Latest / Becker’s Healthcare Podcast / Mark Behl, President & CEO of NorthBay Health

Transcript

Mark Behl, President & CEO of NorthBay Health · Becker’s Healthcare Podcast

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• 0:32
  Hello, and welcome to the Becker's Healthcare podcast.
• 0:35
  My name is Will Riley with r one.
• 0:38
  I am joined today by Mark Bail. Mark
• 0:41
  is the president and CEO of NorthBay Health
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  in California. Welcome to the podcast, Mark. Well,
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  thank you, Will. Appreciate having me here. You
• 0:49
  bet. You bet.
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  So to start us off, Mark, tell us
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  a bit about your role, tell us a
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  bit about NorthBay, the community that you serve.
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  Sure. Yeah.
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  So I'm the president and CEO of NorthBay
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  Health, and, I've been there since October
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  2023.
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  NorthBay Health's a great independent
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  regional community based health system.
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  We're located in between San Francisco and Sacramento,
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  so we cover pretty pretty broad area,
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  Napa County,
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  Solano County, Yolo County,
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  all the way up into Sonoma County.
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  What's the what's the community in the area
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  like? Is it is it rural? Is it
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  urban? Yeah. So we're definitely in when you
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  look at the Bay Area, there's about 15,000,000
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  people.
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  In the North Bay there, it's definitely more
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  suburban, more rural settings.
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  Obviously, there's a lot of agriculture,
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  Ventnor's, for example, in Napa and Sonoma.
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  So it's definitely has more of a
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  sort of a rural kind of feel to
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  it at times. Okay.
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  And what are some of the key initiatives
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  and things that you're trying to do as
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  a health system as you go into 2026?
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  Well,
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  I would say primarily one is we announced
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  a couple years ago that we would have
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  our ambulatory network strategy,
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  which is really transforming our system from more
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  of a a hospital based system to definitely
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  geographically dispersed,
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  ambulatory
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  care,
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  primary care, specialty hubs,
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  ASCs,
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  you know, really helping prepare us for the
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  future. And so that's a significant investment.
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  We have to build out new locations, recruit
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  more providers.
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  And so that's been a huge focus for
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  us in in '25, and we'll continue into
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  '26, '27.
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  And,
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  the other one I would say is we're
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  moving from Cerner to EPIC. That's a significant
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  investment
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  of resources, but also,
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  will help transform this into that ambulatory,
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  system. Got it. So that's another one. And
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  then, obviously, we're just trying to
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  deal with the challenges, the legislative challenges that
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  are in front of us from the state
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  of California,
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  at the federal level.
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  Really just trying to keep up with those
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  and trying to, you know, make sure that
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  our strategies and tactics are prepared for them.
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  Got it. Thank you. That's great grounding.
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  I'd like to start by talking a little
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  bit about
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  technology.
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  Obviously, you're in the middle of an EMR
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  transition.
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  I wanna pose a a question to you.
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  It feels like, historically, health care has moved
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  fairly conservatively
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  when it comes to technology.
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  Right? Not necessarily been on the leading edge.
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  But it also feels like that is a
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  bit different with the adoption and implementation of
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  AI based tools and technologies.
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  And it feels that there's much more enthusiasm,
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  much more pull for some of those technologies
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  than prep maybe we've seen in health care
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  before. Do you think that's true?
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  I do think that's true.
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  It's an issue when you say conservative. Yeah.
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  I I think over the history, you know,
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  in health care, traditionally,
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  we have not adopted
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  new technologies.
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  In fact,
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  even going back to the electronic medical record,
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  we were sort of, faced with penalties if
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  we didn't, implement it.
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  So it's always been sort of kicking and
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  screaming,
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  sort of to adopt some of these technologies.
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  Not not with the health care delivery, you
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  know, in terms of, you know, the technology
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  in the ORs
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  and in the bedside, but, definitely, you know,
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  from a systems perspective. So,
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  I think in this, new wave as we
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  talk about AI, it definitely does feel different.
