Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Tommy Ibrahim, Network President & CEO, Bassett Healthcare Network

Transcript

Dr. Tommy Ibrahim, Network President & CEO, Bassett Healthcare Network · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Tommy Ibrahim,
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  network President and Chief Executive Officer of Bassett Healthcare Network.
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  Tommy, it's a pleasure to have you on the podcast today.
• 0:12
  Thank you so much, Laura. Looking forward to it.
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  Well, I know there's a lot happening,
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  and we're gonna talk through some of the big challenges and trends and rural
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  healthcare today. But before we dive into the broader discussion,
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  I was wondering if you could tell us a little bit more about yourself and your
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  background?
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  Yeah, no, happy to. Um, uh, my name is Dr. Tommy Ibrahim.
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  I'm an internist by background, uh, trained, uh,
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  greater Baltimore Medical Center, uh, in b Baltimore, Maryland. And, uh,
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  practice as a and internist for the first, you know,
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  several years of my career before getting tugged into the leadership domain.
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  And, um, you know,
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  I have been very fortunate and blessed over the past couple of decades, uh, to,
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  uh, advance into larger position executive roles, um, that have, uh, you know,
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  essentially prepared me for, um, the, uh,
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  incredible opportunity that I have today, uh, leading, uh,
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  Bassett Healthcare Network. So, delighted to, uh,
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  spend some time with you today.
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  Fantastic. Well, you know, I was wondering if we could start off with, um,
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  talking a little bit about some of the big challenges of rural healthcare today.
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  What are you really seeing on the ground floor,
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  and how are you navigating these challenges?
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  Well, thanks so much, Laura. I mean, I think the challenges are really copious.
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  Um, you know, we're dealing with, uh, some of the other, uh, you know, major,
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  um, uh,
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  problems that the healthcare industry in its entirety is dealing with at this
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  current time. Um,
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  but I would also say that rural healthcare in general is exponentially, uh,
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  you know, more affected. Uh, and that's for, uh, a variety of different reasons,
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  you know, most are, uh, community related, um, or, uh,
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  just geographically, uh, you know, uh, related. Uh, others might be, uh,
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  staffing, uh, you know, related or op other facets of operations, you know,
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  playing a key role. Um, and, and certainly, uh,
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  as a rural healthcare organization, we feel the brunt, um, uh,
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  of most of those areas. So, for example, it is, um, you know,
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  significantly more challenging for us to recruit, uh, to our communities. Uh,
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  there's a,
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  a general shortage across the entire industry now for both physicians as well as
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  nurses. Uh,
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  and I believe the recent statistic was actually about 200,000 or so physicians
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  left healthcare just last year, and about a hundred thousand nurses, uh,
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  decided to leave healthcare last year.
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  So we're all fighting for the same constrained pool of resources,
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  and it's exponentially harder for us in a rural environment to be able to
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  recruit talent to really service the, the needs of the community. Um, you know,
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  layering into that, the very unique social determinants of health, uh,
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  of rural populations in general. Uh, our communities are largely elderly. Uh,
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  you know, they're, uh, poorer, uh, less digitally inclined. Uh,
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  we might have challenges with broadband access and transportation, uh,
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  all of which get in the way of patients truly accessing the care that they need,
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  uh, in the way that they need it. And, you know,
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  as healthcare leaders and as a healthcare organization,
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  we have to really solve for those problems, uh, as we, uh,
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  take into account the needs of our community. And,
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  and we're doing a number of different things to try to address that. And, uh,
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  you know, as an organization, one of our, one of our major, uh,
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  I think strategic priorities is, uh,
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  to align with other partners and other affiliations, uh,
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  who are aligned with our mission, aligned with our vision to ensure that we are,
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  um, you know,
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  driving the strategies and the initiatives forward that really make sense for
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  our community. So, as an example,
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  we've just launched a major partnership not too long ago with Andreesen
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  Horowitz, uh, which is a, uh, a major venture capital firm, a major, you know,
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  digital, uh, innovator, uh, in the Silicon Valley. Um, and that, you know,
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  the premise of that partnership is to look at how we could begin to really
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  redesign the care delivery system to meet the needs of rural geographies in
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  particular, and making sure that, you know,
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  we're layering in solutions that make sense for our community. That's just one,
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  uh, you know, recent example. Uh, another is, uh,
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  a broadening partnership and relationship that we've built with Columbia
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  University, where we're bringing world class cardiovascular services, uh,
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  to our community through telehealth. Uh, and, uh, again,
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  really optimizing on, uh,
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  virtual and digital channels to serve the community in the best way possible.
