Welcome to Becker's Health Care podcast. I'm Chris
Sosa, your host, and I'm thrilled to be
joined today by doctor James Moore. He is
president of the Connecticut Children's Specialty Group and
the system chief medical officer and chief clinical
network development officer for Connecticut Children's.
Jim, thank you for joining us today. Hi,
Chris. I appreciate the opportunity.
As as you mentioned,
I'm doctor Jim Moore.
I also, in addition to the system chief
medical officer,
and president of our Connecticut Children's Specialty Group.
I'm also a practicing
newborn intensive care doctor or neonatologist
here at our level four,
NICU here in Hartford at Connecticut Children's.
Perfect, Tim. Thanks you for giving us a
little bit of overview of what your career
entails.
Today, we've got you on the podcast to
discuss any number of things going on at
Connecticut Children's. Clearly, things have been busy over
there, which is great.
So let's start with this. Let's look back
at 2025,
and that is simply what would you say
is the most important initiative or initiatives
that you led in the last year? Just
take us through how they evolved and the
results of them.
Sure. If you don't mind, I might like
to even back up just because I'm sure
some of the listeners might not know what
Connecticut Children's is, and if I could just
take a moment to just maybe
give a highlighted,
view of that.
We are,
the only
independent,
nonprofit
health system in Connecticut and only one of
two in New England
that's actually a 100%
dedicated to
pediatric care. We are a freestanding
children's hospital located here in Hartford, but we're
also
a health system,
that actually
has,
facilities and services in three different states in
Connecticut,
Massachusetts,
and New York.
As,
Chris,
mentioned to you earlier, we actually just opened
up a brand new
190,000
square foot tower this past December.
We now have about 215
beds in our primary facility.
And in addition to that, we partner with
three adult hospital systems,
across
the two states, in Connecticut and New York,
and provide care to 15 different hospitals other
than that.
Our 30 specialty and primary care centers are
located
in Connecticut, Massachusetts,
and New York,
and we have about 570
specialists. We're an academic training center for Yukon.
We have students, residents, and fellows. We're also
involved in research
and innovation initiatives. So,
a lot of times, I think people just
assume we're,
freestanding children's hospital in Downtown Hartford, but we're
actually much more regionalized.
Wonderful. Jim, thank you for clarifying all of
that. I'm glad you got a chance to
let us know
more about what Connecticut's
Connecticut Children's is all about and all the
affiliations
and all the work that you and your
compatriots do over there. So, yes,
thank you for taking us through that. Let's
look at at 2025.
So you have a lot going on.
What would you say is the most important
initiative that you led?
Just take us through everything about it, you
know, whether it's how it started,
what the results were, and anything else you
find important in this moment.
I appreciate that. And I think, you know,
as we look at,
health care in general, the economics are
more challenging than ever and our margins are
thinner. So it really puts pressure on us
to perform
at the highest level.
I'd like to actually maybe touch on two
different initiatives.
I'll I'll try to keep them not,
not going on for too long but Hey.
Don't worry about it. One of the the
first challenges we we were facing
was,
capacity and
you know, we definitely had an unmet need
in the market.
We had more patients that needed to come
in.
But I think like a lot of organizations,
we didn't have a ton of capital to
just add bricks and mortar.
So then we had to turn around and
say, alright. How do we accomplish this? And
a lot of this kinda fell on efficiency.
So we've
really needed to be able to track our
space utilization especially around managing
capacity,
in our busiest locations especially.
You know, we
really kinda tackle that in multiple different ways.
We needed to be precise and rigorous in
the management of that utilization. I think the
old school
approach is is that, well, these rooms are
ENT rooms, and these rooms
are general care rooms. We had to take
the approach that they're all kind of touchdown
rooms and multiple different areas can utilize them.
To accomplish that, we actually created dashboards to
look at room utilizations
by each of the divisions that occupied those
clinics
and then rearrange space and utilization to proactively
look at
issues we knew were coming up. I think
a lot of times we all know clinicians
have to spend time in the hospital and
when they're in the hospital they're not in
clinic.