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  There feels like,
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  there is more
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  of the, you know, the organization really wanting
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  to find solutions, really wanting to be more
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  embrace this new technology.
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  And every day, it seems like,
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  there's there's a little more hope, I think,
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  this time around that there are some solutions
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  out there that will really get to, you
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  know, some of the core frustration
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  that our teams are having. So I I
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  agree with that. I think it's, different today.
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  And what why why is that? Why is
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  that why is that more positive energy around?
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  Is it just that the technology just works
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  and so people see it immediately? Or, like,
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  what what is it? Do you think Yeah.
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  I I think that that's it. I think
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  people are now experiencing it every day in
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  their own lives,
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  and they're seeing how they're transforming,
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  the way that they, you know, get their
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  entertainment, the way that they,
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  order goods and supplies, and,
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  just the way they connect with others and
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  the way that they do their own research.
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  They're they're it's changing. Everything's,
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  you know, sort of happened
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  so rapidly that they're they're sort of now
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  waiting to see that in the work environment.
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  And so I think that's where, you know,
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  we're seeing the pull come from. You know,
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  it's different when you you're experiencing it and
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  you can see the value of it, but
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  you're not seeing it translate into your workplace.
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  Yeah. Okay.
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  So when you think about health care innovation,
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  one of the things we think about is
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  a couple of archetypes or ways that that
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  innovation can be delivered.
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  Incumbents
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  on one hand and let's call them insurgents
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  on another. So, you know, incumbents, you've got
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  large established health systems, established payers, large technology
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  providers like the EMR players and so on.
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  So they, you know, those folks have all
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  the data, the infrastructure, and so on. And
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  then you've got insurgents,
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  like, coming in with a different agenda, very,
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  maybe, AI native technology enabled solutions looking for
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  for different kinds of different ways of working.
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  When you think about innovation at North Bay,
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  are you an incumbent? Are you an insurgent?
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  Are you using incumbents or insurgents? Like, how
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  how are you where where are you in
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  that mix? Yeah. Well, we talk about that
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  a lot. And,
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  we have to be because we're an independent
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  you know, system, we're not, you know, positioned
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  to be,
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  the insurgents.
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  We're really not going to be the pioneers
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  in this space. We really have to be
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  more like early adopters Uh-huh. Of technology that's
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  proven.
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  And so because we just simply would we
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  would spend a lot of money and energy
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  and resources,
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  because there is that. In any new technology
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  or any new venture, there's a certain amount
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  of that, you know, sort of trial and
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  error and research and development and having to
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  invest,
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  a lot of a lot of money from
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  the organization to find out that something might
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  not work. Mhmm. And so we'll we just
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  can't really put ourselves in that position.
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  So we will look to where there's been
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  success,
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  in our environment.
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  Now I'm not saying that we wouldn't, you
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  know, take some, some bets on some things
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  that we think will work, and and we're
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  going to do that.
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  But I think we're gonna be very, very
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  more very much more reserved than than maybe
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  other systems,
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  particularly the larger systems.
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  And your, I mean, your your your EMR
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  replatforming
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  is a big
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  initiative here too. Right? So that must play
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  into your thoughts around the future of technology
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  enablement at the health system clearly. Yes. Right?
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  Tell us more about that. Yeah. It's a
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  big driver for the decision to make the
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  move. We really feel like,
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  you know, that investment that EMR allows them
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  of those those technologies and that, that investment
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  that's being made, through Epic,
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  and having seen that
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  from the marketplace around us. We're we're now,
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  one of the only systems in California still,
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  on the system that we're on. So
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  looking around us and knowing that our customers,
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  our patients,
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  are all using Epic has been a big
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  driver for us. We know that they have
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  the technologies that they've invested in in an
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  ambulatory setting, which again is different than becoming
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  a hospital, you know, based strategy.
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  So
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  that sets us up to have some of
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  that technology that we would otherwise have to
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  go and find in the marketplace
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  to sort of bolt on to what we
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  have today.