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  And there's just a number of other partnerships and affiliations and other
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  strategies that we've put into place to make sure that, uh, you know,
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  we're addressing the very unique, uh, and subtle needs of overall patients.
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  I love that. I think that makes a lot of sense.
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  And it's so helpful to know how you've been redesigning that care delivery
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  system to match your population and the patients that you serve.
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  I can imagine it's so helpful within the community to have those services and
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  access to facet in order to, uh, have care when it's needed.
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  Now, you know,
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  as you were talking through a lot around the staffing and labor issues, um,
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  obviously all healthcare organizations are experiencing them to some degree,
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  but in rural healthcare,
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  that recruiting people into spaces that are non-urban into spaces that,
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  you know, might not be as typical is an extra challenge. So, you know,
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  what is your strategy for recruiting and retaining great talent over the last
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  couple of years,
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  especially what's worked really well and where are you looking ahead in the
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  future?
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  Yeah, it's such an important question. And, um, you know, at Bassett,
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  we're really trying to take a very, um, you know, uh,
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  thoughtful a and comprehensive approach, um, to, uh, to this really,
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  uh, significant need, um, focusing predominantly on retention. Um, you know,
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  we found, obviously, uh, that, uh,
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  becoming an employer of choice and investing in our people,
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  investing in our culture is the single most important thing that we can do. Um,
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  you know, we,
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  we have great people already and it's really important for us to make sure that
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  we're putting in place processes and initiatives to,
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  to ensure that they're feeling valued and appreciated for the work that they do,
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  um, and, uh, that they're, you know, interested in staying with Bassett for the,
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  for the entirety of their careers. And that's, that's largely where we have, uh,
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  a tremendous amount of, uh, of focus right now. Um,
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  we've been investing into our people over the course of the past couple of
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  years, certainly since the pandemic has started, uh,
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  we've layered in about $50 million worth of investments into our workforce. And,
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  you know, we, we, uh, uh, very, um,
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  happily employ over 4,500 people across the health system. Uh, and, you know,
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  those, uh, investments, uh, come in the form of, you know,
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  salary and wage adjustments, other bonus payments that we've put into place,
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  tuition reimbursement programs. We've also, uh,
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  looked at leadership development opportunities, uh, to, to ensure, uh,
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  that there's a, a long-term pipeline of leaders, uh, into the organization. And,
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  um, have, have really, uh, just tried to again,
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  connect with our frontline and our leadership teams to ensure that they're
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  feeling appreciated for the tremendous work that they do. That's, that's,
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  I think our first and single most important strategy is to really hold on to the
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  people that we already have. Um, you know, on the recruitment side, uh, it,
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  it's so challenging because every single healthcare organization is dealing with
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  this right now, and we're all vying and sort of going after the,
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  the same pool of resources. And, uh, it's really about, um, you know,
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  who is gonna be, uh, that employer of choice. And, and, you know, I, I think,
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  uh, that the landscape has really shifted in, in, in workforce,
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  and people are looking for, uh, you know, a,
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  a place that they can connect to from a mission and values perspective, uh,
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  where they can feel fulfilled, uh,
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  both personally and professionally with their new employer. Um,
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  and I think it all goes back to, you know, creating a wonderful, uh, uh,
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  experience for our employees and, um, creating a,
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  an incredible culture that people are proud to be a part of. And, and again,
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  we're investing a lot of time and effort, um, you know, in that regard as well.
