Latest / Becker’s Healthcare Podcast / Karen Janousek, Chief Population Health and Growth Officer at Sinai Chicago

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Karen Janousek, Chief Population Health and Growth Officer at Sinai Chicago · Becker’s Healthcare Podcast

0:02
This is where health care leadership comes together.
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Becker's sixteenth annual meeting brings more than 3,500
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hospital and health system executives and nearly 800
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speakers to Chicago April.
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This series event includes keynote conversations with Dallas
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Cowboys legend Troy Aikman and former president George
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w Bush. 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. We're looking forward to hosting you
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in Chicago.
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This is Laura Dierda with the Becker's Healthcare
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podcast.
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I'm thrilled today to be joined by Karen
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Janicek, vice president and chief population health growth
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officer at Sinai Chicago.
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Karen, it's a pleasure to have you on
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the podcast today.
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Thank you, Laura, for inviting me. I'm very
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excited to be here, and happy New Year
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to you and your audience.
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Thank you. Happy New Year. Well, I I'm
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excited for our conversation today because I know,
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you know, in health care, there's so much
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happening and so much changing,
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in this time. So it's so important to
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get perspective from you and other health care
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leaders on how they're navigating
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things in in their perspective on the future.
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But before we dive in, can you tell
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us a little bit more about yourself as
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well as Sinai Chicago?
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Certainly. Thank you, Laura. Here at Sinai, I
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am the chief population health and growth officer.
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And so tucked under all of that is
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everything that has to do with our value
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based and managed care work here for the
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system. So it's a value based partnerships with
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the payers.
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It's everything to do with our work with
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our accountable care organization,
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our physician hospital organization,
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as well as all of the work that
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is tied to the Illinois health care transformation
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collaboratives of which Sinai participates in two of
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them. And then finally, as I like to
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jokingly say, all other duties is assigned, which
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includes special projects that come up,
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whether it's within the value based care space
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or not. And so that's a little bit
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about the role within our organization here.
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Oh, that's fantastic to to know a little
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bit more about it. And and what an
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important role you play in Chicago in keeping
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the community healthy and and safe. Now, you
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know, when you think back about the last
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year or so, what was the most important
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initiative you led? What did you do, and
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what were the results?
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Very good. Thanks, Laura, for that. I think,
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it splits in two different ways as I
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as I think about it. The first one,
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certainly is in the value based care space.
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And here, I would say it leans in
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very heavily on the work and the success
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we have had with, within our ACL reach
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product,
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in the area of completing annual wellness visits.
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Within our ACL, we are one of the
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star providers
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for that metric.
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Why that is important
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is simply because,
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it becomes the gateway in which our patients
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become,
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affiliated with and work with our primary care
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physicians and our specialist physicians.
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Sinai Chicago, as many of your listeners may
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be aware of, is Chicago's
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largest,
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and oldest private safety net.
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That translates
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into serving the South and the West Sides
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Of Chicago,
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with a very heavily,
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concentration
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of ambulance runs. So we serve about 76,000
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patients,
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via, via a in the ER. 28,000 are
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coming from ambulance runs. I say all that
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to say that often our ER is the
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front door into,
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into our work and and our emphasis
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on connecting with the patients and getting them
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in for annual well you know, annual wellness
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visits
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begins to start
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creating the the connectivity between the patient and
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the provider. So we're very, very thrilled,
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with that particularly
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in the in the ACL,
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reach population.
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I credit,
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a lot,
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of success. I credit the success to the
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teamwork,
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specifically with both our providers and our frontline
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caregivers, our CHWs,
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who have been trained up in how to
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work with with the patients to get them
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in for annual wellness visits,
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and just a
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a tenacity to continue to work with with
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them and get get the patients and the
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providers educated.
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The other thing I would credit is having
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a good data system to be able to
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know if we are actually,
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achieving the goal. And then finally, it's daily
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leadership. I credit my management team for being
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able to,
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work the reports and see how progress is
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is going,
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all in service of of the patient. So
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that's the first one. I was very, very
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excited about. The second one falls under that
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all other duties is kind of assigned.
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So back in, the 2024,
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our CEO director Zike asked several of us
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to kind of weigh in on
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how do we,
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bring even more of a service line,
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philosophy and approach to clinical drug trials.
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Here at Sinai, we have Sinai,
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Community Health Institute with which is our research
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arm, our epidemiological
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research arm.
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However,
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we have had physicians and we have participated
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in clinical drug trials before.
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Now, however, we want to,
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fully expand this where it makes sense to
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the different specialties that could serve our community.
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And so we spent twenty five
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working on the plan of action, the strategic
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plan, identifying
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the partners in the clinical research organizations that
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we wanna work with, identifying the actual medical
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specialties,
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identifying what we actually need to do to
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our EMR, which is EPIC,
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through the Community Connect model that allows us
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to,
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to,
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operate the clinical trials. And so as we
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come into 2026,
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we know who our first partners will be.
