Latest / Becker’s Healthcare Podcast / David Goldberg, President & CEO of Mon Health System and Davis Health System and Executive Vice President at Vandalia Health

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David Goldberg, President & CEO of Mon Health System and Davis Health System and Executive Vice President at Vandalia Health · Becker’s Healthcare Podcast

• 0:00
  This is Scott Becker with the Becker's Healthcare
• 0:03
  Podcast.
• 0:04
  I am thrilled today to be joined by
• 0:06
  a leader who's a magnificent leader who we
• 0:08
  love getting to visit with. We're joined today
• 0:11
  by David Goldberg.
• 0:13
  David's the president and CEO of MonHealth.
• 0:16
  He's also the executive vice president of Vandalia
• 0:19
  Health, and he'll he'll help me make sure
• 0:21
  I'm pronouncing that correctly.
• 0:23
  David, I love getting a chance to visit
• 0:24
  with you. Can you take a moment to
• 0:27
  introduce yourself to the audience and tell people
• 0:29
  a little bit about MonHealth, about Vandalia Health
• 0:31
  and health care in West Virginia?
• 0:34
  Well, Scott, it's always a pleasure to be
• 0:36
  with you and to do this after the
• 0:37
  holiday weekend is great. Vandalia Health was created
• 0:41
  in 2022
• 0:42
  as the merger of Charleston Area Medical Center
• 0:45
  health system based in Charleston, West Virginia,
• 0:47
  and Mon Health System anchored in Morgantown, West
• 0:51
  Virginia. We came together,
• 0:53
  formed the second largest health system in the
• 0:55
  state.
• 0:56
  We were blessed to have the Davis Health
• 0:58
  System join us two years ago.
• 1:00
  So now we're a 17 hospital system,
• 1:04
  more than 200 ambulatory locations
• 1:06
  covering parts of Ohio,
• 1:08
  Southwest Pennsylvania,
• 1:10
  Western Maryland,
• 1:11
  a little bit of Virginia, and, of course,
• 1:13
  West Virginia. 13,000
• 1:15
  employees,
• 1:16
  and thrilled that we're able to keep community
• 1:19
  care close to home, laser focused with our
• 1:21
  board of directors of West Virginia residents taking
• 1:23
  care of West Virginians.
• 1:27
  Thank you. And what's the largest town in
• 1:28
  West Virginia? Tell us a little bit more
• 1:30
  about the geography of West Virginia. I know
• 1:31
  it still is a very impoverished state, but
• 1:33
  it's got these crown jewels of the state
• 1:35
  like Mon Health and Vandalia.
• 1:37
  Tell us a little bit about sort of
• 1:38
  West Virginia.
• 1:40
  So West Virginia as a whole, we're about
• 1:42
  1,800,000
• 1:43
  residents.
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  The largest cities of note would be Charleston,
• 1:46
  which is our state capital,
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  as well as Huntington, West Virginia, Wheeling, Weirton,
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  are all large cities. Morgantown, we call it
• 1:54
  the university city, is about an hour and
• 1:57
  twenty minutes south of Pittsburgh where I sit.
• 2:00
  And, you know, we're a very proud group.
• 2:02
  I'm a WVU graduate.
• 2:04
  I joke we've been socially distancing since 1857.
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  We're very loyal to our state. We're very
• 2:10
  humble.
• 2:11
  We work hard,
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  and, you know, Vandalia was brought together to
• 2:15
  make sure that access,
• 2:16
  quality care, service is the forefront of what
• 2:19
  we do each and every patient, one patient
• 2:21
  at a time.
• 2:23
  Thank you. And talk a little bit about
• 2:25
  when when you look at the trends you're
• 2:27
  watching in health care,
• 2:29
  it seems like West Virginia is doing a
• 2:31
  better job than other states in getting its
• 2:33
  physicians back there.
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  So many challenges in rural health care today.
• 2:38
  What what are some of the trends you're
• 2:39
  watching in in West Virginia?
• 2:41
  It seems like West Virginia is just moving
• 2:43
  in the right direction versus so many other
• 2:45
  places. What's your sense of that and what
• 2:47
  trends are you watching?
• 2:49
  Well, I think that's a great question. I
• 2:51
  mean, we're 1,800,000
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  people and, you know, you talked about our
• 2:54
  rural nature.
