Latest / Becker’s Healthcare Podcast / Expanding Access and Advancing Rural Care with Kyle Kramer

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Expanding Access and Advancing Rural Care with Kyle Kramer · Becker’s Healthcare Podcast

• 0:02
  - Every health system executive right now is being
• 0:04
  - asked to do something that has no useful
• 0:06
  - precedent,
• 0:07
  - make durable technology decisions in an environment that
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  - looks meaningfully different every six months.
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  - The pace isn't slowing,
• 0:14
  - the vendor landscape isn't getting simpler, and the
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  - cost of missteps
• 0:18
  - keeps rising.
• 0:19
  - Becker's eleventh annual IT and Revenue Cycle Conference,
• 0:23
  - The Future of AI and Digital Health, exists
• 0:25
  - for exactly this challenge.
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  - Here, you'll find more than 2,500 executive level
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  - attendees,
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  - 600 plus speakers, and four days of sessions
• 0:34
  - built around the questions leaders are actually wrestling
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  - with.
• 0:37
  - How to scale AI responsibly,
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• 0:44
  - revenue cycle, and how to make tech investments
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  - that hold up over time.
• 0:48
  - Join us September fourteenth through the seventeenth at
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  - the Hilton Chicago.
• 0:53
  - You can register on our events page at
• 0:55
  - beckershospitalreview.com
• 0:57
  - by clicking on the events tab in the
• 0:59
  - upper right.
• 1:00
  - Hello, everyone. This is Scott King live from
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  - Becker's first ever rural healthcare leadership summit, joined
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  - by a very special guest, Kyle Kramer, chief
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  - executive officer of Day Kimball Health. Kyle, how
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  - are you? Thanks so much for being here.
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  - Great. It is, wonderful to be here, and
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  - it's exciting to
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  - be a part of the inaugural rural health
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  - leadership summit. No. So happy to have you.
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  - Thanks so much, Kyle. And before we kinda
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  - dive into some topics and questions for you,
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  - I just wonder if you can just kind
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  - of tell us a little about your background
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  - and your, system.
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  - Yeah. You bet. I,
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  - interestingly enough, started in
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  - academic medicine back in 1991 at the University
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  - of Texas and Hermann Hospital in Houston, have
• 1:37
  - been
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  - a part of the Penn State University Health
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  - System in Hershey, PA, was at Yale New
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  - Haven Health
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  - in, in Southern Connecticut, and then moved down
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  - to Mainline Health on the West Side Of
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  - Philadelphia. All large systems,
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  - all academically focused, and all tertiary, coronary referral
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  - type, systems as well. And it's been a
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  - few years doing consulting work and now have
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  - been at Day Kimbell Health for the last
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  - six and a half years, which is by
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  - far the smallest place I've ever been.
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  - 104 beds, 22 bassinets serving a very rural
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  - population, which is
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  - very different because we don't provide all of
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  - the big services that you would expect in
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  - academia,
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  - but we do serve the primary
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  - and basic health care needs of an a
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  - community in Connecticut
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  - that is designated rural and otherwise wouldn't have
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  - access to care as readily as they do
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  - now. Providing a great service to community and
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  - appreciate you detailing
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  - your,
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  - your journey in health care with us. Just
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  - with so much going on in health care,
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  - just curious, what's currently commanding most of your
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  - attention as a leader right now?
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  - So we are,
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  - as I mentioned, a very small system, and
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  - we have been on an affiliation journey and
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  - have been in discussions with the University of
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  - Connecticut health,
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  - system, you Yukon,
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  - as it as it were. And,
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  - we are working diligently towards that. But, you
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  - know, the biggest things that we have to
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  - deal with today in our area are are
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  - transportation, and it's related to ambulance transport.
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  - It's related to moving patients from
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  - our facility to a higher level of care,
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  - or it's also related to moving them to
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  - skilled facilities when they're leaving our institution.
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  - You know, there there aren't as many people
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  - to draw from in our geography. So as
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  - a consequence, we've been working creatively on developing
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  - our own solutions. We have a number of
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  - staff members who work in our emergency department
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  - who actually are trained EMTs and or paramedics.
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  - So rather than relying on others, we're working
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  - to build our own, which is not something
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  - that we had ever intended to do. But,
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  - you know,
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  - you know, necessity is the mother of invention,
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  - and, we're on the game. No. That that
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  - sounds great. It'll help patients a lot. And
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  - just curious, you know, in a year marked
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  - by rapid change, what recent decision or pivot
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  - required the most leadership conviction from you as
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  - an individual, particularly when it came to aligning
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  - people, resources, or capabilities?
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  - So we've been
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  - very fortunate,
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  - over the course of the last three or
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  - four years. I've been given the opportunity to
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  - chair the state's rural health task force working
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  - closely with the comptroller,
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  - Sean Scanlon, for Connecticut. And,
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  - you know, we've established a number of priorities
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  - through that, but, over obviously, with the federal
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  - government having last year appropriated
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  - 50,000,000,000
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  - towards rural health transformation,
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  - we were very excited because that meant that
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  - we would potentially see some level of funding.
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  - What we've learned,
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  - in the last number of months is that
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  - every state's process is different. Right. And we
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  - are essentially building a stealth bomber on the
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  - way down the runway, and we've gotta lift
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  - that sucker up over a mountain.
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  - And it's all moving very fast. A lot
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  - of the folks that we're working with have
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  - literally just been hired three and four weeks
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  - ago.
