Latest / Becker’s Healthcare Podcast / Dr. Sandra Scott, Chief Executive Officer of One Brooklyn Health

Transcript

Dr. Sandra Scott, Chief Executive Officer of One Brooklyn Health · Becker’s Healthcare Podcast

0:00
Hello, everyone, and welcome to the Becker's Healthcare
0:02
Podcast. I'm Mackenzie Bean, associate vice president and
0:06
managing editor of Becker's Hospital Review.
0:09
Today, I am so thrilled to be joined
0:11
by doctor Sandra Scott, the CEO of One
0:14
Brooklyn Health in New York City. Doctor Scott,
0:17
thank you so much for joining us on
0:18
the podcast today.
0:20
Well, thank you for having me, and happy
0:21
New Year to you. Happy New Year to
0:23
you. It's hard to believe it's already 2026,
0:26
and we're rocking and rolling.
0:28
I know, you've been on the podcast before,
0:31
doctor Scott. But for any listeners who might
0:32
have missed that episode, I'd love to kick
0:34
things off with a,
0:36
introduction. If you can tell us a little
0:37
bit more about yourself, your leadership background, which
0:40
was pretty
0:41
impressive and trailblazing, and then maybe a little
0:43
bit more about One Brooklyn Health as well.
0:46
Certainly. So,
0:48
I am originally
0:50
from,
0:51
Louisiana, New Orleans, Louisiana, and begin my career
0:55
in health care as an emergency physician.
0:58
I did my training at Boston Medical Center.
1:01
And then after graduating from,
1:05
the residency training,
1:06
I moved to New York City
1:09
and began practicing emergency medicine
1:12
here in Central Brooklyn.
1:14
And then over the ensuing twenty years ago,
1:17
went from a frontline
1:19
emergency physician to a physician leader
1:22
to a hospital leader.
1:24
And in, around May
1:27
2025,
1:27
I was named the CEO of One Brooklyn
1:30
Health.
1:31
And One Brooklyn Health is a small
1:34
safety net health system located in Central Brooklyn.
1:38
So, you know, Brooklyn is a large heavily
1:40
populated borough of New York City.
1:43
We consist of two hospitals.
1:46
We have actually two nursing homes.
1:49
We have a cadre
1:50
of out
1:51
patient practices, both subspecialty
1:54
and primary care practices,
1:56
and then we also have an assisted living
1:58
facility.
1:59
Most of our patients are actually insured by
2:03
Medicaid
2:04
and a smaller number by Medicare, and then
2:06
we have a very, very small population
2:09
of commercial patients. So we're really taking care
2:12
of,
2:13
the patients who are largely insured by government
2:15
insurance.
2:17
And our focus
2:18
is, of course, to uplift the, health outcomes
2:21
of the communities that we that we serve.
2:25
Absolutely. I appreciate
2:26
that overview. I know you have a rich
2:29
history of leadership at One Brooklyn Health prior
2:32
to your
2:33
current role. You were,
2:35
the executive director of Brookdale Hospital Medical Center
2:37
and the first woman for the sharing person
2:39
card to serve in that role in the
2:41
hospital's history.
2:43
I guess looking more specifically over
2:46
the past year in your CEO role,
2:50
what would you say is the most important
2:51
initiative that you've led,
2:54
and what results have you seen so far?
2:57
So
2:58
our health system is actually a relatively new
3:00
health system. I mean, we we've only come
3:03
together,
3:04
in the past, you know, five years or
3:07
so, and I think
3:08
those listeners who participated
3:10
in mergers and acquisitions
3:12
and,
3:13
can understand the complexity of bringing together.
3:16
We actually originally worked three separate institutions that
3:20
came together as one.
3:22
I represent the second CEO of the system.
3:25
And I think the thing that I'm most
3:27
excited about, after being named the the the
3:30
permanent CEO, because I served in the interim
3:32
role for some number of months,
3:35
is that we were actually able to come
3:37
together,
3:38
and create a system
3:41
strategic
3:42
plan, which coincided with so we really started
3:46
that process
3:47
just as HR one,
3:49
was passed.
3:50
And,
3:52
also, the system is participating in a pilot
3:55
global budget initiative.
3:57
And if things remain the same, we anticipate
3:59
in
4:00
2028,
4:01
2027,
4:02
2028, we're going to move to what's called
4:05
a global budget method of reimbursement.
4:08
And that means that about 60% of our
4:11
patient population,
4:12
we will have one,
4:15
dollar amount that we have to manage to
4:18
take care of that population as opposed to,
4:20
like, a fee for service type model. And
4:23
so our
4:24
strategic planning process
4:26
had to take into consideration
4:29
the provisions within HR one that will impact
4:31
our patient population and our reimbursement,
4:34
and we had to take into consideration that
4:36
we have to move more and more towards
4:39
a population health
4:41
driven model. And so I think that exercise
4:44
that two or three things.
