,495 --> 00:14:21,014 right thing to do for the state of 384 00:14:21,014 --> 00:14:23,115 Illinois in terms of the cost of care. 385 00:14:23,735 --> 00:14:25,654 Absolutely. No. It's it's incredible to hear the 386 00:14:25,654 --> 00:14:27,735 investments that you're making into this part of 387 00:14:27,735 --> 00:14:30,100 the city, and and I do wanna follow-up 388 00:14:30,100 --> 00:14:32,419 with you on on the Medicaid changes that, 389 00:14:32,659 --> 00:14:34,519 we are seeing coming down the pipeline 390 00:14:35,059 --> 00:14:36,440 under HR one, 391 00:14:37,059 --> 00:14:40,179 largely going into effect next year. But I 392 00:14:40,179 --> 00:14:42,340 know I know your organization has been, 393 00:14:42,965 --> 00:14:45,304 really preparing for this ahead of time. 394 00:14:45,764 --> 00:14:46,745 You you 395 00:14:47,125 --> 00:14:48,965 said publicly, I believe, last year that you 396 00:14:48,965 --> 00:14:52,105 were conducting a clinical program review in response 397 00:14:52,165 --> 00:14:53,544 to some of these these changes, 398 00:14:54,404 --> 00:14:58,029 under HR one, and it's nearly 60% of 399 00:14:58,029 --> 00:15:00,029 your inpatient stays are covered by the program, 400 00:15:00,029 --> 00:15:00,690 I believe. 401 00:15:01,230 --> 00:15:03,309 So, you know, we've been hearing from leaders 402 00:15:03,309 --> 00:15:05,950 all over the country, both from health systems 403 00:15:05,950 --> 00:15:08,750 to insurers, about how they're how everyone is 404 00:15:08,750 --> 00:15:09,730 prepping now, 405 00:15:10,110 --> 00:15:11,985 to get ahead of this this massive change 406 00:15:11,985 --> 00:15:13,205 for the entire system. 407 00:15:13,665 --> 00:15:15,045 Can you give us the Lurie's, 408 00:15:15,504 --> 00:15:17,985 version of that and how you're navigating this? 409 00:15:17,985 --> 00:15:20,085 Yeah. The Lurie perspective of all that. 410 00:15:20,945 --> 00:15:22,705 Well, you know, I mean, in in in 411 00:15:22,705 --> 00:15:23,605 doing so, 412 00:15:24,290 --> 00:15:25,910 you know, I I think it's important. 413 00:15:26,370 --> 00:15:26,870 Look, 414 00:15:27,250 --> 00:15:30,370 Medicaid is is a critically important program for 415 00:15:30,370 --> 00:15:30,950 the country. 416 00:15:31,649 --> 00:15:34,290 People often don't realize that half the country's 417 00:15:34,290 --> 00:15:37,250 kids are covered by Medicaid, and that's certainly 418 00:15:37,250 --> 00:15:38,470 the case here in Illinois. 419 00:15:39,254 --> 00:15:42,695 Despite that, they only they're only responsible for 420 00:15:42,695 --> 00:15:45,835 about 18, maybe 20% of the overall Medicaid 421 00:15:45,894 --> 00:15:48,295 cost. So to me, it would again, it 422 00:15:48,295 --> 00:15:50,955 makes sense to make the long term investment 423 00:15:51,029 --> 00:15:53,430 in kids is to really sustain the Medicaid 424 00:15:53,430 --> 00:15:55,769 program at least as it relates to kids. 425 00:15:55,910 --> 00:15:57,450 And so let's let's 426 00:15:57,830 --> 00:16:00,570 let's make no mistake about it. HR one 427 00:16:01,190 --> 00:16:03,050 is a is a disaster. 428 00:16:03,750 --> 00:16:05,370 That at the same time, 429 00:16:06,524 --> 00:16:08,225 I'll I'll give the federal government 430 00:16:09,084 --> 00:16:10,544 credit for recognizing 431 00:16:10,924 --> 00:16:13,164 there are opportunities to make it better, to 432 00:16:13,164 --> 00:16:15,325 make the program better. And that's part what 433 00:16:15,325 --> 00:16:17,264 we just talked about in the Austin community. 