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  Talking about that ambulatory
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  strategy and that ambulatory setting and thinking about
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  technology,
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  what what are you looking to do to
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  make life better for the physicians
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  Mhmm. The and the patients, right, that that,
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  that are coming together in those ambulatory centers
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  using technology?
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  We wanna try to, you know, make it
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  as frictionless as possible. Right? And I think
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  that those interactions that our physicians have with
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  the record has to change, and it is
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  changing.
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  You're seeing that today with some of the
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  ambient AI that we're using, and we'll continue
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  to to to have that with Epic as
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  we,
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  expand that.
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  That's much different than it was ten years
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  ago. You know, our physicians were, you know,
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  spending $2.03 hours documenting and going into the
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  record
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  oftentimes late at night to have that technology
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  available.
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  That's gonna be very meaningful to them, and
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  they already see that today.
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  The same thing with our with our patients.
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  They wanna be able to schedule appointments. They
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  wanna be able to get their results. They
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  wanna be able to communicate with their with
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  their physician or APP
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  without having to wait. Everything needs to to
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  happen in, you know, in in real time.
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  And so those,
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  investments that we're making are on how do
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  we create that type of experience that they're
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  that they have today
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  and everything else they do in life. Right?
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  Yeah.
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  If you, you know, wanna order food, you
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  know, from a restaurant, you can do it
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  on your phone, and and, you know, forty
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  five minutes later, it's at your doorstep.
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  And you don't you really have to do
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  much, but just, you know, scroll through the
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  app, make the selection, and meet them at
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  the door. And so when you look at
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  health care, you know, that those are the
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  things that we're up against. You know? We're
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  gonna have to figure out ways to provide
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  solutions that that feel like that. Yeah. How
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  about on the administrative side,
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  and using AI or just new technologies there?
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  Like in
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  tell us a little bit about maybe some
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  of your payer relationships
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  and how they're playing out and potentially then
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  the role of technology in
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  making that relationship better if it if it
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  needs to be improved. Yeah.
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  Well, yeah. So we we do actually spend
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  a lot of time with, some of our
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  payers, you know, trying to develop better relationships
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  and trying to understand,
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  how they're approaching that,
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  with consumers, with their with their members. Right?
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  Mhmm.
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  And how we can,
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  help work together
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  to create a better experience. For example,
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  we have some of our payers who were
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  were are actively connecting with their members while
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  they're in the, you know, sort of health
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  care process,
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  to try to reach out to them, whether
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  it be, you know, whether it's rehab or
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  therapies or behavioral health,
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  telemedicine,
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  and to
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  not have that connected into our system, to
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  not have this ability to that creates, you
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  know, this,
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  fragmentation of care. And so we're working with
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  them. We're we all share in the same
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  goal here. We're trying to, you know, create
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  better outcomes. Mhmm. And so we have to
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  work together on that. And those payer provider
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  relationships have have been, you know, strenuous to
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  at the to say the least. And so,
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  like, any relationship, you have to invest in
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  it. And so we are spending time with
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  our payers trying to meet regularly to have
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  conversation about what's working, what's not working, what
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  can we do better.
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  And that's, I think, gonna be important as
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  we're going forward. Mhmm. Mhmm. If you look
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  at other areas like that, you know,
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  maybe that can help as you think about
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  maybe your epic implementation or other forms of
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  technology,
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  do you think that you can use technology
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  much more in some of those financial processes
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  than you have done? Right? It's always been
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  a very manual kind of area and space,
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  but it feels like it's ripe for transformation
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  through technology
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  Yes. That payer interface, revenue. Yes. That's the
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  payer interface in particular.
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  No no question about it. It's a very
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  manual process. It's very frustrating process,
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  for the payers. It's very, you know, frustrating
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  for the health care systems. It's frustrating for
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  the patient.
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  So I think that trying to figure out
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  tech solutions there is gonna be really important.
