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AHLA's Speaking of Health Law
C-Suite Roundtable: Health Care Corporate Strategies in a Challenging Environment
Rob Gerberry, Senior Vice President and General Counsel, Summa Health, speaks with health care corporate leaders about strategies they are using to help their hospitals and health systems navigate the current challenges facing the industry. They discuss how they are tackling financial headwinds, dealing with inflationary pressures when working with payer partners, keeping the Board educated on industry trends and getting buy-in for strategies, working with ancillary businesses and real estate portfolios, striking the balance between clinical and corporate assets, and creating partnerships between the operational and legal teams.
Rob’s panel includes Kyle Armstrong, President, Baylor University Medical Center, Matt Morgan, Vice President and Hospital Administrator, Deer Valley Medical Center, and Joe Yoder, President, Legacy Health Willamette Region.
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Speaker 2:This episode of A HLA speaking of health law is brought to you by A HLA members and donors like you. For more information, visit american health law.org.
Speaker 3:Hello everybody, and thank you for joining another edition of our C-Suite podcast series. This month, we're excited to have talented leaders , uh, across the country who are leading their health systems , uh, through the challenging times that we're all experiencing in the healthcare space. I'll introduce each of our different panelists today and allow them to give a little bit about their background, and we'll start with Kyle Armstrong.
Speaker 4:Hey, good afternoon. Thanks so much for having me. My name is Kyle Armstrong. I serve as President of Baylor University Medical Center , uh, located in downtown Dallas. It is the flagship , uh, quaternary academic medical center that's part of Baylor Scott and White Health , uh, which is the largest not-for-profit system in the state of Texas.
Speaker 3:Great, thanks, Kyle. And we'll turn to Matt Morgan next.
Speaker 5:Hey, thanks, Rob. Um, so yes, Matt Morgan. I am a Vice President Hospital Administrator for Deere Valley Medical Center with , uh, honor Health Services , um, based out of , uh, Phoenix , uh, in Scottsdale. So Deer Valley Medical Center. Um, it's a level one , uh, trauma center, full service hospital. Um, serves the area of North Phoenix , uh, and parts of , uh, the growing , uh, north Valley here in Phoenix.
Speaker 3:Great. Thanks, Matt and Joe Yoder.
Speaker 6:Thanks, Rob. It's great to be here today with you guys. Uh, my name is Joe Yoder. I serve as the president of the Willamette Region for Legacy Health. Uh, legacy Health is a seven hospital system locally owned in Portland, Oregon. Uh, my areas of responsibility include two of our southern , uh, metro hospitals , uh, one , uh, 150 bed community medical center, and then another more semi-rural 50 bed , uh, facility a little bit further south of town.
Speaker 3:Great. Thanks, Joe. And for our audience , uh, I'm Rob Gerber. I'm the Chief Legal Officer here at Summa Health and Akron, Ohio. I also serve , uh, on the American Health Law Board of Directors. And again, appreciate our three panelists joining us today. So to start our conversation today , our first question is, with all the financial headwinds facing health systems, what strategies are each deploying to tackle the challenges in front of us? And maybe we'll start in reverse order. We'll start with Joe .
Speaker 6:Yeah. I, I think the financial headwinds as you, you , um, outlined or are not unique to any of our organizations, really. Um, we're focused on the blocking and tackling , uh, just the basics around productivity management , uh, supply use, you name it . All the stuff that we've been doing for years has just had the volume turned up on it quite a bit , uh, unique from that. We've also seen a more intense focus on length of stay. We've just seen that the quicker we can churn , uh, our throughput and get that flywheel moving, the more access we're able to create for patients. But it also is a big financial win for us as we're able to get more patients into those beds , uh, as opposed to having them stay longer and, and take up days that are just unfunded. On top of that, we have , um, engaged in a sale of our lab. I know this has been something that's happened , um, on both coasts. Uh, we have sold our lab services to LabCorp , um, really not as much financial driven . It will have some financial benefits to us, but we just believe that they're gonna be a better partner for the community as well as us have the ability to expand access , uh, for our patients. So looking for those win-win relationships , uh, that really improve patient care is also something we're keeping an eye on.
Speaker 3:Joe, both coast and , and here in the Midwest. We also sold our lab business recently to Quest. So we've , uh, embarked upon the same strategic , uh, initiative. Next we'll go with , uh, Matt.