434 00:16:17,325 --> 00:16:19,345 That's part of what we believe are opportunities 435 00:16:19,964 --> 00:16:20,784 to improve 436 00:16:21,430 --> 00:16:23,110 the the quality of the care and the 437 00:16:23,110 --> 00:16:25,110 outcomes at a lower cost for many kids 438 00:16:25,110 --> 00:16:27,269 that are covered in Medicaid. So we're all 439 00:16:27,269 --> 00:16:28,629 in on that, but to do it in 440 00:16:28,629 --> 00:16:30,950 the way that the HR one bill proposes 441 00:16:30,950 --> 00:16:33,350 to do it is, not not the way 442 00:16:33,350 --> 00:16:35,690 that we would believe to be approaching that. 443 00:16:36,284 --> 00:16:37,745 Nonetheless, that's what the future, 444 00:16:38,365 --> 00:16:40,044 at least at this point looks like we 445 00:16:40,044 --> 00:16:41,725 have coming. And so certainly, we have to 446 00:16:41,725 --> 00:16:44,365 look at what impact that that will have 447 00:16:44,365 --> 00:16:45,184 on the future. 448 00:16:45,725 --> 00:16:47,245 I will, before we jump to that, just 449 00:16:47,245 --> 00:16:50,709 parenthetically also just state the, you know, I 450 00:16:50,709 --> 00:16:53,750 wanna give our Illinois Hospital Association leadership and 451 00:16:53,750 --> 00:16:54,149 our, 452 00:16:54,789 --> 00:16:57,110 our, health and family services in the state 453 00:16:57,110 --> 00:16:57,769 of Illinois 454 00:16:58,149 --> 00:17:00,009 leadership credit for, 455 00:17:00,629 --> 00:17:03,209 the success in getting a state directed payment, 456 00:17:03,669 --> 00:17:04,169 altered, 457 00:17:04,585 --> 00:17:06,265 for the next couple years for us. That 458 00:17:06,265 --> 00:17:08,265 brings in a higher Medicaid rate for the 459 00:17:08,265 --> 00:17:10,904 time being before HR one hits. And so 460 00:17:10,904 --> 00:17:12,525 that frankly is a lifeline, 461 00:17:13,144 --> 00:17:15,945 for many of, of us, our critical access 462 00:17:15,945 --> 00:17:18,184 and safety net institutions. And so we have 463 00:17:18,184 --> 00:17:20,710 some breathing room. And that breathing room is 464 00:17:20,710 --> 00:17:22,549 to your point, giving us the time to 465 00:17:22,549 --> 00:17:23,049 understand 466 00:17:23,589 --> 00:17:24,890 what clinical programs 467 00:17:25,349 --> 00:17:27,429 we wanna continue to maintain that we know 468 00:17:27,429 --> 00:17:29,829 are high quality. We know that they're mission 469 00:17:29,829 --> 00:17:32,390 aligned. And importantly, as we look at what 470 00:17:32,390 --> 00:17:34,945 the rates are anticipated to bring, they are 471 00:17:34,945 --> 00:17:36,005 also financially, 472 00:17:36,625 --> 00:17:39,205 sustainable from that aspect of it. So 473 00:17:39,825 --> 00:17:42,144 we also are looking at opportunities in terms 474 00:17:42,144 --> 00:17:43,684 of technologies that, 475 00:17:44,465 --> 00:17:46,065 you know, the the AI, 476 00:17:46,545 --> 00:17:49,700 opportunities that allow us to be more operationally 477 00:17:50,159 --> 00:17:52,419 efficient and be able to reduce, 478 00:17:53,039 --> 00:17:55,460 the overall cost and burden of the work, 479 00:17:55,519 --> 00:17:57,940 but still being able to maintain these delivery 480 00:17:58,000 --> 00:18:00,799 services overall from that aspect of it. But, 481 00:18:01,200 --> 00:18:03,200 there's there's no doubt all of us, I 482 00:18:03,200 --> 00:18:05,255 mean, all of us that have a significant 483 00:18:05,255 --> 00:18:06,234 amount of Medicaid, 484 00:18:06,855 --> 00:18:08,855 business are going to be having to make 485 00:18:08,855 --> 