Speaker 0: 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.

Speaker 1: Thanks, Chris. Great to see you.

Speaker 0: 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?

Speaker 1: 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.

Speaker 0: 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

Speaker 1: 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.

Speaker 0: 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?

Speaker 1: 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.

Speaker 0: 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.

Speaker 1: 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.

Speaker 0: 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.

Speaker 1: 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.

Speaker 0: 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.

Speaker 1: 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.

Speaker 0: 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.

Speaker 1: Absolutely. I look forward to seeing you in April, Chris. Thank you for your time.