Speaker 5:Yeah, I , uh, I think no different than Joe. You know, our mentality too has been kind of a back to the basics, if you will, you know, getting out of all the challenges with the, with the pandemic , um, you know, all the resiliency that our teams had to , had to do and pivot to, to, to get through that. And then now just getting back to some of the basics on how can we, you know, optimize our labor force, improve performance , um, and efficiencies. So, you know, the same for us. We've , uh, we've made a lot of good headway in , um, in our workforce optimization , um, improvement in, in turnover across the board , um, you know, and being creative with how we're attracting , uh, talent. Um, so, you know, I I think everything's on the table, you know, to attract , um, new talent and you really have to , um, you know, be accepting of , of what , uh, what new models are out there. So, you know, we've, we looked at new models to staffing , um, you know, optimizing our network float pool. Um, you know, we've made it made good headway in reducing contract labor. Happy to say we , um, um, the , the really the only contract labor utilizing now is, is we still have some of these multi-year international contracts, but some of those will be up this year. So, you know, we made some headway and, and , uh, but continue to, to focus on, on how we can just , um, be innovative and, and , and keep and retain talent , um, along the throughput and length of stay. Again, that, that Joe mentioned, it's , it's huge focus for us. Um, we partnered with , uh, with a vendor called Q NTUs. Um, it's, it's helping us with , um, with kind of , um, it optimizes our discharge planning , um, you know , um, with uses AI machine-based learning. Um, so we've incorporated a lot of that and , uh, you know, we're piloting new multidisciplinary rounding process , uh, here at my hospital. We , we've done that and , and made some good headway partnering with, you know, our hospitalist team , um, our nursing team, case management, utilizing the software. So we're, we're , uh, we're pushing, you know, the bar and trying to make an impact on reducing length of stay because we , we saw that creep up over the last few years , um, as well. So, so yeah, we're, we're having some good early results with that. Um, you know, another thing with this NTUs tool , uh, that we're gonna pilot is , uh, they also look to optimize our perioperative scheduling platform. So right now, I mean, we're, I think we're on an Excel spreadsheet, so utilize , utilizing this tool, it'll help , it'll help us with just be more proactive, you know, so we look to have better utilization of our block, optimize that schedule, which will in turn, you know , um, get us a , an uptick in those surgical volumes that we're seeing. So, so those are a few things we're looking at.
Speaker 4:Great .
Speaker 3:Uh , what's been your focus at Baylor with your team? Yeah ,
Speaker 4:I mean, it's, it's sort of encouraging to hear the , the challenges and strategies. Um, were pretty consistent across the country. You know , a lot of the things that Joe and Matt spoke to have really been focus areas for us. Um, kind of foundational productivity management. That's kind of always been a hallmark of our health system, I think, of most health systems. So , uh, ensuring that we're appropriately staffed everywhere is super important. There's been a , a real focus on reducing premium pay and , and contract labor, and we've been , uh, relatively successful in that regard today. We don't have any agency staff in any of our nursing departments. We have a little bit of agency staff remaining in interventional radiology, but by and large , um, we've moved past that, which has been great. Uh, length of stay throughput, all of those things are also huge focuses of ours. I would say we've, we've probably moved from focusing on productivity , uh, feeling pretty good there, although it's something we have to always keep our eye on , uh, towards really challenging and, and very complex multifactorial throughput issues. And so , um, we know there's opportunity for us on length to stay, so we continue to, to try to work on that. Uh, the , the other reality for us is we're really fortunate to be, I mean , Matt's kind of in the same boat, DFW Dallas-Fort Worth is growing , uh, and continues to be one of the fastest growing parts of the country. And so , uh, we're really capacity constrained, which is the other real , uh, factor for us with throughput. We've gotta figure out how to move people through more efficiently so we can accommodate , uh, the growing patient population , uh, in north Texas. Uh, so there's also, for us, on top of the expense management and efficiency side, a ton of focus on growth. Uh, so how do we, at least at Baylor University Medical Center, really do a good job of marketing , uh, and capturing the sub subspecialty patient , uh, population for services here that we're uniquely equipped to provide. So , whether that's organ transplantation, some of the things we do , uh, in our oncology service line, like bone marrow transplant and CAR T therapy , um, those are kind of niche services that we have expertise in. And making sure that , um, we have the capability to say yes when patients are looking for , uh, a place like ours to get care. We wanna make sure we make that easy. Uh, so that's been on the growth side, some things we've been focused on. Great .