00:18:11,115 these hard decisions as we look at it. 486 00:18:11,734 --> 00:18:12,554 And so 487 00:18:12,855 --> 00:18:14,714 my my bigger concern, 488 00:18:15,494 --> 00:18:17,255 as we look at what the future brings 489 00:18:17,255 --> 00:18:20,250 is to not forget where the biggest bang 490 00:18:20,250 --> 00:18:23,710 for health care investment, including Medicaid investment, 491 00:18:24,169 --> 00:18:26,190 is in the country. And that's still 492 00:18:26,490 --> 00:18:29,210 in the future generations of this country. And 493 00:18:29,210 --> 00:18:31,234 so I think as long as we we 494 00:18:31,234 --> 00:18:33,154 keep that in mind and consider how we 495 00:18:33,154 --> 00:18:34,375 might be able to adjust, 496 00:18:34,755 --> 00:18:37,075 the future of Medicaid to ensure that the 497 00:18:37,075 --> 00:18:38,835 children are covered and that they're, 498 00:18:39,154 --> 00:18:40,355 continuing to drive, 499 00:18:40,914 --> 00:18:41,815 health and well-being, 500 00:18:42,195 --> 00:18:44,355 that is the future of driving our healthy 501 00:18:44,355 --> 00:18:46,779 communities that will benefit all of us. So 502 00:18:46,779 --> 00:18:48,940 a lot of advocacy. I'm very proud that 503 00:18:48,940 --> 00:18:52,059 we're, an important voice of pediatric expertise and 504 00:18:52,059 --> 00:18:52,559 advocacy, 505 00:18:53,420 --> 00:18:56,000 both with a very favorable administration in Springfield, 506 00:18:56,140 --> 00:18:58,220 but, even with the work that we do 507 00:18:58,220 --> 00:18:59,920 at the federal level in DC. 508 00:19:00,315 --> 00:19:02,075 But these are going to be challenging times 509 00:19:02,075 --> 00:19:04,315 coming around the corner, and and, we'll continue 510 00:19:04,315 --> 00:19:05,835 to work hard on making sure that we 511 00:19:05,835 --> 00:19:07,755 continue to to meet the demands of the 512 00:19:07,755 --> 00:19:09,615 kids that we're privileged to care for. 513 00:19:10,075 --> 00:19:13,674 Certainly. Certainly. Tough decisions, challenging times ahead, but 514 00:19:13,674 --> 00:19:15,660 it is good to hear, that the state 515 00:19:15,660 --> 00:19:16,400 is supportive 516 00:19:16,859 --> 00:19:18,320 of expanded assistance, 517 00:19:18,859 --> 00:19:20,559 to to help navigate this. 518 00:19:21,500 --> 00:19:23,119 Going back to what you had said earlier, 519 00:19:23,180 --> 00:19:25,340 Tom, and just in terms of why you're 520 00:19:25,340 --> 00:19:25,840 expanding, 521 00:19:26,299 --> 00:19:28,539 in certain areas and the dearth me trying 522 00:19:28,539 --> 00:19:31,345 to meet that, dearth of, lack of care 523 00:19:31,345 --> 00:19:33,524 access you see in certain parts of Chicagoland. 524 00:19:34,625 --> 00:19:36,544 I wanna read you a stat from from 525 00:19:36,544 --> 00:19:38,085 some of our recent reporting, 526 00:19:38,625 --> 00:19:41,424 that that twenty percent of hospital pediatric units 527 00:19:41,424 --> 00:19:41,924 nationally 528 00:19:42,384 --> 00:19:44,804 have closed over the last decade. 529 00:19:45,549 --> 00:19:47,789 I'm I'm sure that's not a surprising statistic 530 00:19:47,789 --> 00:19:48,849 to you, but I wonder 531 00:19:49,230 --> 00:19:51,730 what role an organization like Lurie 532 00:19:52,029 --> 00:19:53,490 should play in the broader 533 00:19:54,269 --> 00:19:55,570 pediatric care system, 534 00:19:56,269 --> 00:19:58,875 and how you're thinking about virtual care, 535 00:19:59,355 --> 00:20:01,375 partnerships like the one with Northwestern, 536 00:20:02,394 --> 00:20:04,335 labor training pipelines to 537 00:20:04,795 --> 00:20:07,595 further address some of these access gaps that 538 00:20:07,595 --> 00:20:09,615 sound like they they could worsen, 539 00:20:10,075 --> 00:20:10,894 in the region. 