Latest / Becker’s Healthcare Podcast / JPM Takeaways, AI Progress, and the Future of Hospitals with Molly Gamble

Transcript

JPM Takeaways, AI Progress, and the Future of Hospitals with Molly Gamble · Becker’s Healthcare Podcast

• 0:01
  Every year, Becker's annual meeting brings health care
• 0:04
  leaders together to unpack the most pressing issues
• 0:06
  facing the industry.
• 0:08
  And every year, those conversations shift in profound
• 0:11
  and unexpected ways.
• 0:12
  This April, more than 3,500
• 0:15
  healthcare executives will return to Chicago for Becker's
• 0:18
  sixteenth annual meeting.
• 0:19
  Seven ninety five elite speakers will offer new
• 0:22
  lessons, new case studies, and predictions about what
• 0:25
  comes next.
• 0:26
  Join us April 13 through the sixteenth.
• 0:29
  For the agenda and event details, visit beckershospitalreview.com
• 0:34
  and click on the events tab in the
• 0:35
  upper right.
• 0:38
  This is Scott Becker with the Becker's Healthcare
• 0:41
  Podcast.
• 0:42
  I am thrilled to weekly
• 0:44
  get a chance to visit with Molly Gamble.
• 0:47
  Molly's the vice chair or vice president in
• 0:50
  charge of editorial affairs at Becker's Healthcare,
• 0:53
  Wong's from editor in chief.
• 0:55
  And we we visit with Molly regularly to
• 0:58
  talk about what stories she's walking watching closely
• 1:01
  in health care.
• 1:02
  Molly, let me turn it to you and
• 1:04
  ask you, are there a couple stories that
• 1:06
  you're watching most closely currently?
• 1:08
  Yeah. Thank you so much, Scott. It's good
• 1:10
  to be back with you. And to to
• 1:11
  kick off 2026,
• 1:13
  I come with some observations and notes from
• 1:15
  the JPM Healthcare Conference that took place
• 1:19
  last week in San Francisco. This was the
• 1:21
  forty fourth
• 1:22
  version of the event, and I think it's
• 1:24
  been interesting to watch it evolve over time.
• 1:26
  But there were definitely some health system centric
• 1:29
  takeaways that I thought we could unpack together.
• 1:33
  I think one of the first, Scott, that
• 1:34
  really stood out to me is this has
• 1:36
  been discussed and
• 1:38
  anticipated
• 1:39
  so frequently. I feel like I've been writing
• 1:41
  about this for, like, ten plus years, but
• 1:44
  the hospital no longer being the center of
• 1:46
  the health system business model. I think ten,
• 1:49
  twelve, fifteen years ago, that was somewhat of
• 1:51
  a
• 1:52
  a remark or anticipation you would hear from
• 1:54
  a lot of the futurists out there. It
• 1:56
  was kind of aspirational.
• 1:58
  And now you're really seeing it happen, and
• 2:00
  it's happening in some substantial but also quiet
• 2:03
  ways.
• 2:04
  So you're seeing systems like Ascension go from
• 2:06
  a 139
• 2:07
  hospitals to 95. It obviously has its pending
• 2:10
  acquisition of AmSurge, which would increase its ambulatory
• 2:14
  footprint
• 2:15
  in really
• 2:16
  major way. You have Sutter
• 2:18
  Health in California. It's already the largest ambulatory
• 2:21
  system in the state
• 2:23
  looking to spend nearly half $1,000,000,000
• 2:25
  on 50 more ASCs.
• 2:27
  And so you're having a lot more of
• 2:29
  these systems
• 2:30
  really plant the flag and make sure that
• 2:33
  their strategy moving forward is outpatient centric.
• 2:36
  I think, Scott, what didn't come up as
• 2:39
  much that maybe this is just something that
• 2:41
  hospital leaders are more close to versus the
• 2:43
  broad system leaders, but we're talking right now
• 2:47
  in virus season.
• 2:48
  I understand this flu season has been pretty
• 2:50
  hard for, especially for certain pockets of the
• 2:53
  country,
• 2:54
  and our team is conducting interviews with leaders
• 2:56
  at hospitals that are at capacity.
