Latest / Becker’s Healthcare Podcast / Creating Sustainable Growth in Community Healthcare with Kurt Barwis

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Creating Sustainable Growth in Community Healthcare with Kurt Barwis · Becker’s Healthcare Podcast

• 0:02
  - The strategic agenda facing hospital and health system
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  - leaders right now is not a short list.
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  - Growth in a consolidating market, sustainable margins in
• 0:09
  - a reimbursement environment that rarely moves in your
• 0:12
  - favor,
• 0:12
  - a tech investment cycle that demands both urgency
• 0:15
  - and discipline,
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  - and a workforce story that is still being
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  - written.
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  - Eker's fourteenth annual CEO CFO roundtable brings together
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  - more than 1,500 executive level attendees and nearly
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  - 400 speakers across four days of sessions that
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  - are designed to help c suite leaders benchmark,
• 0:32
  - pressure test, and sharpen their priorities.
• 0:35
  - Not in the abstract, but against the real
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  - decisions they'll face heading into the next year.
• 0:39
  - It's the kind of event you leave with
• 0:41
  - a clear sense of where you stand and
• 0:42
  - what comes next.
• 0:44
  - So join us November second through the fifth
• 0:46
  - at the Hyatt Regency in Chicago, and come
• 0:49
  - ready to do the hard thinking.
• 0:50
  - Register on our events page at beckershospitalreview.com
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  - by clicking on the events tab in the
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  - upper right.
• 0:58
  - This is Laura Dierda with the Becker's Healthcare
• 1:00
  - podcast.
• 1:01
  - I'm thrilled today to be joined by Kurt
• 1:03
  - Barwiss, president, CEO, and CFO of Bristol Health.
• 1:06
  - Kurt, it's a pleasure to have you on
• 1:07
  - the podcast today. Sure. I am thrilled to
• 1:09
  - be here with you today.
• 1:11
  - Fantastic. Well, I'm excited for our conversation. I
• 1:13
  - know we're gonna talk a lot about how
• 1:14
  - things are going at Bristol Health, some of
• 1:16
  - the cool things you're doing there as well
• 1:18
  - as your perspective on the future. But before
• 1:20
  - we dig in, can you tell us a
• 1:21
  - little bit more about yourself and your background?
• 1:24
  - So I've been at Personal Health now for,
• 1:27
  - twenty years.
• 1:28
  - And,
• 1:29
  - prior to that, I,
• 1:31
  - was in Southern Maryland at a hospital, and
• 1:33
  - then Northern Maryland, I've been on all sides
• 1:35
  - of this. I started out, at a small
• 1:37
  - hospital in Philly, Paul James Hospital,
• 1:40
  - and, went into public accounting
• 1:42
  - and,
• 1:44
  - went into,
• 1:45
  - medical device sales and distribution
• 1:47
  - for a little while,
• 1:48
  - manufacturing,
• 1:49
  - health care, medical device manufacturing, and then I
• 1:52
  - did a start up.
• 1:53
  - So I've been I've been on all sides
• 1:55
  - of this,
• 1:56
  - this environment. It's actually pretty interesting to have
• 1:58
  - that kind of perspective.
• 2:00
  - Yeah. Absolutely. I can imagine you draw on
• 2:02
  - all those different experiences as you're going through
• 2:04
  - all your day and and decision making too,
• 2:06
  - which is fascinating.
• 2:08
  - So give us a quick state of the
• 2:10
  - union at Bristol Health. What's going well this
• 2:12
  - year, and what are you focused on for
• 2:13
  - the rest of 2026?
• 2:15
  - Well, that's that's an interesting question because,
• 2:18
  - hopefully, by the end of twenty six,
• 2:21
  - we will have gone through a transaction with
• 2:23
  - UConn Health,
• 2:24
  - here in Connecticut, and we will be a
• 2:26
  - member of the UConn Health, network community network.
