Latest / Becker’s Healthcare Podcast / Nick Barcellona, Chief Financial Officer at West Virginia University Health System

Transcript

Nick Barcellona, Chief Financial Officer at West Virginia University Health System · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
• 0:04
  - understand what it takes to lead a health
• 0:05
  - system right now. The decisions are enormous.
• 0:08
  - The variables are constantly shifting, and the stakes
• 0:11
  - of getting a call wrong don't stay contained.
• 0:14
  - That's not a complaint. It's a structural reality.
• 0:17
  - And it's why the most effective c suite
• 0:19
  - leaders are deliberate about where do they go
• 0:21
  - to pressure test their thinking.
• 0:22
  - Becker's fourteenth annual CEO and CFO roundtable
• 0:26
  - brings together more than 1,500
• 0:28
  - executive level attendees
• 0:30
  - and nearly 400 speakers for four days built
• 0:32
  - around growth, financial sustainability,
• 0:35
  - workforce strategy, and the leadership questions that don't
• 0:38
  - have easy answers.
• 0:39
  - Join us November second through the fifth in
• 0:41
  - Chicago.
• 0:42
  - For the agenda and event details,
• 0:45
  - visit beckershospitalreview.com
• 0:47
  - and click on the events tab in the
• 0:49
  - upper right.
• 0:51
  - This is Laura Dierdoe with the Becker's Healthcare
• 0:54
  - Podcast. I'm thrilled today to be joined by
• 0:56
  - Nick Barcelona, chief financial officer at West Virginia
• 0:58
  - University Health System. Nick, it's a pleasure to
• 1:01
  - have you on the podcast today. Thanks, Lauren.
• 1:03
  - Good morning.
• 1:04
  - Good morning.
• 1:05
  - Well, I'm looking forward to our conversation. I
• 1:07
  - know we've got a lot to talk about
• 1:09
  - and some really, really interesting things you're doing
• 1:11
  - at West Virginia University Health System. But before
• 1:14
  - we dig in, can you tell
• 1:16
  - us a little bit more about yourself and
• 1:16
  - your background?
• 1:18
  - Happy to do so.
• 1:20
  - Yeah. So I am, as you said, the
• 1:21
  - CFO here in at WVU, W Medicine.
• 1:24
  - I've been here for about three and a
• 1:26
  - half years now.
• 1:29
  - And I came to West Virginia from Philadelphia
• 1:31
  - where I was the system CFO at Temple
• 1:34
  - Health.
• 1:35
  - Prior to my time in Philadelphia, I spent
• 1:37
  - more than fifteen years in Pittsburgh and that
• 1:40
  - surrounding region at UPMC.
• 1:43
  - And way back when I actually started my
• 1:44
  - career as an engineer at, General Electric, and
• 1:47
  - I worked,
• 1:48
  - at GE,
• 1:50
  - first on the technical side, and then I
• 1:52
  - went through their financial management program and corporate
• 1:55
  - audit staff,
• 1:56
  - prior to to making the switch over into
• 1:58
  - health care.
• 2:00
  - That's amazing to hear. And, you know, what
• 2:02
  - a great journey and experience to have in
• 2:03
  - in different industries, and I can imagine a
• 2:05
  - lot to bring into your current role. So,
• 2:08
  - I guess, could you start with giving us
• 2:10
  - a quick state of the union?
• 2:11
  - What has gone well this year, and what
• 2:13
  - are you focused on for the rest of
• 2:14
  - 2026?
• 2:16
  - Yeah. So we have been, well, jeez. It
• 2:19
  - feels like we've been in growth mode, for
• 2:21
  - forever since I've arrived here, but we continue
• 2:24
  - to be in growth mode with our health
• 2:25
  - system.
• 2:27
  - We will wrap up this fiscal year at
• 2:29
  - at nearly 9,000,000,000,
• 2:32
  - in operating revenue, 25 hospitals across four states,
• 2:37
  - as of today.