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  You know, I think on a, on a broader strategic scale, um, you know,
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  we have to also continue to,
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  to reinvent and re-engineer the care delivery model so that we could also reach
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  broader, uh, pools of, of people resources. And, you know, it it,
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  it goes back to my original thought about, uh, you know,
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  digital and virtual playing a key role into the future. Uh, you know,
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  we very much believe that we're gonna have to evolve, uh, towards a,
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  a virtual first model and, and key specialties and,
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  and really allow patients to access, uh, their care delivery, uh, uh,
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  system, uh, through a virtual means. And that means looking at, yeah. And, uh,
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  APCs and more nurse practitioners, uh,
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  to support virtual care delivery services, uh, looking at, uh,
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  virtual primary care, virtual I c U care, virtual nursing care, uh,
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  and other, uh, digital means, uh,
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  to really create a support structure that's needed for our people,
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  but most importantly for our communities.
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  Absolutely. I love that. And, and definitely that,
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  those two pillars of being able to have the great culture and taking care of the
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  workforce, really investing in them, and then at the same time,
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  making sure you've got those tools, the digital virtual care available.
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  I think that's really, um, so crucial,
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  especially in the rural healthcare setting. Um, from your perspective,
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  when you're looking at the virtual care areas, um,
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  what does it take to stand up a program like that? And, and are there any,
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  I guess,
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  unique considerations for the rural field as you're trying to connect more
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  virtually and really, um, you know, reach out to a,
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  a rural population with the, the virtual care?
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  Yeah. You know, we actually, um, uh, at Bassett we have a, a very solid, uh,
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  information technology, uh, backbone and infrastructure.
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  And we also have the electronic medical record and, um, you know,
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  virtual capabilities already built into, uh, the system. So we are, uh,
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  you know, we're an epic shop and we've been, uh, with Epic for a very long time.
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  There are a number of, of wonderful resources that are readily available to us.
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  Uh, we recently launched a partnership also with, uh, Optum, um,
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  who handles a lot of our information technology systems and has really helped
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  advance us, um, from a cybersecurity perspective and,
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  and other technology means to ensure that we're delivering, uh, the care, uh,
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  in, in a seamless and, and safe fashion for our community. Um,
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  and we've had wonderful clinicians who, over the course of the past, uh,
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  couple of years, particularly throughout the pandemic, have, uh, really, um,
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  gotten accustomed and have adopted, uh, you know,
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  a a virtual platform as part of our care delivery infrastructure as a whole. So,
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  you know, from that vein, we've been very, very pleased and,
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  and very happy with our progress. And, um, you know,
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  we're spending a lot of time right now really trying to understand what, uh,
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  barriers might exist, um, to, to broadband that, that, uh, you know,
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  potentially would get in the way of enabling our patients to access care
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  delivery through a virtual means.
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  So going back to social determinants around broadband access, um, and other,
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  you know,
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  connectivity issues that might exist that we would have to address holistically
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  to ensure that this is a, a valuable, successful strategy. And, you know, I,
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  I'm feeling more and more confident that as we look across the region, um,
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  and as, as new technologies emerge, like cellular and 5G and, and,
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  and satellite and other capabilities like that, that, uh,
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  broadband access will become inevitably, uh, much improved, um, and,
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  and will allow our patients to really be served in,
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  in the way that they need to be served. So I'm very optimistic, um,
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  as we continue to invest in infrastructure and, and, um,
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  partner with other regional and national players to ensure that connectivity,
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  uh, uh, exists for our people, um, that, uh, we will, uh,
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  ultimately be very successful here.
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  That's fantastic to hear. And you know,
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  one of the other things I wanted to ask you about too is value-based care.