• 2:30
  - So a lot of a lot of our
• 2:32
  - time and energy and focus right now is
• 2:34
  - on the due diligence and and closing the
• 2:36
  - transaction,
• 2:38
  - along with, you know, making sure we get
• 2:40
  - across the finish line. So,
• 2:42
  - focusing on our financial,
• 2:44
  - health,
• 2:45
  - revenue cycle. Recruiting physicians, you know, is a
• 2:48
  - big part. We had some primary care losses
• 2:50
  - last year, which affected our our bottom line,
• 2:53
  - and, we've had a really successful recruitment cycle.
• 2:56
  - But the the number one thing is to
• 2:59
  - really sustain and secure our mission for for
• 3:02
  - a long, long time by becoming part of
• 3:04
  - a larger organization.
• 3:07
  - Got it. Absolutely. Wow. I I think that's
• 3:09
  - really helpful to understand and being in that
• 3:11
  - position.
• 3:12
  - And and I can imagine, you know, with
• 3:13
  - all the uncertainties in healthcare right now,
• 3:16
  - becoming a part of UConn is helpful, but
• 3:18
  - at the same time, I know it's a
• 3:19
  - lot of work too. So, what's that process
• 3:21
  - been like, and and how have you been
• 3:23
  - navigating through the different things that come up
• 3:25
  - when when you're trying to become part of
• 3:27
  - a larger system?
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  - So great question. You know, it's really,
• 3:33
  - a matter of focus. Like,
• 3:35
  - you know, because, obviously,
• 3:37
  - in in that this kind of a situation,
• 3:40
  - you've got the board, the medical staff, the
• 3:42
  - community. You've got all these constituent bases that,
• 3:45
  - wanna know what's going on and be informed.
• 3:47
  - So you you have a balancing act. You
• 3:49
  - know?
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  - It it's people wanna know as soon as
• 3:52
  - they can know. So I I honestly, I
• 3:54
  - think the biggest thing is as soon as
• 3:56
  - something material, like, we sign an LOI,
• 3:58
  - when that happens,
• 3:59
  - boom, communication goes out and and make sure
• 4:02
  - that people are are aware of what what
• 4:04
  - what's going on in the process.
• 4:07
  - And and it's also managing the team, leading
• 4:09
  - the team, making sure that the people that
• 4:12
  - need to be engaged, the due diligence responses
• 4:14
  - that need to happen
• 4:16
  - happen. And then,
• 4:17
  - lastly, working with legal counsel,
• 4:20
  - through document,
• 4:21
  - drafts and terms of documents to make sure
• 4:24
  - that, there's a cadence and the process keeps
• 4:26
  - moving.
• 4:27
  - And, and here in Connecticut, we have a
• 4:29
  - certificate of need process. So so getting everything
• 4:32
  - done, ready, prepared, and filed
• 4:35
  - just starts a hundred and twenty day process.
• 4:39
  - So at this point,
• 4:41
  - you know, we I'm hopefully on track to
• 4:43
  - close this thing out by, December,
• 4:46
  - last week in December, first week in January.
• 4:48
  - We all know that's holiday season,
• 4:50
  - so probably likely first week in January.
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  - Oh, that's great to hear.
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  - Fantastic. And, you know, as you're going through
• 4:58
  - this process,
• 4:59
  - what are some of those big headwinds that
• 5:01
  - you're keeping an eye on and preparing for?
• 5:04
  - Yeah. So, obviously, the headwinds are very strong
• 5:07
  - right now. I mean, you know, you look
• 5:08
  - at all the changes that are that are
• 5:10
  - hitting us HR one,
• 5:12
  - the, outpatient proposed,
• 5:14
  - rules that that hit us, the first of
• 5:17
  - of January of twenty twenty seven,
• 5:19
  - changes to you know, it it seems like
• 5:22
  - we've got all these different directional things hitting
• 5:24
  - us, on three forty b. You've got you've
• 5:27
  - got potential,
• 5:29
  - congressional,
• 5:30
  - legislation,
• 5:31
  - coming out that could clarify some things that
• 5:34
  - people have been asking about for a long
• 5:35
  - time,
• 5:37
  - and interpreting
• 5:38
  - maybe, you know, lots of different ways. And
• 5:40
  - then you've got, you know, the outpatient rule,
• 5:42
  - which essentially,
• 5:44
  - cuts the amount that Medicare is gonna pay
• 5:46
  - for three forty b drugs.
