Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Expanding Access and Transforming Care for Children with Special Health Needs with Dr. Matthew McDonald

Transcript

Expanding Access and Transforming Care for Children with Special Health Needs with Dr. Matthew McDonald · Becker’s Healthcare -- Pediatric Leadership Podcast

• 0:02
  - The strategic agenda facing hospital and health system
• 0:04
  - leaders right now is not a short list.
• 0:07
  - 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,
• 0:16
  - and a workforce story that is still being
• 0:19
  - written.
• 0:20
  - Eker's fourteenth annual CEO CFO roundtable brings together
• 0:23
  - more than 1,500 executive level attendees and nearly
• 0:27
  - 400 speakers across four days of sessions that
• 0:30
  - 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
• 0:37
  - decisions they'll face heading into the next year.
• 0:39
  - It's the kind of event you leave with
• 0:40
  - 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,
• 0:48
  - and come ready to do the hard thinking.
• 0:50
  - Register on our events page at beckershospitalreview.com
• 0:54
  - by clicking on the events tab in the
• 0:56
  - upper right.
• 0:58
  - This is Laura Dierda with the Becker's Healthcare
• 1:00
  - podcast. I'm thrilled today to be joined by
• 1:02
  - doctor Matt McDonald, president and chief executive officer
• 1:05
  - of Children's Specialized Hospital, part of RWJBarnas
• 1:08
  - Health. Matt, it's a pleasure to have you
• 1:09
  - on the podcast today. Thrilled to be here,
• 1:11
  - Laura. Thanks for having me. Absolutely. Now I'm
• 1:14
  - excited for our conversation. I know we're gonna
• 1:16
  - be digging into some of the cool things
• 1:18
  - you're doing at Children Specialized as well as
• 1:19
  - how you're thinking about the future. But before
• 1:21
  - we dive in, can you tell us a
• 1:23
  - little bit more about yourself and your background?
• 1:25
  - My name is Matt McDonald, and I'm a
• 1:28
  - pediatrician
• 1:29
  - by background and a CEO through a series
• 1:32
  - of wonderful blessings. I've been the CEO at
• 1:34
  - Children's Specialized
• 1:35
  - Hospital now for five years
• 1:38
  - and, have enjoyed every second of it.
• 1:41
  - Love it. That's awesome. And, you know, when
• 1:43
  - you think about children's specialized,
• 1:46
  - what what are some of the things you're
• 1:47
  - known for? What is kind of special about
• 1:49
  - the work that you do there?
• 1:51
  - Children's Specialized Hospital
• 1:53
  - is
• 1:54
  - a pediatric rehabilitation
• 1:56
  - hospital,
• 1:58
  - and network
• 1:59
  - where we are known,
• 2:01
  - to be amongst the nation's leaders
• 2:04
  - in pediatric rehabilitative
• 2:05
  - care as we would traditionally think about it.
• 2:08
  - But our purpose is much broader. Our purpose
• 2:11
  - is to help
• 2:12
  - children with unique health care challenges,
• 2:15
  - children
• 2:16
  - with,
• 2:17
  - special health care needs reach their full potential.
• 2:21
  - So in New Jersey and now beyond New
• 2:24
  - Jersey,
• 2:25
  - we're known for that commitment to helping,
• 2:28
  - kids that
• 2:29
  - need,
• 2:30
  - a lot of extra help, whether it be
• 2:32
  - in our inpatient rehab where we're,
• 2:35
  - helping
• 2:36
  - young people with spinal cord injury
• 2:38
  - or across,
• 2:40
  - the state where we're helping more than ten
• 2:42
  - thousand children
• 2:43
  - with autism,
• 2:45
  - by way of example.
• 2:47
  - That's amazing to hear. What an incredible work
• 2:49
  - that you're doing and such an important,
• 2:52
  - patient population to be working with too. I
• 2:54
  - know it makes a big difference for the
• 2:56
  - kids and their families, so I I appreciate
• 2:58
  - that. Now could you give us a quick
• 3:00
  - state of the union? Where are you at
• 3:02
  - today with children specialized, and what are you,
• 3:05
  - looking forward to in the next for the
• 3:07
  - rest of 2026?
• 3:09
  - Well, 2026
• 3:10
  - at Children's Specialized has been an amazing
• 3:12
  - year.
