Latest / Becker’s Healthcare Podcast / Expanding Community Access and Building the Future of Care at NorthBay Health with Mark Behl

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Expanding Community Access and Building the Future of Care at NorthBay Health with Mark Behl · Becker’s Healthcare Podcast

• 0:00
  This is Laura Dierdahl with the Becker's Healthcare
• 0:02
  Podcast. I'm thrilled today to be joined by
• 0:04
  Mark Bail, president and chief executive officer at
• 0:07
  North Bay Health. Mark, it's a pleasure to
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  have you on the podcast today.
• 0:10
  Oh, thank you, Laura. Appreciate it. Absolutely. Now
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  I'm I'm excited for our conversation. I know
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  we'll go through a lot of some of
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  the,
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  things that you've been working on over the
• 0:18
  last year as well as your perspective on
• 0:19
  the future. But before we dive in, can
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  you just tell us a little bit more
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  about yourself and NorthBay Health?
• 0:26
  Yeah. Absolutely. Yeah. So, Mark Bail. I'm the
• 0:28
  president and CEO of NorthBay Health, as you
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  said. And,
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  we are a, independent,
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  locally,
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  governed nonprofit health system that, is in Northern
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  California.
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  And, our area,
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  they always describe it sort of in between
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  Sacramento
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  and San Francisco. We have the,
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  four counties of,
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  Napa,
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  Sonoma,
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  Yolo, and Solano County is our main presence,
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  that we have today.
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  We've been
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  in,
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  the area for sixty seven years and really
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  just a, kind of a simple focus of
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  caring for,
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  our neighbors and strengthen health of the communities
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  we serve by being,
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  really sort of, you know, sort of, closer
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  to home where people live,
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  where they where they also where they,
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  sort of work and don't have to travel
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  over bridges to get their care, you know,
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  in the in the cities of Northern California.
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  Absolutely. I know that can be quite a
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  trek,
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  you know, to get to some of those
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  more,
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  urban areas. And so having that care closed
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  home is so incredible,
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  for many people within these communities. Now could
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  you talk about an initiative that you did
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  in the last year? So what did you
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  do, and what were the results?
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  Yeah. Absolutely. So for the last couple years,
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  I would say our most important,
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  strategic priority has been, delivering on our ambulatory
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  network strategy,
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  which is, you know, really rethinking how and
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  where care is delivered across these communities.
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  And like, you know, many health systems, we
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  recognize that care, you know, just can't be
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  centered only around the hospital anymore.
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  Patients need convenient access points in their neighborhoods.
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  And over the past year, we've been very
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  intentional
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  about building
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  a network through urgent care, primary care,
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  and specialty clinics really embedded in the communities,
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  particularly in areas where access has historically been
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  limited. So,
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  as part of that work, we've opened up,
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  seven new
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  neighborhood locations to help you, you know, sort
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  of meet the growing community need.
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  And, also,
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  we're very proud about going into areas that,
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  have not had health care available
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  without driving long distances and sometimes up to
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  thirty minutes to get to, the next health
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  care clinic. So we've added these locations,
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  and they're really designed to
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  not not just deliver care, you know, every
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  day for those communities, but also,
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  a way to connect with the communities to
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  really,
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  to to become part of them, to be
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  a fabric of the those communities in a
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  in a much different way. So, it's been
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  really exciting to do that,
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  and, we're gonna continue on that throughout, 2026.
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  That's great to hear. And, you know, so
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  beneficial to be able to quickly stand up
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  some of those new locations and bring care,
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  that's very much needed into those, communities. Now,
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  you know, when you're looking at some of
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  those specialty clinics, urgent care, other locations that
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  are are coming up, how do you make
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  the decision about where to locate them, and
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  and what does it truly take on the
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  resource side to bring some of these things
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  to life?
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  Yeah. So,
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  it's it's a great question, and we spent
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  a lot of time,
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  really before,
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  we've started implementing this strategy
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  of trying to understand the you know, looking
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  at the clinical demographics
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  of each of these communities.
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  So our goal is to have primary care
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  within fifteen minutes of every resident of the
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  communities we serve. So
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  really understanding
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  what,
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  when we look at those communities, what their
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  needs are, and they're a little bit different
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  by community. Right? Because some communities,
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  may have,
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  younger families. It may require more pediatric services.
