Latest / Becker’s Healthcare Podcast / Chris Johnson, Founder and CEO of Bluebird Kids Health

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Chris Johnson, Founder and CEO of Bluebird Kids Health · Becker’s Healthcare Podcast

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  - There's a small circle of people who truly
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
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  - Welcome to the Becker's Healthcare podcast. I'm Chris
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  - Sosa, your host, and I'm thrilled to be
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  - joined today by Chris Johnson. He is founder
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  - and CEO of Bluebird Kids Health. Chris, thank
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  - you for joining us today.
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  - Chris, thanks for having me. Looking forward to
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  - it. Yeah. Me too. And before we get
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  - into the crux of our conversation, Chris, could
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  - you please let our audience know just a
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  - little bit more about yourself and Bluebird Kids
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  - Health?
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  - I'd be I'd be delighted to.
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  - So as you said, I'm the the founder
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  - and CEO of Bluebird Kids Health. We're a
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  - pediatric
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  - primary care organization.
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  - We deliver
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  - clinic and virtual based primary care to,
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  - to children,
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  - generally under the age of 18.
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  - Currently located,
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  - in Florida along the Eastern Seaboard,
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  - and continuing to expand,
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  - each month with new locations and new, new
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  - markets that we hope to serve.
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  - So, Chris, let's back up a little bit
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  - here. You've been at this
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  - for about two years, if I'm not mistaken.
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  - So
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  - what would you say led to the inception
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  - of Bluebird Kids Health
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  - and do the whole reason why you wanted
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  - to start this company? Yeah. This organization, I
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  - should say.
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  - Absolutely. So so I've I've spent a lot
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  - of my, my career in medical groups and
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  - value based care. So before
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  - starting Bluebird Kids Health,
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  - I was part of an organization called Landmark
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  - Health,
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  - which was
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  - a national based in home primary care business,
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  - value based primary care business
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  - for seniors,
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  - with serious illness.
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  - Had many roles at that organization, ran one
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  - of our early markets,
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  - participated as a leader of our corporate strategy
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  - and corporate development teams, and actually led the
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  - business for about three years as we expanded
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  - from about 10 states to 38 states across
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  - the country.
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  - And I've had a deep passion for a
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  - belief that if you can align incentives
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  - in primary care, you can really have the
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  - care model deliver what's needed for,
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  - the patients and the families that you serve.
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  - After doing that, that that about... It was
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  - about ten year stint at at Landmark Health,
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  - and part of that was at UnitedHealth Group,
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  - saw that there was a real opportunity
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  - for,
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  - an innovative care model in children.
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  - And
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  - and
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  - really what was happening, it has evolved in
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  - the country over the last several decades are
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  - we have more and more children who are
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  - covered under government programs, so either Medicaid or
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  - CHIP.
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  - Around half the children in The US actually
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  - today are covered under those programs.
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  - That's different than when I was young and
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  - growing up where it was more like twelve,
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  - fifteen percent of children. So it's really it's
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  - really something that's increased
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  - dramatically
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  - over the last forty years or so.
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  - I think the the
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  - glass half full view of that is it's
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  - really... We as a country have agreed that
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  - all children should have access
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  - to health care. Maybe the the glass half
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  - full view of that is it's a, you
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  - know, a shame that such a large percentage
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  - of children aren't able to get access to
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  - insurance through commercial coverage.
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  - But we we saw this opportunity, and and
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  - these children traditionally have and the families have
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  - a harder time getting access
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  - to,
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  - to to pediatricians. They tend to live in
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  - communities
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  - that we call, pediatric care deserts.
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  - And so this is... These are areas where
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  - the number of pediatricians,
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  - needed to serve all those children is about,
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  - you know, it could be 50 below what
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  - is necessary, sometimes even 75%
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  - below the number of pediatricians necessary. And so
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  - what you see is there's a really large
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  - percentage of children
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  - today who don't have access to a pediatrician.
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  - In pediatrics, in a... In an interesting way,
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  - it's really like the original value based care
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  - program that existed. If you look at what
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  - pediatrics,
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  - what the AAP, the American Academy of Pediatrics,
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  - puts forward as their recommended,
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  - set of interventions by age. If you look
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  - at what we as a country have agreed
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  - we should pay for, for children,
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  - it really all is about developmental screens,
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  - early interventions,
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  - preventative care
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  - for children to really help set them up
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  - for a long success... Successful life. It's not
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  - so much about, like, hey, make sure that
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  - you're the healthiest possible 12 year old. Absolutely.