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  And those,
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  again, require cooperation and collaboration,
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  you know, with each other to try to
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  figure that out.
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  Trying to figure out how do we take
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  those repetitive tasks
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  that our employees have today, trying to process,
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  you know,
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  the revenue cycle for us
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  and create tech solutions that can allow them
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  to focus on the on the top priorities.
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  Yeah. Because ultimately, what we're trying to do
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  is we're trying to, you know, take that
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  whatever happened in our system
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  and translate that into, you know,
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  the for the payer, what
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  has happened so that we can get paid
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  and so that, you know, we can we
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  can adjudicate that and create really a a
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  frictionless process for the patient. That's really the
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  ultimate goal. Yeah. Right. Right.
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  Mark,
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  bring us home. You you talked at the
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  start a bit about the legislative environment. Maybe
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  we can end there,
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  because it's obviously pretty dynamic both at the
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  state and federal level. Tell us about some
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  of your concerns and hopes for that world
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  in 2026.
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  Well,
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  again, you know, we're we're in the state
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  of California, and so, there's a lot of
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  regulatory requirements there in California. And, you know,
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  we have a a governor and a president
• 13:58
  that don't get along very well right now.
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  So we're trying to, you know, sort that
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  out and what that's gonna mean for us.
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  Ultimately,
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  it creates challenges that, on the again, from
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  a just a payer,
• 14:10
  from the payer side in terms of government.
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  About 70% of our,
• 14:15
  revenue comes in from government payer sources. Right.
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  Either Medi Cal, which is Medicaid,
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  or, Medicare.
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  And both of those are have cuts on
• 14:23
  the table, significant cuts on those that we're
• 14:25
  facing.
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  So when you talk about our financial, you
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  know, strategies around that, we again, we're we're
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  trying to transform as an organization
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  into from from a hospital to ambulatory.
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  So we're gonna have to continue making those
• 14:39
  investments, but you also have to prepare. Well,
• 14:41
  the way to prepare for that when 70%
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  are being subsidized by government payers,
• 14:47
  we're gonna have to get really good at
• 14:48
  value based care.
• 14:49
  We are have to we have to be
• 14:51
  able to manage patient populations and take some
• 14:53
  value based arrangement or some risk based arrangement,
• 14:57
  with the with those payers, with those government
• 14:59
  payers
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  in order for us to be successful long
• 15:01
  term. Now this old model of taking the
• 15:04
  commercial revenue that's coming in and continue to
• 15:07
  increase that,
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  you know, to the consumer
• 15:10
  to help offset,
• 15:11
  you know, the subtleties we have in the
• 15:13
  government side is just simply not gonna work.
• 15:14
  It's not a recipe for success. So,
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  we're gonna have to invest in ways to
• 15:19
  manage, patient populations and take risk.
• 15:23
  Mark, is there anything else on your mind
• 15:25
  as we as we wrap up right now?
• 15:27
  No. I I think it's exciting times. I
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  mean, I was just,
• 15:31
  right now, you know, in San Francisco, you
• 15:33
  can you can get into a, you know,
• 15:36
  Waymo, a taxi that has powered by AI.
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  It drives you around the city, and they're
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  very prominent.
• 15:41
  You know, I I use them all the
• 15:43
  time when I go into the city. I
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  actually prefer them,
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  and I think it sort of represents the
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  sort of the excitement of what it could
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  mean when we talk about technology in the
• 15:53
  future.
• 15:54
  But it's very it can also be scary,
• 15:56
  you know, for health care systems. Again, because
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  traditionally, we don't really embrace that. But I
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  think if we can, if we can really
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  keep this momentum going and start to use,
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  you know, AI to help, you know, our
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  frontline teams and our patients,
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  I think we're gonna be successful.
• 16:12
  Wonderful. Thank you very much, Mark, for spending
• 16:14
  time with us today. Thank you. Will, thank
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  you. Appreciate having me here. Thank you. Thank
• 16:18
  you.