• 2:40
  - And that's, you know, here in September
• 2:42
  - 2026.
• 2:43
  - But in the next month,
• 2:45
  - we will finalize
• 2:47
  - a deal to have the hospitals from Independence
• 2:49
  - Health System join,
• 2:52
  - our family here. And then the month after
• 2:55
  - that,
• 2:56
  - we are working towards Orchard Park,
• 2:59
  - joining our health system. And then one one
• 3:02
  - twenty seven Fulton County Medical Center in McConnelsburg,
• 3:05
  - Pennsylvania
• 3:07
  - join our health system. So seven new hospitals
• 3:10
  - really over the next,
• 3:12
  - three and a half months here,
• 3:14
  - which will take us to 32 hospitals again
• 3:16
  - across four states and, you know, just on
• 3:18
  - an OPREP perspective, put us over 10,000,000,000.
• 3:22
  - So we're we're pretty excited,
• 3:25
  - about that. We're we're also running pretty fast
• 3:28
  - to make those things happen smoothly.
• 3:31
  - You know, it's
• 3:32
  - it's always a challenge, when you're adding new
• 3:35
  - folks, and you wanna make sure that you
• 3:37
  - are getting those integrations right,
• 3:40
  - from the start,
• 3:41
  - so that they, you know, can take advantage
• 3:43
  - of of what you bring as a health
• 3:45
  - system. And we have a great track record
• 3:47
  - with that, and we work really, really hard
• 3:49
  - to make sure that that continues.
• 3:53
  - I love it. I I think, you know,
• 3:55
  - it's really cool to have that opportunity to
• 3:57
  - bring in others into the organization
• 4:00
  - and really expand what you're doing. Growth mode
• 4:02
  - is,
• 4:03
  - so important, and I know not all health
• 4:06
  - systems are are being there. So when you
• 4:07
  - think about, you know, the last,
• 4:09
  - couple of years, how were you able to
• 4:11
  - get to this point where, you know, you're
• 4:14
  - in a spot where you're excited about growth,
• 4:16
  - have growth upcoming, and just continue to, see
• 4:19
  - a lot of great opportunities ahead.
• 4:22
  - Yeah.
• 4:23
  - You know, I think it and I know
• 4:25
  - you're gonna ask me about this, so I'll
• 4:27
  - I'll I'll answer sort of carefully here, I
• 4:29
  - guess. But, you know, look, there's plenty of
• 4:31
  - challenges,
• 4:32
  - certainly. And, you know, there's some scary headwinds
• 4:35
  - coming our way from a health care perspective
• 4:38
  - in general. But I think for us,
• 4:40
  - it's a couple different things. Right? So, you
• 4:42
  - know, part of our strategy
• 4:45
  - is is really looking across the markets that
• 4:48
  - we serve
• 4:49
  - and making sure that we're delivering on the
• 4:52
  - two part mission, right, which is improving the
• 4:54
  - health trajectory
• 4:56
  - of West Virginians and all those surrounding regions
• 4:58
  - that we serve
• 5:00
  - and then carrying out the teaching mission of
• 5:02
  - WVU.
• 5:04
  - And a big part of how we've done
• 5:06
  - that is providing access, care closer to home.
• 5:08
  - And so what does that mean? That's regionalization
• 5:12
  - and it's investing in in our regions from
• 5:14
  - a strategic capital perspective,
• 5:17
  - from a physician recruitment perspective,
• 5:19
  - from leveraging technology and telehealth. And those are
• 5:22
  - sort of the traditional organic ways that we're
• 5:24
  - delivering. But then the inorganic way is, right,
• 5:26
  - is by growing the footprint, right, and expanding
• 5:28
  - into,
• 5:29
  - you know, near geographies
• 5:31
  - that that's, you know, serve the same patient
• 5:34
  - population that we're used to serving and and
• 5:36
  - doing it in a way that that leverages
• 5:38
  - our model that's been very successful. Right? We
• 5:40
  - consider ourselves
• 5:42
  - to be a rural health care system. Right?