4:46
Number one,
4:47
it helped us to really
4:49
double down on the importance of integration
4:52
and that we must function as one Brooklyn
4:55
Health and really break down those, siloed barriers
4:58
that still existed,
5:00
between the the the three campuses that came
5:03
together as one. And then we had to
5:05
collectively face some of the challenges and transitions
5:08
that are taking place that are historical
5:12
in health care in this day and time.
5:14
And so I'm very proud of the fact
5:16
that we were able to collectively go through
5:18
that exercise. It really required
5:20
making some difficult decisions,
5:23
facing some hard realities. I know we'll probably
5:25
talk about some of the headwinds that we're
5:27
all facing in health care these days. And
5:30
so I'm really proud of the fact that
5:31
we were able to
5:33
get through that process.
5:35
And as
5:36
a single health system, it was also the
5:38
first time, in the 2025
5:41
that we did an employee engagement survey. And
5:44
I think that also many leaders that are
5:46
listening to this podcast
5:48
understand the importance of employee engagement
5:52
and having data
5:53
to help drive initiatives to improve engagement is
5:56
is very exciting. So, you know, some,
6:00
really big big steps and,
6:03
big initiatives, a strategic plan. Strategic plans can
6:06
take anywhere from three to six months, so
6:08
we did a really rapid fire intensive strategic
6:11
planning process.
6:13
And then, of course, an employee engagement,
6:16
survey and process is also a big initiative.
6:18
So I'm proud that we did those as
6:20
one Brooklyn Health and are able to use
6:23
both of those,
6:25
processes to help guide our future.
6:28
Absolutely. And and no small feat at all,
6:30
especially considering
6:32
the current complexity
6:33
of the health care landscape and and, you
6:35
know, what's happening on the federal level. As
6:37
you mentioned, HR one proving to have some
6:40
significant financial and operational impacts on hospitals.
6:43
Let's talk about those headwinds a bit now.
6:46
You know, what does the next year look
6:49
like for you in terms of the strategic
6:51
plan and thinking through a lot of the
6:52
big priorities for your system and these headwinds
6:54
that health systems across the country are facing?
6:58
So I'll start off with population health management.
7:01
I mean, historically,
7:02
in health care,
7:04
we tended to think about the individual patient
7:07
and the individual patient needs.
7:09
What the value based purchasing,
7:13
and really valuing
7:14
quality at a global level
7:17
is doing within health care is encouraging us
7:19
to really think about populations.
7:22
So what I mean by that, for example,
7:24
you might think about the diabetic population that
7:27
you're serving. Alright? And what kind of navigators,
7:31
technology,
7:32
changes in access
7:34
can we put in place
7:36
so that the health outcomes of the population
7:39
are lifted up. Right? And so in order
7:41
for health systems to be able to do
7:43
that, you have to have data
7:46
to tell you the direction that your population
7:48
is going. So not just the, for example,
7:50
hemoglobin
7:51
a one c of a particular patient,
7:54
but looking at the
7:56
compliance and hemoglobin a one c, which is
8:00
a a test that we use to measure
8:01
blood sugar management,
8:03
but you would look at that that test
8:06
across the entire population
8:08
and judge your performance based on how are
8:10
you improving the outcomes for that total population.
8:14
So for the communities that we serve, high
8:16
blood pressure management is a major challenge.
8:20
I've mentioned diabetes is a major challenge,
8:22
heart failure,
8:24
obesity,
8:25
asthma.
8:26
So rather than, you know, being focused on
8:29
individual patients and practices,
8:31
changing our platforms
8:33
so that we can actually communicate with our
8:35
providers,
8:37
both nursing and physicians,
8:38
how we're doing for the entire population that
8:41
we serve. So that's number one.
8:44
And then, of course, I'm sure that your
8:46
listeners are very attuned to some of the
8:48
challenges with, health care coverage,
8:52
and and some of the changes with the,
8:54
Affordable Care Act. So we know that in
8:57
New York state,
8:59
a large number of patients will lose access
9:01
to health insurance.
9:03
And that means when people do not have
9:06
access to health insurance,
9:08
then they're not likely to keep their primary
9:10
care appointments, and they're more likely to access
9:13
health care through the emergency department.
9:15
So we have to think about how do
9:17
we
9:18
create processes,
9:20
for those that who are either underinsured
9:23
or uninsured
9:24
to help them remain connected to care so
9:27
that we are still able to take care
9:29
of them when they're, you know, in their
9:30
preventive health stages or early in their disease
9:34
states and not wait until it's quite frankly
9:36
too late.
