Latest / Becker’s Healthcare Podcast / Dr. Terry Gilliland on Geisinger’s Strategy for Growth, Access and Innovation

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Dr. Terry Gilliland on Geisinger’s Strategy for Growth, Access and Innovation · Becker’s Healthcare Podcast

• 0:02
  - The strategic agenda facing hospital and health system
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  - leaders right now is not a short list.
• 0:07
  - Growth in a consolidating market, sustainable margins in
• 0:09
  - a reimbursement environment that rarely moves in your
• 0:12
  - favor,
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  - a tech investment cycle that demands both urgency
• 0:15
  - and discipline,
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  - and a workforce story that is still being
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  - written.
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  - Eker's fourteenth annual CEO CFO roundtable brings together
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  - 400 speakers across four days of sessions that
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  - Not in the abstract, but against the real
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  - decisions they'll face heading into the next year.
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  - It's the kind of event you leave with
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  - a clear sense of where you stand and
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  - what comes next.
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  - So join us November second through the fifth
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  - at the Hyatt Regency in Chicago,
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  - and come ready to do the hard thinking.
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  - Register on our events page at beckershospitalreview.com
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  - by clicking on the events tab in the
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  - upper right.
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  - This is Laura Dierdahl with the Becker's Healthcare
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  - podcast. I'm thrilled today to be joined by
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  - doctor Terry Gilliland, who's the president and CEO
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  - of Geisinger. Terry, it's a pleasure to have
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  - you on the podcast today. Thank you for
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  - having me.
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  - Absolutely. Now I'm excited for our conversation. I
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  - know Geisinger is such an innovative health system.
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  - There's so many cool things that you're doing
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  - and truly,
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  - a a lot around value based care as
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  - well. So I'm excited to dig in. But
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  - before we do, can you tell us a
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  - little bit more about yourself and your background?
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  - Oh, well, certainly. I grew up as a
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  - general surgeon and,
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  - progressed through
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  - a variety of different leadership roles, both within
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  - Kaiser Permanente and then started outside of Kaiser
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  - Permanente at Centerra Healthcare in Southeastern Virginia
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  - and then Blue Shield of California. Took a
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  - little bit of time off with an AI
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  - startup
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  - and,
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  - been here for the last three years at
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  - Kaiser Group.
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  - Well, that's great to hear. And I can
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  - imagine, you know, there there were some things
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  - during that AI startup period that you can
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  - take into your current role or it's such
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  - a an interesting background and experience than to
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  - come in as CEO of a health system?
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  - Yeah. I mean, the startup world is very
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  - different from, running a big organization like Geisinger.
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  - So it was a tremendous learning experience for
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  - me.
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  - Absolutely. Well, could you give us a quick
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  - quick state of the union of Geisinger?
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  - What's gone well this year, and what are
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  - you focused on for the rest of 2026?
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  - Yeah. Well, thank you for asking. You know,
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  - we've gotten back to the basics at Geisinger,
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  - which is to drive towards our purpose. Turns
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  - out our our founder got it right a
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  - hundred years ago
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  - when she told us to build a hospital
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  - and make it the best.
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  - And so we've narrowed it down to four
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  - things that are actually from our people,
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  - which is we're here to provide exceptional care
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  - to all. We're here to foster trust, connection,
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  - well-being.
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  - We wanna lead health care forward, and we
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  - wanna strengthen our communities.
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  - And so in these last three years since
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  - I've been here, we're continuing with our turnaround,
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  - and it was a straight up turnaround,
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  - with really good momentum across the organization. So
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  - we're continuing to make investments. We'll make Geisinger
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  - stronger for the next decade
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  - and not necessarily just responding to this year's
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  - pressures, which are substantial.
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  - No. Absolutely. And, you know, when you think
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  - about those pressures, I'm curious, what are the
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  - things that occupy most of your mind? What
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  - headwinds are you keeping your eye on for
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  - and preparing for?
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  - Well, it's pretty obvious. So we have a
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  - tremendous amount of financial pressure in health care,
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  - in general. It's real. It's getting harder.
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  - There's challenges with reimbursement.
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  - So rising costs, workforce pressures,
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  - and, of course, growing demands. And even though
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  - we are in a demographic here in Central
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  - Pennsylvania that's getting older
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  - and it's also getting a little bit smaller,
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  - there's a lot of health care demand that
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  - we just
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  - struggle to meet. And so we're trying to
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  - figure out ways to be creative
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  - in order to meet that demand.
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  - The second thing is that's front and center
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  - is
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  - we're experiencing a number of different federal policy
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  - changes, whether it's HR one or the outpatient
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  - prospective payment
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  - system rules that's coming out with respect to
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  - three forty b,
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  - the ACA, and the reduction in subsidies,
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  - higher patient cost share.