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  It may have, more women's health services. And
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  so the needs of that community are gonna
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  look different from, you know, say, a a
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  retirement
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  community
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  where you have an aging population with chronic
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  conditions, and they have much greater needs in
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  terms of specialty services and, you know, screenings
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  and, other services. So
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  we tailor them according to how we see
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  the needs of that community, and and that
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  that's where it gets back to really embedding
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  within the community and understanding
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  from those those people that live there
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  of really what their challenges are. And then,
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  you know, in terms of resources, it it
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  is a significant,
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  investment because you have to
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  it's not just the building themselves and the
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  improvements that go into them, but oftentimes, it's,
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  we have to recruit physicians,
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  and advanced practice clinicians who can go and
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  work there. And we're we're,
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  fitting each one of these with telemedicine. So,
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  the technology
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  needs to be, in at least one of
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  the rooms out there
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  available to, you know, sort of be very
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  progressive in the care that we provide in
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  specialty services in the future. So,
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  a lot of infrastructure that goes into that.
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  And then again, our own internal resources just
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  standing up, you know, each one of these,
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  it takes, you know, certain amount of effort
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  and time, you know, from, you know, recruitment
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  to,
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  licensing
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  to accrediting,
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  you know, just to marketing and communications that
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  goes along with this. So it is a
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  heavy lift, but we've seen great results, and
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  the impact has been pretty measurable here,
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  across our ambulatory network.
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  Last year, we saw over 320,000,
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  patient visits.
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  30 over 30,000 of those were urgent care
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  visits,
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  or expanded our primary care substantially
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  by, almost 45 new providers, physicians, and APPs.
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  They did over 95,000 visits and then about
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  200,000 specialty visits. So,
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  encouraging, you know, improvements.
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  We have a lot of work to do
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  and still really kind of focusing on how
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  to
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  create the best experience in those in those
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  areas and, again, expanding that telehealth that I
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  talked about. But, it's been a lot of
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  fun, and I think the communities have really,
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  really been excited to see, you know, us
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  make that investment in their community.
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  I love that. And I think that investment
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  is so critical,
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  and cool to understand everything that goes into
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  those decisions. Now looking ahead for 2026, what
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  are some of the big priorities and headwinds
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  that you're most focused on?
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  Yeah. So 2026 is gonna be a a
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  a very exciting year, but also a very
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  challenging year. You know? One of the areas
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  I would say,
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  I I sort of think there are three
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  major areas probably similar to a lot of
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  organizations.
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  Expanding access to care continues to be our
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  main focus. There's a significant demand out there,
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  for health care today.
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  So we're gonna continue to focus on ways
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  to expand our our access and reach.
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  Driving operational transformation, I mean, that's part of
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  it. I think with the challenges that we
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  have,
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  throughout the industry
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  with the just there's there's I I say
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  some of them are challenges, but some of
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  them are opportunities in the sense that the
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  challenges will be on the workforce and how
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  we must work differently, be more efficient, try
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  to find ways to reduce costs.
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  But there's also opportunities. I mean, obviously, AI,
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  we're you know,
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  it seems like every day we're talking about
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  how AI could potentially
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  enhance and transform the way we do things.
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  So we wanna continue to focus on that.
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  So and then the third bucket I would
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  say is maintaining our financial,
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  stability. You know, we have had a positive
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  operating margin now here for the last three
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  years, which is a really, strong performance,
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  Especially when you consider,
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  you know, across the country and across the
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  even California, almost 50% of hospitals are underwater.
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  It just speaks to the challenges we all
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  have. And and with HR one,
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  you know, and these the declining reimbursement, there's
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  people that are gonna be without health care,
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  access with insurance. And so those are all
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  things that we're gonna have to focus on
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  together. But,
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  you know, I would say just access remains
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  the major focus. And, again, how do we
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  transform this? So maybe we can deliver,
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  a different model of care that's gonna be
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  more efficient that can help address, you know,
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  some of the financial challenges.
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  And then the last thing I would just
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  say is this is not a small thing,
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  but our transition to Epic. You know? So
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  we are,
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  going through,
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  that transition about the end of this year.
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  And, of course, there's a a lot of
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  work that's led up, you know, to do,
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  to being able to do that. And so
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  that's obviously something we have to keep moving
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  and ensure we're on our timelines to do
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  that.
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  But it's going to be a better experience
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  for our clinicians and our patients.
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  And so for that reason, I'm really excited
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  about that as well.
