Latest / Becker’s Healthcare Podcast / The Evolution of Healthcare Transactions & the Rise of Ambulatory Care with Eric Tower

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The Evolution of Healthcare Transactions & the Rise of Ambulatory Care with Eric Tower · Becker’s Healthcare Podcast

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  This is Scott Becker with the Beckers Health
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  Care podcast.
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  I'm thrilled today to be joined by a
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  lawyer and health care leader,
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  that I've long respected.
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  We're joined today by Eric Tower. Eric is
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  a partner at Blank Rome, a great law
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  firm, and I think practices largely in the
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  health care transactional and regulatory area, but he'll
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  tell us more.
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  Eric, I met you a long time ago.
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  Can you take a moment and introduce yourself
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  and tell the audience what you do?
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  Sure.
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  Well, going back, years ago, I started up
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  working in health law after getting my LLM
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  at Loyola University in Chicago.
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  Worked on the East Coast in Washington, DC
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  with a with a couple of law firms
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  doing what was then called for profit health
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  care.
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  We didn't have the distinction with private equity
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  and venture capital and all that other good
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  stuff. You either fell in with the health
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  systems or you did the for profit.
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  And that was a lot of,
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  roll up acquisition work,
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  typically in the ambulatory space.
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  Eventually, I got a call from Advocate Healthcare,
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  and I ended up going in house there
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  and being responsible,
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  for their medical group,
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  a lot of their ambulatory operations and their
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  transactions.
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  You know, at that point, Advocate,
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  you know, had a couple 100 physicians.
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  By the time I left, we grew that
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  to close to 2,000,
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  and we went from doing small acquisitions
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  to mergers with entire health systems.
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  Since then, I've gone back to a law
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  firm,
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  and I practice in,
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  health care transactions. I do some work with
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  health systems,
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  do a fair amount of work on the
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  ambulatory side,
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  and I also do a lot of work,
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  you know, kinda bringing the two together as
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  it were,
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  which is really a lot of fun,
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  as health care has continued to evolve.
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  Well, fantastic.
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  And and talk a little bit about what
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  are the most interesting
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  deals
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  or things that you're working on now that
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  you're seeing now? Tell us a little bit
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  about what you're watching and what's interesting.
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  What what's really interesting to me right now
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  is the way everything is rapidly evolving on
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  the ambulatory
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  side of things.
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  So as you will remember, you go back
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  a few years and the health care system
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  was very fragmented and everyone had their own
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  peace.
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  And they would do everything they could within
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  their peace. And then
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  when the patient needed something else, it wasn't
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  their responsibility anymore and out the door they
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  went.
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  What you're seeing now is a lot of
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  conflation
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  between
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  the historic pieces and and people use the
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  term pay viders
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  and,
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  you know, there there's this thing called site
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  neutral payments.
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  So hospitals traditionally got more money if they
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  cared for someone within the hospital
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  than an ambulatory provider did, and that's all
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  starting to go away. There's a lot of
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  pressure to
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  treat patients close to home, give them high
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  quality care,
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  and do it in a cost effective manner.
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  And a lot of times, that's not going
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  to be within the walls
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  of a hospital.
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  And that's resulting in a lot of change.
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  Hospitals are realizing they can't be all things
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  to all people.
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  And you have a lot of new new
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  entrants in the field.
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  But by the same token, you also need
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  to care for people within the existing frameworks,
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  and that's resulting in a lot of fun
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  and interesting transactions,
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  to be honest.
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  That that's really I think it's just starting
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  to be honest, and we're gonna see a
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  lot more movement there,
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  as well as, frankly, a lot more scrutiny
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  as people try to figure out what does
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  this all mean.
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  So it's really an exciting time to practice
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  in the field.
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  Truly, truly fascinating.
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  You you went to four incredible institutions.
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  You you went to one of them that's
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  not gonna be known maybe nationally by your
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  audience, but a fantastic institution.
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  You you were at Saint Ignatius,
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  one of the great high schools in our
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  area,
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  Northwestern,
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  obviously great college, University of Wisconsin,
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  fantastic big 10 institution
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  that that I'm a huge fan of. You
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  also did the LLM at Loyola, one of
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  the best LLM programs in the nation. And
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  and I'm gonna ask you, and I'm not
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  just sort of,
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  stacking all these schools up for for no
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  reason. I'm gonna ask you,
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  what's the best and worst to them? You
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  don't have to answer that. But if not,
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  which one did you enjoy, and where did
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  you grow the most?