• 5:44
  - That's our focus. That will always be our
• 5:46
  - focus, and we think we're pretty darn good
• 5:48
  - at it. Right? And so we we we
• 5:50
  - leverage technology, as I said. So, you know,
• 5:52
  - we have Epic, and we put in Epic
• 5:55
  - very quickly.
• 5:56
  - For example, Wheaton Hospital, which which joined us
• 5:59
  - in 2025.
• 6:00
  - We acquired Wheaton one one
• 6:02
  - of of 2025.
• 6:04
  - We had them up and running on our
• 6:05
  - instance of Epic by April of that same
• 6:07
  - year. Right? And with seven hospitals coming in,
• 6:10
  - they won't quite go
• 6:11
  - as fast as that one, but it's really
• 6:13
  - it's a key part of what we do.
• 6:15
  - Right? And
• 6:16
  - and, you know, having that
• 6:19
  - EMR consistent across all of our locations, whether
• 6:22
  - that's hospital based, whether that's physician based and
• 6:26
  - including on our insurance,
• 6:28
  - side as well where we are actually processing
• 6:30
  - claims
• 6:31
  - through Epic Tapestry. We think that makes a
• 6:34
  - very smoother seamless experience for our patients and
• 6:37
  - for our
• 6:38
  - physicians and providers, care providers, nurses, etcetera, in
• 6:41
  - all of our locations. And so that's a
• 6:43
  - core part of what we're focused on,
• 6:46
  - from an integration perspective. And and probably the
• 6:49
  - other thing that we do is we run
• 6:50
  - a very lean corporate overhead here.
• 6:53
  - We target our our corporate functions to be
• 6:56
  - at seven and a half percent or less
• 6:59
  - of our top line operating revenue,
• 7:01
  - on a percentage basis. And, you know, you
• 7:03
  - can look at the industry standards, but you
• 7:06
  - see lots of organizations that have that number
• 7:08
  - in the double digits. So we're very proud
• 7:10
  - of of kinda running a lean mean, if
• 7:12
  - you will, corporate overhead. But it really allows
• 7:14
  - our local business units to focus on delivering
• 7:17
  - care and making smart strategic decisions.
• 7:20
  - And, you know, our job at corporate is
• 7:22
  - to make sure that we're we're holding them
• 7:24
  - accountable.
• 7:24
  - We're giving them good tools like Epic and
• 7:26
  - other things that, you know, that we provide
• 7:29
  - at a at a centralized level
• 7:30
  - so that they can tailor that, you know,
• 7:33
  - care to each one of the different communities
• 7:35
  - that we serve. That was a long answer,
• 7:37
  - but, hopefully, I I I covered your question
• 7:39
  - there.
• 7:41
  - No. Absolutely. I mean, I think that's such
• 7:43
  - a great point. And I know on the
• 7:44
  - technology side, having that integration
• 7:46
  - go well, a kind of a playbook. Obviously,
• 7:48
  - not every institution's the same, but to your
• 7:50
  - point, being able to understand what it takes
• 7:52
  - and the importance of bringing all locations together
• 7:56
  - and what you can do with that, at
• 7:58
  - the corporate level really makes a big difference.
• 8:00
  - And so I love that focus, and it's
• 8:01
  - helpful to understand how you're thinking about it
• 8:04
  - and what that means
• 8:05
  - really, on our financial side too.
• 8:08
  - And and to your point, you know, headwinds,
• 8:11
  - there are a lot of them. So what
• 8:12
  - are some
• 8:13
  - of the things that you are thinking about
• 8:14
  - or looking at from your seat and what
• 8:16
  - are you keeping an eye on for the
• 8:17
  - next year or so?
