Latest / Becker’s Healthcare Podcast / Chuck Porth, CEO at Uncompahgre Medical Center

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Chuck Porth, CEO at Uncompahgre Medical Center · Becker’s Healthcare Podcast

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This is Laura Dierdahl with the Becker's Healthcare
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Podcast.
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I'm thrilled today to be joined by Chuck
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Porth, CEO of Ancompahgre Medical Center. Chuck, it's
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a pleasure pleasure to have you on the
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podcast today.
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Thank you.
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Now I'm excited for our conversation because I
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know we've got a lot to talk about.
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Healthcare is in such a fascinating time right
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now and truly, you know, looking at,
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how it's evolving and transforming in rural spaces
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is gonna be, just a huge, huge part
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of the future going forward. But before we
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dive into our broader discussion, could you tell
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us a little bit more about yourself and
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Campagre Medical Center?
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Certainly.
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I'm an Eagle Scout, a graduate of the
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University of Missouri,
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a fellow in the American College of Healthcare
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Executives,
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and a product of some of the larger
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integrated healthcare systems in The US,
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and currently live and work on the Western
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Slope Of Colorado
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at Uncompahgre Medical Center.
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Our service area is roughly the size of
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Delaware
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and is designated
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as rural slash frontier
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since it has roughly seven people per square
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mile in it.
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UMC
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is a federally qualified health care center, and
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we strongly focus
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on providing comprehensive primary care.
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And as an FQHC,
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our mission includes providing health care
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regard
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regardless
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of a person's ability to pay.
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Having said that, we also see a healthy
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contingent of insured
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as we can demonstrate
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quality results.
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So not only are we designated
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as a patient centered medical home,
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but we participate in several value based contracts
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where year after year,
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say, for example, the Medicare shared savings program,
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our clinical
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outcomes for diabetes,
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hypertension,
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and others
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are currently best in state.
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That's amazing to hear. And, you know, certainly
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such a unique,
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population that you're serving, but, so important to
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have that primary care and strong health care,
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specialty services as well, within the community because
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it makes a big difference in how they're
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able to access care and then truly have
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healthy
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lives. So,
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that's incredible to hear what you've been able
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to accomplish there. Now what do you think
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is the most important initiative that you've led
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in the last year or so? What did
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you do, and what were the results?
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Okay. Well,
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briefly, we mentioned quality care,
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which is an evergreen
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initiative as it also builds trust with those
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that we serve.
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And we take our role as a medical
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home very seriously.
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So we started a couple of programs that
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address the high number of patients who are
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reporting issues
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with the social determinants of care.
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So, for example, we've started a free patient
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transportation
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service
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where we'll
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drive out to the patient's home, bring them
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to their appointment, and then return them home.
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And we've also started
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delivering food
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to those folks that qualify who are also
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homebound.
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So those things are going on.
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We also now have a dental program
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since in our part of the world, a
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high percentage of children
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experience dental decay by the time they reach
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kindergarten,
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and almost forty percent
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of our residents who are 18 years or
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older have already lost at least one tooth
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due to dental decay.
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We're
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one of the few dental programs accepting Medicaid
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and non insured in the area.
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And the result of that program, it's it's
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been in operation since November,
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is that, our next available appointment is is
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several months out. We do maintain emergency
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slots, so if something
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comes up,
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people can still get in to take care
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of it.
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We're constantly looking for additional grants to help
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offset the cost of programs like that and
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so that we can expand it. So
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those are what comes to mind.
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Well, that's amazing to hear. And, I I
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so appreciate you outlining those programs because it
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it really makes a difference being able
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to deliver
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those services and and helping those patients. I'm
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curious in particular, when you look at the
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dental program, what did it take to set
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that up and, really get it operational? I
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know from a funding perspective is one thing,
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but then looking at making sure you've got
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the right, people in place to deliver the
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services and and manage that on the operational
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side too. What does that look like?
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Well, it it revolved around a couple of
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different things. One is
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is making sure we're setting things up so
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that,
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when it comes to making
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prosthesis,
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that we're doing it as effectively
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and inexpensively
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as we can.
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So we spent a lot of time,
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securing funding and getting the equipment
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that we needed in place.
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You put your finger on it. The hardest
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part was finding the right,
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expertise,
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and I think we've got a dentist and
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a hygienist now
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that
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understand
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and are bringing quality
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to the table,
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which we're able to demonstrate.