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  - But we're very excited that through a very
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  - rapid
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  - cycle engagement
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  - with a number of key members of my
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  - leadership team,
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  - we've been able to bring a vision of
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  - improving access, increasing equitability of service distribution, and
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  - impacting affordability to light, and we've got a
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  - conditional approval of a little over $20,000,000
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  - to support those initiatives.
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  - How does that or how did that challenge
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  - assumptions you may have had, and and what
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  - did it change
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  - about how you approach decision making, you know,
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  - talent or organizational readiness today?
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  - So we've we've always been very intentional about
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  - the leaders that we recruit into the organization.
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  - And, obviously, in small and rural areas, you're
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  - you're not drawing from as larger pools. So,
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  - therefore, you're looking for people that, number one,
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  - have a predisposition for small market, but number
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  - two, have the ability to be very agile
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  - and nimble,
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  - embrace the philosophy of change is permanent, change
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  - is constant, and change is never going to
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  - stop.
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  - We have been very fortunate to have brought
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  - some leaders into our organization that embrace that
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  - philosophy,
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  - have worked with us very nimbly, and have
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  - bought into a vision of our job as
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  - a rural health provider, number one, is to
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  - serve the foundation of primary care, but it's
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  - really to increase access, improve
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  - the the amount and opportunities for specialty
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  - service that are available as well as, you
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  - know, working on making things more affordable. So
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  - if we we philosophize that if we can
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  - address the first two,
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  - we will be able to improve affordability because
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  - we're getting people in earlier, identifying risk
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  - in an elective form so that we can
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  - manage against it while people are more well
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  - so that they don't become acute when and
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  - that's when you get into the really costly
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  - stuff. Yeah. And you just laid out a
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  - few things that leaders are are dealing with.
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  - Where do you think is is the one
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  - thing where that's to be more decisive?
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  - Oh, gosh. The the the one thing, you
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  - know, it's, it's it's really about access. You
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  - know, quite frankly, if we
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  - if we are really going to be as
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  - an industry moving further and further towards value
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  - based care and really demonstrating that outcomes are
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  - where
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  - the sweet spot is, we've gotta be focused
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  - on getting people in early, identifying
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  - potential for risk, understanding family history,
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  - and managing against those risks in a form
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  - that allows people to maintain wellness
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  - rather than allowing them to become sick. And
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  - our health care system across this country
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  - does a great job with advanced disease management.
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  - We have a lot of very high acute
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  - services
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  - that are amazing, awesome, and some of the
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  - best in the world. But if you look
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  - at the model of care that other countries
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  - have embraced, it's really more focused on the
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  - forward end of life,
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  - identifying things early and managing from a primary
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  - care basis. And that's really where we think
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  - the sweet spot is, especially in a rural
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  - area where
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  - people don't necessarily have the ability to travel
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  - great distances for specialty services. So if we
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  - can do a better job on the forward
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  - end,
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  - manage that risk more effectively,
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  - we prevent people from having to leave where
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  - they live, where they work, where they own
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  - a business, where they may be raising
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  - crops, where they may be raising animals, and
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  - and whatnot. And that, I think, is a
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  - is a real opportunity for us to make
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  - a difference. Absolutely. I'm meeting patients in the
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  - community where they are. It always helps. As
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  - a certainty has become the new norm, what
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  - leadership habit or mindset has been most critical
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  - in keeping your organization and your people moving
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  - forward?
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  - Well, I think the the marines
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  - say it best, improvise, adapt, and overcome.
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  - The reality is that we know that change
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  - is
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  - never going to stop
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  - being a part of what we do. I,
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  - I learned from my very first boss when
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  - I was at the University of Texas at
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  - Hermann Hospital,
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  - LA Myers, that my job as a leader
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  - is to oversee all, act on some, and
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  - overlook a lot.
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  - Now that takes on a lot of different
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  - meanings, but, you know, we have so much
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  - that we're responsible for, but there's specific things
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  - that we really need to lean into
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  - and manage, and that's where we feel like
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  - this access,
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  - equity, affordability piece comes to play. And there's
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  - certain things that we're just never gonna be
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  - able to to change. We we can't
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  - be the the harbinger of change for what
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  - happens with the payer model. We can't be
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  - the purveyors of advanced specialty services. What we
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  - can do is manage patients better
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  - earlier in life so that they may not
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  - become as acutely ill or need those services
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  - as readily.
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  - And that's where we really feel we make
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  - a difference. And part of what we tell
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  - our team every day, Scott, is that, you
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  - know, you can choose
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  - to think when you put your feet on
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  - the ground in the morning that, you know,
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  - oh, I have to go to work. Or
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  - you can conversely and more positively say, today's
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  - the day I get to make a difference.
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  - And in rural health care, that opportunity to
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  - make a difference is very real, and it's
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  - very palpable amongst the people that you serve
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  - because you're deeply connected with them because they're
• 9:52
  - a part of your community and you're part
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  - of the community as well.
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  - We see people out at restaurants, grocery stores,
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  - at Tractor Supply, at at Lowe's or or
• 10:01
  - Home Depot, and they'll tell us what we're
• 10:03
  - doing well,
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  - but they'll also tell us what we still
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  - need to work work on. And that partnership
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  - as a community provider really does, I think,
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  - put us in a better position where we're
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  - relatable, engaged, and focused
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  - in a much more deep and meaningful way.
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  - Yeah. I think you established a lot of
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  - trust in the community to get that feedback.
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  - So very well put, Kyle. Thanks so much
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  - for joining us on the podcast, and thanks
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  - for speaking at the rural health care leadership
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  - summit. Very excited about it. Thank you so
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  - much.