• 8:19
  - Yeah. I mean, I think that the obvious
• 8:22
  - answer and probably the answer everyone would share
• 8:24
  - is just what's going on with our funding
• 8:27
  - mechanisms,
• 8:28
  - in particular,
• 8:29
  - you know, our government funding mechanisms,
• 8:32
  - and what's out there with HR one or
• 8:34
  - the one big beautiful bill and some of
• 8:36
  - those impending sort of cuts,
• 8:39
  - you know, that that are are impacting many
• 8:42
  - of us already and are are, you know,
• 8:44
  - are gonna ramp up,
• 8:45
  - from an impact perspective in the near future,
• 8:48
  - in particular with federal fiscal year '28 kind
• 8:51
  - of looming on the horizon and some significant
• 8:54
  - cuts,
• 8:55
  - you know, coming.
• 8:57
  - I think that's the biggest headwind that probably
• 9:00
  - many of us are are struggling with.
• 9:04
  - You you know,
• 9:05
  - look.
• 9:06
  - This is
• 9:08
  - it's not a new phenomenon. I think every
• 9:11
  - you know, I've been in health care for,
• 9:12
  - jeez, 2004. So twenty two years, I guess,
• 9:16
  - now.
• 9:17
  - And and,
• 9:19
  - you know, I I think there's always something
• 9:21
  - looming on the horizon.
• 9:23
  - This this feels different,
• 9:26
  - just because of the the magnitude or the
• 9:28
  - scope of, you know, a trillion dollars. Right?
• 9:30
  - If you if you break down what's in
• 9:32
  - HR one from a cut perspective.
• 9:35
  - And and, you know, we've really become more
• 9:37
  - and more dependent on government payers, you know,
• 9:40
  - in particular.
• 9:41
  - Many organizations,
• 9:43
  - have a high Medicaid mix these days. I
• 9:45
  - I think we are certainly one of them
• 9:47
  - based on the geography and and the demographics
• 9:50
  - that we serve.
• 9:52
  - You know, and and and we're proud of
• 9:53
  - that, but we need to make sure that
• 9:55
  - we're defending,
• 9:56
  - you know, those those payments. In particular, the
• 9:59
  - if you look at the state directed payment
• 10:01
  - programs,
• 10:03
  - you know, what's out there with, you know,
• 10:05
  - some of these other, like, the work requirements,
• 10:07
  - the enrollment eligibility checks. These are significant challenges,
• 10:12
  - for us. And and so I think it's
• 10:14
  - it's a little bit of a combination
• 10:16
  - of,
• 10:17
  - you know, figuring out how you can advocate.
• 10:19
  - And I I'll tell you, I think that's
• 10:21
  - something we don't do well in health care.
• 10:24
  - You know, we don't have a good track
• 10:26
  - record. We often are fighting over,
• 10:28
  - you know, our piece of the pie,
• 10:31
  - you know, individually
• 10:32
  - as opposed to banding together with other health
• 10:35
  - systems and providers out there and being able
• 10:38
  - to advocate more generally
• 10:40
  - for our sector. I think that's something that
• 10:42
  - we could all do a better job of.
• 10:45
  - But I think it's also about, you know,
• 10:47
  - just being smart and and, you know, strengthening
• 10:50
  - and stabilizing the balance sheet and and playing
• 10:52
  - defense, if you will,
• 10:55
  - because we are an organization as are many
• 10:57
  - other nonprofit health systems across this country that
• 11:00
  - that are focused on our mission.