9:38
Mhmm.
9:39
I'm curious,
9:40
you know, as you're preparing for this potential
9:43
increase in uninsured and underinsured
9:45
patients,
9:46
you know, can you elaborate a bit on
9:48
what your response will look like there? And
9:50
and does this almost change, like, how you
9:52
think about population health and who really owns
9:55
that effort across the system?
9:57
Well, I would say, you know, in my
10:00
humble opinion, I believe that health care systems
10:03
have a responsibility.
10:04
I believe that community based organizations have a
10:07
responsibility,
10:09
and I also believe that insurers have a
10:11
responsibility.
10:12
Right? So some of the barriers, for example,
10:15
are,
10:16
work requirements.
10:18
Right? So patients who are required to work
10:21
to maintain their Medicaid coverage
10:23
have to go through a number of hurdles
10:25
to be able to demonstrate that they're actually
10:28
working.
10:29
And so I think, you know, for people
10:30
who enter the healthcare system,
10:32
we should be able to recognize when they're
10:35
at risk for losing their health coverage and
10:37
then provide them with resources
10:39
to get over those hurdles to document that
10:42
they are indeed working and qualify to receive
10:44
Medicaid.
10:45
If they're in the community,
10:47
I think it's important that those community based
10:50
based,
10:51
organizations that they're,
10:52
in contact with also have the resources to
10:55
assist.
10:56
And then also
10:57
the health insurance companies
10:59
should be readily available to help people get
11:03
over the barriers that might prevent them from
11:05
remaining insured.
11:06
So I I don't, you know, I think
11:08
we are a part of the solution,
11:10
but,
11:11
more than ever,
11:13
health systems must work in collaboration with community
11:16
based organizations and our insurers to help people
11:19
remain, insured.
11:21
Mhmm.
11:22
And so much of that visibility into patients
11:25
at risk of, you know, potential health outcomes
11:27
or losing their coverage, like you said, are
11:29
tied to the data piece. Can you elaborate
11:31
just a bit more on what you're doing
11:34
there to help drive population health efforts forward?
11:37
Well, we're actually an epic shop.
11:40
So our electronic health system, we're on one
11:43
instance of Epic across the entire system.
11:46
And we're even,
11:48
actively implementing,
11:50
Epic in our long term care platform
11:52
so that whether the patient's in ambulatory care,
11:56
long term care, or nursing home, or in
11:58
our acute care business,
12:00
they're all on one
12:02
platform of EPIC. And so that allows us
12:05
to be able to capitalize
12:07
on,
12:08
using, some of the population health management
12:12
resources that Epic has available to us.
12:15
And so that's the direction we're going. It
12:17
just it's the easiest
12:19
software for us since we're already on Epic
12:21
and they have some very,
12:23
outstanding tools to be able to manage population
12:25
health. But for those health systems that are
12:28
not on an Epic platform,
12:30
there are many other,
12:33
tools and other applications that one can use
12:35
to be able to monitor the health outcomes
12:38
of of of large sets of of of
12:40
patients within a given population.
12:43
Mhmm. So we spend a lot of our
12:46
conversation looking at some of the headwinds coming
12:48
for 2026
12:50
and your action plans there. I'd love to
12:53
flip that now and talk about the opportunities.
12:55
I'm curious, where do you see the best
12:57
opportunities for growth for One Brooklyn Health in
13:00
2026?
13:01
And maybe what does growth really mean to
13:03
you this year?
13:05
Well, I'm gonna say two things. I think
13:08
that,
13:09
you know, artificial
13:11
intelligence is incredibly
13:13
exciting.
13:14
It gives us an opportunity
13:16
to use technology
13:18
to
13:19
help create better access to care.
13:22
We talked about data mining, and you can
13:24
imagine,
13:25
even within Epic, there are some AI tools
13:27
that help you to
13:29
mine the data. So for example, if a
13:31
frontline physician
13:32
wanted to look at all of the diabetics
13:34
in their practice,
13:36
There are some tools within Epic that allow
13:38
them to, with the assistance of AI, more
13:41
easily do that data mining.
13:43
Before you had to have some very specific
13:45
skills and know how to search through the
13:48
record. And now it's kind of like, you
13:50
know, some
13:51
of the AI tools that are in our
13:53
browsers. Right? You can say where, you know,
13:56
where are the patients,
13:57
located that are diabetics in my community, and
14:00
you'll get a ZIP code analysis.
14:02
So I think,
14:03
both in terms of data
14:06
utilization,
14:07
AI tools are exciting.