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So those were the two hardest parts. Once
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we had the, providers lined up,
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then we let them
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choose the,
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dental staff that was going to support them,
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because I believe in a captain of the
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ship approach. So we wanted those two individuals
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to be totally responsible for the quality of
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care provided in the in the dental suite.
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That's really helpful to understand and and hear
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about how, you put the program together. Obviously,
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having great dental health is so important to
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overall health too. And,
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so I I appreciate that. And then also
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when you're thinking about the food delivery and
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and some of the other social determinants of
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health and population health care, I think that's
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something
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that, you know,
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some hospitals and
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organizations are trying to build additional programs around
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because it's been overlooked as part of the
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responsibility of a hospital or health care delivery,
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FQHC, those kinds of things. But,
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what is your role really there? How do
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you, manage those types of programs that are
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outside of the hospital or outside of the
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facility,
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and make sure that everything is,
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running smoothly and really providing the value that
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it should be into the community?
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Well, that goes back to,
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being a primary care medical home.
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We believe that when we accept that, and
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we've
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had that designation for around fifteen years now,
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that that creates a special
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responsibility
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and bond with those in our
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in our service area.
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So
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we're responsible,
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and we accept the responsibility.
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So having said that then, then we're back
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to the
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total definition
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of health,
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which is more than just
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passing the yearly annual exam.
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So,
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for example, when COVID was here, we were
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we became a distribution center for the,
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for the shots, for the immunizations,
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and coordinated with all of the providers in
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the area. So
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that's our approach.
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That's our philosophy,
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and that's what we try to put in
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place. So to the extent we can, we
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can't do everything, but to the extent we
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can,
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we try our best
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to
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put in place
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what the entire population needs in order to
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be as healthy as they can be.
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That's such a helpful mindset and really, really
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great way to think about these things and
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then build the strategy around it. I'm curious.
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Looking ahead, what are some of the big
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priorities that you have your eye on as
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well as the headwinds that you're focused on
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for the next twelve months or so?
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You know, it's interesting. When I was in
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college,
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one of the
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debates we always seem to have revolved around
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the question of,
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is health care a right?
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Well, I believe that now we know it's
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not
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because if it wasn't right, somebody would pay
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for it, and that's not going on.
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As an example,
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given both the state and federal budget problems,
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my Medicaid
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medical reimbursement
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decreased 13%
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this year,
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and I'm seeing a decrease in both the
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number and amount of grants available to help
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make up the difference.
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Having said that, my expenses are not going
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down.
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So
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when you look at all of that, what
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we're trying very hard to do is
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keep
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direct patient care whole,
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which means administration
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and administrative
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duties
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are being asked to do more with less,
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while the administrative burden is going on.
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So
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that is
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the big headwind
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right now.
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And so to compensate,
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we're looking for new revenue streams because diversification
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is the name of the game.
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And we're also looking for strategic partnerships
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that might be able to,
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partner with us in some way
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to either increase the n
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that we're taking care of or, in other
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ways, help alleviate or offset some of the
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costs.
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Fascinating to hear. And I I think it's
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especially,
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pointing it right now to talk about, you
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know, those Medicaid reimbursement drops and expenses continuing
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to increase. It seems like, you know, is
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putting,
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so many hospitals, but especially those in rural
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areas and serving,
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the underserved populations in a really tough spot.
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And so when you think about those, diversified
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revenue streams,
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can you share with us anything that you're
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considering or,
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how you're going about deciding what that next
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step will be?
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Yeah. Certainly. I can I can provide a
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little bit of insight? And and in regards
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to the state, this I'm in the state
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of Colorado.
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And so right now, once again,
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the state of Colorado was looking at an
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$800,000,000
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budget
11:12
deficit,
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which means that more cuts are coming. And
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so the game is not over, and it's
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not finalized.
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But we're looking at the continuum of care
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across the board.
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So
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we're looking at,
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there's almost nothing out here as an example,
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and when if you talk about aging in
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place.
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So that could be an opportunity. We're looking
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at
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what can be done on an emergency basis
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that might be available to us. So
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we're not really talking about jumping into non
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health care activities
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too much
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at this particular point in time.
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We are participating
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in the alternative payment methods that are being
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presented as options to us
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in an effort to diversify.