• 11:01
  - And that mission is to serve out, you
• 11:03
  - know, the the communities,
• 11:06
  - and the patients and families we serve, not
• 11:08
  - just for the next, you know, quarter
• 11:10
  - or year or two or three years, but
• 11:13
  - for the next hundred years. Right? It's very
• 11:16
  - different than
• 11:17
  - many for profit sectors that are focused on,
• 11:19
  - you know, quarterly results. And so it's a
• 11:22
  - tough challenge for us right now. And I
• 11:24
  - think, you know, look, we've we've gotta be
• 11:26
  - smart. We've gotta leverage that technology. We've gotta
• 11:29
  - grow where we can. I also will say
• 11:32
  - not to be, you know, totally,
• 11:34
  - negative on it. Like, I think it's gonna
• 11:36
  - present some opportunities,
• 11:38
  - from a growth, from a consolidation
• 11:40
  - perspective. And so I think that's where, you
• 11:42
  - know, sharpening our skills,
• 11:45
  - utilizing and learning from the new folks that
• 11:47
  - join our health system,
• 11:49
  - because, you know, we're not perfect, and we
• 11:51
  - don't have all the answers. And we often
• 11:52
  - learn from those new
• 11:54
  - hospitals and providers and and leaders that join
• 11:57
  - our health system, and that just makes us
• 11:59
  - better and stronger. And so I think that's
• 12:01
  - the flip side of the coin is I
• 12:02
  - think there's gonna be more opportunities to grow
• 12:05
  - and more opportunities to to get better and
• 12:08
  - improve,
• 12:09
  - you know, what we're doing and how we're
• 12:11
  - doing it. So it's, you know, certainly it's
• 12:13
  - challenging, it's stressful, but I think oftentimes
• 12:16
  - some of those, you know, big sort of
• 12:18
  - what feel like cataclysmic events in our industry
• 12:22
  - often bring great opportunities as well. And so
• 12:24
  - you can't you can't take your eye off
• 12:26
  - the ball.
• 12:29
  - Such a good point. And, you know, especially
• 12:31
  - looking at,
• 12:32
  - how, you know, has the financial situation shift,
• 12:36
  - has policy shift, has, you know, you just
• 12:38
  - never quite know exactly,
• 12:40
  - what's gonna be on the table for the
• 12:42
  - next year being a nimble organization.
• 12:45
  - To your point, I have certain advantages so
• 12:47
  - you can can innovate. You can take advantage
• 12:49
  - of the opportunities that do come along. And
• 12:52
  - and your thoughts on comparing what you do,
• 12:55
  - as a nonprofit health system from the for
• 12:57
  - profit world, is definitely a point well taken,
• 13:00
  - trying to plan for the future and needing
• 13:02
  - to,
• 13:04
  - serve the community no matter what their financial
• 13:06
  - constraints are. So I wanna dig deeper into
• 13:09
  - some of the different opportunities that you're seeing
• 13:11
  - as a result. You know, where do you
• 13:13
  - think
• 13:14
  - good opportunities for WVU over the next two
• 13:16
  - to three years or so?
• 13:18
  - Yeah.
• 13:19
  - Great question. You know what? Look. I think
• 13:21
  - there will
• 13:23
  - certainly be opportunities to grow,
• 13:26
  - you know, in this sort of the more
• 13:28
  - traditional sense. Right? So whether that's
• 13:31
  - expanding into,
• 13:32
  - you know, near or contiguous geographies from a
• 13:35
  - provider perspective or from a hospital
• 13:37
  - perspective,
• 13:38
  - be that, you know, sort of organic, meaning,
• 13:41
  - you know, building new facilities or expanding existing
• 13:44
  - facilities or inorganic. Right? Like adding new members
• 13:47
  - to the family. I I think that that
• 13:49
  - will continue and and likely, potentially,
• 13:52
  - you know, because of the challenges that we
• 13:54
  - just talked about, you might see some more
• 13:56
  - opportunities.
• 13:59
  - But but what I would say, I think,
• 14:01
  - for us is a core part of our
• 14:02
  - strategy is what we're doing from an insurance
• 14:05
  - perspective. And Peak Health, which we formed in
• 14:07
  - 2023,
• 14:08
  - has grown
• 14:09
  - exponentially in a very short period of time,
• 14:12
  - you know, north of 80,000 covered lives and
• 14:15
  - soon to be, you know, I think well
• 14:17
  - over a 100,000 covered lives.