Speaker 3:Which of you bring a strong operational , uh, expertise to your institutions? And a lot of focus, it sounds like, on the expense side, you know , maybe pivoting to the revenue side, how have your payer partners been willing to adjust to the inflationary pressures we're all experiencing and adjust your pricing? Maybe we'll start with Matt on that one.
Speaker 5:Yeah. Um, so , uh, it's been challenging. Um, you know, the feedback I've received from , um, some of our , our colleagues , uh, uh, that work in the system directly is , uh, not, not too much has changed. Um, unfortunately , uh, those negotiations have still been contentious. I think their, their take on inflation and, you know, what they see versus what we are feeling , um, there's still a , there's still a wide gap , um, in, in that. So , um, it , it's still proved difficult. I think, you know, for the future, as we know, you'll, we'll see more , um, you know, more , um, value-based care models moving away from fee for service . I think where we've , uh, where we've made some headway is , um, you know, they're, they're willing to put more dollars kind of in those quality bonuses , um, you know, more at risk versus , um, versus just squarely raising, you know, flat rates year to year . So , um, so yeah,
Speaker 3:Kyle , how about you?
Speaker 4:Yeah, I'd say pretty similarly. A lot of our managed care contracting work happens with our, our system teammates. And generally speaking, I mean, they, they do a very good job of helping tell the story of our health system with payers. I wouldn't say that it's probably that different at Baylor Scott and Wyatt than it is at other health systems across the country. We are fortunate to have pretty large geographic footprint , um, and , and , and , and good scale. So that, that helps in terms of the negotiations that the things we talk more about , uh, would really be around our accountable care organization, the Baylor Scott and White Quality Alliance, and the success that, that, that part of our system is having at basically directly contracting with employers. And you've got payers involved in that as well. Um, but having success delivering the type of both health quality outcomes along with finance and , um, cost savings. So , um, that's really been a bigger strategy for us in the last year or two. We know that negotiations with the payers are, are , I think, gonna be what they are. Um, and I would , I would say we've had some success there, but in terms of trying to control what we can control, the work we do with our A CO trying to ensure that we're delivering great outcomes, a lower price point for the employers we work with, and that's been a real proof of concept that we've had some success with, and we'll continue to , uh, press forward and, and hopefully that's another way for us to negotiate with payers as well.
Speaker 3:Joe, how about on your end in the northwest?
Speaker 6:Yeah, we're in somewhat of a unique , uh, market in that we're heavily competing with , um, employer plans. So we , uh, have Kaiser very prevalent in our market , uh, as well as , uh, another large Catholic system, which owns , um, which owns a health plan. And between those two, they take over 50% of the commercial market share. Uh, so when you look at what's left over , uh, we really don't have the scale and , uh, depth into , uh, some of those first dollar contracts that allow us to really move the needle on them . Um, also challenging, this is in the state of Oregon , um, which I think we've seen, it's either in Maryland or Massachusetts. Uh, we have a cost growth target , uh, implemented on our , um, on our health insurance premiums in the state. So , uh, the commercial insurers have a backstop, meaning they can't go above 3.1% every year in growth. Uh, and those are measured and that, that , uh, actual percent is measured by the year over year premiums. They pay two health systems. So even in an inflationary environment like we're seeing today , uh, from a a regulatory standpoint, we are disadvantaged now. Our state hospital association is doing a lot of work to change that narrative and try to , uh, advocate on our behalf , uh, to have some of the costs around staffing , uh, excluded from that formula. But nonetheless, when it gets to the , um, to the table and we're trying to increase rates based on the inputs that we see , uh, we've been largely unsuccessful.
Speaker 3:So, drew , you mentioned trying to change that narrative. One of the challenges that we've, we've seen is, you know, with the , uh, access issues that Kyle also brought forward, we've got borders in our emergency room, we've got long wait times for services. Do you see people contacting their congressmen, their employers and letting 'em know just how challenging healthcare is now? Or have you and Matt and Kyle also seen that be a struggle,
Speaker 6:At least in our state here in Oregon? Um, it's still the hospital's fault. Uh, we haven't quite seen the , uh, the perception out there change , uh, that this is, there's some regulatory issues that are causing this , uh, this scenario , um, which unfortunately is just the environment we're in. But like I said, hopefully our state association , uh, gets out there and starts advocating on our behalf a little bit more.