• 5:49
  - And and then you've got the rebate program.
• 5:51
  - So we are you know, we rely on
• 5:53
  - the three forty b program. We are, we
• 5:56
  - are a disproportionate share hospital, so it's a
• 5:58
  - very important thing. So my eye is very
• 6:00
  - much on that. We actually spent a lot
• 6:01
  - of time responding to the inquiry that had
• 6:04
  - to do with the rebate program.
• 6:06
  - We we submitted a full,
• 6:08
  - response to CMS for that. So so, you
• 6:12
  - know, changes in the environment, changes around us.
• 6:14
  - And then I think the other thing that's
• 6:16
  - really important is constantly paying attention to, you
• 6:19
  - know, how can we
• 6:21
  - address affordability for our communities? How can we
• 6:23
  - address and what's our part and role in
• 6:25
  - that,
• 6:26
  - in terms of, you know, making health care
• 6:29
  - accessible, making it more affordable?
• 6:31
  - Because each one of us, every hospital, every,
• 6:33
  - you know, organization out there can can can
• 6:36
  - really
• 6:37
  - do make a difference in their communities. So,
• 6:39
  - you know, how do we lean out the
• 6:41
  - organization? How do we make good decisions?
• 6:43
  - We've gone through a lot of analytics on
• 6:45
  - service lines.
• 6:46
  - And,
• 6:47
  - and to the to the most extent possible,
• 6:50
  - how can we reconstruct those things so that
• 6:53
  - we don't have to eliminate those things?
• 6:56
  - Absolutely. I think that makes a lot of
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  - sense. And, you know, it's a really smart
• 7:00
  - way as a leader to think about all
• 7:02
  - the different headwinds, all the different policy changes
• 7:04
  - and challenges I know that affect the financial
• 7:06
  - health and stability
• 7:08
  - of of hospitals and and systems like yours.
• 7:10
  - And so, I think especially hearing, you know,
• 7:13
  - kind of the challenges with primary care too
• 7:15
  - on your side or the changes there.
• 7:17
  - What does it look like, you know, to
• 7:18
  - kind of prepare for these things going down
• 7:20
  - the pipe? Are you,
• 7:22
  - thinking through different ways to bring revenue into
• 7:25
  - the system, or or how do you really
• 7:26
  - prepare for so many different potential financial hits
• 7:29
  - in the next twelve to twenty four months?
• 7:32
  - Yeah. You know, in the old days, we
• 7:33
  - used to say we had to really try
• 7:34
  - to grow over them.
• 7:36
  - So,
• 7:37
  - growth is is the is the thing that
• 7:39
  - matters, and it's the right kind of growth.
• 7:41
  - So we are certainly doing that. We are
• 7:43
  - constantly paying attention. We just finished the medical
• 7:45
  - staff development plan. We've got a recruitment plan.
• 7:48
  - We are a,
• 7:49
  - a HPSA health pressure shortage area, so we
• 7:52
  - recruit extensively through the j one waiver program.
• 7:55
  - We're attractive in Connecticut, you know, even though
• 7:56
  - we're a lot of the state. It's attractive.
• 7:59
  - So a lot of a lot of the
• 8:01
  - growth and issues around recruiting the specialist and
• 8:04
  - those things that our community needs access to.
