Latest / Becker’s Healthcare Podcast / Sutter North’s Growth and the Future of Value-Based Care with Dr. Steven Blair

Transcript

Sutter North’s Growth and the Future of Value-Based Care with Dr. Steven Blair · Becker’s Healthcare Podcast

• 0:02
  - The strategic agenda facing hospital and health system
• 0:04
  - leaders right now is not a short list.
• 0:07
  - Growth in a consolidating market, sustainable margins in
• 0:09
  - a reimbursement environment that rarely moves in your
• 0:12
  - favor,
• 0:12
  - a tech investment cycle that demands both urgency
• 0:15
  - and discipline,
• 0:16
  - and a workforce story that is still being
• 0:19
  - written.
• 0:20
  - Eker's fourteenth annual CEO CFO roundtable brings together
• 0:23
  - more than 1,500 executive level attendees and nearly
• 0:27
  - 400 speakers across four days of sessions that
• 0:30
  - are designed to help c suite leaders benchmark,
• 0:32
  - pressure test, and sharpen their priorities.
• 0:35
  - Not in the abstract, but against the real
• 0:37
  - decisions they'll face heading into the next year.
• 0:39
  - It's the kind of event you leave with
• 0:40
  - a clear sense of where you stand and
• 0:42
  - what comes next.
• 0:44
  - So join us November second through the fifth
• 0:46
  - at the Hyatt Regency in Chicago,
• 0:48
  - and come ready to do the hard thinking.
• 0:50
  - Register on our events page at beckershospitalreview.com
• 0:54
  - by clicking on the events tab in the
• 0:56
  - upper right.
• 0:58
  - This is Laura Dierda with the Becker's Healthcare
• 1:00
  - podcast. I'm thrilled today to be joined by
• 1:02
  - doctor Steven Blair, president and chief executive officer
• 1:04
  - of Sutter North Medical Group. Doctor Blair, it's
• 1:07
  - a pleasure to have you on the podcast
• 1:08
  - today. No. It's great to be here. Thanks.
• 1:11
  - Absolutely. Now I'm excited for our conversation. I
• 1:13
  - know we're gonna talk a little bit about
• 1:14
  - some of the cool things you're doing right
• 1:16
  - now and then dig into your perspective on
• 1:18
  - the future as well. But before we dive
• 1:19
  - in, can you tell us a little bit
• 1:20
  - more about yourself and your background?
• 1:22
  - Yeah. So, so by by training, I'm a
• 1:24
  - family medicine, physician. You know, I'm
• 1:27
  - the group president for one of there's actually
• 1:30
  - eight groups in the Southern Health System.
• 1:32
  - And, so North is,
• 1:33
  - one of the smaller groups, and we have,
• 1:36
  - hundred and thirty hundred and thirty clinicians.
• 1:38
  - It's a,
• 1:40
  - it's a, multi specialty group.
• 1:42
  - We're located, I don't know, about forty five
• 1:43
  - minutes north of Sacramento. So we do, sit
• 1:46
  - in kind of a situation where we're probably
• 1:48
  - I would consider us
• 1:50
  - you know, a little more rural, not, extremely
• 1:52
  - rural, but a little more rural than, a
• 1:53
  - lot of the rest of the footprint within
• 1:55
  - Sutter. But, yeah, it's it's a great place
• 1:57
  - to work. I've been, I guess, I've been
• 1:58
  - in charge of the group since
• 2:00
  - 2020,
• 2:02
  - during COVID, and,
• 2:03
  - been in the been in the area since,
• 2:05
  - 2000. So I worked as a solo physician,
• 2:08
  - small group physician, and then joined Sutter and
• 2:09
  - then now lead the group. So,
• 2:12
  - but, yeah, it's it's a pleasure to be
• 2:13
  - in there, and it's a it's a nice
• 2:15
  - opportunity to still practice clinical medicine as well
• 2:17
  - as,
• 2:18
  - spend some time in that leadership role.
• 2:21
  - That's great to hear. And, you know, being
• 2:22
  - able to, have that,
• 2:24
  - double role in being the clinical side as
• 2:26
  - well as leadership, it really gives you a
• 2:28
  - great, vision and ability to impact,
• 2:31
  - how health care is transforming and changing within
• 2:34
  - the organization. So that's really great to hear.
• 2:36
  - Now could you give us a quick state
• 2:37
  - of the union for Sutter North Medical Group?
• 2:40
  - What's going well this year, and what are
• 2:41
  - you focused on for the rest of 2026?
• 2:44
  - So for Center North, it's, it's been an
• 2:46
  - it's been a great opportunity the last few
• 2:47
  - years working with,
• 2:49
  - Sutter Health and, the growth, since Warner, took
• 2:52
  - over the helm of Sutter Health. I think
• 2:54
  - we've grown probably
• 2:56
  - somewhere between 25%
• 2:59
  - or so
• 3:00
  - in clinicians. And, so primary care has grown.
• 3:02
  - We've grown some specialty care.
• 3:04