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  - Just make sure you're the healthiest pop pop...
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  - Possible 12 year old, but we're also setting
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  - you on a trajectory to be,
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  - healthy in your twenties, your thirties, your forties,
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  - your fifties,
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  - hopefully, so so you can be, live the
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  - most kind of meaningful, healthy life you can.
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  - So you mentioned that you're down in Florida
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  - right now primarily, but you've had some experience
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  - with expansion in other walks of your, career
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  - so far. So when you look at possibly
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  - expanding, what
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  - conditions do
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  - you examine to determine whether that can and
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  - should happen?
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  - Yeah. We we really
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  - look for, Chris,
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  - these these care deserts that that that I
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  - was mentioning too. So there's kinda... I I
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  - think you can think of expansion in a
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  - couple ways. Some people think of expansion in
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  - terms of, you know, how many,
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  - how many states can you light up around
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  - the country and say, hey. We're in fifth...
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  - 50 states. We really think about it more
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  - in kind of like a micro community perspective,
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  - where
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  - we really, when we cite one of our
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  - new locations, we actually look at where all
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  - the children,
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  - where all the existing pediatricians.
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  - And we try to narrow in on communities
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  - where we see there's a really big supply
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  - demand mismatch between
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  - the,
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  - the kind of the care delivery assets needed
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  - to best serve those children
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  - and,
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  - the the the number of children,
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  - that are in existence. So we think a
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  - lot about that, and then we think a
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  - lot about density.
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  - I think in in health care
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  - to be really meaning... A meaningful part of
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  - the health care ecosystem,
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  - you can't just kind of be
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  - like a one off. You need to be
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  - able to,
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  - work with the other health care infrastructure
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  - in that community, whether those are,
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  - specialist groups, whether those are hospital,
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  - hospital groups,
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  - health plans.
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  - And so we really seek to be, you
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  - know, one of the top, you know, three...
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  - One to three,
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  - pediatric care providers in the communities when we
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  - decide to plant the flag there.
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  - And, again, really focused on serving what I
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  - call the non consumers
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  - of pediatric care today. It's not about... Our
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  - our strategy is not to say, we think
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  - we have a better better care model than
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  - many out there and a more innovative care
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  - model, but we really are trying to find
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  - the folks who today don't have access,
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  - give them that access, and then dramatically improve
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  - the,
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  - level of care and the outcomes,
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  - that they're able to achieve, by being a
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  - part of the Bluebird Kids, family.
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  - And certainly those numbers that you mentioned that
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  - fifty percent of
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  - children in The US
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  - are are covered by Medicaid,
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  - it's
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  - it's a huge number to be sure and
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  - and one that's growing.
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  - So when you look at
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  - Bluebird's mission,
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  - how would you say that it positions itself
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  - to cover this population?
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  - Yeah. Our our our mission
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  - is is to provide,
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  - exceptional care so all children can thrive.
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  - And so it's it's both about, like, high
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  - quality care as well as making sure that
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  - that care model is available to all all
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  - children. And so we we thought long and
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  - hard about how we built our clinical model,
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  - how we built our operations model
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  - to make sure that we could meet the
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  - needs of a broad set of of the
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  - population. So
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  - I should say, I I know we're talking
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  - about Medicaid. We we also proudly serve a
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  - large commercial population.
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  - And
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  - part of how we try to build
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  - the consumer experience
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  - when you come to our clinics is
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  - whether,
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  - you know, you have the nicest house in
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  - one of the nicest neighborhoods in the community
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  - or you're living in a more emerging part
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  - of the community.
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  - When you walk through our door, you feel
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  - respected. You feel like you have the trust
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  - of our of our providers, and you're really
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  - having the best pediatric experience,
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  - that one could have,
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  - really regardless of kind of, like, which side
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  - of that socioeconomic
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  - spectrum you're having.
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  - We've then tried to leverage a lot of
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  - technology, Chris, to make sure that,
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  - to overcome a a bunch of things. One,
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  - like, from an operating expense perspective to make
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  - sure that we are... We're providing comprehensive services,
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  - but we're doing them in an efficient
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  - way.
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  - And so in in a lot of times,
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  - we're actually able to provide more comprehensive care
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  - coordination services, care management services
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  - than most pediatric practices are. And we're actually
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  - able to do it on a relatively efficient
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  - way because we're using technology in order to
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  - deliver,
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  - many of those solutions.