Speaker 3:Kyle , Matt , how has the narrative been in your markets? I know no hospital wants to raise their hand and be the one , one saying we've got challenges. Have you seen the industry come collectively together to better message this?
Speaker 4:You know , I think in Texas, in Dallas-Fort Worth proper , there is a , a Dallas-Fort Worth Hospital Council that represents all the different hospitals in and around DFW. Um, that's a wonderful organization. They do a great job advocating on behalf of the hospitals in DFW. Um , and then obviously the Texas Hospital Association , uh, is doing that at a state level. I, I think for us, it's pretty similar to what Joe shared. Um, there is not a ton of, you know , during the pandemic, there was obviously a lot of, a lot of advocacy and support for hospitals. I almost think coming out of the pandemic, it's, it's been a harder message at the state level, certainly. So I don't know that , uh, there's been a ton of rallying or sym sympathy for our hospitals are full. Um, you know, they, they are looking to us to fix that problem. And right now, I'd say we're , we're doing that largely kind of independently of other support .
Speaker 5:Yeah, I'd say it's similar , um, during the pandemic a , you know, we , um, participate in, in the , the Phoenix , um, hospital council and, and a lot more support over the last two years. But, you know, now , um, haven't heard too much , um, as it relates to, to, you know, how , um, how , um, they can, they can help fix. It's really, you know, we're taking upon ourselves to , uh, to, to shoulder that burden and come up with solutions. So
Speaker 3:Yeah, we're not hearing the support, the bang in of pots and pans like we saw during the pandemic for healthcare. Sure. We're seeing more just it's costly, fix it. And so that's been a , a real challenge, we think with the messaging. It's not just the providers as we know in this industry , uh, the payers, the pharmaceutical companies, we're all in this together, and that's the message we've been trying to get out. So when you think about getting patients from your board or your finance committee, a lot of organizations have been on two year back to budget plans. We may be coming up on the expiration of those two years. How do you keep your board or your finance committee educated on industry trends, that it's not just your organization that's having these challenges and getting the buy into some of the strategies that you brought forward today? Um, maybe we'll start with Joe. Yeah.
Speaker 6:We're really fortunate. Our , uh, our board members and even some of our advisory council members are very supportive of the hospital. Uh, these are folks who live in our community and have , um, long had the back of , uh, of our hospitals. And so just from a foundational level , uh, they come to the table with a lot of trust , um, in the work that we're doing. Uh, when we talk to them, we, we really are transparent about the cost pressures. Um, and it's, at least in our state, we're, we're in a heavily , um, organized labor environment. So the , uh, rates that are , um, our staff make across all , uh, of the different hospitals are public because these are organized , uh, organized , um, agreements that are out there for anybody to see. So we can be quite transparent with the , um, the pay ranges of our competitors. And it's very simple. You know, our board finance folks and our board members are , are smart individuals. A lot of 'em are small business owners themselves. It's very easy to explain to them, here's what it costs , uh, for us to hire people, and here's how much we get reimbursed. They clearly can see those two lines and how they cross. Um, and so once you're really open with them about the , um, the situation, I think they're quite sympathetic to us and , and are really some of our best advocates , um, and help us manage that message out in the community. Uh, so to answer your question, Rob, I, I, I couldn't ask for a better, better group of individuals helping support us . They've been fantastic.
Speaker 3:Excellent. Matt , how about in your end ?