• 14:20
  - You know,
• 14:21
  - recently, you know, we've we've seen significant growth
• 14:25
  - in our Medicare Advantage product
• 14:29
  - there. We've we've driven significant,
• 14:32
  - savings from an employee benefits perspective and efficiency
• 14:36
  - that we've driven,
• 14:38
  - as we've grown the ASO book of business
• 14:41
  - that we have with peak.
• 14:42
  - We are expanding,
• 14:44
  - you know, into having an an ACA marketplace
• 14:48
  - entry with an exchange product.
• 14:50
  - We're gonna have a D SNP product next
• 14:52
  - year. I think those are are smart and
• 14:55
  - measured,
• 14:57
  - growth opportunities for us. And, you know, we've
• 14:59
  - had conversations about expanding into Medicaid, and I
• 15:02
  - think you've seen some health systems
• 15:05
  - do that with providers sponsored plans and some
• 15:08
  - do it really well, and some have had
• 15:09
  - some missteps and have had to to to
• 15:11
  - go backwards on that. And so we're we're
• 15:13
  - trying to be pretty methodical here, but,
• 15:16
  - you know, and move into it in a
• 15:18
  - measured way. But I'm really proud of what
• 15:20
  - that team has accomplished,
• 15:22
  - and, you know, with their star rating and
• 15:24
  - the movement they've seen and just the the
• 15:27
  - patient experience or the covered life ex experience,
• 15:30
  - excuse me, that we that we're we're having
• 15:32
  - there.
• 15:34
  - I I really think that's a core part
• 15:35
  - of our strategy for the future.
• 15:38
  - And, you know, I think it translates well
• 15:41
  - into
• 15:43
  - helping to ultimately improve that health trajectory
• 15:46
  - of the the the communities we serve. Right?
• 15:48
  - So thinking more and having a better way
• 15:51
  - to to get into population health
• 15:54
  - and
• 15:55
  - value based care. You know, I I think
• 15:58
  - it it really sets us up for success,
• 16:01
  - over the the long term,
• 16:04
  - and and really being able to to more
• 16:06
  - effectively and efficiently
• 16:08
  - help provide the best care and access to
• 16:11
  - to those patients. So I'm I'm really, really
• 16:13
  - excited
• 16:14
  - about what we're doing right now with with
• 16:16
  - PEAK Health.
• 16:19
  - That's amazing. I mean, it's great to hear
• 16:21
  - the results and understand the impact that PEAC
• 16:24
  - is making on, you know, the community and
• 16:27
  - and your team there internally. So,
• 16:29
  - that's really interesting. And I know you mentioned,
• 16:32
  - population health and the value based care and
• 16:34
  - the different,
• 16:36
  - opportunities
• 16:37
  - to really care for communities in a smart
• 16:39
  - and meaningful way.
• 16:41
  - What has worked well in that perspective where
• 16:44
  - you kind of thinking about,
• 16:46
  - continuing down this population health value based journey?
• 16:49
  - What does that look like for you?
• 16:51
  - Yeah. I mean,
• 16:53
  - the I don't know that there's
• 16:55
  - a a a a, magical, you know, solution.
• 16:59
  - I think it requires a lot of work,
• 17:01
  - and it requires,
• 17:02
  - I think,
• 17:04
  - committed leaders and and providers that are embedded
• 17:07
  - in communities that can help
• 17:10
  - translate, you know, what what care or what,
• 17:13
  - access is needed for each one of the
• 17:15
  - communities. Like I said differently, I think one
• 17:17
  - size fits all is not a good strategy.