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  - We're also using it to help democratize access.
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  - So it allows us to have twenty four
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  - seven availability.
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  - It allows us increasingly to be,
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  - multilingual
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  - at all touch points throughout our throughout our
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  - practice,
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  - even though not all of our patient... Not
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  - all of our employees are able to speak
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  - all the different languages that folks come through
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  - our... Come through the doors to seek care,
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  - a lot of the tools that we have
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  - are all multilingual built. So you can actually
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  - have most of your experience in either the
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  - native parents' language
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  - or their child, which sometimes, by the way,
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  - is also different.
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  - And
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  - so we really thought thought long and hard.
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  - But... And then finally, we really focus on
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  - building as comprehensive a care model as we
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  - can. We know getting into the physician's office
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  - can be really challenging.
• 10:29
  - We integrate behavioral health into our care model,
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  - because we know it's hard to have... To
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  - make... Getting one doctor's appointment can be hard
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  - enough. Getting two sometimes just doesn't work.
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  - And and third, just because of the Medicaid
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  - population that we do serve, sometimes getting that
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  - referral can be incredibly challenging, even more challenging
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  - than if you have commercial coverage just due
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  - to,
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  - as you all know, the the challenges of
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  - reimbursement rates across different payer types.
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  - Certainly. I have a couple follow-up questions for
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  - you there, Chris. Let's start with this one.
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  - So I love the detail that you mentioned
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  - about having to reach or endeavoring to reach
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  - people who speak a lot of different languages.
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  - And, certainly, you know, there are quite a
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  - few of them where you're based down in
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  - Florida. So is that...
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  - What percentage
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  - of that is finding providers and and other
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  - staff who speak those languages, and what percentage
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  - of that is leaning into technology to help
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  - reach those patients?
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  - Yeah.
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  - I don't know if I can give, like,
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  - a a percentage. I haven't thought about it
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  - in that in that,
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  - specific,
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  - way, but I would say it... It's both.
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  - So
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  - when we can, we we do try to
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  - hire
• 11:37
  - providers and
• 11:38
  - staff that,
• 11:42
  - are are comfortable
• 11:43
  - speaking in the predominant language where that where
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  - that,
• 11:47
  - clinic is located,
• 11:49
  - whether that's bilingual,
• 11:52
  - you know, often in in foreign English and
• 11:55
  - Spanish,
• 11:56
  - or sometimes Spanish
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  - only.
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  - But we also know that there are many
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  - other languages
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  - that,
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  - different different families speak. And so that's where
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  - a lot of times, like, we leverage technology
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  - because we're just not gonna be able to
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  - have a, you know,
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  - at every location a provider that speaks every
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  - conceivable language that someone may may walk through
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  - the door. And so that's automating a lot
• 12:19
  - of our patient booking to be in, patients'
• 12:22
  - native languages. A lot of the forms and
• 12:24
  - assessments that we do to be in that
• 12:26
  - in that patient's native language.
• 12:29
  - Being able to translate medical records into,
• 12:33
  - various language for folks. And then in the
• 12:35
  - actual exam room, we leverage different technologies to
• 12:38
  - allow the,
• 12:40
  - the the the family and the provider,
• 12:43
  - to be able to, communicate,
• 12:45
  - when they're in for for for the encounter.
• 12:47
  - So it's it's it's definitely both,
• 12:50
  - that are... Play a really important role.
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  - It makes a lot of sense, Chris. So
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  - the other follow-up question I wanted to ask
• 12:55
  - you was... So
• 12:56
  - as you mentioned, you're you're coming into
• 12:59
  - these areas of Florida that that have established
• 13:02
  - health care ecosystems. Right? And you mentioned that,
• 13:04
  - you know, you're not just trying to fly
• 13:07
  - on your own. You're trying to
• 13:09
  - integrate into this in in certain ways.
• 13:12
  - And how do you go,
• 13:15
  - in... Of your your organization given that so
• 13:18
  - many of these other organizations have been there
• 13:21
  - much longer than you have?
• 13:23
  - Yeah. A a a a couple ways.