Speaker 5:Yeah, some similar, I , uh, you know, in my role here, I don't , um, sit on , uh, those, those board , uh, and board finance committee meetings, but, but I do have a local advisory , um, board and med exec , and yeah, what , what , what I've done is, is, is transparency is key , um, upfront with the , the challenges that , uh, my hospital is facing, the , the system is facing. And then, you know , also, you know, provide that framework of here's how we stack up with, with the rest of the valley, you know, the state and nationally. And, you know, when you do that , um, you know, we, we've , uh, we've been, you know, performing a little bit better than, than some, some others. Um, so I think that just helps , um, convey, you know, a tough message that , um, you know, we're not the only ones in this and , uh, and but, but through this, we, we've still , uh, managed to, to come out a little better than than others. So, you know, and great , uh, team members here , um, you know, really engaging , uh, the team looking for, for their areas of expertise because, you know, they're obviously in different industries , um, but, you know, have been great stewards, great advocates for the hospital, for the health system, and, and really, you know, getting feedback from our physician leaders. I mean, they , um, very engaged wanting to , um, you know, to understand how they can help, how they can , um, be part of, you know, if, if it's , uh, cost savings initiatives where absolutely we need them at the table where , um, where they can help us with, with , with strategies. They've been more than willing to help. I mean, this, you know, they're heavily invested. This is their home , um, and they want what's best for, for this hospital and this system. Um, so , um, so their engagement has been, has been very good.
Speaker 3:Great . Kyle, anything that you would add?
Speaker 4:Yeah, I would , uh, I think I'm really fortunate, much like Matt and Joe , uh, the board that I have the opportunity to work with, both at the local level, then our holdings board that has responsibility for the entire enterprise. Uh, they've been incredibly supportive. Uh, these are people with , uh, good knowledge of healthcare. They understand the healthcare environment. Uh, they're committed to the su success of the organization, but they have been really thoughtful about, you know, what are realistic expectations to have right now? What are the things that we can help support the organization , uh, towards, you know, meeting its goals. So I , I think it's been, we've been really , uh, thankfully really fortunate. And in addition , uh, Baylor Scott and White has had, like, everybody, it's been challenged , but we've had pretty strong financial results for the past two years , uh, which has , you know, allowed us to continue investing at a time when that hasn't been the case everywhere. We've been fortunate in that regard.
Speaker 3:So as your boards or your management teams has looked at your portfolio of assets, Joe mentioned, you know, looking at your lab and transaction that, how have you looked at your ancillary businesses, your real estate portfolio? Is there anything that you'd share as far as how you've looked at that during these times? And maybe we'll start with Joe since he brought up the lab deal.
Speaker 6:Yeah, e even outside of the lab , um, we're absolutely an active , um, uh, active in looking at ways that we can joint venture or partner with somebody , uh, in the ancillary space. Um, there's a lot of different ways that can go and, and without trying to be too revealing , uh, here to the world , um, I can tell you that we are a absolutely looking at how we can , uh, expand our partnerships with either external groups. Um, you know, that's a big win for us financially too, so that we don't have to bear the, the , all of the capital cost , uh, to enter a market like that, but also strategically just makes a ton of sense to go at it with a partner , um, especially in a , a dynamic environment like we have here in Portland .
Speaker 3:How about Kyle? How's Baylor approached that?
Speaker 4:Yeah, Baylor's really had a longstanding sort of openness to joint ventures. And so , uh, today we have active joint ventures through a partnership with USPI, and that's principally , uh, in the surgery center, in surgical hospital space. Uh, we have specialty hospital joint ventures , uh, in orthopedics in one location. And then , um, you know, probably more notably within , uh, cardiology and CV surgery , um, joint venture with physician owners in both of those respects. Uh, and we have that in the outpatient imaging space. So that's been, I think, a key strategy for the health system for a long time. It certainly helps drive engagement with some of our partners , uh, on the medical staff side to give them an opportunity , um, to practice in a place that they've got a , uh, an investment in. Um, and I think you'll see us continue to do that and identify , uh, opportunities where it makes sense. Another thing we're doing right now with the partner that we're kind of just in the early phases of piloting is , uh, hospital at home. We have a third party partner there , uh, a company called Contessa , uh, that, that hasn't been expanded across the entire enterprise, but a couple of hospitals are already engaged in that work. Uh, it's probably too soon to say like, what the future of that is. It's pretty selective in terms of what patient profile really makes sense for a hospital at home as a model. But we think there is a real promise there. It's something we'll continue to do, and if there's other areas we identify a partner that makes sense, I think you'll see us be opportunistic in that.
Speaker 3:Great. And Matt, anything Deb ?