540 00:20:11,275 --> 00:20:11,775 Yeah. 541 00:20:12,470 --> 00:20:14,549 Well, there's a there it's important for folks 542 00:20:14,549 --> 00:20:17,349 to realize the some of some of the 543 00:20:17,349 --> 00:20:19,269 factors that have that drive that. And it 544 00:20:19,269 --> 00:20:21,190 is not surprising because it was our research 545 00:20:21,190 --> 00:20:22,970 team that published that work. So, 546 00:20:23,269 --> 00:20:24,089 we're we're 547 00:20:24,470 --> 00:20:27,109 too intimately familiar with those challenges across the 548 00:20:27,109 --> 00:20:27,609 country. 549 00:20:28,015 --> 00:20:30,595 I I think what we just talked about 550 00:20:30,734 --> 00:20:33,855 was Medicaid. Much of this really started or 551 00:20:33,934 --> 00:20:34,654 and was even 552 00:20:35,214 --> 00:20:36,974 much of it started before the pandemic, but 553 00:20:36,974 --> 00:20:39,294 was accelerated from the pandemic and a a 554 00:20:39,294 --> 00:20:41,794 very practical thing that happened during that time. 555 00:20:42,240 --> 00:20:44,720 Fortunately, kids were not impacted by COVID as 556 00:20:44,720 --> 00:20:47,440 much as adults. And because of the number 557 00:20:47,440 --> 00:20:49,759 of adults that needed inpatient beds, many of 558 00:20:49,759 --> 00:20:53,059 these systems that had small inpatient pediatric beds, 559 00:20:54,559 --> 00:20:56,579 provided them to adults and 560 00:20:57,115 --> 00:20:58,794 suddenly realized that when there's an adult in 561 00:20:58,794 --> 00:21:00,174 the bed paid for by Medicare, 562 00:21:00,634 --> 00:21:01,994 you do much better than when you have 563 00:21:01,994 --> 00:21:03,934 a kid in that bed provided by Medicaid. 564 00:21:03,994 --> 00:21:05,774 So it does get back to that differential 565 00:21:05,835 --> 00:21:09,355 of of adult versus pediatric reimbursement for care, 566 00:21:09,355 --> 00:21:11,274 even though I believe pediatric care is much 567 00:21:11,274 --> 00:21:12,509 harder than adult care. 568 00:21:13,230 --> 00:21:15,950 So that's one driver is just financially, it's 569 00:21:15,950 --> 00:21:18,029 more challenging in terms of providing that kind 570 00:21:18,029 --> 00:21:20,269 of care. The second you mentioned and alluded 571 00:21:20,269 --> 00:21:21,009 to the workforce, 572 00:21:21,869 --> 00:21:24,525 there are additional statistics that look at 573 00:21:25,404 --> 00:21:25,984 the increasing 574 00:21:26,285 --> 00:21:28,285 challenge that we're seeing of, 575 00:21:28,924 --> 00:21:31,644 medical students coming out of school and deciding 576 00:21:31,644 --> 00:21:33,904 to pursue pediatrics, and then even, 577 00:21:34,445 --> 00:21:37,825 folks that pursue pediatric training going into subspecialty 578 00:21:38,125 --> 00:21:40,990 fellowship training. Those are all on decline. 579 00:21:41,369 --> 00:21:43,069 And so we know that there's a 580 00:21:43,369 --> 00:21:44,990 a a growing dearth of subspecialists 581 00:21:45,369 --> 00:21:46,190 that are available, 582 00:21:46,890 --> 00:21:49,289 which which really creates a couple of things. 