• 13:27
  - You know, it's a... Our our team spends
• 13:30
  - a lot of time trying to meet
• 13:32
  - all of the different
• 13:34
  - community organizations
• 13:36
  - that serve
• 13:38
  - families and children
• 13:39
  - in the communities we enter,
• 13:42
  - whether that's
• 13:43
  - school related,
• 13:45
  - boys and girls club, other other kind of
• 13:47
  - social services that exist in a community.
• 13:50
  - And,
• 13:52
  - obviously, there's day one where they're just learning
• 13:54
  - about you for the first time. And then
• 13:56
  - after you've been there for a while, there's
• 13:57
  - there's stronger bonds and more and more touch
• 14:00
  - points.
• 14:01
  - And we... I think we all have, like,
• 14:02
  - a common goal, which is how do we
• 14:04
  - better get the services that we can offer
• 14:07
  - to the families that are that are in
• 14:09
  - need. On the on the traditional health... Health
• 14:11
  - care side, start... You know, our team spend
• 14:13
  - a lot of time meeting the different health
• 14:15
  - care delivery providers
• 14:17
  - across across the geographies as we enter them,
• 14:20
  - the the hospitals, the specialist networks,
• 14:24
  - letting them know who we are, looking to
• 14:27
  - say, hey. You know, we're we're building a
• 14:29
  - presence here,
• 14:30
  - as we continue to have more and more
• 14:32
  - patients serve, how do we build the right
• 14:33
  - care coordination pathways to make sure we're getting
• 14:35
  - the right information to you, you're getting the
• 14:37
  - right information back to us so we provide
• 14:39
  - really high quality
• 14:41
  - exceptional care,
• 14:42
  - together.
• 14:43
  - And then I'd say, oh, like like, in
• 14:45
  - terms of, like, the other,
• 14:47
  - pediatricians,
• 14:48
  - we we really do try to... It's not
• 14:51
  - that there are no pediatricians in the community
• 14:53
  - when we we enter into. I think there's...
• 14:55
  - We're not really a rural health solution. We're
• 14:57
  - kind of an urban, suburban,
• 15:00
  - focused focused organization.
• 15:02
  - But there are large communities
• 15:04
  - where really there are not enough pediatricians. And
• 15:07
  - so we
• 15:08
  - we we go in not to say, hey.
• 15:11
  - You know, there's a gas station across the
• 15:13
  - street. We think we can get half their
• 15:15
  - customers at our gas station. We try to
• 15:17
  - go to the to to to the neighborhood,
• 15:19
  - to the corner block where there really isn't
• 15:21
  - another,
• 15:22
  - pediatrician and and and start to bring more
• 15:25
  - access,
• 15:27
  - to to that community. And and as I
• 15:29
  - shared earlier, we really see this as... There's
• 15:31
  - a there's a tremendous,
• 15:34
  - number of children today who really are... Do
• 15:36
  - not have a relationship with a pediatrician. That's
• 15:39
  - that's kind of the non consuming gap that
• 15:41
  - we're really,
• 15:42
  - seek... Seeking to fill.
• 15:44
  - Gotcha. So, Chris, no doubt there are a
• 15:47
  - number of challenges that Bluebird has faced in
• 15:50
  - the last couple of years and will into
• 15:52
  - the future. But at this point in time,
• 15:54
  - having been established for as long as you
• 15:56
  - have, what would you say are the biggest
• 15:59
  - one or two challenges that you've had to
• 16:01
  - face, and how have you overcome them?
• 16:04
  - Yeah. We we... You know, we've we've touched
• 16:06
  - on some of them, already, Chris. I'd say
• 16:08
  - I'd say,
• 16:09
  - one we haven't touched on quite quite as
• 16:11
  - much is
• 16:12
  - a lot of times when we're entering a
• 16:14
  - community, we we we are de novo focused.
• 16:16
  - So we don't we don't usually enter a
• 16:18
  - community and say, hey. There's an existing practice.
• 16:21
  - Like, let's make them into a Bluebird kids
• 16:23
  - practice.
• 16:24
  - We say, hey. There's this need.
• 16:26
  - No one... There's not a pediatrician here. There's
• 16:29
  - not enough pediatricians. Let's let's, you know, build
• 16:31
  - our own beachfront here.
• 16:34
  - And when you're doing that, it it takes
• 16:36
  - time to build
• 16:37
  - the reputation
• 16:38
  - and build, kind of the awareness
• 16:41
  - in that community. And we invest a lot
• 16:43
  - in that.