• 17:19
  - Right? So having the ability,
• 17:21
  - to be connected to those communities both on
• 17:24
  - a on a provider perspective and on an
• 17:26
  - insurance perspective is key. And one thing that's
• 17:28
  - unique though about how we've structured Peak is
• 17:31
  - we really view Peak
• 17:33
  - as a cost center. Right? So I think
• 17:35
  - in many other instances where you see these
• 17:37
  - integrated delivery and financing networks or payer providers,
• 17:40
  - if you will,
• 17:42
  - you kinda have the two competing, if you
• 17:44
  - will, even though they're in the same
• 17:47
  - entity, you know, they're both trying to drive
• 17:49
  - margin, they're both trying to deliver a bottom
• 17:51
  - line.
• 17:52
  - And for us, we really view peak as
• 17:54
  - a cost center. Right? So we wanna, you
• 17:57
  - know,
• 17:58
  - use peak as a tool so that we
• 18:00
  - can improve,
• 18:02
  - the experience and the outcomes and the care
• 18:04
  - of of the patients in those communities and
• 18:07
  - empower the providers. And and, you know, I'm
• 18:09
  - not saying we have it all figured out
• 18:11
  - or that we're perfect, but it's it's really
• 18:13
  - helped us identify opportunities certainly from a back
• 18:17
  - office perspective and red tape perspective, you know,
• 18:20
  - things,
• 18:21
  - like,
• 18:22
  - you know, challenges with denials or challenges with,
• 18:26
  - pre authorizations, etcetera.
• 18:28
  - You know, we we have delivered the the
• 18:30
  - lowest cost,
• 18:33
  - from an administrative perspective, certainly with peak. That's
• 18:36
  - probably the, you know, frankly, the easiest sort
• 18:38
  - of,
• 18:40
  - you know, surface to scratch as it relates
• 18:42
  - to how we're we're integrating the two. I
• 18:44
  - think it's harder when it comes to how
• 18:46
  - do you actually change, you know, clinical pathways
• 18:50
  - and care delivery.
• 18:52
  - And so for us, it's about aligning those
• 18:54
  - resources. So not having a care navigator on
• 18:56
  - the plan side and a care navigator on
• 18:58
  - the hospital side, but actually just having a
• 19:00
  - care navigator
• 19:01
  - who's going to sort of cross both those
• 19:03
  - boundaries and really do what's best for the
• 19:05
  - patient and the family and work with the
• 19:07
  - physicians to try to best provide
• 19:10
  - timely information so that you can make informed
• 19:12
  - clinical decisions.
• 19:13
  - You know, we we we run all of
• 19:15
  - our hospitals,
• 19:17
  - with our insurance,
• 19:18
  - plant with peak on a capitated basis.
• 19:21
  - And that's challenging,
• 19:23
  - and it's certainly something different than how they're
• 19:26
  - used to the CFOs for each of those
• 19:28
  - hospitals are used to getting paid, so to
• 19:29
  - speak.
• 19:31
  - And we're relatively early in it, but I'm
• 19:33
  - I'm really excited about the the information sharing
• 19:38
  - and, you you know, some of the the
• 19:40
  - thought process shifts to where, you know, you're
• 19:42
  - really focused on trying to keep those patients
• 19:44
  - healthy and out of your hospital.
• 19:46
  - It's a totally different way to to think
• 19:48
  - about care. And it's not new. Right? This
• 19:50
  - this concept has been around for decades,
• 19:53
  - but you gotta kinda put your money where
• 19:55
  - your mouth is and change those payment mechanisms
• 19:57
  - to to really try to drive change, and
• 19:59
  - and that's exactly what we're doing with peak
• 20:01
  - health.
• 20:02
  - I love it.