Speaker 5:Yeah. Uh , same for honor health , we've all , we've all always engaged partners , um, where it makes sense. So in our ambulatory surgery center strategy , uh, free sending eds , um, our cancer network , um, urgent care, you know, we, we've engaged partners in those areas , uh, um, where it's made sense. I think, you know, for us in the future , um, you know, where we're located and kind of where we're looking to , um, to expand in the valley. I think obviously with the impact , um, financially , um, kind of narrowing our strategy a little bit , uh, to more, more focused areas of, of Phoenix and the Valley, rather than, you know, just trying to get in in every nook and cranny. It's, it's a big area. So kind of a more focused approach. Um, and , you know, our strategy probably similar to others is, you know, as we, as we look at , uh, real estate ventures , um, you know, where it's outside of our primary service area, then absolutely we , you know, we're more willing to engage partners where we feel we have, you know, more risk , um, getting into markets that, you know, we, we don't know the lay of the land , um, still maybe unknown if , um, you know, if , uh, it's gonna be a good venture, you know, if, if, if the , that that community will buy in. You know , um, we have a freestanding ed, I'll use that. An example. We're we're building our third freestanding ed, and , and in the first one it was , uh, way in our West Valley , um, an area we haven't been in. And we engaged two partners in that, an operator and a developer. Um, um, and , uh, on the flip side , uh, we, we put our second one right in , right in the middle of Scottsdale, and we accepted a lot more of that risk because we, we know that's our backyard. We know the lay of the land. So , um, yeah , so
Speaker 3:Great. So with many of us being in budget season right now, we all know how much fun that could be. How are you looking at preserving bedside assets while at the same time recognizing that to run an enterprise the size of many of our organizations, you need some corporate services, you know, that , uh, are able to keep things , uh, running along well. So how do you strike that balance between clinical and corporate assets during some of these financially challenging times? Maybe we'll start with Kyle.
Speaker 4:Yeah, so I think that's always kind of a dynamic tension. I would say Baylor Scott and Wyatt has been pretty unequivocal in their commitment to ensuring we have the right resources at the bedside. So from a clinical personnel standpoint, I think philosophically that will always be most important to our health system. Um, we know that we need a lot of different corporate infrastructure to support the work that happens at the hospital. Um, and so that's always part of the equation, but I , I would tell you at least in terms of how our system thinks about that , um, if there's a decision about whether we're going to add , uh, a resource at the bedside that's needed versus , um, maybe somebody in a, in a non-patient care, non-patient facing area , uh, the bias there is always gonna be at the bedside. Uh, we need both. And fortunately, we're, we're in a pretty solid financial position to where , uh, we don't think we're having to make some of the really hard trade-offs there, but in a vacuum, I think you'd see us always defer to making sure we have the adequate personnel at the bedside.
Speaker 3:Great. Joe, how have you struck that balance?
Speaker 6:Uh , mu much like Kyle said , uh, we, we take a very similar philosophical approach that we will always be deferential to our, our frontline caregivers. Um, unfortunately , uh, you know , our financial position took quite a big hit over the last , uh, few years, and we have had to make some very difficult decisions around reducing leadership roles , um, and reducing some of our corporate , uh, corporate roles as well. You know, fortunately, a lot of those have been open positions that we have just decided to move forward without. Um, but nonetheless, it's been really, really challenging, but we always put it through the lens , uh, like you or Kyle mentioned of how can we do this in service to supporting our frontline caregiver
Speaker 3:And Matt ,
Speaker 5:Yeah , same, same philosophy for honor , health . Um, you know, we , uh, you know , uh, a strategic initiative , um, we , you know, we want to be the employer choice and, and that really haven't, hasn't wavered. I think, you know, for us stabilizing the workforce, you know, that that's a top priority. And, you know, when we do that, we just feel that our other , uh, our other strategic initiatives based on performance quality, improving safety will , will fall into place. So that, that continues to be a major focus and, and has been a huge investment for us and absolutely , um, you know , focus on , on those, those clinical bedside caregivers , uh, that make the difference. You know, we , um, we're , uh, we pride ourself . We , uh, all six of our , uh, facilities are magnet accredited , um, that hasn't wavered and we , you know, for, for that , um, standard, and we're gonna continue to, to focus efforts to, to maintain that status. We just feel it's a , it's a excellent , um, quality indicator of, of , of nursing and , uh, has has been an excellent , um, recruitment tool as well for , uh, for us in the Valley. So we'll continue to be a focus for us. Wellness will continue to be a focus for us. Um, you know, some of the things at the corporate level. Yeah. Um, we've had a, you know, a few changes, a few com , you know, combining roles, I think no different than what a lot of systems are seeing, you know, we've seen some, I think where we've had network leadership roles , um, a little now, a little more decentralized, where those are coming back to the facilities and, and taking on some more responsibilities. We're sharing a lot of our physician executive leadership roles between campuses. Um, so I think you'll continue to see a , a little more of that. But, but as , uh, Joe and Kyle mentioned, still a , still a focus on , uh, our clinical teams and, and, and how we can continue to en to , uh, engage tho those teams.