• 3:14
  - First of all, we're serving more children than
• 3:16
  - we ever have in the past, and that's
• 3:18
  - due to our,
• 3:20
  - significant focus on access. We're tracking toward
• 3:24
  - 50,000
• 3:25
  - children,
• 3:26
  - and,
• 3:27
  - that's a significant number given that we're a
• 3:30
  - specialized hospital,
• 3:32
  - caring for children with special health care needs.
• 3:35
  - We're also proud to be delivering measurable nation
• 3:37
  - leading outcomes in quality and safety. We've had
• 3:40
  - outstanding results in patient and employee experience inclusive
• 3:44
  - of, new initiatives around,
• 3:46
  - Google reviews, which has gone very well.
• 3:49
  - And then lastly,
• 3:51
  - the cherry on top is that we've had
• 3:53
  - strong financial performance,
• 3:56
  - really aided by year over year growth. So
• 3:59
  - all of these successes,
• 4:02
  - 100%
• 4:03
  - are are built upon
• 4:04
  - our fundamental commitment to our purpose. You know,
• 4:07
  - we're we we're building these successes by helping
• 4:10
  - children
• 4:11
  - reach their full potential with truly
• 4:14
  - real
• 4:15
  - family centered and patient centered care.
• 4:19
  - That makes a ton of sense. And, you
• 4:20
  - know, wow. Nearly 50,000 children are tracking towards
• 4:23
  - 50,000 children is huge. And and so,
• 4:26
  - you know, and knowing that you've got that
• 4:28
  - capacity and,
• 4:31
  - have that type of demand for the services
• 4:33
  - that you provide,
• 4:34
  - You know, how are you really making sure
• 4:36
  - that as time goes on, you're able to
• 4:38
  - continue to,
• 4:40
  - you know,
• 4:41
  - have the the teams there to serve those
• 4:43
  - patients, make sure that you've got everything in
• 4:45
  - place as I'm sure the need continues to
• 4:47
  - grow?
• 4:49
  - Well,
• 4:49
  - we're we we track against,
• 4:52
  - some,
• 4:54
  - key tailwinds and key headwinds.
• 4:56
  - For us at Children's Specialized,
• 4:59
  - it's it's really about vision over circumstance and
• 5:02
  - making sure that we deliver on that purpose
• 5:04
  - regardless of the circumstances in which we work.
• 5:08
  - I'll give you a few of
• 5:10
  - the headwinds,
• 5:12
  - that that we track and tell you about
• 5:15
  - the strategies that we're using to,
• 5:18
  - combat those headwinds and make sure that we
• 5:20
  - continue to
• 5:21
  - take care of these children that that that
• 5:24
  - need us.
• 5:25
  - In pediatric services,
• 5:28
  - already, there's a lag behind,
• 5:31
  - what we're able to supply
• 5:33
  - and what the children need. And
• 5:35
  - the potential reductions in Medicaid funding is a
• 5:38
  - headwind
• 5:39
  - in our ability to be able to to
• 5:40
  - close those
• 5:42
  - gaps that already exist, and that's especially true
• 5:45
  - at children specialized,
• 5:47
  - for vulnerable children,
• 5:49
  - be it children
• 5:50
  - born in difficult socioeconomic
• 5:53
  - circumstances,
• 5:54
  - children managing chronic illness,
• 5:57
  - and children well supported by
• 5:59
  - Medicaid. So broadly,
• 6:02
  - what we're trying to do is align the
• 6:04
  - supply of services
• 6:06
  - and care
• 6:07
  - along with innovation
• 6:08
  - with what children need
• 6:10
  - in a way that's financially sustainable,
• 6:13
  - and that's inclusive
• 6:14
  - of doing things like developing
• 6:16
  - the workforce,
• 6:18
  - changing the way
• 6:20
  - we deliver care,
• 6:22
  - along with making efforts to ensure that these
• 6:24
  - services are properly funded,
• 6:27
  - into the future.
• 6:29
  - That makes a lot of sense. And in
• 6:30
  - that last point, when you talk about the
• 6:32
  - financial sustainability,
• 6:34
  - in continuing to grow the workforce, I mean,
• 6:37
  - those are things that hospitals and systems across
• 6:39
  - the country are trying to think through and
• 6:42
  - troubleshoot and figure out what is going to,
• 6:45
  - help propel them into the future where funding
• 6:47
  - sources are gonna come from when I know,
• 6:49
  - you know, it can on a dime based
• 6:51
  - on policy or economic situation
• 6:54
  - change really quickly. So, you know, when you
• 6:56
  - think about the financial stability and sustainability of
• 6:59
  - what you're doing at Children's Specialized,
• 7:02
  - is there anything new that you're looking at
• 7:04
  - in in terms of trying to,
• 7:07
  - build, you know, additional revenue, bring it into
• 7:09
  - the organization? Or how do you think through
• 7:12
  - that financial stability piece of it with your
• 7:14
  - executive team to make sure that you're in
• 7:17
  - a good position no matter what happens over
• 7:18
  - the next twelve to twenty four months?