• 2:59
  We had one in Iowa had to suspend
• 3:02
  elective surgeries for flu,
• 3:04
  to make capacity for patients and the high
• 3:08
  volume of patients related to this virus season.
• 3:10
  So as much as the
• 3:13
  playbook
• 3:14
  is pushing health systems to think outside of
• 3:17
  the acute
• 3:18
  hospital model,
• 3:19
  you still are seeing the reality in the
• 3:21
  day to day. A lot of these hospitals
• 3:24
  are operating at the brink, and we're gonna
• 3:26
  see how this continues to evolve as more
• 3:28
  uninsured continue to to add up under the
• 3:30
  OBBBA.
• 3:33
  And and and let's talk about that. Really,
• 3:35
  this concept that there's this really challenging juxtaposition
• 3:39
  of hospitals are totally full, totally full.
• 3:43
  And and they're having trouble getting people out
• 3:45
  of their ER into the hospital,
• 3:48
  and and just there's there's
• 3:50
  really challenging spot. Many hospitals operate to get
• 3:52
  total capacity. And at the same time, there's
• 3:55
  so much movement of care in so many
• 3:57
  different places
• 3:58
  to other spots.
• 4:00
  And
• 4:01
  maybe it's the hospitals becoming less the total
• 4:04
  center of health care,
• 4:06
  but it does seem that even so, they're
• 4:08
  still quite quite full.
• 4:10
  And maybe it's and not or hospitals and
• 4:14
  everything else taking care of patients and doing
• 4:16
  so in a supply constrained environment,
• 4:19
  because at the end of the day, not
• 4:20
  seeing all the technology,
• 4:22
  we still need doctors and nurses. So so
• 4:24
  really challenging. And and then you could still
• 4:27
  get reminded of this stuff. Like, you mentioned
• 4:29
  the the flu season being bad, and all
• 4:31
  of a sudden, the hospital's again being overwhelmed.
• 4:34
  And, obviously, we saw this so many times
• 4:35
  during COVID.
• 4:37
  So so as much as the country wants
• 4:38
  to get away from a hospital centric
• 4:40
  model
• 4:41
  and certainly you're right. USPI went from being
• 4:44
  a hospital company to as much being a
• 4:45
  surgery and outpatient surgery company.
• 4:47
  Ascension's trying the same transformation. Other places are
• 4:50
  too.
• 4:51
  And maybe it's not so much that hospitals
• 4:53
  aren't needed. It's just hard to make money
• 4:54
  in hospitals. These systems are trying to hit
• 4:56
  this balance of outpatient and inpatient,
• 4:59
  but the hospital still seem very sorely needed
• 5:01
  in terms of our nation.
• 5:03
  I couldn't agree more. And I I think
• 5:05
  that what you're hearing is the hospital is
• 5:07
  less the core of the health system business
• 5:10
  model. But I think to your point, Scott,
• 5:12
  it is very much still the core of
• 5:13
  so much of the care model. So I
• 5:15
  I think, it's it's something to be to
• 5:17
  be careful about because as you see more
• 5:19
  and more systems look to
• 5:21
  another health system leader on the East Coast,
• 5:23
  he he would always remind me that, you
• 5:25
  know, hospital revenue was about 46%
• 5:28
  compared to outpatient.
• 5:30
  You know, that makes sense. That that clearly
• 5:33
  illustrates at a business model level, the hospital
• 5:36
  is not as important as it once was.
• 5:38
  But I think to your point, Scott, when
• 5:39
  it comes to access and acuity of care
• 5:42
  and uninsured, which will continue to be
• 5:45
  accepted and treated under EMTALA
• 5:48
  and ERs, I think the hospital will continue
• 5:51
  to hold a very, very important, position when
• 5:54
  it comes to to care and access.