• 8:06
  - So just earlier today, we were talking about
• 8:08
  - ENT,
• 8:10
  - which we not had for years, but now
• 8:11
  - we have a chance because somebody who graduated
• 8:13
  - from high school right right down the street
• 8:16
  - is now coming potentially back as an ENT
• 8:18
  - surgeon in the community that she grew up
• 8:20
  - in. So,
• 8:21
  - those are the things that, you know, you
• 8:23
  - you look at. And at the very same
• 8:25
  - time,
• 8:27
  - you know, we've implemented staffing productivity measures that
• 8:29
  - that, when I wake up in the morning,
• 8:31
  - I can know exactly
• 8:33
  - for every four hour block of time where
• 8:35
  - we, you know, where we staffed appropriately, where
• 8:38
  - we overstaffed, where there are shortages in staffing.
• 8:40
  - I get a full report for the last
• 8:42
  - twenty four hours,
• 8:44
  - and there's accountability around that. So people are
• 8:46
  - taking actions. We get reports on overtime,
• 8:49
  - premium pay, all of those things. And then
• 8:52
  - most importantly,
• 8:54
  - every Friday,
• 8:55
  - we meet for a couple hours, and we
• 8:57
  - go through all the revenue cycles for all
• 8:59
  - of our entities and really kind of look
• 9:01
  - at what are the opportunities, how do we
• 9:03
  - improve, how do we address denials and bad
• 9:06
  - deaths. I I just saw this morning,
• 9:08
  - we had our medical group,
• 9:10
  - finance committee meeting, which is well attended by
• 9:13
  - physicians. It was really pretty cool to hear
• 9:15
  - the physicians interact.
• 9:16
  - And and for the last month, they or
• 9:18
  - last I think it was last month, they
• 9:20
  - collected,
• 9:22
  - 87%
• 9:23
  - of the co pays and deductibles at the
• 9:25
  - point of service.
• 9:26
  - That's huge. I mean, you know, because because
• 9:28
  - if you don't collect those things, all of
• 9:31
  - a sudden, you may not collect those things.
• 9:33
  - So,
• 9:33
  - so I I just spread it around a
• 9:36
  - little bit, but really kind of pay attention
• 9:38
  - to all the areas of opportunity,
• 9:40
  - making sure that things are really, you know,
• 9:43
  - happening. The patient is always the center of
• 9:45
  - the universe.
• 9:46
  - Quality, you know, how do we deliver and
• 9:48
  - how do we face the community and do
• 9:49
  - it in the right ways?
• 9:51
  - I love that. I think it makes so
• 9:53
  - much sense and, you know, I appreciate how
• 9:55
  - much work and effort it takes in order
• 9:57
  - to find that those growth paths and then
• 10:00
  - build a culture, build a a team that,
• 10:02
  - understands what the big goal is and is
• 10:05
  - able to, you know, really put all their
• 10:07
  - efforts, in moving in that direction. So, it's
• 10:10
  - cool to hear about the clinicians in the
• 10:11
  - finance meeting.
• 10:13
  - Oh, I'm really interested there. Yeah.
• 10:16
  - I could I could tell you having the,
• 10:19
  - you know, the, the
• 10:21
  - the managers of the practice, the practice managers
• 10:24
  - and directors involved
• 10:26
  - in the revenue cycle discussions
• 10:28
  - has exponentially
• 10:30
  - decreased
• 10:31
  - our denials and authorization timeliness,
• 10:35
  - and the co pay collections,
• 10:37
  - because they're there. You know? In many organizations,
• 10:39
  - all of that is separated into finance or,
• 10:42
  - you know, revenue cycle.
• 10:44
  - Blending them together, I think, is the secret
• 10:46
  - sauce. You know? Because once they realize
• 10:49
  - they can actually make a difference,
• 10:51
  - they actually have the power to get the
• 10:53
  - staff to do it real time. So it
• 10:55
  - works. It it very much works.
• 10:57
  - Awesome. Yeah. That's great to hear. And, you
• 10:59
  - know, to that point in the growth discussion,
• 11:02
  - where do you see the best opportunities over
• 11:03
  - the next two to three years, a bit
• 11:05
  - of a longer time horizon just to continue
• 11:07
  - to to grow and develop as a system?