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So not everything is based upon the traditional
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fee for service model.
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So there's a lot of things going on.
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But given what has already gone on, we
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have to be very smart in how we
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invest
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in the future.
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That makes a lot of sense, and it's
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helpful to know kind of your mindset going
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into all of this. And I'm curious, have
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you, or will you be able to access
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anything from the rural health transformation program or
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is that still,
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a little bit uncertain as to how that
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will play out as well?
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Well, we're not sure how it's gonna work.
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We're going to try to participate in that.
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And we have ideas in regards to
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how to utilize the funds,
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but it's still very, very early
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in that. And so the we'll say the
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jury's still out on it.
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I see. That makes a lot of sense.
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Perfect. Well, you know,
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I'm wanna know. We we've talked about some
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of the challenges in the situation that, you
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know, you're in as a rural health care
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facility.
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What is the hardest thing you'll have to
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do in the coming year? What do you
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think that will be?
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What we just talked about,
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their revenue streams
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and what's happening to them. So the hardest
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thing is going to be to adjust to
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cash flow.
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We're going to have to be more flexible
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in what we do,
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because all of our revenue streams are
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uncertain
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at this point in time.
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So that's the biggest hurdle. The biggest concern
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right now is is
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health care, at least in our part of
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the world, has lost its predictability
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as far as secure funding sources.
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So it's it's
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it's creating almost a month by month, where
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are we at and what do we have
14:03
to do type of attitude.
14:09
That you know, it's it's a hard place
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to be in and and not having some
14:13
of that uncertainty, especially. But as, obviously, the
14:16
CEO, you know, you're able to manage that
14:19
the best you can. How do you help
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your teams really,
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make sure that they're not feeling, you know,
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too,
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too much stress around that uncertainty or making
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sure that they're focused on the right things
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as well, you know, given some of the
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challenges that we've talked about today?
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Well, I'm blessed. I've got
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a management team and a group of employees
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that get it and are committed.
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And so we are doing as best we
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can in regards to that. One of the
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other things, though, that it's forcing us to
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do
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is I am now decreasing the number of
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FTEs I have
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and going more to contract
15:04
people that are
15:06
no not w two employees.
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So that creates
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another issue in regards to how do how
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do we work with one another.
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An opportunity he it presents is that I
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can literally hire anybody anywhere in The United
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States to help us out.
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And so we've we've had folks in four
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different states
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helping us out here, which if we had
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a traditional model of employment,
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I would not be able to find those
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type of folks.
15:39
So it's it's creating
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opportunities for us to create a different model
15:46
of what working at UMC
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means,
15:49
and we're all learning.
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But we're all committed to learning,
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how to go forward in these different models.
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That sounds like a great way to approach
16:03
it and really make sure that everybody is
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working together and rowing in the same direction
16:07
and, focused even during some of these times
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of, high uncertainty and change. I And the
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last thing I wanted to ask you while
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I have you here is, where do you
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see some of the best opportunities
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for growth in the future?
16:20
Well, we're looking at two things. One is
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vertical expansion. We talked about,
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aging in place, so home health,
16:28
assisted living, those types of things.
16:30
We're looking at,
16:32
improved
16:33
models as far as emergency care is concerned.
16:37
But we're also looking at strategic partnerships. So
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if we you look up and down the
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continuum,
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how can we better work with our hospital
16:45
partners? How can we better work with those
16:47
folks that are providing other types of services
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in our community,
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which includes first responders,
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etcetera?
16:58
So that's how we're kind of approaching it.
17:01
I'm not really looking at doing
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a bigger
17:05
what we're already doing,
17:07
because we know what the revenue streams associated
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with that are or aren't.
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And so we're looking at
17:16
looking at different ways in order to provide
17:18
care and service and expertise to the area.
17:25
Got it. That makes a lot of sense.
17:26
Chuck, thank you so much for joining us
17:28
on the podcast today. This has been such
17:30
a a fun and,
17:31
informative conversation. I really appreciate how open you've
17:35
been with us about some of the things
17:37
that, you've been working on, some of the
17:38
successes, as well as some of the challenges
17:41
that are upcoming. So thank you so much
17:42
for your time, and I look forward to
17:44
continuing the conversation.
17:45
It's been a pleasure. Thank you.