• 5:57
  I I think that's right on. No. Thank
• 5:59
  you. It's it's a mix of business model
• 6:01
  versus patient need, and there are places where
• 6:04
  that business model and patient need lines up
• 6:06
  well and why you see hospitals, again, reinvesting
• 6:08
  so much in orthopedics, oncology, cardiovascular
• 6:12
  because there's both need and money,
• 6:14
  but it's challenging for all those places where
• 6:15
  there's a mismatch, where there's tremendous need, but
• 6:18
  not enough money or not enough supply.
• 6:20
  Fascinating.
• 6:21
  Maui, tell us something else that you're watching
• 6:23
  closely currently.
• 6:25
  The other trend line I would point to
• 6:27
  from the conference was, you know, overall, I
• 6:29
  heard that the the presentations from the health
• 6:31
  systems were, like, relatively rosy.
• 6:33
  This is an event where they were pretty
• 6:35
  pretty forward looking with bright dispositions and then
• 6:38
  some of the margin pressure they're facing. You
• 6:40
  have some big systems that were represented, Scott,
• 6:42
  but another big trend line we're starting to
• 6:44
  see, I don't think this is as much
• 6:46
  of a surprise, but we've talked in the
• 6:47
  past about AI and its evolution. It was
• 6:49
  in this pilot phase for a couple years,
• 6:51
  and now you're just seeing more and more
• 6:53
  systems have some results to show for it.
• 6:56
  This is exciting for our team. I know
• 6:57
  we really enjoy being able to report on
• 6:59
  what is actually has changed with these tools
• 7:02
  and technologies in place.
• 7:04
  So you've got, you know, health systems, like,
• 7:06
  talking about how many hundreds of thousands of
• 7:08
  nursing clicks they eliminated,
• 7:10
  cutting contract labor spend. Providence cut theirs by
• 7:14
  about 62%.
• 7:16
  WellSpan, setting a goal of saving 400,000
• 7:19
  staff hours annually.
• 7:20
  So this is becoming more and more when
• 7:22
  we I know you and I have talked
• 7:24
  about in the past. Technology will not solve
• 7:26
  the workforce
• 7:27
  crisis, but you're seeing more systems at least
• 7:30
  have results to show for making some of
• 7:32
  these investments in these tools and how they
• 7:34
  are paying off for their people. So So
• 7:36
  I think that's something we'll continue to stay
• 7:38
  curious about in the year ahead. Ideally, more
• 7:40
  and more of these implementations and rollouts and
• 7:42
  pilots that we reported on will just continue
• 7:45
  to have a through line for what that
• 7:46
  actually means today and what it's actually changed
• 7:48
  in those organizations.
• 7:51
  Yeah. Thank you. No. I think that's fascinating.
• 7:52
  And and you're seeing different spots where it's
• 7:55
  really taking off and having impact
• 7:57
  on the administrative side, the ambient listening side.
• 8:02
  Still sort of getting there in that diagnostic
• 8:04
  side and the specialist side, but but helpful
• 8:07
  tools. But it it does seem like cascading
• 8:10
  different places
• 8:11
  where AI and technology is having the most
• 8:14
  impact, and and it seems like it's gonna
• 8:16
  be a evolution over the next several years,
• 8:18
  really.
• 8:19
  Mhmm. Mhmm. Very much so. And then I
• 8:22
  think the other and final note was just
• 8:25
  value based care.
• 8:26
  This is something that I've read some commentary
• 8:28
  saying, like, value based care is dead. Like,
• 8:31
  it just does not have the momentum it
• 8:32
  once did. We used to see systems basically
• 8:35
  publicly make a pledge that they wanted an
• 8:37
  x percent of their revenue
• 8:39
  under risk by this year. That doesn't seem
• 8:41
  to happen as much or as frequently or
• 8:43
  as with much visibility,
• 8:45
  but it's I I would argue it's it's
• 8:47
  not that. I think you're seeing the Medicare
• 8:49
  Advantage,
• 8:51
  ACO performance, risk based contracts
• 8:54
  really showing up as central to so many
• 8:56
  financial discussions.