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  - They're gonna take significant resources out of our
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  - health care system. And it's particularly challenging we're
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  - in rural communities
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  - because if we don't make our margins, then
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  - sometimes you can get to the place where
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  - you have to displace
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  - our health care workers,
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  - and that makes it doubly it's kind of
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  - a double impact on the rural communities.
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  - Yeah. That is definitely a challenge, and I
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  - know many,
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  - hospitals and systems across the country are looking
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  - at those pressures, financial and and workforce and
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  - headwinds and and more and trying to, figure
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  - out where they're going to invest, what makes
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  - the most sense for,
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  - building a sustainable organization in the future. So
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  - I know you mentioned
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  - earlier that you are making investments and see
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  - spaces where you want to, continue to grow
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  - and develop. So can you talk a little
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  - bit more about that? Where are you
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  - focusing those efforts and those investments to,
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  - grow in the future?
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  - Yeah. I'd say we have two areas that
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  - we're focusing on. One is not, what some
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  - systems are currently doing, and it's our Geisinger
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  - health plan, which we've had for about forty
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  - years.
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  - And rather than say, oh, this is hard
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  - and dump the plan,
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  - we've made the necessary changes including leadership top
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  - to bottom
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  - to grow profitably.
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  - We believe that integrated care and coverage is
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  - one of Geisinger's biggest strategic advantages,
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  - and it lets us think beyond individual encounters
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  - and focus instead on prevention, outcomes, total cost
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  - of care, which is super important for the
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  - communities that we serve. We've got to get
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  - to better outcomes at a lower total cost
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  - of care.
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  - We also wanna make sure that we strengthen
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  - the plan and put it on a sustainable
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  - path. And in the past, we focused on
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  - government payers, well, really back in 2013.
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  - And it was the right thing at that
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  - right moment in time, whether it was Medicare,
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  - Medicare Advantage,
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  - or Medicaid expansion,
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  - we grew quite a bit through those programs.
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  - And we I'd say we neglected, but we
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  - intentionally just, didn't put as much focus on
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  - commercial membership. And
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  - now with some of the lumpy ride with
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  - the government programs, it's allowed us to focus
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  - on commercial pro commercial membership
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  - so that we can grow that and fundamentally
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  - make our health plan a little bit more
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  - stable.
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  - But, you know, to the broader point, what's
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  - really important is that the greater alignment between
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  - our plan and our clinical enterprise
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  - means a better experience,
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  - better outcomes for our patients and providers, lower
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  - friction, better affordability.
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  - So the good news, we already have a
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  - dance partner with our health plan, and so
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  - we wanna utilize it to its, to its
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  - fullest.
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  - The second major area of focus is, really
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  - all about access.
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  - Most communities that we serve access is a
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  - challenge,
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  - but we simply can't pull back at this
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  - point. And so
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  - we've got to be able to create that
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  - access. Now there's traditional things that that we
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  - are doing. We're building a couple of new
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  - towers. They're big. It's what the community needs.
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  - It's literally transitioning
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  - from double occupancy, which has a lot of
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  - challenges, to single occupancy rooms,
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  - in general.
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  - We also are expanding services in certain communities,
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  - whether it's oncology or behavioral health.
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  - But what we've realized is that, we're never
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  - gonna achieve the access we need by physical
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  - plant or by services
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  - or by simply increasing the number of providers.
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  - We've gotta fundamentally redesign how care is delivered.
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  - And so that means that and we've identified
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  - in a couple specialties that, as an example,
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  - where we have a very limited,
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  - number of providers
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  - that we counted them up. There's one that
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  - had 21,000
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  - patients that we felt had clinical conditions that
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  - would warrant,
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  - we call repatriating back to primary care. Well,
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  - if you think about how much
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  - demand how much supply that frees up for
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  - our specialists and those
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  - various ones that are constrained, that's a game
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  - changer for making it so that people can
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  - actually come in and see,
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  - the right provider at the right place, the
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  - right time.
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  - And it's tantamount for for making it so
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  - that access is reality of our communities.
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  - Now I'll just say that we are nowhere
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  - near where we need to be, but we're
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  - at least on that trajectory to achieving that.
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  - That's really helpful to understand. And, you know,
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  - so interesting to hear your thoughts on growing
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  - the health plate and further integration with the
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  - health system. I I think, it seems like
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  - there's a lot of ways that,
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  - the two interacting can work together for, bringing
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  - it seems it sounds like the ultimate goal
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  - is better, care for patients and more access
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  - to your second point. And so when you
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  - think about both of those things and and
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  - the access in particular,
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  - how does that change, you know, the way
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  - that your teams, whether it's the leadership and
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  - then clinicians as well, are thinking about things?
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  - And what, how do you see the health
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  - system workforce and and, just way of delivering
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  - care changing in the future?
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  - Well, it's a fantastic time in health care
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  - right now because we have a convergence of,
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  - let's just say the substrate of technology
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  - that previously was,
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  - it it simply wasn't possible.