• 11:09
  - Yeah. So great great question. I think a
• 11:12
  - difficult question to answer because as you think
• 11:14
  - about, like, you know, we've been all in
• 11:16
  - on March
• 11:17
  - and, you know, we opened up a clinic,
• 11:19
  - you know, so an MTM clinic,
• 11:21
  - and it's being extremely well received and the
• 11:24
  - and the growth and the opportunity there is
• 11:26
  - tremendous.
• 11:27
  - We have a retail pharmacy.
• 11:29
  - And then on the other side of the
• 11:30
  - equation, you've got all these headwinds that are
• 11:32
  - negative coming towards three forty b. And and
• 11:36
  - this morning, when we talked about it with
• 11:38
  - all the physicians,
• 11:39
  - you know, the patients
• 11:41
  - really are embracing,
• 11:44
  - that concept of having a pharmacist who's got
• 11:46
  - a contractual relationship with the primary care physician
• 11:49
  - or the specialist
• 11:50
  - who then becomes kind of the concierge persons
• 11:53
  - for those patients.
• 11:54
  - I see that as a huge growth opportunity.
• 11:57
  - I mean, around us, we've had some of
• 11:58
  - the big box pharmacies closed down. So pharmacy
• 12:02
  - to me is a is a is an
• 12:03
  - opportunity
• 12:04
  - despite the fact that we may end up
• 12:06
  - not getting the reimbursement that we used to
• 12:08
  - get. We'll still get the discounts, hopefully, that
• 12:10
  - we get from $3.40 b.
• 12:12
  - Specialty services, I think, you know, layering in
• 12:15
  - the services that we don't have that the
• 12:17
  - the community is still looking for,
• 12:20
  - and then redesigning things that we do.
• 12:23
  - So, really, we like a great example, we
• 12:25
  - just went through our cardiac and pulmonary rehab
• 12:27
  - services. Now it was staffed by some of
• 12:30
  - the most experienced nurses, but we didn't have
• 12:32
  - any exercise physiologists in there.
• 12:34
  - Exercise physiologists cost less money,
• 12:37
  - and so we changed out the staffing. So
• 12:39
  - it's critically thinking in every single area
• 12:41
  - and making sure that your construct is really
• 12:45
  - the one that that is gonna get you
• 12:46
  - the best, you know, best return,
• 12:49
  - the best experience for the patients, and be
• 12:51
  - the most economical.
• 12:53
  - That makes a ton of sense. And, you
• 12:55
  - know, having that, kind of overall
• 12:58
  - mindset and and thinking through, like, the reimbursement
• 13:01
  - and looking at, you know, where, the specialties
• 13:03
  - are at any given time. I know it
• 13:05
  - can change quickly, but,
• 13:07
  - you know, having that value, that return, and
• 13:09
  - and and,
• 13:10
  - really, you know, cool to have some of
• 13:12
  - the concierge things coming through as well. So,
• 13:15
  - that makes a ton of sense. And are
• 13:17
  - there any other areas that you are really
• 13:19
  - looking at investing in in particular?
• 13:21
  - Well, there is something kind of controversial that
• 13:23
  - I'm Yeah. Doing. Sure. So it made me
• 13:26
  - think of it like,
• 13:28
  - you know, this whole concept of site of
• 13:29
  - service, which is under challenge. So there's some
• 13:32
  - proposed changes in the outpatient rule that go
• 13:34
  - after that.
• 13:35
  - I've actually looked at it, and and so
• 13:38
  - you take so we have a very
• 13:40
  - significant population of primary care physicians who work
• 13:42
  - for Optum,
• 13:44
  - and and they and they score
• 13:47
  - your specialists. Right? And they score your specialist
• 13:49
  - on total cost of care. So all of
• 13:52
  - my, say, for example, physical therapy locations or
• 13:55
  - hospital site of service. So that it costs.