583 00:21:49,289 --> 00:21:51,130 Number one, it creates really a a a 584 00:21:51,130 --> 00:21:54,089 national competition for expertise. And then when you 585 00:21:54,089 --> 00:21:56,164 go down to a local market like Chicagoland, 586 00:21:56,464 --> 00:21:58,964 you realize it's really hard to have sufficient, 587 00:21:59,744 --> 00:22:01,505 workforce to be able to provide the kind 588 00:22:01,505 --> 00:22:03,984 of services that I've, alluded to that that 589 00:22:03,984 --> 00:22:06,304 we're privileged to be able to to provide 590 00:22:06,304 --> 00:22:08,544 because of the the special workforce that we 591 00:22:08,544 --> 00:22:10,940 have. So that certainly is a key strategy 592 00:22:10,940 --> 00:22:12,779 for us is to continuing to have one 593 00:22:12,779 --> 00:22:15,679 of the most competitive pediatric residency programs. 594 00:22:16,779 --> 00:22:19,119 We're estimated to be the third most competitive, 595 00:22:19,259 --> 00:22:19,759 meaning, 596 00:22:21,099 --> 00:22:23,524 folks really want to come, to Lurie Children's 597 00:22:23,524 --> 00:22:25,765 for their pediatric training. And I think Chicago 598 00:22:25,765 --> 00:22:27,765 as a great city is also a great 599 00:22:27,765 --> 00:22:28,744 draw for that. 600 00:22:29,444 --> 00:22:31,944 And then we're continuing to try to, 601 00:22:32,565 --> 00:22:34,984 encourage them to come out of that residency 602 00:22:35,044 --> 00:22:38,130 training program and stay in our subspecialty fellowship 603 00:22:38,190 --> 00:22:39,009 pro programming. 604 00:22:39,470 --> 00:22:41,549 So being able to sort of train your 605 00:22:41,549 --> 00:22:42,369 own and, 606 00:22:43,150 --> 00:22:46,109 populate that critically important workforce is is really 607 00:22:46,109 --> 00:22:47,009 critical there. 608 00:22:48,349 --> 00:22:50,429 Whether you can continue and and I will 609 00:22:50,429 --> 00:22:52,595 say that those strategies are ones that are 610 00:22:52,595 --> 00:22:53,974 being shared across 611 00:22:54,355 --> 00:22:56,774 really the national leading peers that we have. 612 00:22:57,075 --> 00:22:58,914 You know, it's been it's been it's been 613 00:22:58,914 --> 00:23:00,694 estimated or projected that 614 00:23:01,634 --> 00:23:04,589 these large independent children's hospitals and large urban 615 00:23:04,589 --> 00:23:07,309 areas like ourselves and and other peers are 616 00:23:07,309 --> 00:23:09,329 are going to be the few remaining 617 00:23:10,029 --> 00:23:13,069 pediatric institutions across the country that are able 618 00:23:13,069 --> 00:23:14,289 to continue to sustain 619 00:23:14,750 --> 00:23:17,410 the kinds of high level, high quality expertise 620 00:23:17,549 --> 00:23:20,394 in the subspecialty area that we're known for, 621 00:23:20,615 --> 00:23:22,714 but we're also now seeing that 622 00:23:23,494 --> 00:23:26,054 come out of the community based opportunities in 623 00:23:26,054 --> 00:23:28,394 providing care. And so we're all 624 00:23:29,095 --> 00:23:31,034 taking the opportunity and responsibility 625 00:23:31,494 --> 00:23:33,515 to lean into that access challenge. 626 00:23:34,089 --> 00:23:36,490 So we're not the first to to develop 627 00:23:36,490 --> 00:23:38,490 a community based hospital like we're doing in 628 00:23:38,490 --> 00:23:41,309 Downers Grove. You've seen Children's Hospital of Philadelphia 629 00:23:41,369 --> 00:23:42,269 do this along, 630 00:23:42,889 --> 00:23:45,769 their area. You you've seen Seattle expand with 631 00:23:45,769 --> 00:23:48,409 partnerships in the Tacoma region. We're seeing our 632 00:23:48,409 --> 00:23:49,149 other peers 633 00:23:49,494 --> 00:23:51,274 have to take a similar strategy 634 00:23:52,375 --> 00:23:56,134 and, really doing it, because of the access 635 00:23:56,134 --> 00:23:58,214 challenge that kids in their market are having. 