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  I love it. I I think, you know,
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  going through those epic transitions, incorporating more technology
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  and really finding ways I know we talked
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  a little bit earlier about,
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  virtual care and ways to incorporate that into
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  the care delivery model,
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  seem to be exciting opportunities. And, you know,
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  when you look at,
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  AI, when you look at technology,
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  you know, how are are you incorporating that
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  and really developing the plan for for that,
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  for NorthBay Health,
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  especially given some of the financial challenges that
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  are are abreast?
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  Yeah. I I think that, you know, first
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  of all, I I do think we have
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  to really get to the people that do
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  the work,
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  and ensure that they're the ones that help
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  improve the work. And so that those AI
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  solutions that we're thinking about, I really we're
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  gonna spend a lot of time in ensuring
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  that we get the input from the people
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  that are going to that are going to
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  use that,
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  or be impacted by that. You know? So
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  we can really understand
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  what the solutions are that you know, what
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  the top priorities are. I think it's hard
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  to invest in solutions.
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  You know, take the the some of the
• 9:57
  the revenue that we do have, you know,
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  not directed to patient care, but directed to
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  these types of improvements.
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  So doing that has to be done in
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  a way that it's actually going to deliver
• 10:07
  a better experience for the people that are
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  either, you know, delivering the care or receiving
• 10:11
  the care. And so, we can't
• 10:14
  afford to have a lot of false starts
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  on this, or we can't really afford to
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  be, you know, sort of way out in
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  front,
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  of our of our, caregivers,
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  on this. We need to keep be hand
• 10:25
  in hand with them. So we've put a
• 10:26
  lot of infrastructure in place just to make
• 10:28
  sure that, these are great ideas and there's
• 10:31
  some really exciting opportunities,
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  but how do we include our teams in
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  the process of identifying
• 10:37
  what the top priorities are so we invest
• 10:39
  in the right places?
• 10:41
  That makes a lot of sense. And, you
• 10:42
  know, it's really critical to have that type
• 10:44
  of alignment organization wide. Now what do you
• 10:47
  think the hardest thing you'll have to do
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  in the coming year will be?
• 10:50
  I think the yeah. I think for a
• 10:52
  lot of systems,
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  certainly top of mind for me is how
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  do we continue to grow
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  and how do we take, you know, the
• 10:59
  our strategies that we have
• 11:01
  and and, you know, not only to grow,
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  but also to innovate
• 11:04
  with the financial realities we have facing health
• 11:07
  care today. You know, our communities need us.
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  They need more access to care. They need
• 11:11
  more services. They're asking for more innovation.
• 11:14
  But the economics of health care are incredibly
• 11:17
  challenging. Right? So for us, the challenge will
• 11:19
  be continuing to invest in areas that matter
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  most. And and like I said, expanding that
• 11:23
  access, seeing the difference that it can make
• 11:25
  in the communities,
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  and really how that's changing, you know, our
• 11:29
  ecosystem here for the the health care system
• 11:31
  in Northern California,
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  is encouraging and exciting. And when we hear
• 11:35
  that feedback from our communities, we know we're
• 11:37
  on the right track. And and so advancing
• 11:40
  the technology like Epic, you know, again, supporting
• 11:43
  our workforce,
• 11:45
  those are all
• 11:46
  big bets for us. You know? But they're
• 11:48
  for the things that we think are gonna
• 11:50
  change those communities and also change,
• 11:53
  the environment for for all of our caregivers.
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  So that's gonna be the challenge is we're
• 11:58
  gonna hit be hit with pressures. You know,
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  we already see it. We see a lot
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  of our,
• 12:03
  medical
• 12:04
  enrolling
• 12:05
  enrollees that are dropping off, you know, that
• 12:07
  won't have coverage.
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  And I think the travesty
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  of all this is that
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  the poor and vulnerable are the ones that
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  are gonna be most impacted by this. You
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  know? So that's who's being left behind.
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  And as a community based health care system,
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  you know, we don't just have a membership
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  model. We don't just have,
• 12:28
  a focus on commercial patients.
• 12:30
  We we are absolutely committed to taking everyone
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  regardless of what's going on, you know, with
• 12:36
  their with their in their lives. And so,
• 12:38
  for us, we're not gonna leave them behind.