And
as much as I think many of us
don't feel we get enough vacation, we do
take vacation and they're not in the clinic
at that time.
We wanted to be able to proactively
use that space. And a lot of those
instances were known
far enough ahead that we could actually repurpose
the space
and get more patients in in other areas.
That actually was highly successful. We actually increased
volume
by about 14%
in five of our key specialties.
We've also been developing plans for extended hours,
but that's been challenging in its own right
because
getting enough staff even for current operations, let
alone expanding
hours,
has been a bit of a challenge.
The second one, which I won't go into
great detail, which is
essentially the same approach, but, you know, now
turning our sites onto the OR and especially
ambulatory
surgery center
was
ways to get OR case volumes that were
actually backing up in several specialties because they
needed more time
to look at a efficiency and maybe being
able to leverage
the staff in a way that could extend
the sessions without
needing a lot of extra FTEs,
to really address some of those backlogs. In
our instance, that was in urology and NT,
and,
we also saw similar gains, especially in urology,
that we saw on the outpatient side.
Tim, thank you for taking us through everything
that's
Connected Children's is working on. Clearly, it's all
worthwhile, and I'm glad to hear that you've
been able to improve your your use volume,
get more cases
addressed.
Let's look ahead now at 2026.
So
we're a little bit into 2026, but only
a little bit. So
in addition to everything that Connected Children's has
accomplished, you mentioned, the new tower,
Huge things going on there. So when you
look at the next year and maybe a
little bit farther than that, what'd you say
are your biggest priorities and any headwinds you've
got going on? And and on the same
plane, any tailwinds that you're looking at?
Well, I mean, I think that's a a
great question. I think we're all really kinda
focusing on that right now.
We also have a new CEO and a
new chair of pediatrics, and we're we're also
in the midst of of, I think, really
trying to address
a lot of things that are changing
rapidly.
And I think many of us can really,
understand the pain point
of, you know, the issues around,
Medicaid rate
reforms and policy changes that have been going
into
effect.
You know, we we need to pay attention
to that because
that actually is a large driver for for
pediatric hospitals. We have a very high proportion
of
Medicaid reimbursement
and that ends up leaving our margins very
thin,
with the kind of proposed federal and state
changes.
This is gonna make that even more
challenging. So, you know,
to me, I think we've
got issues in the immediate sense, maybe in
the next year, but probably looking long term
as well.
And so, I mean, we obviously need to
work on our efficiencies. We talked a little
bit about that already,
trying to reduce
cost by maybe putting some of the services
as outpatient rather than inpatient.
We also need to get reimbursed appropriately for
the work that we're doing. This means paying
attention to coding and billing, reducing denied claims,
especially for things that are in our control,
and appropriately capturing
revenue.
But I think, realistically,
if we only take the approach to that,
we're only going to maybe get a a
short term benefit. You know, that traditional approach
of of,
you know, getting more bed days, more hospital
volume,
especially in today's climate of, you know, accelerating
costs, decreasing reimbursements
is not gonna be financially sustained.
We actually have to broaden our revenue streams.
You know, I think if we
look to
what our services provided traditionally,
sick care alone actually touched maybe ten percent
of the total pediatric population. We need to
be thinking much more
broadly. And whether that is, you know, through
mechanisms of partnering with primary and preventative care,
partnering with other health systems to put care
closer to home,
maybe home care, getting kids out of the
hospital and and into
a lower cost type of situation.
These
are ways that where you've got to start
thinking about
both improving more lives,
but also doing it in a way that
is going to be sustainable and potentially new
revenue streams.
You know I think the that'll have the
greatest long term impact.
You know, I think one of the ways
that can be done, and that varies kind
of state to state is, you know, value
based care. You know, that in and of
itself
actually
really helps to align reimbursement with what you're
really trying to do long term,
but it also rewards
outcomes and promotes quality. So I think we've
gotta look at new ways to actually provide
the services,
that improve children's health.
We need to actually,
improve quality and outcomes.
We need to touch more lives.
But to be able to sustain ourselves, there
may need to be new
ways to get paid for whether we're doing
school based care or others.