• 8:58
  So, Scott, I just wanted to note that
• 8:59
  there's,
• 9:00
  I'm sure, plenty more reporting that our team
• 9:02
  will be doing on this. But when it
• 9:04
  comes to,
• 9:05
  value based care, there might have been a
• 9:07
  slowdown, especially post COVID in those immediate years
• 9:09
  after the pandemic.
• 9:11
  But I I think a lot of systems
• 9:12
  out there seem to be seeing value based
• 9:14
  care as as not an option for them,
• 9:16
  but a a must.
• 9:19
  No. I think that's right. And there are
• 9:21
  so many different definitions of value based care.
• 9:23
  And and part of it is
• 9:26
  it's it's probably almost
• 9:28
  better to talk in terms
• 9:30
  I I find value based care to be
• 9:32
  such a euphemism, and I don't mean to
• 9:34
  offend people, but you've got
• 9:36
  taking risk on one side, and you've got
• 9:39
  fee for service on the other side.
• 9:41
  And I would argue that most physicians and
• 9:44
  health systems,
• 9:45
  whether they're doing it in a fee for
• 9:47
  service environment or risk based environment,
• 9:50
  better believe that they're get that they're giving
• 9:52
  value for the care they're giving.
• 9:54
  That that the idea that value based care
• 9:56
  is just a risk based concept
• 9:59
  is sort of a
• 10:01
  it's a prejudice or bastardization
• 10:03
  against one payment system,
• 10:05
  which we may all agree has challenges.
• 10:08
  But but I think if you talked to
• 10:09
  an obstetrician gynecologist who's delivering a baby and
• 10:12
  getting paid whether they're getting paid for it,
• 10:13
  and they're certainly not cleaning up on it,
• 10:16
  they must believe they're getting they're giving value
• 10:18
  for the care they're giving just as well
• 10:20
  as an OBGYN that would be doing it
• 10:22
  under a risk based contract situation. So I
• 10:25
  think part of the issue is the framing
• 10:26
  of all this is so bastardized
• 10:29
  versus reality,
• 10:30
  and it becomes almost
• 10:32
  consulting talking points that drive us one way
• 10:34
  or the other,
• 10:35
  versus the reality of I I think most
• 10:38
  providers believe they're giving value for care. Now
• 10:40
  they might be getting paid for fee for
• 10:42
  service. They might be getting paid under risk.
• 10:45
  But but either way,
• 10:46
  they they probably believe they're giving
• 10:49
  good value for the care they're they're giving.
• 10:52
  Mhmm. Mhmm. I couldn't agree more. Like, the
• 10:54
  the lexicon of it and the language of
• 10:56
  it and, you know, under the umbrella
• 10:58
  of value based care of BBC, I mean,
• 10:59
  you've got, like, bundles. You've got global payment.
• 11:01
  Like, there's just so many flavors of that.
• 11:03
  So I know, Scott, we've got someone on
• 11:05
  the team working on a story because it's
• 11:07
  we're coming up on the ten year anniversary
• 11:09
  of, CJR, the comprehensive joint replacement program,
• 11:13
  that was implemented under CMS. And so we're
• 11:15
  just gonna be asking some questions of health
• 11:16
  systems that participate in that if it, you
• 11:18
  know, help sharpen their muscles. What are the
• 11:20
  after effects that still stay from that that
• 11:22
  big pilot that really moved
• 11:25
  bundles from an option to a mandate ten
• 11:28
  years ago.
• 11:29
  So more to come on that, but I
• 11:31
  think it's a it's an interesting
• 11:33
  as much as I can get really tired
• 11:34
  of hearing that term, quite frankly,
• 11:37
  I think there's probably a lot to be,
• 11:39
  learned about what's happening with value based care
• 11:41
  right now amongst some of the largest systems,
• 11:44
  especially.
• 11:45
  Could not agree more. Molly, as always, fantastic
• 11:48
  to visit with you. Thank you for joining
• 11:50
  us on the Becker's Healthcare podcast, and more
• 11:52
  importantly, thank you for your leadership every day.
• 11:55
  Thank you for joining us. Thank you so
• 11:56
  much, Scott.