Welcome to Becker's Healthcare Podcast. I'm Chris Sosa,
your host. And I'm thrilled to be joined
by Ben Goodstein. He is vice president and
chief ambulatory officer of Dayton Children's Hospital
and president of Dayton Children's Specialty Physicians. Ben,
thank you for joining us today. Thanks, Chris.
Great to see you. Yeah. Likewise. So glad
to have you on. So for those in
our audience who maybe are not too familiar
with yourself and Dayton Children's, could you give
us a little bit about both? Sure. We're
about a 230 bed children's hospital, one of
the six smallest in the country. We are
on the most competitive market in the world
when it comes to pediatrics. There are six
other pediatric hospitals in the state of Ohio
and two in Indianapolis that that are all
part of our,
our our region,
for health care for kids.
And it makes us a very,
unique hospital amongst them as one of the
only stand alone independent children's hospitals that's that
small.
Thank you, Ben. So
before we get into 2026,
let's look a little bit back at 2025.
So looking at that year, what would you
say is the most important initiative you led?
Just give us a bit about, the results
that happened and how the whole project evolved.
It could be more than one, but, you
know, let's start with one. So I I
would I would start off with behavioral health.
We're we're investing about a $180,000,000
into behavioral health.
In August 3 on August 13, we, opened
up our new behavioral health hospital,
which is a standalone 48 bed hospital
with a 12 bed crisis center, a day
treatment program,
a bridge program, psychiatry, and psychology.
So, basically, the entire
behavioral health network is in that building, which
is fantastic.
At the same time, we started redistributing
therapists
throughout our region and beyond,
specifically
linking them up with our other nine 19
or 20 offsites that we have so that
the families could, access that that therapy
outside of the main campus in in their
communities.
A huge opportunity for us to to engage
the community.
We got some state funding, about $25,000,000
of the building was funded by the state.
And then the Mateel family,
the previous owners of Vimes Dog Food,
gave us a $10,000,000
grant, which was really beneficial.
So the name of the building is the
Mathieu Center for Health and Wellness,
and and we couldn't do this without without
donors like them.
Since we opened in August, we expected a
slow ramp up. We've been at 90% or
95% capacity since the day we opened. That
is primarily in our inpatient units.
We're open to 30 beds at this point.
We expect to open the other 18 beds
in the next two months.
The the need for this kind of care
has definitely outpaced what expectations were.
And really import more importantly,
we're serving a a unique population of kids,
and that strategy has really paid off for
the community as a whole.
Some of the benefits from that is the
payer mix on the inpatient unit is, about
a fifty fifty split, but we're able to
be profitable on that unit, which helps us
fund some of the other things we do
in our behavioral health network.
Some of those things include integrated primary care
with behavioral health, where we have a psychologist
and a psychiatrist go into a primary care
practice,
teach up some of the providers on how
to manage low level issues with mental health,
and then provide a therapist in their clinic
two to three days a week to do
local therapy, for any of those kids that
we can manage in their clinic,
to keep the kids away from the hospitals
and hopefully out of the inpatient world. Our
readmission rates in that behavioral health, 48 bed
unit right now is less than twelve percent,
which is really good for behavioral health, and
a lot of that has to do with
the advanced services and the relationships
we have with other mental health community partners,
along with our services. So when a kid
leaves our unit, we warm hand off them
to some type of therapist,
psychologists, psychiatrists,
LASW, or LPCC. So that would be the
biggest thing we did last
last year. That's certainly huge, Ben. Congratulations to
you and the whole organization on putting all
that together.
Let me ask you, though. When you're
launching such a enormously
important
project, what's something you've learned
going through that whole process?
Yeah. I I think the biggest thing we
learned is when you move patients from one
hospital
in the same system to another hospital that's
separate from the main building, there is a
lot of challenges that we did not necessarily
were apprised of. We even had a transition
company that came in,
Yellowbrick, to to help support us through that.
But we put a crisis center over there,
and that's a level b ED.
And the number of transfers is one of
the things we didn't expect.
Some of these count kids come in with
medical conditions as well as behavioral health conditions,
and transferring back and forth between the hospital
and this this unit
was a big struggle. I think in the
first forty five days, we had over 200
transfers.
So that was not something we expected.
We've since figured that out, and did some
more streamlining.
A lot of this stems from when a
patient's in our ED,
we were discharging them and readmitting them over
in this other location, and what we needed
to do was a transfer. But it's just
working through that that that process and understanding
that we're never gonna be perfect at this.
We're not supposed to be perfect at this,
but we're learning and and and and moving
forward positively from each one of these little
hiccups that we've found.
Yeah. Certainly. Constant improvement is is an admirable
goal and probably the best one you can
hope for in those sort of settings. But,
yeah, I'm glad things are
are improving on that end. Alright. Ben, let's
take this opportunity now to look ahead. So
what would you say are the biggest priorities
and headwinds you're focused on for this year?