636 00:23:58,214 --> 00:24:00,394 And so we take that as an important 637 00:24:00,454 --> 00:24:01,994 responsibility to do so. 638 00:24:02,375 --> 00:24:03,194 I I think 639 00:24:03,519 --> 00:24:05,299 the other unique piece 640 00:24:06,400 --> 00:24:07,059 about ourselves 641 00:24:07,359 --> 00:24:09,440 in the Chicagoland market, and and this does 642 00:24:09,440 --> 00:24:10,980 extend to other peers, 643 00:24:11,679 --> 00:24:14,740 is you you can't have a static system, 644 00:24:14,960 --> 00:24:17,119 a static health system. You have to advance 645 00:24:17,119 --> 00:24:19,085 it. And I think what we're so proud 646 00:24:19,085 --> 00:24:21,484 of is the extraordinary growth of our research 647 00:24:21,484 --> 00:24:23,585 enterprise. When I got here ten years ago, 648 00:24:23,964 --> 00:24:26,125 you know, we probably had around $20,000,000 649 00:24:26,125 --> 00:24:27,264 of research expenditures. 650 00:24:27,724 --> 00:24:30,059 We're now well over $140,000,000 651 00:24:30,059 --> 00:24:31,980 of research expenditures. And what what does that 652 00:24:31,980 --> 00:24:33,339 mean? It only means that we have a 653 00:24:33,339 --> 00:24:34,399 research enterprise 654 00:24:34,940 --> 00:24:37,759 that is advancing what we understand about diseases. 655 00:24:37,899 --> 00:24:40,859 It's, it's identifying new therapeutic ways to take 656 00:24:40,859 --> 00:24:43,274 care of kids. It's It's developing new treatment 657 00:24:43,274 --> 00:24:43,774 strategies, 658 00:24:44,794 --> 00:24:46,554 and it's and it's informing us what the 659 00:24:46,554 --> 00:24:48,474 next questions are. So to your point, our 660 00:24:48,474 --> 00:24:49,375 research enterprise 661 00:24:49,835 --> 00:24:51,595 being able to tell us, hey, places are 662 00:24:51,595 --> 00:24:53,434 closing around the country. We better step in 663 00:24:53,434 --> 00:24:55,789 and do it. So I think that important 664 00:24:55,929 --> 00:24:56,429 essentiality 665 00:24:56,809 --> 00:24:59,849 of our discovery enterprise that complements and advances 666 00:24:59,849 --> 00:25:02,250 what we do on the clinical side is 667 00:25:02,329 --> 00:25:04,890 it's just our mission focus. And, again, I 668 00:25:04,890 --> 00:25:06,109 think it's our responsibility 669 00:25:07,095 --> 00:25:09,894 as the only laser focused children's hospital in 670 00:25:09,894 --> 00:25:11,434 Chicago and across Illinois 671 00:25:11,734 --> 00:25:13,515 to continue to drive that mission. 672 00:25:14,294 --> 00:25:15,894 Well, Tom, we've covered a lot of ground 673 00:25:15,894 --> 00:25:16,375 today. 674 00:25:17,015 --> 00:25:18,934 Anything else we're missing that you wanna make 675 00:25:18,934 --> 00:25:21,015 sure we mention to our audience or any 676 00:25:21,015 --> 00:25:23,409 final bits of advice you wanna offer all 677 00:25:23,409 --> 00:25:25,750 your colleagues listening in from around the country? 678 00:25:26,289 --> 00:25:28,230 No. You know, I mean, I I I 679 00:25:28,450 --> 00:25:30,210 think the one thing I would reflect on 680 00:25:30,210 --> 00:25:30,929 is is, 681 00:25:31,409 --> 00:25:33,829 how how challenging it is today. 682 00:25:34,369 --> 00:25:36,855 We've talked about the the reimbursement pressures with 683 00:25:36,855 --> 00:25:38,634 Medicaid and what's coming down the pipe 684 00:25:39,335 --> 00:25:40,875 in the pediatric world. 