• 7:21
  - Well, one is is that we're we're always
• 7:23
  - trying
• 7:25
  - to grow the services that we currently,
• 7:29
  - have that that add value.
• 7:32
  - That's not a novel concept, but,
• 7:35
  - certainly a fundamental that has served us well.
• 7:39
  - Secondly
• 7:40
  - is through,
• 7:41
  - innovation,
• 7:42
  - particularly our center for discovery innovation and development.
• 7:45
  - We're trying to diversify revenue streams. So as
• 7:47
  - an organization, we're not wholly dependent upon,
• 7:51
  - the way that we've traditionally delivered
• 7:54
  - services.
• 7:55
  - Of course, that innovation is well within,
• 7:58
  - our purpose and aimed toward improving
• 8:01
  - inclusion,
• 8:02
  - and the welfare and health of
• 8:05
  - children and young people with
• 8:07
  - special health care needs.
• 8:09
  - And then lastly,
• 8:10
  - through the health care system, RWJBarnabas
• 8:13
  - Health and places like the Children's Hospital Association,
• 8:18
  - We're making sure that we're advocating
• 8:20
  - and helping people to understand
• 8:23
  - the importance
• 8:24
  - and the outcomes and the value
• 8:27
  - that these services,
• 8:29
  - provide,
• 8:31
  - particularly,
• 8:32
  - in our case, to the sixty five percent
• 8:34
  - of our patients that
• 8:36
  - are,
• 8:37
  - dependent upon Medicaid to finance,
• 8:40
  - these services.
• 8:42
  - So in that regard, we are doing as
• 8:45
  - much storytelling
• 8:46
  - as we can
• 8:48
  - in order to build awareness around what it
• 8:50
  - what it really means to have adequate,
• 8:54
  - health care coverage and what it really means,
• 8:57
  - for health care providers to be properly funded
• 9:01
  - and what the impact is
• 9:04
  - on the potential
• 9:05
  - and the trajectory
• 9:07
  - of our nation's children.
• 9:11
  - Absolutely. I I love that. And, you know,
• 9:13
  - what an inspiring point to think through, you
• 9:14
  - know,
• 9:15
  - what you're actually
• 9:17
  - servicing and the services you're providing, you know,
• 9:19
  - in needing that financial support and instability in
• 9:22
  - order to,
• 9:24
  - deliver for these patients who need so,
• 9:27
  - so badly these services and the families and
• 9:29
  - and what that means for the community at
• 9:31
  - large. And, I'm curious. You've talked a little
• 9:33
  - bit about growth in terms of wanting to
• 9:35
  - make sure you're always growing the services that
• 9:37
  - you have to make sure you're adding value.
• 9:39
  - Could you talk a little bit more about
• 9:41
  - that and discovery and innovation you're doing as
• 9:43
  - well? What are are are some of the
• 9:45
  - things that or projects initiatives, anything along those
• 9:48
  - lines that, can illustrate
• 9:50
  - your continued best opportunities for growth in the
• 9:52
  - next two to three years or so?
• 9:55
  - I sure can.
• 9:56
  - Generally,
• 9:59
  - amongst the children that we serve,
• 10:02
  - we know that there's access gaps.
• 10:05
  - We also know that children with special health
• 10:08
  - care need can needs continue to have
• 10:10
  - unmet,
• 10:12
  - needs.
• 10:13
  - So we are definitely focused on reaching
• 10:16
  - more children. There's a few key areas of
• 10:18
  - growth for us,
• 10:20
  - really three that I'll share with you. One
• 10:22
  - is
• 10:24
  - we have to enhance access to pediatric behavioral
• 10:26
  - health.
• 10:27
  - The prevalence and incidence
• 10:29
  - of, those diseases is rising,
• 10:33
  - and, the kids need help in that way.
• 10:35
  - We're gonna answer that bell on their behalf.