And probably looking at ways for innovation and
development of new technologies because I think the
bed reimbursement in the hospital model is not
going to be the way of the future.
I think a lot of your colleagues in
health care leadership would absolutely agree with you,
Jim. And I'll give you the I do
wanna give you a chance to expand on,
some of those growth opportunities that Connected Children's
has in a minute.
In for the meantime, though, I do wanna
ask you, what do you think is the
hardest thing you're going to have to do
in this coming year? Doesn't mean you're not
looking forward to doing it. Just means you
might need a little bit different level of
focus or community focus to get that goal,
whatever that is, accomplished.
Chris, I think that is is going to
be critical, and I think the way I'll
answer that may be slightly,
different than many people might assume. I I
think
the problem we're all facing
is really
that if
you are looking at the landscape right now,
you've got workforce shortages, you got labor costs
that are all contributing to this.
We're all experiencing this whether it's pediatric specialists,
nurses,
allied health professionals.
This is all really
producing both challenges getting folks in to provide
the services, and it unfortunately is impacting
higher labor costs.
You know, if you try to just say,
well, we'll go out and get new ones
or or not address,
turnover,
recruiting and retaining specialized care is really actually
quite expensive.
And so we're focusing on kinda the the
other side, which is to once you've got
folks in the door,
you wanna make sure they wanna stay. And
I think that's really important.
We
are working, I would say, most diligently right
now
on our culture work.
We call our our work on culture our
one team and providing better health through a
one team approach.
You know, we've had a very strong mission
and I think
anytime you talk about taking care of sick
kids
and, you know, being able to
be involved with kids and families,
it's kinda easier for kid people to get
behind
that. And,
you know, I I think it is gives
us a bit of a head start.
But what we really wanna strive for
is for our our team members to feel
like they actually both belong here
and that they can succeed here.
And that hopefully, they feel they're supportive of
each other. You know, there was a great
description of kinda that mentality
that came from one of our floor team
members. And it was like, you know, the
way they described that was
we want folks to answer the call bell.
You know? When you you got that nurse
call button on
and and, you know, often I've been
even with some of my own family in
the adult hospital and the bell just rings
and rings.
And a lot of times, it's because people
are short staffed or they're taking care of
other families.
What we wanna encourage is is that, you
know, everybody feels empowered to be able to
answer that call bell and take care of
that child and take care of that family.
And
if you can
get that kind of feeling,
if
your team members can feel like they're heard,
more importantly that they're valued,
and that what they're coming to is not
just a job.
They're gonna be much more wanting to stay
in the organization. They feel they can grow
in the organization,
and they
hopefully will be easier to retain. And it's
a lot easier to to manage staffing when
you've retained employees than to constantly be looking
for new ones.
I think we've got that strong culture, but,
you know, I I think we can always
do more.
And then the other thing that we've gotta
do is develop new avenues to to help
broaden out the the number of potential
team members, not just for us, but for
everybody. And that probably looks at colleges and
even younger, let's say, high schools,
to enlarge,
the recognition and both understanding and interest in
these careers because
I think
there are folks out there wanting to go
into this, but we also need to support
the education
system because
often there are
two, five, 10 times more applicants than there
are spots available to train them. So we've
got multiple different issues,
but, you know, we know workforce is expensive.
Replacing workforce is even more expensive.
Keeping workforce is what we're all trying to
do, but we've gotta make the environment
where people feel that they've got a real
opportunity.
And then we've gotta be able to
both raise awareness and actually drive folks to
wanna be a part of this.
That's an excellent description of the landscape that
you're dealing with right now, Jim. I do
wanna ask just to follow-up.
Certainly,
every organization
like yours wants to build a culture, and
I think that a lot of them are
succeeding in some way, shape, or form.
How do you know, though,
beyond just what you're hearing in the hallways
of Connecticut Children's,
that this culture is succeeding in becoming,
more inviting and more
sustainable
for clinicians and and others who work there?
I think that is
looking at it through multiple lenses. I mean,
we obviously
do feedback, We do employee,
surveys,
during the year as well.