• 2:55
  West Virginia
• 2:56
  has pockets of greatness and pockets of good
• 2:59
  access. I'm talking from the northern part of
• 3:01
  the state where you can get to Baltimore
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  or Washington or Pittsburgh or
• 3:05
  Ohio pretty easily for higher level care you
• 3:08
  may not be able to get at home.
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  The more Southwest
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  you go in pockets or east,
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  yeah, you you think east. Oh, you're close
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  to DC. Well, you could be in a
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  very rural community without a major interstate
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  or, access road, and you have to wind
• 3:22
  around to get out, up, and over.
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  So our goal at Vandalia Health has been
• 3:27
  able to bring care close to home. We've
• 3:30
  been very lucky this year in physician recruitment.
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  Across our enterprise, we brought in nearly 200
• 3:36
  doctors,
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  nurse practitioners,
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  physician assistants,
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  CRNAs,
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  you name the allied health professional,
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  onto our campuses to be able to take
• 3:46
  care of our patients.
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  Many of our doctors travel to some of
• 3:49
  these rural communities to offer oncology or pulmonary
• 3:52
  care or neurology care or urological care, because
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  we can't get people to live right in
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  those little rural communities. And most of us
• 4:00
  know, if you don't make it easy to
• 4:01
  access health care, patients aren't gonna go. And
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  if they don't go, they're gonna get sicker,
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  health care is gonna get more expensive, and
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  families are gonna suffer because their loved one,
• 4:11
  gets sicker. So our goal is to be
• 4:13
  able to get care close to home through
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  telehealth,
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  through making sure we have specialists close,
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  and also to make sure that we recruit
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  into the communities and hopefully get people to
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  live there. Some trends, pharmaceutical expenses on everybody's
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  radar.
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  Last year, the year before it was the
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  GLPs.
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  Well, this
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  year, you know, it's $3.40 b,
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  making sure that the costs are reduced to
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  get access to care and pharmaceuticals to our
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  patients.
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  Labor costs are still some a driver for
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  us. While we're rural, we have to pay
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  competitively,
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  like, the states around us to get people
• 4:47
  to live in our state. And while they'll
• 4:49
  come to a rural state, they still wanna
• 4:51
  get paid, what the going rate is, and
• 4:53
  we wanna be competitive to do that. Health
• 4:55
  benefits is another area.
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  While our employees
• 4:59
  and colleagues might be healthy, some of their
• 5:01
  dependents, where we call them beneficiaries on the
• 5:04
  health plans,
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  are a little costly, and we wanna take
• 5:07
  care of our families, but it's also a
• 5:08
  cost that we're trying to manage. And then
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  lastly,
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  the trend on IT,
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  the the fastest growing part of our budget
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  in most health care providers besides the medicines
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  and the benefits is the investment in technology,
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  whether it be artificial intelligence or electronic milk
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  record medical records
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  or other investments, they're very costly. And, if
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  you're a mostly Medicare, Medicaid state like West
• 5:31
  Virginia,
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  where your rates are fixed, the costs are
• 5:34
  high, and we have to manage our costs,
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  manage our revenue, our expenses, and our levels
• 5:38
  of investment to be, very proactive.
• 5:42
  Thank you. No. That that makes sense. I
• 5:44
  mean, so much of the dollars are coming
• 5:46
  in, Medicaid, Medicare, some commercial, but some of
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  those different dollars are not going up in
• 5:52
  any significant way or they're fixed dollars. At
• 5:54
  the same time, the expenses continue to rise
• 5:56
  and continue to try and innovate and provide
• 5:59
  better and better care. You got rising cost
• 6:02
  and and relatively flat reimbursement.
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  Talk for a second, David. As you look
• 6:06
  at 2026,
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  what are you most focused on and excited
• 6:10
  about as you move towards this next year?
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  Well, then there's the macro and the micro.
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  I'll start with the micro. We're still merging
• 6:17
  all of our assets into an integrated delivery
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  system. And as many of us know, when
• 6:22
  you build scale, you wanna take out waste
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  to the system, reduce your costs so you
• 6:26
  can take those excess dollars that you generate
• 6:29
  and invest them into your people, invest them
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  into technology,
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  invest them into pro programs that benefit our
• 6:35
  community. As a five zero one c three
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  or a tax exempt organization,
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  we wanna be very careful with the dollars
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  we invest so we could benefit our communities
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  and make them more livable and healthy. From
• 6:46
  a macro perspective,
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  there's a lot of, you know, trials and
• 6:49
  tribulations
• 6:50
  related to what is or isn't coming out
• 6:52
  of Washington related to Medicaid reimbursement,
• 6:56
  reductions that'll come from that, three forty b.