• 10:38
  - Two
• 10:39
  - is to build additional clinical services
• 10:43
  - and centers of excellence that help close the
• 10:45
  - gaps
• 10:46
  - for children with special health care needs.
• 10:49
  - So centers of excellence like our Down syndrome
• 10:52
  - center of excellence,
• 10:54
  - autism center of excellence,
• 10:57
  - closing gaps for children with functional neurologic disorder,
• 11:02
  - those are opportunities for children specialized
• 11:05
  - that are
• 11:06
  - a little different than typical
• 11:09
  - children's hospitals or
• 11:11
  - acute care providers.
• 11:13
  - And then three
• 11:14
  - is to utilize specialized and post acute care
• 11:18
  - services, including rehabilitation,
• 11:21
  - to improve chronic illness management,
• 11:24
  - reduce health care misadventures,
• 11:26
  - and, most importantly, to
• 11:28
  - improve longitudinal
• 11:30
  - outcomes
• 11:31
  - for, a niche population. For example,
• 11:35
  - utilizing
• 11:36
  - our inpatient rehabilitation
• 11:39
  - vehicle
• 11:40
  - to improve outcomes
• 11:42
  - for children
• 11:44
  - and young people
• 11:45
  - with poorly controlled
• 11:48
  - type one diabetes.
• 11:49
  - We have a program there with wonderful outcomes,
• 11:53
  - and we believe that we can use that
• 11:55
  - model to improve
• 11:57
  - outcomes for,
• 11:58
  - other chronic illnesses and diseases.
• 12:01
  - I love that. And, you know, I I
• 12:04
  - appreciate a a ton of what you're saying
• 12:06
  - in terms of being able to close the
• 12:08
  - access gaps for your patients and in the
• 12:10
  - patient population. And I can imagine, especially,
• 12:13
  - when you look at the services that you
• 12:15
  - provide, they're unique and specialized. And so, you
• 12:18
  - know, could you talk a little bit about
• 12:20
  - bringing those,
• 12:21
  - specialists in to do those kinds of things
• 12:23
  - and,
• 12:24
  - building that workforce that is equipped to,
• 12:28
  - you know,
• 12:29
  - serve your patients. I I think a lot
• 12:31
  - of hospitals and systems right now are are
• 12:33
  - struggling with their top pipelines and especially on
• 12:36
  - the clinical side and trying to make sure
• 12:38
  - they've got,
• 12:40
  - the right
• 12:41
  - folks coming into the organization. And so has
• 12:44
  - is it,
• 12:46
  - easy or or there's some challenges in building,
• 12:48
  - the workforce that you need to provide these
• 12:50
  - special services?
• 12:52
  - That's a great question, Laura. And in short,
• 12:55
  - the workforce
• 12:57
  - is inadequate to meet the needs
• 12:59
  - of our kids, particularly for the specialties,
• 13:03
  - in medicine
• 13:04
  - that Children's Specialized
• 13:06
  - provides.
• 13:08
  - And in short,
• 13:09
  - there's no hope to
• 13:12
  - recruit our way out of the access gaps.
• 13:17
  - So we have committed,
• 13:19
  - a few different
• 13:20
  - strategies
• 13:22
  - in order to,
• 13:24
  - build up the workforce.
• 13:26
  - But we also have to,
• 13:28
  - think outside of the box
• 13:30
  - and stop relying on traditional ways of delivering
• 13:33
  - health care services,
• 13:36
  - in the way that, I was trained as
• 13:38
  - a pediatrician or people in health care are
• 13:40
  - always accustomed.
• 13:41
  - So on the workforce development
• 13:43
  - side,
• 13:44
  - we are we are doing things like creating
• 13:48
  - clinical fellowships
• 13:50
  - for pediatricians
• 13:51
  - and nurse practitioners
• 13:53
  - in some of these niche specialties
• 13:55
  - so that those folks have
• 13:58
  - adequate training and then can,
• 14:00
  - come and
• 14:02
  - serve more children and help with access to
• 14:04
  - those services.
• 14:06
  - Second is we're changing the care delivery models
• 14:10
  - so that our,
• 14:12
  - specialists can function at the top of their
• 14:14
  - licensure,
• 14:15
  - and we can utilize,
• 14:17
  - very capable
• 14:19
  - professionals
• 14:20
  - to deliver services
• 14:22
  - for children,
• 14:24
  - with
• 14:25
  - autism,
• 14:26
  - in a way that is
• 14:29
  - more appropriate,
• 14:30
  - more cost effective,
• 14:32
  - and ultimately
• 14:34
  - allows children to get the services they need
• 14:36
  - faster
• 14:38
  - and,
• 14:39
  - with without
• 14:41
  - really obnoxious wait times,
• 14:43
  - for those services.