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Yay.
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And we know,
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which which kind of clinical areas we wanna
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focus on, and we're, going to start probably
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early q two,
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implementation
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of what we need to do within Epic.
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So those are two big wins, I think,
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for 2025,
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that will continue to inform our work for
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'26.
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That's amazing to hear. In in all big
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undertakings for
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any hospital organization, but especially looking at everything
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else that you're trying to do right now
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in in the patients that you're serving. So
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that's really impressive. How do you,
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kind of transform your teams and keep people
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focused, especially when you've got a lot of
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different projects and initiatives going on?
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Great great question. I we have a small
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but mighty team as I always like to
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say, and I think it always comes back
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to
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communication
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and communication
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and explaining
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what is the what is the the purpose
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of of the project, what is your role
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in it, what is the goals, and then
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always checking back in on how are we
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doing,
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on achieving the goals or not achieving the
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goals. What are the barriers to to success
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that I can work,
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to remove
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or bring the right resources across the institution
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together to help remove.
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And so I think it's that constant repetitiveness
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of the communication
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cycle and the issue resolution cycle that allows
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us to advance any initiative that we're involved
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within our value based care
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space forward.
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That's fantastic to hear. Now looking ahead, what
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are some of the big priorities and headwinds
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you're focused on for 2026?
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Another great question, and there is a lot
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of them,
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out there. I don't think any 2026
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conversation or headwinds conversation,
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would be complete without, an homage to HR
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one.
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Becker is in many other organizations out there
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have written a lot about,
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the impact of of, what's coming out of
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Washington with HR one. But some of the
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headwinds that will impact us on the value
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based care side can range from anywhere from,
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you know,
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loss of Medicaid eligibility,
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the loss of any of the ACA,
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add ons to it,
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Patients who then if, if they've lost the
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eligibility
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or if there is a work requirement
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for Medicaid on on the eligibility,
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strong possibility some patients may not seek care.
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If they don't seek care, then we're going
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to end up seeing a greater disease burden
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which then ends up running through all of
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our systems
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and impacts overall the the expense and more
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importantly the quality of the patient's life. So
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with that kind of as a backdrop,
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on everything, you know, we the headwinds that
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we expect to see continue to see is
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just rising cost,
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of of cost any business but especially in
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the health care sector. Labor cost, tech costs,
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acquisition cost, whatever cost we're continuing to see
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it, increasing. The premium expensive going up, you
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know, care utilization
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is going up as well. That then translates
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into
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quite a bit of volatility when you think
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about it in a value based or a
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shared savings. So if you've got raising rising
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costs
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and you're not quite sure how,
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that's going to be managed or how much
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their their their rise will be and you're
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trying to manage to a medical loss ratio
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of x,
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it makes the challenge of that even even
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greater. I think the other thing to keep
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in mind is some of the forthcoming at
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least in in Illinois,
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Some of the forthcoming
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regulatory complexity changes that will will occur,
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starting in July.
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It has been passed here in Illinois, the
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seventy two hour rule and the gold card
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rule,
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which will be implemented in July. And so
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very soon, we're starting to see more and
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more of what that's gonna look like, how
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that's going to feel. In some instances, it's
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it will be of help to the providers,
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and it may be but it may be
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more of a burden to get it stood
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up and understood how to work between the
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the payer and the provider with the with
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these,
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roles. I think the other comment that I've
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made on headwinds again continues with workforce.
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And here,
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keeping,
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you know, we're still all dealing with some
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shortages. You're dealing with providing burnout. You're dealing
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again with labor costs. But all of that
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bringing it back into the value based world
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threatens,
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the delivery capacity
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as well as it threatens the overall quality.
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Here, I think quality of HEDIS,
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completing some of the some of the HEDIS
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studies that we have to that have to
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be done. So I think simply put,
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there will always be,
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the ongoing,
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challenge,
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to work on
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how do you balance the near term financial
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priorities
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versus the investments that one needs to make
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in value based care. Be it at a
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personnel level, a technology level, a partnership level,
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a data level. And so there's a push
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pull in anywhere,
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when doing when doing value based,
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care in this current climate.
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And so
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to sum up on the priorities, it's the
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balance between achieving the clinical and achieving the
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financial.
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One of the ways we're trying to do
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that is by limiting the number of measures
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that that we're participating
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in, like, not
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19 heaters measures. Let's get it down to
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a more manageable number. And let's see if
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in fact, it can be pretty much standardized
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across the health plans. I'll give a shout
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out to the Illinois Medicaid MCOs who have
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started to move along those lines. Still work
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to be done in Medicare and in commercial,
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but it's coming along.
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And then it's it's always paying attention to
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what are the what are the value based
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care programs that are out there.