• 16:45
  - But the the... Our best... The best way
• 16:47
  - that we can build
• 16:49
  - trust and brand is by having the patients
• 16:51
  - who receive care with us go out and
• 16:53
  - tell their families and friends, like, what a
• 16:55
  - great experience they had. And so we spend
• 16:56
  - a tremendous amount of time focusing on that.
• 17:00
  - The challenge is, you know, it takes time
• 17:02
  - to have lots of patients who come through
• 17:03
  - your door and are are starting are starting
• 17:06
  - to refer. So that's that's probably been, like,
• 17:07
  - one of the areas over the first couple
• 17:10
  - years as we've opened up multiple
• 17:12
  - new new markets,
• 17:14
  - where we've spent a lot of time and
• 17:16
  - energy, not just building brand awareness, but building
• 17:18
  - those really,
• 17:20
  - I'd say, like, patient... They're they're they're kind
• 17:22
  - of, you know, brand ambassadors for us. It's
• 17:24
  - it's... There... There's no formal role, but people
• 17:27
  - have a great experience and then are excited
• 17:28
  - to tell their family and friends,
• 17:32
  - about Bluebird Kids Health and the the promise
• 17:34
  - that we wanna make to the communities that
• 17:37
  - we're serving.
• 17:38
  - And then the the other big one is
• 17:40
  - is is what you touched... The... This kind
• 17:42
  - of... The challenge of really
• 17:44
  - trying to build from the ground up an
• 17:46
  - organization
• 17:48
  - that is,
• 17:52
  - able to meet a combination of, like, the
• 17:54
  - social the social challenges
• 17:56
  - that are sometimes faced by
• 18:00
  - patients who, you know, are oftentimes might be
• 18:03
  - like a single single parent
• 18:05
  - working with multiple children. It can be hard
• 18:07
  - to get in during
• 18:08
  - traditional operating hours. How do we best serve
• 18:10
  - them so that the kids can still get
• 18:12
  - access to care while the family can still
• 18:14
  - make sure that there's,
• 18:16
  - you know, the the the the parent or
• 18:17
  - the guardian can maintain their their their employment.
• 18:21
  - Yeah. The challenges around multi,
• 18:24
  - kind of multi language
• 18:26
  - that that that that that results in. I
• 18:28
  - don't think we're perfect at it yet, but,
• 18:30
  - like, we have been very intentional about making
• 18:32
  - sure that we can have extended hours, that
• 18:35
  - we can meet needs outside of kind of
• 18:37
  - your traditional
• 18:38
  - practice operation hours,
• 18:40
  - and then,
• 18:41
  - really trying to build all of our workflow.
• 18:43
  - So as much as possible, they're they're multilingual
• 18:45
  - from kind of a native perspective. It's not
• 18:47
  - like, hey. We've been doing everything in English.
• 18:50
  - Now let's just figure out how to put
• 18:51
  - Spanish on top of this. Like, really, how
• 18:53
  - do we how do we
• 18:54
  - build the technology from the ground up to
• 18:56
  - be able to, you know, do Spanish, then
• 18:58
  - do Haitian Creole, then do Cantonese,
• 19:01
  - you know, and and and so on and
• 19:03
  - so on in a way that's really scalable.
• 19:07
  - Gotcha. So, Chris, let's look ahead a little
• 19:09
  - bit.
• 19:10
  - And, hopefully, you're gonna be around for a
• 19:12
  - good long time helping kids get the care
• 19:14
  - that they need. So what would you say
• 19:17
  - the next five or so years look like
• 19:19
  - at BlueBird?
• 19:20
  - Yeah.
• 19:22
  - Really, there there there are two things that
• 19:23
  - we're we're super focused on. One is, you
• 19:25
  - know, continuing to,
• 19:28
  - expand the number of children who we are
• 19:30
  - serving.
• 19:31
  - And the second is continuing to
• 19:34
  - invest in the care model and the technology
• 19:37
  - that's going to continue to,
• 19:39
  - allow us to be the leading kind of
• 19:41
  - clinical practice across the country.
• 19:43
  - We think that there... A lot,
• 19:47
  - a lot of the technology that is out
• 19:49
  - there today is going to continue to evolve
• 19:52
  - how
• 19:52
  - patients expect to receive care, how parents expect
• 19:55
  - to receive care, and really be able to
• 19:57
  - change how we as a provider group are
• 19:59
  - able to provide
• 20:00
  - even more timely comprehensive care. And so we're
• 20:03
  - spending a lot of time thinking about
• 20:05
  - what does, you know,
• 20:07
  - everyone having CHAT GPT in their pocket
• 20:10
  - mean for a pediatrics practice. We still really
• 20:12
  - do believe that you need a relationship with
• 20:15
  - a pediatrician.