• 13:58
  - When you go into that calculus, it increases,
• 14:01
  - the score. So if you're, say, a four,
• 14:04
  - their primary care physicians are not, you know
• 14:06
  - and I don't know the exact, so I'm
• 14:08
  - not sure if it's one to four or
• 14:09
  - whatever it is. But
• 14:11
  - your surgeons could be phenomenal, high quality, the
• 14:14
  - best of the best,
• 14:15
  - but when you get to that metric, they're
• 14:17
  - not gonna get the referrals.
• 14:19
  - So the controversial thing that that I'm looking
• 14:21
  - at is
• 14:22
  - giving up on-site of service. You know, moving
• 14:25
  - my ambulatory locations
• 14:27
  - into
• 14:28
  - a different construct, which is
• 14:31
  - ambulatory pricing, not hospital pricing.
• 14:33
  - Because what do I want more? I want
• 14:35
  - my patients to stick around. I want them
• 14:37
  - to get their services in the community,
• 14:39
  - and I wanna get the referrals. So we
• 14:41
  - were doing the math, and I think my
• 14:43
  - my finance team said you're gonna lose $200,000.
• 14:45
  - And I'm like, yeah. But think about all
• 14:47
  - the orthopedic surgery I'm gonna pick up that
• 14:49
  - I'm losing, and all the patients who once
• 14:51
  - they leave the community may not come back
• 14:53
  - for their services. So,
• 14:55
  - so I kinda look at it a little
• 14:56
  - bit differently, and I think the analytics
• 14:58
  - everybody's situation's different,
• 15:00
  - but I think you have to go through
• 15:02
  - the analytics
• 15:03
  - very carefully. Obviously, if you have a, you
• 15:05
  - know, a a cancer center,
• 15:07
  - which with cost structure is very different
• 15:09
  - or, ambulatory surgery or a surgery center that
• 15:12
  - does, you know,
• 15:14
  - after hours, something like that, maybe you wanna
• 15:16
  - keep it that way. You wanna keep it
• 15:17
  - as a hospital site service, but you gotta
• 15:19
  - do the analytics.
• 15:21
  - Right. Absolutely. Stay close to that data and
• 15:24
  - and really then you'll understand what what the
• 15:26
  - likely performance is, but that's fascinating. I think
• 15:29
  - something that more and more hospitals seems like
• 15:31
  - are bumping up against in terms of trying
• 15:33
  - to figure out the side of service and
• 15:35
  - what's actually gonna, you know, make the biggest
• 15:37
  - long term difference,
• 15:38
  - for care as well as the financial side.
• 15:41
  - Yeah. Yeah. Yeah. So it's a fascinating situation,
• 15:44
  - and it'll be interesting to see what happens
• 15:46
  - over the next couple of years.
• 15:48
  - Yep. Now before we wrap up, I'm curious,
• 15:51
  - could you tell me about a leader who
• 15:52
  - you admire really from any industry and why
• 15:54
  - you admire them?
• 15:56
  - That's that's kind of an easy one. I'm
• 15:58
  - on the board of the American Hospital Association,
• 16:00
  - and Rick Pollock is president and has been
• 16:02
  - for years. I've known him for a good
• 16:05
  - part of my year my career even before
• 16:07
  - he was the president of the American Hospital
• 16:08
  - Association. Rick is
• 16:10
  - stepping down this year, and,
• 16:12
  - you know, I could tell you in terms
• 16:15
  - of a leader,
• 16:16
  - someone who constructs an incredible team, someone who
• 16:19
  - engages with the communities. I can go back,
• 16:21
  - and I remember
• 16:23
  - when I was, you know,
• 16:25
  - I I don't wanna say nobody, but I
• 16:26
  - was not really anybody important at a hospital.
• 16:29
  - And and Rick was in the,
• 16:31
  - advocacy area of the American Hospital Association. He
• 16:33
  - called me, you know, routinely, like, once a
• 16:35
  - year. What's going on? How are you feeling?
• 16:37
  - What do you think is is is important?
• 16:40
  - He's that kind of a person.