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  We're gonna have to figure out how to
• 12:42
  do that. So that's that's probably the the
• 12:44
  hardest is, you know, sort of,
• 12:46
  you know, the challenge that we have ahead
• 12:48
  of us is how do we commit continue
• 12:49
  to focus on,
• 12:51
  that access and growth and innovation
• 12:53
  and balancing how do we design systems that
• 12:56
  are not leaving people behind.
• 12:58
  And, and I think that's, gonna be a
• 13:00
  challenge for everybody. But,
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  I also think that,
• 13:03
  there's a need for a change in the
• 13:05
  way we do things, you know, in health
• 13:07
  care and across the systems. And so this
• 13:09
  is gonna challenge us, but I think if,
• 13:11
  we approach it in this from the from
• 13:13
  the standpoint that we can do better than
• 13:17
  what we have today, and we can do
• 13:19
  that alongside our communities and trying to figure
• 13:22
  this out together as a community, I just
• 13:25
  think that that we're gonna find, ways to
• 13:27
  get through it.
• 13:29
  I love that. I mean, it's such a
• 13:30
  important point that you're making, but also inspiring
• 13:33
  way to look at it and really navigate
• 13:35
  through the challenging times that we're facing today
• 13:37
  and,
• 13:38
  truly prepare the organization not only to overcome
• 13:41
  those challenges and and continue to,
• 13:43
  provide care, but then be in a position
• 13:45
  to thrive in the future.
• 13:47
  I'm curious, you know, when you look at
• 13:49
  some of those financial pressures and,
• 13:52
  obviously, the need to innovate,
• 13:55
  how do
• 13:57
  you prepare for for,
• 13:59
  you know, kind of those
• 14:00
  medical cuts and those kinds of things. I
• 14:02
  mean, are you looking at additional revenue streams,
• 14:04
  or or where are the dollars do you
• 14:05
  think gonna come from?
• 14:08
  Yeah.
• 14:09
  Yeah. I I think that's that's a great
• 14:11
  question because we talk about it all the
• 14:13
  time. Like, we're gonna have to find ways
• 14:15
  You tell them about diversifying our revenue. That
• 14:17
  is one aspect of it.
• 14:19
  We're going to have to find,
• 14:21
  what services that we can provide in a
• 14:23
  way that, you know, we're looking at grants.
• 14:25
  You know, we're looking at community partnerships. We're
• 14:27
  looking at, you know, ways we can work
• 14:29
  with other health care partners to come together.
• 14:32
  We do that today with Kaiser Permanente. We're
• 14:34
  working very closely with them on some of
• 14:36
  the behavioral health needs that are in the
• 14:38
  community here, working with our our counties,
• 14:41
  working with, you know, our elected officials and
• 14:44
  trying to help ways to come together. And
• 14:46
  that's kind of the spirit of all of
• 14:48
  this is that,
• 14:49
  this is a community problem. Right? And so
• 14:52
  it can't be solved by one health care
• 14:53
  system. It's not gonna be solved by at
• 14:55
  the federal level.
• 14:57
  And so it's going to have to be
• 14:58
  communities coming together. So we really engage with
• 15:01
  these communities to help, you know, really come
• 15:03
  together to try to find solutions. But, you
• 15:05
  know, I also do think it speaks to
• 15:07
  building out a model
• 15:09
  that's going to be,
• 15:11
  more efficient than we have today.
• 15:13
  And when you have hospital based systems, you
• 15:16
  have to put support the hospital based infrastructure.
• 15:19
  And so if the only way you can
• 15:21
  drive that, you know, more revenue and diversify
• 15:23
  revenue is getting more and more people into
• 15:25
  a hospital setting,
• 15:27
  I think that's gonna be very difficult for,
• 15:29
  for health care systems to really survive long
• 15:32
  term. They're going to have to find a
• 15:33
  way to develop a network and a model
• 15:36
  that can, you know, be more,
• 15:39
  in a value based capitated,
• 15:41
  model. And we have a we have a
• 15:43
  lot of our revenue that comes in from
• 15:45
  capitation.
• 15:46
  And so you have to have a network
• 15:48
  that can manage that and an infrastructure to
• 15:50
  manage that. So this part of what we're
• 15:52
  building
• 15:53
  is really, going to help us prepare for
• 15:55
  the future. So it's not only doing good
• 15:57
  today and connecting those communities differently, but it's
• 16:00
  also preparing us that we can change our
• 16:02
  health care, you know,
• 16:04
  financial model by allowing us to get revenue
• 16:07
  more than just what comes in the hospital.