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  - I can still remember ten years ago having
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  - my chief information officer draw on my whiteboard,
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  - this concept of
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  - a a a layer
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  - of data
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  - that used to be just electronic health record,
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  - but now it's the Internet of things and
• 9:05
  - everything that's can be known about an individual.
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  - Next layer up is a layer of insight,
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  - which
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  - sometimes is now artificial intelligence. And then that
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  - last layer is and the last leg is
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  - a layer of engagement. How do you get
• 9:18
  - people so that they care about their health,
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  - that they eat healthy, that they have good
• 9:21
  - extra good good habits?
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  - And we're at this amazing place where that's
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  - now possible with the technology that we have.
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  - And so health care will change because and
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  - it's changing right in front of us. Because
• 9:33
  - now instead of everybody having to get their
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  - medical information from their primary care provider or
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  - from a specialist,
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  - there's a huge funnel now out there that
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  - we can provide the patients the opportunity to
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  - explore
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  - better ways to achieve their health without necessarily
• 9:49
  - having to use our traditional bricks and mortar.
• 9:51
  - And so the the universe in health care
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  - has expanded because of what's available with technology,
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  - But it has to still be tethered to
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  - a system of care so that when you
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  - do need that care, you can come in
• 10:02
  - and see it.
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  - And so we're we're fundamentally retooling how we
• 10:06
  - think about,
• 10:08
  - patient member acquisition,
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  - if you will, and getting them directed
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  - to to the right care, the right place,
• 10:14
  - the right time. And we've been saying that
• 10:15
  - for a lot of years. But to me,
• 10:17
  - it's now,
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  - possible and it's available.
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  - That's amazing to hear and just so cool
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  - to have that type of technology at your
• 10:25
  - fingertips powering the vision of where health care
• 10:28
  - could go. And it seems like there's also
• 10:30
  - a a strong element of,
• 10:32
  - the patient satisfaction and experience that goes into
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  - the more integrated system as well,
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  - that could be really valuable in the future
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  - too.
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  - Yeah. I completely agree. You know, it's
• 10:46
  - hardly a day that goes by where I
• 10:47
  - don't hear about some experience where people just
• 10:49
  - simply can't get into the care that they
• 10:51
  - want at that particular moment in time.
• 10:54
  - And it's not because,
• 10:55
  - what they have doesn't matter. It doesn't need
• 10:57
  - to be cared for. But what we try
• 10:59
  - to ask is whether or not it can
• 11:01
  - be cared for in a little bit different
• 11:02
  - way and be very,
• 11:04
  - every every bit as much satisfying
• 11:07
  - to the consumer patients, member that we have
• 11:10
  - in front of us.
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  - Absolutely. Well, I think that is amazing to
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  - hear and just, you know, so cool to
• 11:16
  - get caught up on everything you're doing at
• 11:18
  - Geisinger. Now before we wrap up, I wanted
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  - to ask,
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  - you know, what do you who do you
• 11:24
  - admire as a leader really from any industry
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  - and why?
• 11:29
  - Well, yeah, it'd be hard to pin it
• 11:30
  - on one person. But I guess, in a
• 11:32
  - category,
• 11:33
  - I admire courageous leaders,
• 11:35
  - who are highly effective,
• 11:37
  - highly engaging. They're doing well by doing good,
• 11:41
  - who developed their eco strength so they can
• 11:43
  - get their ego out of the way,
• 11:45
  - so they can be a positive force for
• 11:47
  - their organization and for the greater good. And
• 11:50
  - you don't actually have to have necessarily a
• 11:52
  - formal title or a role.
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  - Many times they're simply out there just doing
• 11:56
  - their jobs because we all lead from where
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  - we stand.
• 12:00
  - For example, just today, I heard about a
• 12:01
  - very complex 14 old child who
• 12:05
  - received just that from an anesthesiologist
• 12:07
  - who had to,
• 12:08
  - back ventilate for six hours, a PICU doc,
• 12:11
  - a respiratory therapist,
• 12:12
  - literally saving this kid's life until they can
• 12:15
  - be transferred to a higher level of care.
• 12:17
  - That's everyday care by heroic people, on the
• 12:20
  - front lines. And so, no no matter where
• 12:22
  - people are, I respect that kind of leadership.
• 12:25
  - I admire it.
• 12:26
  - I love it. Terry, thank you so much
• 12:28
  - for joining us on the podcast today. This
• 12:30
  - has been a really fun conversation. I,
• 12:32
  - have enjoyed hearing all about what you're doing
• 12:34
  - at Geisinger and inspiring too. And I'll I'll
• 12:36
  - look forward to seeing you as well, our
• 12:37
  - CEO CFO roundtable. I know you'll be speaking
• 12:40
  - and digging deeper into many of the things
• 12:42
  - we talked about today, and so it'll be
• 12:43
  - fun to see you in person.
• 12:45
  - Alright, Buzz. Thank you again so much for
• 12:47
  - having me. I'm looking forward to two months
• 12:49
  - from now.