But we also get kinda direct, you know,
leadership rounding feedback and and things that,
our team members are saying are pain
points. We've developed,
you know, what we call the
the red tape,
work group. You know, we we have a
lot of things that people are like, these
are
pains in my my my feet that are
are I need to get the stone out
of my shoes, so to speak.
And we actually
empower and allow those teams to actually help
provide some of those solutions.
But we also need to develop
the the,
you know, our our entire workforce. And whether
that's kinda giving them that personal experience when
they're onboarded
to leadership development during the, you know, course
of their career,
We also have actually started a pilot
for some of our leaders
to actually, I think, kinda help model
the the culture that we're all trying to
achieve,
but also to help develop it. And,
you know, I hate to use this,
my colleagues in HR will probably hate me,
but what we're trying to do is avoid
HR speak and make it be much more
almost grassroots.
And, you know, they know what they need
best. They know what is most valuable to
them. We just need to help support it.
That makes total sense. Thank you, Jim.
Lastly, I simply wanna ask you, as I
alluded to before, what
opportunities for growth you think Connecticut Children's needs
to capitalize on in the coming year,
five years, whatever time period you think is
appropriate?
I
I think that I we're all kinda focusing
on this, and,
you know, I would almost put it into
a couple of buckets.
I would say maybe
both the primary medical center, the quaternary hospital,
and then kind of our more,
community and outpatient focus.
Internal,
you know,
we've got to be able to leverage
not just our own hospital, but our partner
hospitals as well
and really focus on being a regional center
of excellence and
maybe getting those various designations
and kind of the things that we do
best and that I think
are
things that will attract people from not just
the local area, but across regions and states.
I think one of the examples of that
is is work that's being done in the
new tower right now.
We're increasing the offerings of our oncology
services
and our fetal care center.
Within the new tower is,
state of the art
advanced cellular and gene therapy.
This includes,
things including bone marrow transplant and CAR T
but
also includes gene therapy for muscular dystrophy,
sickle cell and other types
of initiatives.
So that is much more than just straight
oncology.
It is actually a much broader program
and that is actually going to draw folks
from,
March larger region as well.
You know, if we
look at the other,
service that I mentioned inside that new tower,
which kinda goes along with our newborn intensive
care unit is
the fetal care center.
This center actually provides care even prior to
birth.
And because it is a full service,
fetal care center,
these babies with complex anomalies can actually even
begin treatment often surgically,
prior to birth.
And then obviously once,
a patient is born especially if they may
not need surgery prior to birth, we have
the full surgical suite and subspecialty
care
services that are available to that mom and
to that child,
immediately after birth.
I think
that helps kind of, you know, distinguish us
from,
you know, many others and,
you know, with centers of excellence in rare
bone,
hematology,
oncology, and others,
that's really where we're going to focus kind
of on the inpatient side.
On the outpatient side, we really need to
leverage that regional care and the care close
to home model.
You know, focusing on expanding
and maybe strengthening
our adult partner locations,
but really also on our ambulatory
services
and locations that are actually outside the main
campus.
Sometimes actually quite far away.
You know, while many of the financial
pressures we're up against are not easily
fixed,
you know, we can actually
do our part to provide care at the
right
location
with the right services at the right time
and actually hopefully do it in a more
cost effective manner. So whether that's providing urgent
care,
ambulatory surgery,
specialty care.
More and more care,
pediatric especially,
is moving more outpatient than inpatient, and we've
gotta be where the patients are,
but we've gotta do it in a manner
that is sustained. And having twenty, thirty different
people providing that care is not, you know,
financially good sense. We wanna be able to
partner with other organizations
to be their preferred per pediatric provider. Say
that three times fast.
And,
also be able to, you know, provide that
care to the families that we serve
now in three states across our region.
Jim, thank you so much for everything you've
been able to share with us today on
the podcast, and we look forward to seeing
you at our conferences coming up later this
year. And, yeah, we look forward to any
time,
paths cross.
Chris, I really appreciate the opportunity. Thanks so
much.