685 00:25:41,255 --> 00:25:42,855 And and and each, you know, the adult 686 00:25:42,855 --> 00:25:44,775 world has its own aspects of it, but 687 00:25:44,775 --> 00:25:46,615 we have challenges in terms of where how 688 00:25:46,615 --> 00:25:50,210 people are recognizing the important critical importance of 689 00:25:50,210 --> 00:25:52,789 vaccination strategies, for example. Right? 690 00:25:53,570 --> 00:25:54,070 We're 691 00:25:54,450 --> 00:25:57,110 we're looking at the ability to provide 692 00:25:57,890 --> 00:26:00,289 appropriate drugs and access to those both for 693 00:26:00,289 --> 00:26:02,130 kids and adults. So the pressures on the 694 00:26:02,130 --> 00:26:03,430 three forty b program, 695 00:26:04,105 --> 00:26:06,744 There's just enormous challenges that we have and 696 00:26:06,744 --> 00:26:08,904 I I think what I've always encouraged our 697 00:26:08,904 --> 00:26:10,924 folks to do is to make sure 698 00:26:11,464 --> 00:26:13,944 that despite the challenges, we stayed anchored on 699 00:26:13,944 --> 00:26:16,789 our mission. And that as things continue to 700 00:26:16,789 --> 00:26:19,029 be challenged and things continue to evolve, you 701 00:26:19,029 --> 00:26:20,710 you can put your head down and and 702 00:26:20,710 --> 00:26:22,250 be defeated by them. 703 00:26:22,869 --> 00:26:25,029 But, frankly, I think that's not the that's 704 00:26:25,029 --> 00:26:27,109 not the position we take, and we have 705 00:26:27,109 --> 00:26:29,144 to just take the opportunities and looking at 706 00:26:29,224 --> 00:26:32,285 how we devise strategies, how we devise operations, 707 00:26:32,345 --> 00:26:35,384 and frankly, how we educate and advocate for 708 00:26:35,384 --> 00:26:35,884 changes, 709 00:26:36,585 --> 00:26:39,244 to those policies that are impacting negatively 710 00:26:39,785 --> 00:26:41,705 the well-being of our kids and therefore the 711 00:26:41,705 --> 00:26:43,545 future of our city and the future of 712 00:26:43,545 --> 00:26:44,205 our country. 713 00:26:44,664 --> 00:26:47,299 So I think as long as folks remain 714 00:26:47,440 --> 00:26:49,599 so anchored and committed to what we come 715 00:26:49,599 --> 00:26:51,279 to work every day to do and improving 716 00:26:51,279 --> 00:26:52,880 the health and well-being of the of the 717 00:26:52,880 --> 00:26:54,799 patients that we're privileged to care for, whether 718 00:26:54,799 --> 00:26:55,859 it's adult or kids, 719 00:26:56,400 --> 00:26:58,660 I think we will continue to thrive, 720 00:26:59,279 --> 00:27:01,934 and continue to drive the best health outcomes 721 00:27:01,934 --> 00:27:03,554 and therefore the best communities, 722 00:27:04,015 --> 00:27:05,775 that we have for our great city and 723 00:27:05,775 --> 00:27:06,595 our great state. 724 00:27:07,454 --> 00:27:08,434 It's a great message, 725 00:27:08,734 --> 00:27:11,054 to close us out with. Doctor Shanley, I 726 00:27:11,054 --> 00:27:13,375 wanna thank you for taking the time to 727 00:27:13,375 --> 00:27:15,480 sit down with us and and for sharing 728 00:27:15,539 --> 00:27:17,779 all about the leader the stuff that's going 729 00:27:17,779 --> 00:27:20,099 on under your leadership at Lurie Children's with 730 00:27:20,099 --> 00:27:22,819 our audience. We really appreciate it. I appreciate 731 00:27:22,819 --> 00:27:25,240 the opportunity, Jacob. Thanks again for having me. 732 00:27:25,494 --> 00:27:27,894 Absolutely. Anytime. And to our audience, if you'd 733 00:27:27,894 --> 00:27:30,214 like to listen to more podcasts from Becker's 734 00:27:30,214 --> 00:27:33,674 HealthCare, you can visit beckershospitalreview.com.