A little bit into '26, but still a
lot to go. And any tailwinds you might
be, looking forward to having boost you.
Yeah. So I would say a couple things.
Some of the biggest priorities right now is
workforce management,
specifically around subspecialty
providers
and making sure that we have a strong
mayor and power plan that supports,
the recruitment and retention of those providers. I
think the retention is the most important thing.
For the last five years at Dayton Children's,
our medical group, which is Dayton Children's specialty
physicians,
our our engagement rates ranged from 96.5
to 98
for the last six years, and we received
the AMA Gold Award for engagement,
for our providers in 2025.
It's a very prestigious award. I think we're
one of maybe a handful of pediatric hospitals
that even received the award. We're the only
one in the state of Ohio to receive
it, And it's really kudos to the way
that we have done our engagement with our
providers,
focusing on wellness,
focusing on, what we call pajama time, making
sure that we give them all the AI
tools necessary for them to be wildly successful.
So
those are some of the big priorities we're
gonna be focusing on. And then, obviously, some
of the the staff
positions are also gonna be really important. We're
struggling with pharmacy techs, surgical techs,
respiratory therapists, x-ray techs, ultrasound techs.
So that that that category of,
highly educated technologists are gonna be a big
priority as we continue to focus moving forward.
And, obviously, our nursing partners. Our nursing partners
are gonna continue to be really difficult positions
to fill,
but we're excited that we have the engagement
that we have. So Dayton Children's at Press
County,
we received a 4.78
out of a five for leadership index, which
is really, really strong.
And I think that kind of culture and
that kind of relationships really
have moved us forward.
I think some of the headwinds that we've
been focused on is primary care alignment.
Primary care has really helped drive
a better clinical quality for the children in
this region.
Not necessarily everyone is owned, but we definitely
have collaborating agreements for a majority of those
pediatric practices.
And that just helps align them with the
the the subspecialists
in the same organization and not having to,
you know, fax a result for or this
one and then send a referral via email
for this one. It really just kinda streamlines
how we run our operations,
which benefits the kids significantly.
The second part of that primary care is
access to primary care and making sure that
we have access to the subspecialists.
So I think those two headwinds have really
helped us focus on what we need to
do for 2026.
So to summarize that, I would say, we
need to focus on recruitment and retention of
the staff that we have, recruitment and retention
of the providers,
and leveraging our APPs to the best of
our ability to support the subspecialists,
and then lastly, making sure that we have
good access,
across our spectrum of care so that the
families in Dayton stay in the Dayton region.
Makes sense, Ben. It sounds like you have
a really good foundation on which to build
and and retain and engage that staff as
difficult to task as that might be,
not just for yourself, but other organizations.
Along those lines, Ben, so what would you
say is the hardest thing you have to
do
this coming year? Doesn't mean you're not looking
forward to it, but it just means that
you're gonna have to have a really special
level of focus to accomplish it. Sure. It's
budget.
Okay.
I think it's gonna be a challenge this
year with budget across the across all organizations.
There's a lot of things going on politically
that could impact our budgets at a state
level and a federal level. So I think
that that's gonna be one of the hardest
things we're gonna have to try to manage
to the best of our ability
in the coming year. Couple things that affect
that is, you know, what's gonna happen at
the federal level with three forty b and
whether that's a successful program
to stay in the in in the hospitals
or whether that's gonna get parsed out to
our state.
And then some other options that that are
gonna be a challenge for us is the
the Medicaid and Medicare reimbursement rates and and
where they stand.
Some other things that are gonna be aligned
with that is we only have x amount
of dollars for capital. And at the rate
that we're recruiting docs, we're running out of
capital
pretty fast pace. So I don't think that
there are insurmountable things, but there are definitely
gonna be challenges in the coming year.
Understood. So finally, Ben,
you mentioned some of the programs that you
have going on where you've been able to
expand and and access to care at Dayton
Children's.
From here on out, what do you see
as the best opportunities for growth at in
your organization? Could be the next
six months, three years, five years, whatever timeline
you feel is appropriate that you're looking forward
right to right now. Yeah. So I I
would say the biggest opportunities for growth is
that we're gonna have a new c suite
leader in the next year. So making sure
that there's clear alignment with that new leader,
making sure that our culture is protected,
and that culture is about engagement and trust.
And then focusing on our core,
market competitive specialties,
at the same time growing our primary care
network, which is gonna be super important.
And then the last part of that is
our organizational growth and behavioral health, making sure
that we're able to do that in a
productive way that serves the community first,
but also supports the organization's three to five
year strategic financial plan.
Thank you so much, Ben. It sounds like
Dane Children's is set up for a really
exciting
year ahead, and hopefully, we'll be able to
catch up with you on all this at
a later date. But in the meantime, you
know, we'll see you come April and, you
know, hopefully, that won't be the last time
our paths cross. Absolutely. I look forward to
seeing you in April, Chris. Thank you for
your time.