Speaker 3:Great . Excellent. Well, we always finish with this question, which is, as you look at your legal partners, both internal and external, what guidance would you give , uh, those lawyers on how they best serve you? How is it best to create a partnership between the operational teams and the legal team? Any advice that you may give? And I'll start with Kyle.
Speaker 4:Yeah. I, I'm grateful. I work with a fantastic legal team at Baylor Scott and White Health. I think , um, the relationships matter, and so in having great relationships with them, including them, and kind of the big picture, what we're trying to accomplish operationally is always really important. I think , uh, for me , uh, I know the answer may be no, but so long as I know that they're considering all possible options , uh, that would, you know, be above board from both a legal and compliance standpoint, when I have confidence that everything's being, being evaluated in that way, I , I know that, look, if you're saying we can't do this, I'm, I'm all in, that's great. I, I, I get it and I don't wanna push forward. Um, but their willingness to consider, you know, what, instead of no, because yes, if like, yes, if we do it in this way, we structure it in this way , um, you know, that's something that has merit that we should consider. Just their willingness to do that always leaves me gratified, because I know there really are partnering on this with me. I think you hear stories sometimes of different legal departments that just say no, almost as a habit. Um, I'm really fortunate that's not the , the environment I work in all the time. And, and to me , that's the biggest thing that gives me a lot of comfort. They're looking out to protect the organization, but they're willing to consider different options in a comprehensive way so we can make the best possible decision for the health system and for the hospital.
Speaker 3:Great. Matt, your thoughts?
Speaker 5:Yeah, I , I'll , uh, you know, I'll echo, I , I work with some great , um, leaders here as part of our legal counsel team led by Shannon Fox Frazier , and , uh, have enjoyed building , uh, relationships with, with that team. They do an excellent job. You know, for, for new temp team members, my advice , um, you know, what attributes no different than what I look for, you know, in my own team members, you know , um, be innovative, be accountable , um, be able to collaborate, know the importance of building, you know, relationships built on trust and , uh, and respect , um, you know, be subject matter experts, you know , um, we rely on that expertise to help guide our decision making . So, you know, keeping up to speed on, on the latest and, and what's new as in terms of regulation, compliance, new models of care, other physician alignment, you know, strategies , um, all things to help keep us out of trouble for sure. So, great .
Speaker 3:And Joe, you're a cleanup hit .
Speaker 4:Yeah,
Speaker 6:I, I , Matt and Kyle said it so well, but I , I would really , uh, double down on Kyle's , uh, comment around working with the operators in a yes if environment. Um, I've worked with far too many , uh, in-house counsel , who you just kind of refer to them as the department of no , um, that, that, you know, that's the answer you're gonna get every time. Uh, but I, I've absolutely worked with some fantastic , uh, in-house counsel who does partner with the way Kyle described, where they're saying, yes, we can do this, but here are the conditions that need to be met to make this compliant. Um, and that's just a much better relationship and one that really ends up serving the organization and , uh, for the better long term .
Speaker 3:I think that's some great advice, and I've written down yes, if , uh, versus no, so I can share that back even with my own team. Uh, so I'll call this the final, final question. We've got a lot of passionate members in our organization, including our past president, Tom, shorter , any comments you wanna make on the impact of his service to his golf game, we'll just leave that one there for our members to , uh, to guess . Uh, thank you all very much for taking some time to join us today, Kyle, Matt, Joe, really appreciate you sharing your insights with our membership. Uh, and thanks again.
Speaker 6:Thank you. Thanks for having me.
Speaker 2:Thank you for listening. If you enjoy this episode , be sure to subscribe to a HLA speaking of health law wherever you get your podcasts. To learn more about a HLA and the educational resources available to the health law community, visit American health law.org .