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  I know that is something that has been a slow crawl in the healthcare space, um,
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  for the past several years, but really is becoming more crucial as resources,
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  um, in healthcare are diminishing to some degree of both financial challenges as
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  well as, uh, staffing time and, and energy. So from your perspective,
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  what's different about value-based care for rural facilities,
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  and where can rural healthcare providers start, um,
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  when they're thinking about moving more in that direction?
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  Yeah, it's absolutely, it's the right thing to do.
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  I'm a big proponent of value-based care. Um, I, I believe, you know,
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  beyond just the traditional, um, you know,
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  premise of improving quality and safety, uh, and reducing cost, that it's,
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  it's just absolutely the right thing to do for the community and for the
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  patient. You know, really taking a very holistic approach. Uh, you know, uh, uh,
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  creating a focus more on prevention and wellness and,
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  and really driving a long-term, uh, health agenda that's, uh,
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  consistent with our mission is, is the way that, that we want to go.
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  And I think is the way that the entire industry must, uh, really advance, uh,
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  in the very near future. Um, you know, for rural, uh, it's, uh,
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  exponentially more challenging to really get on that pathway. And it's because,
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  uh, you know, we operate on razor thin margins as it is. There's a,
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  a very low risk, uh, appetite across the board, uh,
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  when you're operating on,
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  on such thin margins if you're operating on any margins at all. And, you know,
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  I think the latest statistic is that 600 or so rural hospitals across the
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  country are at risk of closure. So, uh, it's,
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  it's very hard for rural organizations to be dealing with the various different
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  environmental and economic challenges that we're dealing with today. And,
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  um, you know, uh, ponder a value-based agenda, uh, whatsoever.
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  And that's something that I think is gonna require, uh,
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  some governmental intervention and,
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  and really close partnerships and alignments with, uh,
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  other payers across the country to really support, uh,
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  the move in this direction. Um, you know,
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  we are very fortunate in the fact that we have been on the value-based, uh, uh,
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  journey over the course of the past many years. Uh,
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  we operate an accountable care organization here at Bassett, um, you know,
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  with 18,000 lines and growing, uh, we also have partnered with regional payers,
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  uh, to look at, uh, Medicare Advantage and, and other, uh, uh,
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  value-based contracting, uh, opportunities, um,
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  and have performed rather well in, in those areas. Um,
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  and we continue to make investments in infrastructure, um, to ensure that,
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  you know, once we're really ready to turn on, um, you know, risk, uh,
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  on a large scale,
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  that we are resourced and we have the appropriate capabilities, uh,
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  in place to ensure that we can be successful. And that comes in, in,
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  in many forms, whether it's layering in, um, uh, digital, uh,
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  analytics, uh, and population health-based analytics capabilities, uh,
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  making sure that we have the appropriate, uh, case management,
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  care management and patient navigation, uh, opportunities, uh,
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  and infrastructure. We've recently just partnered with a,
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  a company that specializes in integrated continuous monitoring.
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  And essentially what that is, is, is remote patient monitoring,
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  where we're able to, uh, track in real time, uh, patients, uh,
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  physiological data and be able to respond with early interventions if,
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  if needed, and,
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  and to try to keep those patients outta the hospital and keep them at home
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  where, where they wanna be. So we're, um, you know,
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  we're a little bit further along and I think we're very well set up, um,
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  you know, as an organization across this geography to,
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  to really take care o of a very large population, um, that, uh,
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  very much wants to be, uh, kept outta the hospital and kept healthy and well, I.
• 15:25
  Love that. I think that makes so much sense. And,
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  and certainly it's helpful to understand the investment that it takes,
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  not only on the infrastructure side, but also, um,
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  within the culture and the teams that you're working with,
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  and then your partners across the line, whether it's the vendors or the payers,
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  uh, to really get yourself set up and ready to go, um,
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  with the value-based care. And in the aco. Two, from your perspective,
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  when you're having these conversations with especially payers,
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  have they changed much over the last few years? Is there additional urgency,
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  I guess, around them now, or has it really been a continued, uh,
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  kind of evolution o of where these value-based contracts could go?