• 6:59
  The I love what I'm seeing. I think
• 7:01
  just today, we saw Eli Lilly is dropping
• 7:04
  the cost of GLP ones if you pay
• 7:06
  cash. So we're seeing a lot of things
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  change in the market, which should improve care,
• 7:11
  improve access, and reduce cost.
• 7:13
  We still need to make ourselves frictionless,
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  make it easier for patients to get in
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  to see their doctors or their health care
• 7:19
  professionals,
• 7:21
  and take care of them in the moment
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  they need our care so we can reduce
• 7:24
  cost and improve our outcomes.
• 7:26
  The nation is moving to value. That means
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  we have to be Johnny on the spot
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  related to getting those people that need care
• 7:33
  in, getting them timely taken care of, following
• 7:36
  up with them timely, and getting to own
• 7:38
  their health care and make it a less
• 7:40
  difficult environment.
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  Those prices, if you will, are relatively fixed,
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  but whether it be a tariff, whether it
• 7:47
  be inflation, are going up. And we have
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  to make sure that we're being good stewards
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  of the dollars that we get for fee
• 7:52
  for service and or
• 7:54
  arrangements with our payers, but we also have
• 7:56
  to be good stewards of those dollars.
• 8:01
  Yes. No. No. Absolutely. And, David, you've had
• 8:04
  this fantastic career. You spent a lot of
• 8:06
  time at Allegheny General Health before moving to
• 8:10
  West Virginia or or taking a position here.
• 8:13
  Talk a bit about what advice would you
• 8:15
  give to emerging leaders in in
• 8:18
  what do you tell somebody who's an emerging
• 8:19
  leader who wants to have an impactful and
• 8:20
  great career?
• 8:22
  So I've been blessed. I've lived in Northern
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  Virginia. I worked at Inova Health System. I've
• 8:26
  worked in Texas with Baptist Health System, part
• 8:29
  of Tennant, Allegheny Health Network, as you mentioned
• 8:32
  in Pittsburgh, and then here with Vandalia.
• 8:35
  And what I say with everybody, healthcare is
• 8:37
  probably the most giving profession back to a
• 8:39
  community you can take on.
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  We cover pretty much every profession or career
• 8:44
  that you would need, whether you're in safety,
• 8:46
  security, IT, finance, healthcare delivery,
• 8:51
  cybersecurity,
• 8:52
  security as a whole, I joke. Health care
• 8:54
  systems and hospitals are like little cities. So
• 8:57
  it's imperative that we give back to our
• 8:59
  communities and stay focused on what the local
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  communities need. Not all of us could be
• 9:03
  all things to all people. But when it
• 9:05
  comes for people coming up the ranks, you
• 9:07
  know, it's pretty easy.
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  Don't take yourself too seriously even though it's
• 9:11
  a serious job.
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  Be into the details enough that you understand
• 9:15
  it and can make a difference, and then
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  hopefully lead your next level leaders to the
• 9:20
  next level,
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  to be successful for the communities we serve.
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  Partner with your clinicians. It's very easy, to
• 9:27
  get into a, you know, I'll say a
• 9:29
  combative situation.
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  Nothing. Everyone is coming to the table wanting
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  to do the best thing for their the
• 9:35
  place they work, for the communities they serve,
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  for the patients we take care of, etcetera.
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  And we god gave us two ears in
• 9:41
  a mouth for a reason. I talk a
• 9:43
  lot, so I try to slow down,
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  to listen more, understand what's being said,
• 9:49
  and then try to galvanize our group to
• 9:51
  come to good solutions.
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  And then at the end of the day,
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  we're dealing with people's lives. Come to work.
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  I I had a a boss many years
• 9:58
  ago say to me, if you don't strive
• 10:00
  for perfection, you'll never get there. And that's
• 10:02
  a high bar.
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  Anything less in health care could mean a
• 10:06
  terrible outcome
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  or a defect or a variation that can
• 10:10
  cause,
• 10:11
  a bad outcome to a patient or to
• 10:13
  a colleague. So we wanna make sure we
• 10:15
  have systems and structures in place to remove
• 10:18
  variability but have a just culture. Where people
• 10:20
  see things that aren't making sense, raise the
• 10:23
  flag or raise the idea for us to
• 10:25
  be better. Because at the end of the
• 10:27
  day, it's all about harnessing the strength of,
• 10:29
  in our case, 13,000
• 10:31
  people to row in the same direction and
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  also make sure at the end of the
• 10:35
  day that our patients are well taken care
• 10:37
  of and that our colleagues are well supported.