• 14:45
  - So we're pretty proud of the inroads that
• 14:47
  - we've had there. We've had good partners with
• 14:49
  - the with the payers to to recognize,
• 14:52
  - those access gaps, and we're gonna continue to
• 14:55
  - try
• 14:56
  - and scale those things
• 14:58
  - over time.
• 14:59
  - And then
• 15:00
  - much more broadly and a little sad for
• 15:02
  - me as a pediatrician is is that
• 15:05
  - we have to keep
• 15:07
  - keep our eye on the macroeconomics
• 15:10
  - of,
• 15:11
  - where education
• 15:13
  - meets the workforce supply,
• 15:15
  - meaning that less folks are entering into pediatric
• 15:20
  - care in general, in particular, pediatric
• 15:23
  - subspecialty care,
• 15:26
  - because it's a less attractive,
• 15:28
  - field than it was before.
• 15:31
  - So we're we're working on some,
• 15:34
  - pipeline development,
• 15:36
  - that will support
• 15:38
  - those shortfalls longitudinally.
• 15:42
  - That makes a ton of sense. And, you
• 15:43
  - know, thank you for slowing that out for
• 15:45
  - us so clearly. I think a lot of
• 15:47
  - dynamics and things going on there, but to
• 15:49
  - your point, you know, being able to
• 15:51
  - figure out how you can, bring some of
• 15:53
  - the training to people who are interested in
• 15:55
  - the field and provide support there,
• 15:58
  - and looking toward the future seems to make
• 16:00
  - a lot of sense. Now before we wrap
• 16:02
  - up here, I wanted to ask you about
• 16:04
  - leadership. Who is a leader that you admire
• 16:06
  - from really any industry and why?
• 16:09
  - Well, that's a great question. And for someone
• 16:11
  - that loves, learning about leadership, teaching about leadership,
• 16:15
  - it's really wonderful for me because I don't
• 16:17
  - have to look very far. I admire
• 16:19
  - our RWJBarnabas
• 16:20
  - Health CEO, Mark Madigan.
• 16:22
  - You Now steering a health care system of
• 16:25
  - our size is no easy task, and
• 16:27
  - what Mark's
• 16:29
  - been able to accomplish,
• 16:31
  - in a short period of time
• 16:32
  - is pretty awesome. He's accomplished significant results across
• 16:37
  - all meaningful domains.
• 16:39
  - He creates remarkable strategy, builds great teams, and
• 16:42
  - then executes
• 16:45
  - by leaning into values, including teamwork and kindness.
• 16:50
  - And yet he remains humble
• 16:52
  - and connected,
• 16:54
  - while
• 16:55
  - being
• 16:56
  - completely unrelenting
• 16:59
  - in
• 16:59
  - his pursuit of excellence,
• 17:01
  - on behalf of the
• 17:03
  - thousands upon thousands of patients and families and
• 17:06
  - employees that that we serve. So what a
• 17:09
  - blessing
• 17:10
  - it is to be able to look up
• 17:12
  - to him,
• 17:14
  - right within our own health care system.
• 17:17
  - Absolutely. That's so cool to hear. And, you
• 17:19
  - know, Mark is definitely
• 17:20
  - one of the leaders that we love to
• 17:23
  - connect with and focus on the spotlight as
• 17:25
  - well. He's just has such a a great
• 17:27
  - message in the way he approaches things. So,
• 17:30
  - I appreciate you highlighting him here and truly,
• 17:33
  - truly, a great leadership all the way around.
• 17:35
  - Well, Matt, thank you so much for joining
• 17:37
  - us on the podcast today. This has been
• 17:39
  - such a fun and inspiring conversation, and I
• 17:41
  - look forward to seeing you as well at
• 17:42
  - our CEO CFO roundtable. I know you'll be
• 17:45
  - speaking,
• 17:46
  - on one of our panels, and so we'll
• 17:47
  - dig deeper into some of these topics there.
• 17:49
  - And it'd be truly great to see you
• 17:50
  - in person. Very much looking forward to it.
• 17:53
  - Laura, thank you so much for having me.
• 17:55
  - And,
• 17:56
  - let me share a little bit about Children's
• 17:58
  - Specialized Hospital.