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  I mean, I think, uh, there's definitely an increasing willingness on,
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  on both sides of the equation to come to the table and align around common
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  objectives. And I think certainly the payers wanna move in that direction and,
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  and we as a health system, as I mentioned,
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  believe that it's the right thing to do. Um, it, it usually is just about,
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  you know, how do we, uh, you know, find a sort of a common platform to,
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  to work on these strategies and these initiatives together. Uh, you know,
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  are there ways to jointly collaborate or potentially even jointly venture, uh,
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  with our payer partners, uh, in, um, uh, you know,
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  making capital infrastructure investments so that we can mutually be successful.
• 16:39
  Um, and, uh, you know, I think moving a little bit away from the traditional,
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  uh, you know, payer provider negotiation, uh, um, you know,
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  uh, discussions to more of a collaborative and, and, um, you know,
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  jointly aligned, um, discussion that, uh, serves a broader purpose.
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  And I'm seeing a lot more, uh, certainly a willingness on,
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  on the health systems part,
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  but also payers to really come together and strategize, uh,
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  for what makes the most sense for our communities. And that's really refreshing.
• 17:09
  Absolutely. I love that. Thank you so much for sharing. Now,
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  before we wrap up our conversation, I was wondering,
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  could you talk through the best opportunities that you're seeing for growth and
• 17:17
  development in the future?
• 17:20
  Yeah, I mean, we're constantly thinking about how we grow our footprint and,
• 17:24
  and reach more lives and, and create a, a, a broader impact across the region.
• 17:28
  Um, you know, we believe, uh, you know,
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  making continued critical investments in ambulatory infrastructure and
• 17:34
  ambulatory services is certainly the way to go.
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  And that's something that we're very interested in. Uh, you know,
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  we're looking at, uh, adjacent communities and, um, trying to identify,
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  uh, areas where we might be seeing out migration or leakage, uh, out of the,
• 17:48
  outta the area. And, and, uh, you know, considering key investments to, uh,
• 17:53
  provide primary care and specialty care services and other ancillary, uh,
• 17:57
  support, uh, services that, uh,
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  would be meaningful and beneficial to the community,
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  and always sort of evaluating that opportunity. Uh, we believe, um,
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  you know, making critical investments in the digital, uh,
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  space is gonna be very important to ensure that we're not only reaching, uh,
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  people across our region,
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  but that we're potentially even penetrating broader markets. Uh, you know,
• 18:19
  with the advent of telehealth, uh, we can, uh, we can reach, uh,
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  patients all over the country and we think that that is a exciting growth
• 18:26
  opportunity for the organization as well, that we continue to explore. Uh,
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  we're always looking at, uh, how we partner with other employers, uh,
• 18:33
  across the region and creating those connections.
• 18:36
  And certainly as we continue to evolve, um,
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  the infrastructure that I mentioned around our population and, and value-based,
• 18:43
  um, health initiatives, uh, continuing to make those investments and,
• 18:47
  and broadening our value-based risk contracts, um, will ultimately create,
• 18:52
  uh, you know, uh,
• 18:53
  a longer term growth for the organization that we're very excited about. So, uh,
• 18:57
  without divulging too much information, we have a lot going on,
• 19:00
  and we're very excited about the future here at Bassett.
• 19:04
  Absolutely. Fantastic. Well, it sounds like you know,
• 19:06
  a future is definitely bright there at Bassett, and,
• 19:08
  and looking forward to catching up with you, um,
• 19:10
  down the road here and just seeing how this has all played out. So Tommy,
• 19:15
  thank you so much for joining us on the podcast today.
• 19:17
  This has been a really fun and insightful conversation,
• 19:19
  and I look forward to connecting with you again soon.
• 19:22
  I'm honored to have been on. Thank you so much, Lori.
• 19:29
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