• 10:41
  Thank you. And and then just taking us
• 10:42
  back one more second. As you look at
• 10:44
  2026,
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  if you look at sort of the
• 10:48
  what you're most excited about, you've got the
• 10:50
  integration going on.
• 10:52
  I don't know how the mountain airs are
• 10:53
  doing right now.
• 10:55
  But but what what, Ari, when you look
• 10:57
  at this next year coming up,
• 10:59
  what gets you going in the morning that
• 11:00
  gets you like, oh my god. Am I
• 11:01
  excited to get to work? Because here's what
• 11:03
  I'm working on.
• 11:04
  Well, I I have, an outstanding
• 11:07
  group of colleagues that I work with.
• 11:10
  This year, our longtime CEO, David Ramsey, is
• 11:13
  retiring this '26.
• 11:15
  Jeff Sandeen, our long term CFO, will ascend
• 11:17
  to the CEO chair.
• 11:19
  They're two great guys,
• 11:21
  who had the vision of bringing Vandalia together,
• 11:23
  and the three of us along with 13,000
• 11:26
  colleagues are forming what we think is an
• 11:28
  integral part of the West Virginia fabric. So
• 11:31
  I'm excited about what more we can do
• 11:33
  to continue the trend as you started off
• 11:35
  with that we're improving the health care trajectory
• 11:38
  of those we serve.
• 11:39
  I think this year is gonna be a
• 11:40
  lot going on, like I said, on the
• 11:42
  IT
• 11:43
  spectrum related to artificial intelligence and how we
• 11:46
  could put tools into the hands of our
• 11:48
  clinicians and our colleagues to make it that
• 11:50
  much easier to do the work that our
• 11:53
  patients expect, which is
• 11:54
  easily accessible, lower cost, higher quality.
• 11:58
  West Virginia has a lot of benefits. The
• 12:00
  Mountaineers this year did not have
• 12:04
  a great year, but I'm on to basketball.
• 12:04
  So I'm already moving forward into March madness,
• 12:06
  I hope, and and will be there. But
• 12:07
  we need to make sure that we are
• 12:09
  making it easy, and we improve our outcomes.
• 12:12
  We're the number one state for smoking. We
• 12:14
  have some of the highest obesity, diabetes, heart
• 12:17
  disease that you'll see around the country. Lots
• 12:19
  of Parkinson's, lots of lung,
• 12:22
  issues.
• 12:23
  We need to work on those and make
• 12:24
  it easy for us to work with the
• 12:26
  other providers in the state and around our
• 12:28
  region to make it easier. The we hope
• 12:31
  that the, president's $50,000,000,000
• 12:34
  rural health care transformation
• 12:36
  grant, we're gonna get our piece of it,
• 12:38
  really makes a dent in the way health
• 12:40
  care was to where we need to drive
• 12:42
  health care into the future. So '26 is
• 12:45
  gonna be a a a incredible year. I'm
• 12:47
  excited for it. And what keeps me going
• 12:49
  every day is no matter what any of
• 12:52
  us do in health care, we're improving people's
• 12:54
  lives and the trajectory of their health care.
• 12:56
  That's exciting to be able to help people
• 12:58
  in need, make sure we stay true to
• 13:00
  who we are, and make people more healthy
• 13:02
  and, hopefully,
• 13:03
  give people a little bit more spring in
• 13:05
  their step.
• 13:07
  David, it's always great to visit with you.
• 13:09
  It always lifts my spirits. Thank you for
• 13:12
  joining us today on the Becker's Healthcare podcast.
• 13:15
  Congratulations
• 13:15
  on what you've accomplished and what MonHealth and
• 13:18
  Vandalia help is accomplishing.
• 13:21
  Thank you so much for joining us.
• 13:23
  Thanks for all you do, Scott. I can't
• 13:24
  wait to get your book, and thank you
• 13:26
  for the opportunity.
• 13:28
  God bless you. Thank you for buying. Thank
• 13:30
  you so much. Take care. Thank you, sir.
• 13:33
  Thank you, sir.