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During 2025,
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we were introduced to three new programs. Some
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we accepted, some we did not for complexity.
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And then literally just this week, we're introduced
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to another one from another payer for activation
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in 2027.
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So I say all that to say that
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the question will become,
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how do you go deeper? Do you go
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wide when thinking about value based care when
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you're trying to manage the near term financial
12:19
performance
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versus the benefit of what value based care
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should bring in the future.
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That's fascinating to hear. You know, a lot
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of, different elements that you're dealing with and
12:30
and trying to, move forward, whether it's as
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you mentioned looking at the HEDIS measures, looking
12:34
at some of the policy changes and shifts
12:37
in how,
12:38
you know, demographics as well for your patient
12:41
population are moving. So, that's really interesting to
12:43
hear a lot of, different things on your
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plate in headwinds. But when you think about
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next year, what do you think the hardest
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thing you'll have to do will be?
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So I think there's, I'll answer that in
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kind of two ways from the hardest thing.
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One of the things we're going through right
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now, working with our actuarial firm is taking
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a look at what we're calling the left
13:04
on the table or the or upstate it
13:07
simply
13:08
in the value based care world. How much
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money did we not earn,
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in terms of,
13:14
performance in the quality HEDIS measures or performance
13:17
in the shared savings measures. And so,
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it's a little early to do the finalization
13:23
of the 2025
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performance, but we we
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we're working at we're working on it to
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get good read to set us up for
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further success in 2026.
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And so one of the hardest things will
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be to
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narrow that gap of what total potential is
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versus what was actually earned.
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What other strategies
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do we think about then when we think
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about
13:50
lowering,
13:52
length of stay, working on readmissions with some
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of our partners?
13:57
What do we do when we're thinking about,
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more of the quality studies. We've used, you
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know, all proper communication channels out there, social
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media to remind patients to come in for
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an annual wellness or get your mammogram screening
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completed when it when it's possible. But are
14:15
there other,
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avenues out there that we need to further
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consider in order to promote
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population health within within our community.
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I think the next challenge with all that
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will be to continue to keep all the
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providers engaged,
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in value based care and for them to,
14:34
to continue to get excited,
14:36
with,
14:38
value based care. So completing the care gap,
14:40
seeing the patient,
14:41
documenting accordingly.
14:43
That is,
14:45
that's mission critical to getting everything completed
14:48
in a value based care world. And then
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I would finally say here in in Illinois,
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we will be dealing with the introduction or
14:56
we are now dealing with the introduction of
14:58
the D SNP, the phytae, you know, the
15:00
phytae SNP programs.
15:02
They started one one. Sinai Chicago participates in
15:05
all of them in service again in the
15:07
community.
15:08
However, we're not I mean, they should work
15:10
out very, very well.
15:11
But we'll have to pay attention to what
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the what does that look like,
15:15
when they actually get up and running,
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more than seven days into the new year.
15:20
Yeah. Absolutely. That's such a good point. You
15:23
know, a lot of, things coming up for
15:25
this next year, you know, that'll be
15:28
helpful, I think, overall, but it's always, you
15:31
know, unexpected things that arise. And so being
15:33
able to be nimble and and pivot and
15:35
having that strong team, that I know you
15:37
have there at Sinai Chicago will be extremely
15:39
helpful. Thank you for running through some of
15:42
those challenges for us. I think, you know,
15:44
so many of them are, echoed and faced
15:47
by other organizations across the country too. So
15:49
to hear how you're thinking about them and
15:51
positioning for the future is great.
15:54
Before we wrap up here, I'm curious, where
15:55
do you see some of the best opportunities
15:57
for growth and and development in Sinai Chicago
15:59
as well?
16:01
I think one of the key areas,
16:03
of growth will continue to be,
16:06
the the the project of the clinical drug
16:09
trials.
16:10
I think, because of the vision of our
16:12
CEO in wanting to bring novel drug therapeutics
16:15
to our
16:16
community, I think that will have an impact,
16:20
an an impact and a support of the
16:22
mission of what we're trying to do here.
16:24
We're using a crawl, walk, run strategy, so
16:27
it's not going to be a lot of
16:29
trials at any one point in time. That's
16:31
going to allow us to bring,
16:34
the these clinical drug trials in a phase
16:36
three and a phase four,
16:38
perspective that have not necessarily
16:40
always been made available
16:42
to our Western, our South Side. So I'm
16:44
very, very excited about that and very energized
16:47
to continue to to see that transform and
16:50
and become
16:51
even more than,
16:52
the smaller scale we've been working at.
16:55
Absolutely. Got it. Well, thank you so much
16:57
for joining us on the podcast today, Karen.
16:59
This has been a a really fun discussion,
17:01
and I look forward to connecting with you
17:02
again soon and seeing you at our annual
17:04
meeting as well in April.
17:06
Very good. Look forward to it. Thank you,
17:08
Laura, very much.