• 20:04
  - That's so cool. Thank you for,
• 20:06
  - explaining a bit deeper there. I know, you
• 20:07
  - know, a lot of organizations, the leaders I
• 20:09
  - talk to are trying to,
• 20:11
  - do very similar things or figure out how
• 20:13
  - they're going to bring more value based care
• 20:15
  - into their communities and thinking about wellness, population
• 20:18
  - health, social determinants, all of those things. And
• 20:20
  - so it's helpful
• 20:21
  - to hear from you and and see that
• 20:23
  - lens that you're looking at it through. So,
• 20:26
  - thank you so much, Nick, for your time
• 20:28
  - today. I have one more question that I
• 20:29
  - wanted to ask about leadership. Who is a
• 20:31
  - leader really from any industry that you admire
• 20:34
  - and why?
• 20:36
  - Yeah. Great question. I love this question, and
• 20:38
  - there's just so many. It's it's it's pretty
• 20:40
  - difficult,
• 20:41
  - to answer that question. I've been very blessed
• 20:43
  - in my career to work for some amazing
• 20:45
  - leaders in current in including my my current
• 20:48
  - leader and,
• 20:49
  - you know, the CEO at Temple Health and
• 20:51
  - and a number of CFOs at at in
• 20:54
  - my UPMC days that are still mentors,
• 20:57
  - of mine to this day. It's kinda
• 20:59
  - amazing to me that I've been so fortunate
• 21:01
  - to work for so many great leaders.
• 21:05
  - But so a good sorta answer to that
• 21:07
  - question with without having to pick one of
• 21:09
  - those those folks is is, you know, Jack
• 21:11
  - Welch
• 21:12
  - is really
• 21:13
  - a leader that that I admire. And and
• 21:16
  - I was I started my career in the
• 21:18
  - Jack Welch days at General Electric, and
• 21:21
  - I was
• 21:22
  - lucky enough to meet him, I think, three
• 21:24
  - or four times,
• 21:26
  - in in in my days at at General
• 21:28
  - Electric. And, you know, he just was was
• 21:30
  - so energetic,
• 21:32
  - and and, you know, very smart, very engaged,
• 21:36
  - you
• 21:37
  - know, and approachable, but also, you know, very
• 21:39
  - intense. And he held folks accountable, and he
• 21:42
  - was always very direct,
• 21:44
  - with his feedback. And you you sorta you
• 21:46
  - felt like if you were lucky enough to
• 21:48
  - get some of his time,
• 21:50
  - you needed to make sure that you didn't
• 21:51
  - waste it. And I think that's,
• 21:53
  - you know, that's that's something that has stuck
• 21:55
  - with me throughout my career and something that
• 21:57
  - I try to bring with me.
• 21:59
  - When I'm interacting with with different, you know,
• 22:01
  - leaders across
• 22:03
  - our health system and across, you know, all
• 22:05
  - sectors that I interact with. And I also
• 22:07
  - look for in my team. Right. And,
• 22:10
  - you know, there's
• 22:11
  - something to be said for being accountable and
• 22:14
  - being driven. And,
• 22:16
  - you know, I think it goes a long
• 22:17
  - way,
• 22:18
  - in in in really helping you in your
• 22:20
  - career and helping your organization. So I try
• 22:22
  - to emulate a lot of those things in
• 22:24
  - in my leadership style.
• 22:28
  - I love it. Yeah. I I think, you
• 22:29
  - know, there's so much to admire about the
• 22:31
  - way Jack Welch approached, leadership and building companies
• 22:34
  - and thinking about, you know, the best way
• 22:37
  - to bring the best out of people. So,
• 22:39
  - Nick, thank you so much for joining us
• 22:41
  - on the podcast today. This has been a
• 22:42
  - really fun conversation.
• 22:44
  - I appreciate your thoughts on a variety of
• 22:47
  - topics that we talked about today, and then
• 22:49
  - we'll be looking forward to seeing you as
• 22:51
  - well at our CEO CFO roundtable. I know
• 22:53
  - you'll be speaking on a panel, and,
• 22:56
  - it'll be great to have the opportunity to
• 22:58
  - connect and learn more from you there.
• 23:00
  - Looking forward to it. Thank you, Laura.