• 16:09
  So,
• 16:10
  it's it's really, I think, twofold there. It's
• 16:12
  how do we come together to address the
• 16:14
  current needs, but how do you also keep
• 16:16
  making those investments,
• 16:17
  on the future needs and future model transformation
• 16:20
  that has to occur?
• 16:22
  I love that. I I think that's such
• 16:24
  a a balancing act that so many leaders
• 16:26
  are figuring out today. And, you know, no
• 16:28
  one right solution, but certainly
• 16:30
  a lot of opportunities in that space. And,
• 16:33
  you know, to your point before we wrap
• 16:34
  up here, I did wanted to ask you,
• 16:37
  to dig a little bit deeper on on
• 16:38
  growth. Where do you see some of those
• 16:40
  best opportunities for organizational growth for continuing to,
• 16:44
  evolve the organization into the space that you've
• 16:47
  been mentioning and describing for the future?
• 16:50
  Yeah. Well, I think it comes from again,
• 16:53
  what's part of it is I do think
• 16:54
  building partnerships and expanding services in ways,
• 16:58
  that your community needs. You know, looking at
• 17:00
  those,
• 17:02
  almost every right. You can see almost every
• 17:05
  business model, every industry where there's been some
• 17:08
  paradigm shift.
• 17:10
  It usually comes out of something
• 17:13
  that was needed
• 17:15
  that's not being provided, and then you feel
• 17:17
  that, you know, as an organization, as a
• 17:19
  company, you come in and you fill that
• 17:21
  need.
• 17:22
  So for us, you know, we're really looking
• 17:24
  at where those lie within the communities. And
• 17:27
  the reality is that almost every community, you
• 17:30
  know, that that, like and, really, this could
• 17:32
  be across The US. When you talk to
• 17:34
  most health care system leaders,
• 17:37
  they all say the same thing.
• 17:39
  The demand is higher than the supply we
• 17:42
  have.
• 17:43
  You know? So it's really
• 17:45
  you know, when you're trying to figure out
• 17:46
  how to provide more hospital
• 17:49
  supply, you know, more more surgeons,
• 17:51
  you know, more interventionists,
• 17:53
  you know, more technical, you know, resources.
• 17:57
  You know? I I just think that's not
• 17:58
  really where the opportunity is at. I I
• 18:01
  think the opportunity that's really asking to be
• 18:04
  filled
• 18:05
  is really upstream
• 18:06
  in that primary care,
• 18:08
  in the general specialty, you know, sort of
• 18:10
  services for managed chronic conditions
• 18:13
  that really are not surgically,
• 18:15
  you know, treated.
• 18:17
  And so for for growth for us,
• 18:19
  it's really
• 18:20
  going into that air that area very you
• 18:23
  know, with a very intentional investment
• 18:26
  to provide services that are needed upstream
• 18:29
  in those primary care and general specialty, you
• 18:31
  know, medicine specialties rather than surgical specialties. And
• 18:34
  that's that's hard to to do because you
• 18:36
  really most of the revenue comes in in
• 18:38
  the hospital.
• 18:39
  But that growth
• 18:41
  the growth really is going to be, you
• 18:43
  know, in that space.
• 18:46
  That is fascinating to hear. Mark, thank you
• 18:48
  so much for joining us on the podcast
• 18:50
  today. This has been such a a fun
• 18:52
  conversation. I know we covered a lot of
• 18:54
  ground, but inspiring to think about what the
• 18:57
  future may hold. I I appreciate your time
• 18:58
  today, and I look forward to seeing you
• 19:00
  as well at our annual meeting in April,
• 19:01
  just a few weeks away.
• 19:03
  It's always great to see you and catch
• 19:04
  up and then continue this conversation and dig
• 19:07
  deeper as well.
• 19:08
  Oh, thanks, Laura. And thanks for, you know,
• 19:10
  giving us a platform here, you know, as
• 19:12
  an independent,
• 19:13
  you know, sort of regional based health care
• 19:14
  systems. We sometimes get lost, you know, with
• 19:17
  the the bigger systems and the urban,
• 19:19
  systems. So thank you for giving us a
• 19:21
  platform to talk a little bit today. Always
• 19:23
  enjoy talking with you, and look forward to
• 19:25
  seeing you, in a few weeks.