14:09
We're also looking at using AI tools to
14:12
just help with, within the clinical processes. So
14:15
we're looking we're actually I think it's next
14:18
week, next Monday,
14:19
we start the implementation of an AI tool
14:23
that actually helps us to monitor patients in
14:25
their room
14:26
to help prevent falls
14:29
and to prevent,
14:30
bed sores, for example. So that's really exciting
14:33
for me, the the the use of AI
14:36
tools
14:37
safely and effectively
14:39
to expand access and to improve our, improve
14:43
our clinical processes.
14:45
In terms of growth,
14:47
I think, you know,
14:49
ambulatory care is where it's at. So where
14:52
we,
14:53
are seated in Central Brooklyn, there are a
14:55
number of patients who actually don't have access
14:57
to care and they're not actually utilizing health
15:00
care. And sometimes we see them show up
15:02
in our emergency departments with end stage cancer,
15:05
you know, end stage heart disease
15:08
and so one of the things that's top
15:10
of mind for me in One Brooklyn Health
15:12
is to get people engaged in care who
15:15
are not currently currently seeking health care. And
15:18
that is a way that we can improve
15:20
the health outcomes of the community, but also
15:22
increase the number of of patients that we're
15:25
actually serving.
15:26
And what does that look like in practice
15:28
to boost that patient engagement and and meet
15:30
them where they are at outside of
15:33
the four walls of the hospital? So I'm
15:34
a big believer of navigators
15:36
and community health workers,
15:38
and we've recently,
15:40
done some reorganization
15:42
with our c suite and our leadership team
15:45
to actually identify
15:47
an individual,
15:48
who's committed to,
15:50
community health
15:51
and give her the resources and the support
15:54
to expand the community health worker or navigator
15:57
role,
15:58
because we know that many people have difficulty
16:02
just navigating the health system, right, how you
16:04
get an appointment.
16:05
Sometimes you need a referral before you can
16:07
see a specialist. Sometimes you have to have
16:10
radiology tests and blood tests before you go
16:12
to the specialist.
16:13
And for some patients, it's really difficult to
16:16
make those appointments and keep those appointments and
16:19
navigate the healthcare system on their own.
16:22
So I think that's one of the keys
16:24
to being able to get patients,
16:27
engaged with care is to help them have
16:30
the resources
16:31
to overcome some of the social
16:33
barriers to care. We also have something that's
16:36
called One Brooklyn Health or OBH at your
16:39
door,
16:40
and we actually send
16:42
our staff out into the community and to
16:46
nursing homes, schools, community events, health fairs to
16:50
actually provide health education
16:53
and try to, you know, encourage people to
16:56
get engaged with care.
16:58
Wonderful. Well, doctor Scott, I appreciate you sharing
17:00
a bit more about your strategic
17:03
focuses for 2026,
17:06
and, how you're tackling some of the headwinds
17:08
coming your way at One Brooklyn Health.
17:11
Let me turn it to you one last
17:12
time. Are there any final thoughts you'd like
17:13
to share,
17:14
or things you're thinking about heading into 2026?
17:17
Well, I mean, I I think for those
17:20
health care leaders that are listening, this these
17:22
are unprecedented
17:23
times in in health care.
17:26
And I really would encourage people to I
17:29
mean, it can feel very daunting and
17:31
and like a doom and gloom situation,
17:34
but I think this is a time where
17:36
we can reimagine
17:38
how we deliver care, reimagine how we engage
17:41
with the community and collaborate with the community
17:44
to uplift the outcomes of the of the
17:47
populations that we serve. So I would encourage
17:49
people. I mean, I I know that some
17:52
of the news feels like bad news and
17:54
daunting news, but I think this is also
17:56
an exciting time in health care given all
17:58
of the advances in technology
18:01
and that the stress is going to drive
18:03
us to work more collaboratively
18:05
together
18:06
to uplift the outcomes of of those that
18:08
we serve, and that includes Becker's. I mean,
18:10
I think your,
18:12
platforms and your conferences
18:14
offer an opportunity for for us to work
18:17
together both locally and across the nation. So
18:20
thank you for all that you do to
18:21
help with the transformation of health care. So
18:24
at One Brooklyn Health,
18:26
we say
18:27
our tagline is a healthier you starts here.
18:30
And, you know, that's really to help people
18:33
connect to
18:34
that we are part of their health care
18:37
journey.
18:38
And so, you know, I think that's just
18:39
a perfect way for us to let our
18:41
communities know that a healthier you starts here
18:44
at One Brooklyn Health. So doctor Scott, thank
18:47
you again so much for joining the podcast
18:48
and and sharing your perspective here. I so
18:51
appreciate it.
18:52
My pleasure. My pleasure. Thank you so much.
18:54
And once again, have a wonderful 2026.
18:57
Thank you. You as well.