• 20:16
  - We still believe that there's a need for
• 20:18
  - a physical exam,
• 20:19
  - but I'm not sure that everything that you
• 20:21
  - traditionally go to a pediatrician's office
• 20:23
  - in five and ten years will mean you
• 20:25
  - have to come to a pediatrician's office. And
• 20:26
  - so we're spending a lot of time thinking
• 20:28
  - about how do we continue to evolve our
• 20:30
  - model so that we're incredibly convenient for patients
• 20:33
  - who are incredibly clinically effective,
• 20:35
  - and we're embracing
• 20:37
  - all of the
• 20:38
  - technologies that are coming,
• 20:41
  - are are coming out and you're... You know,
• 20:42
  - you all are hearing about in the news
• 20:45
  - probably more often than you'd like, from from
• 20:47
  - time to time.
• 20:48
  - Oh, yeah. Certainly, Chris. We at Becker's as
• 20:51
  - well as all of our readership and audience,
• 20:54
  - so many of them are asking the the
• 20:56
  - questions that
• 20:57
  - you just mentioned about where SHAT GPT and
• 21:00
  - other AI
• 21:02
  - sources fit into
• 21:04
  - the information that
• 21:06
  - patients receive and how they interact with their
• 21:08
  - doctors differently. That could be a whole other
• 21:10
  - podcast
• 21:11
  - that we could do. Maybe we don't wait
• 21:12
  - into that just now or today, but maybe
• 21:14
  - in the future.
• 21:15
  - But what I do wanna know, we're all
• 21:17
  - about sharing wisdom and knowledge here at Becker's.
• 21:21
  - No doubt you are as well. So lastly,
• 21:23
  - so what would you say other providers can
• 21:25
  - learn from Bluebird Kids Health at this point
• 21:27
  - in time?
• 21:29
  - Yeah. I I I think what we have
• 21:31
  - done well and and will continue to invest
• 21:34
  - in is is making sure that we are
• 21:38
  - leveraging
• 21:39
  - technology
• 21:40
  - in a way that,
• 21:42
  - first and foremost,
• 21:43
  - helps to better delight our patients and our
• 21:46
  - consumers. So we always need to make sure
• 21:47
  - that whenever we
• 21:49
  - implement technology, it's actually better for
• 21:52
  - the the family, the caregivers, and the patients
• 21:55
  - that we serve,
• 21:56
  - but also being very intentional. And what's one
• 21:58
  - of our values is actually reimagining what's possible
• 22:02
  - On our on our own end, rethinking how
• 22:04
  - we do... How, like, medical groups historically have
• 22:07
  - done things
• 22:08
  - and making sure that
• 22:09
  - we understand what the outcome is that we
• 22:11
  - need to get to, not necessarily, like, what
• 22:13
  - is the process and not, like, recreating the
• 22:15
  - process with technology, but
• 22:17
  - thinking of better ways to get to that
• 22:19
  - outcome.
• 22:20
  - And I think we've... The team that we
• 22:22
  - have has done a lot of thinking about
• 22:24
  - that and challenged
• 22:26
  - a lot of the ways that, you know,
• 22:27
  - things have been done, if you will,
• 22:30
  - to try and make a
• 22:32
  - better experience for consumers and a more scalable,
• 22:35
  - sustainable,
• 22:36
  - operation for a medical group going forward.
• 22:39
  - Yeah. Certainly, if you can get to that
• 22:41
  - delight
• 22:42
  - reaction
• 22:43
  - from whether it's, your own staff when new
• 22:45
  - technology is rolled out or especially your patients,
• 22:48
  - that's gonna be a huge win. No doubt.
• 22:50
  - Well, Chris, thank you so much for joining
• 22:52
  - us on the podcast today. I'd love to
• 22:54
  - have you here to talk about everything that
• 22:57
  - Bluebird's doing and what it might be doing...
• 22:59
  - Hopefully be doing in the future, and I
• 23:00
  - look forward to next time our pass cross.
• 23:03
  - Chris, thanks so much for having me. It
• 23:04
  - was a real pleasure.