• 16:42
  - And and and having the chance to be
• 16:44
  - on the board member with a full room
• 16:46
  - of people that I admire and and respect,
• 16:49
  - having
• 16:50
  - Rick, you know, help me, you know, even
• 16:52
  - to the point where I was doing something
• 16:54
  - where I had to give an award at
• 16:56
  - one of the annual meetings,
• 16:58
  - and Rick is in there with me teaching
• 17:00
  - me how to use the teleprompter.
• 17:02
  - That's who he is. Like, he's he's a
• 17:04
  - person who
• 17:05
  - who gets to know people, who really does
• 17:08
  - bold things. And I could tell you right
• 17:10
  - now, I'm gonna miss him so much, as
• 17:13
  - he goes on to this next important part
• 17:15
  - of his his life. And I also wanna
• 17:17
  - put in a, you know, a major plug
• 17:19
  - for, you know, Steve Welsh, who's now gonna
• 17:21
  - take over the reins of the American Hospital
• 17:23
  - Association. He was the hospital association exec for
• 17:26
  - Massachusetts for years. I got to know him
• 17:28
  - on my regional policy board, which I chair
• 17:30
  - for the And even before that, what an
• 17:33
  - incredible transition. What an incredible leader,
• 17:36
  - leadership change. And the way it was done
• 17:38
  - was just done,
• 17:39
  - with with absolute perfection and,
• 17:43
  - really exciting things to think about in the
• 17:45
  - future. Very positive.
• 17:47
  - Despite all the turmoil and headwinds,
• 17:49
  - I think there is a pathway forward personally,
• 17:51
  - and I believe that the
• 17:53
  - has got a leader that also feels the
• 17:55
  - same way.
• 17:57
  - Absolutely. No. It makes a ton of sense,
• 17:58
  - and it's so helpful to have that type
• 18:00
  - of leadership, especially in DC and thinking about
• 18:03
  - policies and and everything else that impact hospitals
• 18:06
  - and health systems every single day.
• 18:08
  - Yeah. It does. There's no question.
• 18:11
  - I I feel like I'm blessed to have
• 18:13
  - gotten to know so many incredible leaders. I've
• 18:16
  - learned so much,
• 18:18
  - from them,
• 18:19
  - and,
• 18:21
  - it's just it's I feel like we're a
• 18:23
  - small community,
• 18:24
  - and that is one of the most important
• 18:27
  - things
• 18:27
  - about health care, this health care environment that
• 18:30
  - we're in. And that together,
• 18:32
  - despite all these headwinds,
• 18:34
  - we're gonna figure it out because that's what
• 18:36
  - we do. We're very passionate. We're very caring,
• 18:39
  - empathetic,
• 18:41
  - and we do what we do for the
• 18:42
  - communities that we serve. And the patient is
• 18:44
  - always at the center.
• 18:46
  - So they're relying on us to figure it
• 18:47
  - out. So I'm very optimistic.
• 18:50
  - That's amazing. Kurt, thank you so much for
• 18:52
  - joining us on the podcast today. This has
• 18:54
  - been such a fun conversation. I learned a
• 18:56
  - ton,
• 18:57
  - from you. It seems like you've got a
• 19:00
  - really,
• 19:01
  - great situation there and obviously continue to grow
• 19:03
  - and pivot with some of the challenges ahead.
• 19:05
  - But looking forward to seeing you as well
• 19:07
  - in person at our CEO CFO roundtable. I
• 19:09
  - know you'll be speaking on a panel, so
• 19:10
  - we'll dig deeper into some of these issues
• 19:13
  - and themes, and then we'll have more questions
• 19:15
  - for you at that point as well. So
• 19:16
  - looking forward to it. Thank you, Laura. I
• 19:19
  - am too. And thank you to Becker's. I
• 19:21
  - mean, you guys do a great job of
• 19:22
  - of really bringing a lot of information out
• 19:25
  - to us, and I look forward to reading
• 19:26
  - it
• 19:27
  - almost every day. Just literally,
• 19:30
  - it's a great source of information for me.
• 19:32
  - So thank you.