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  Sure. Well,
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  at saint ignatius,
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  I I read a book by herman hass,
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  called Siddhartha, and it was, you know, basically,
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  it's about the journey of life
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  and the fact that you go through and
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  you gain new insights,
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  you know, everywhere you go.
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  And that book has stuck with me and
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  I I actually try to apply it all
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  the time in in being reflective on my
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  life.
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  I I think my takeaway from that book
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  is I can't call out any one single
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  one of those colleges or where educational institutions
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  as being dispositive. It's more a layering process.
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  If you were to look at what the
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  prime mover was, you know, it would be
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  Saint Ignatius,
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  but I got a lot out of every
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  one of those schools.
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  And I think,
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  you know, I'm still trying to evolve even
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  independent of those schools, so I I couldn't
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  segregate anyone out. But but, again, it started
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  at Saint Ignatius.
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  No. And I and I love that. And
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  those are all great institutions that I'm huge
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  fans of each of them. Now I live
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  not that far from Northwestern. So even though
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  I didn't go to Northwestern,
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  I grew up cheering and love Northwestern sports.
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  I learned one of my great lessons in
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  talent in sports from Gary Barnett.
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  And and this is a lesson I learned
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  again with Bill Self that when a coach
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  says
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  to the media and to the team, I
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  am never leaving,
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  what that really means is that they're negotiating
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  and leaving soon.
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  And Gary Barnett, who led Northwestern to the
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  Rose Bowl, which was a once in a
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  lifetime thing if you're a Chicagoan,
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  gave this
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  lecture to the press to everybody. I am
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  never leaving Northwestern,
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  and I was like, oh my god. That's
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  so great. He's staying. And then the next
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  week, he announced he's going to University of
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  Colorado, and it was a life lesson learned
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  that when a coach says that, that means
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  they are actually leaving and negotiating. It was
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  really really a fascinating I I truly an
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  experience for me. But so so tell us
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  about
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  you're doing so many interesting things. Great career.
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  I'm gonna ask you two more questions. First,
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  what are you most focused on and excited
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  about currently? Where are you most focused and
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  excited currently?
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  Yeah. I I'm really enjoying doing some of
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  the work,
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  helping these new entrants and and helping the
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  health systems,
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  you know,
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  evolve. So
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  the payment systems are changing.
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  People are saying we can't continue doing what
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  we've done before. And there's a lot of
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  really great partnership that's starting to take place,
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  and a lot of people who are who
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  are starting to provide care outside of the
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  box. I mean, I think some of that
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  started with the infamous
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  pay viders,
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  but you're starting to see people who they're
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  not all things to all people, but they're
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  expanding outwards, and they're coming up with new
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  ways to relate, and and that's a lot
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  of fun. It's a challenge too because people
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  are then doing stuff outside of their immediate
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  comfort zone.
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  But as a lawyer, it's it's very exciting.
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  No. I think that I think that's right.
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  And you've had this great career. I remember
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  meeting when you were advocate.
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  You were always just a a terrific leader
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  and person.
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  Sadly, never did enough business with my law
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  firm, but still a fantastic leader and person
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  who I always had really tremendous respect for
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  as a really good, good person and a
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  great lawyer.
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  Talk about you've had this great career where
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  you were
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  outside private practice,
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  then in house for a long time, now
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  back to private practice.
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  What what advice would you give to emerging
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  leaders or people trying to have meaningful careers
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  or great careers?
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  Well, since I mentioned literature a little bit
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  before,
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  I'll go back and mention something else. There
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  was a book I read
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  actually at northwestern
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  called the clown by einrich wool and it
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  starts off, you know, I'm a clown a
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  collector of moments
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  And I think one of the things that's
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  been the most fun is having exposure to
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  a lot of different,
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  a lot of different insightful leaders myself
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  and
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  a lot of different situations.
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  And
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  I try to take something away from from
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  everything every day
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  that I can. And it's funny how some
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  of those situations,
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  you know, you think in the moment, well,
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  it's a one off and it's never gonna
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  come up. But then in the future, you
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  end up drawing on some insight from that
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  where you would never expect it. I kind
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  of draw an analogy to youth sports
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  and if you really want to develop
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  a talented athlete nowadays,
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  they say it's best to be a multi
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  sport athlete because there are different skills
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  and they're not readily apparent, but over time
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  it helps develop you. So I draw on
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  that and I think, well, there are all
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  these moments.
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  There was the time someone walked into my
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  office
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  and clinical integration
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  kind of came to be,
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  which is now a big part of value
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  based care.
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  It was just a one off moment.
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  Some of the various transactions that I worked
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  on
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  that just were
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  crazy one offs,
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  But the approaches, the methods, the psychology,
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  which is a huge part of doing any
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  transaction,
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  all become really important, and you just carry
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  that with you. So if you're developing,
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  you've got to keep an open mind and
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  then just reflect a bit, I think. I
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  I I I love that. And and give
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  me again
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  I've got the second one, the clown.
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  The the title or the first book that
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  you referenced that you read while at Saint
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  Saint Ignatius?
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  Herman Hess Siddartha.
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  Eric, you you've built this great career. You're
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  an absolute pleasure to visit with
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  any colleagues or clients that you work with
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  that send out to you as doing great
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  work or or that have been great mentors
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  to you anybody that you'd like to give
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  a shout out to as long as you're
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  on the podcast?
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  Wow. Well, that's a that's a really long
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  list, you know, I'll mention someone who I
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  think many listeners would know and that would
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  be lee sax
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  Jim dan is a tremendous leader.
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  Take a second on lee sax because lee
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  people don't realize this back when advocate was
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  just advocate chicago
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  Lee was sort of the architect of a
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  lot of their physician growth strategy.
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  And a lot of people don't know doctor
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  Lisak, at least of now now,
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  you know, twenty years later, when from when
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  he was really, really driving that. Talk a
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  little bit about the the the talents of
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  Lee and what he did, if you don't
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  mind. Well, I think that
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  what Lee did, frankly, was revolutionary in the
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  time, and I talked about how everything was
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  fragmented.
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  And we came up with the idea that
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  we should
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  integrate
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  hospitals and Physicians and that was really the
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  first step.
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  Towards, you know, what is today value based
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  care
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  and then eventually his Insight was well,
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  you know we should go beyond that and
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  we should
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  take
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  responsibility for the totality of care of the
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  patient
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  and you know there are others obviously who've
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  who've done a lot of work in that
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  But I give Lee credit because he's the
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  one who actually was on the ground and
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  he implemented that
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  and he executed on him. And then there
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  are a number of other leaders
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  who worked with him. I mean, there's Mike
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  Engelhardt, Rishi Sika.
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  There are people all across the country right
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  now
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  who, you know, are revolutionizing
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  health care because of that.
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  And those are some really great leaders as
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  well that you just mentioned. That's fascinating. It
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  all comes out of that that tree. It's
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  almost like a Bill Belichick, Nick Saban tree
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  of leaders that have developed under them. I
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  know Rishi just is a brilliant, brilliant person,
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  and, and Engelhardt is as well. Those are
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  really good, good people.
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  Fascinating. And I I I apologize for putting
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  you on the spot there because I didn't
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  prep you to think about that. I know
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  it's always a pressure pull situation, so
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  bear with us. But I I I I
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  love always hearing
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  the name of Lee Sachs and what doctor
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  Sachs did because it it was really remarkable.
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  And not just the slots and the execution,
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  but the people skills and the bringing people
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  together skills, an unusually
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  talented leader.
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  Yeah. I think,
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  well, so much
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  that's happened at American healthcare draws back to
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  him even you know the Affordable Care Act
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  his testimony helped
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  with the creation of the idea of
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  clinical integration value based care population health care
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  whatever you want to call it you know,
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  that was
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  academic,
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  you know, at least from my perspective until
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  he actually
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  created the mechanisms to do that and frankly
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  advocate today
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  has grown
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  based upon the principles that you expounded. It
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  was
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  core to the to the transaction strategy
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  was being able to provide that continuum of
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  care and that was really,
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  unique and revolutionary at the time.
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  No. Literally remarkable. I I wanna thank you,
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  Eric. It's great to get a chance to
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  visit with you again. It's it's an amazing
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  breadth of of person that you'll have and
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  intellect that you'll have. It's really a pleasure
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  for me to get to visit with you.
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  Thank you so much for, joining us today,
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  on on the Becker's Healthcare podcast. Just fantastic.
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  Again, Eric Tower,
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  long term leader, advocate,
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  now
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  partner lawyer at Blank Rome, great health care
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  law firm, and a terrific person. Eric, thank
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  you for making the time with us today.
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  I'm flattered to be on here.