  - We serve basically, the population we have is
• 3:08
  - well, the catchment area is probably a couple
• 3:09
  - 100,000, but, the local population has doubled over
• 3:13
  - the last twenty years. But,
• 3:15
  - I would say that we we serve probably,
• 3:17
  - and we have panel probably about 50% of
• 3:20
  - the population in our area in Yuba City
• 3:22
  - and,
• 3:23
  - the surrounding area, which is a it's a
• 3:24
  - great afternoon. Being in the clinical side, it's
• 3:26
  - nice to hear from the patients
• 3:28
  - exactly what their experiences are when they
• 3:31
  - get our facility. So I would say the
• 3:33
  - state union's been great. We've grown.
• 3:36
  - I can say that, you know, revenues are
• 3:37
  - up and,
• 3:39
  - the financial picture and, the ability to lead
• 3:41
  - a group is, much more
• 3:44
  - much easier, when you're in the situation we're
• 3:46
  - in with all the growth that you've seen
• 3:47
  - and you've heard about with Sutter Health. We've,
• 3:49
  - grown into value based care network.
• 3:52
  - I think that's some of the things that,
• 3:53
  - Sutter Health is moving forward with, and I
• 3:55
  - think, it's nice to be able to, even
• 3:57
  - in the rural population,
• 3:59
  - still perform and still,
• 4:02
  - be a participant in that in that value
• 4:03
  - based care. I think that really is the
• 4:06
  - the future for us as value based care.
• 4:08
  - As you know, there's been some changes at
• 4:10
  - the federal level with regards to,
• 4:12
  - Medicaid,
• 4:14
  - in our case, Medi Cal, but Medicaid funding
• 4:16
  - as well as Medicare funding.
• 4:18
  - With those changes, I think the only way
• 4:19
  - that we can continue to grow and deliver
• 4:21
  - what we wanna deliver to the patients is
• 4:22
  - really through value based, care approaches.
• 4:26
  - Got it. That makes a ton of sense.
• 4:28
  - You know? I I love that. I think
• 4:29
  - looking at your growth over the last few
• 4:31
  - years, obviously, is really impressive, not only with
• 4:34
  - the physicians you've been able to bring into
• 4:36
  - the network, but I I can imagine too
• 4:38
  - with just providing more services and expanding access
• 4:41
  - to care. And then,
• 4:42
  - you know, looking at all of the different
• 4:44
  - ways that that has helped grow the program
• 4:46
  - and then from your perspective too and thinking
• 4:48
  - about value based care.
• 4:50
  - You know, I am curious. How do you
• 4:52
  - work with the team, to really make that
• 4:54
  - a reality? I know it can be a
• 4:55
  - big change and something we've been talking about
• 4:57
  - in health care for so long. So what
• 4:59
  - is actually making that a reality today? And
• 5:02
  - I I'm just curious on how you're thinking
• 5:03
  - about that.
• 5:05
  - I think and so and maybe this is
• 5:07
  - a little bit of a luxury of being
• 5:08
  - a smaller group. I think that,
• 5:11
  - one, I had I definitely know everybody in
• 5:12
  - the group. It's it's small enough for me
• 5:14
  - to know everybody.
• 5:16
  - I think that, there's a very close knit
• 5:18
  - network and ability to communicate within the group.
• 5:20
  - So I think our ability to really push
• 5:23
  - towards improvement and things like patient satisfaction is
• 5:26
  - is,
• 5:27
  - I don't wanna say it's easy, but it's
• 5:28
  - definitely,
• 5:29
  - much more manageable.
• 5:31
  - I think that,
• 5:32
  - we're able to communicate well with people as
• 5:34
  - far as,
• 5:36
  - you know, what are the how are they
• 5:37
  - doing in the metrics for value based care,
• 5:38
  - which, you know,
• 5:40
  - we look at different measures. But, you know,
• 5:41
  - we do well in hypertension. We do we
• 5:43
  - do we do well in diabetes.
• 5:45
  - We do well in other population health. We've
• 5:47
  - had the benefit of having Sutter Brain Sutter
• 5:50
  - Sync, which is
• 5:51
  - an opportunity to help us with our you
• 5:53
  - know, it's gonna help with our heart failure
• 5:54
  - program as well as our hypertension program,
• 5:57
  - eventually adding in diabetes. And it's it's basically
• 5:59
  - it's a remote
• 6:01
  - remote monitoring and remote, treatment. And, you know,
• 6:03
  - there's a group of pharmacists involved
• 6:05
  - that helps take some of the burden off
• 6:07
  - of our primary care.
• 6:08
  - I think the other key for us,
• 6:11
  - is that we are about
• 6:13
  - I would say we're probably 30%.
• 6:16
  - Maybe just a third is easier to say.
• 6:18
  - Thirty, thirty three percent,
• 6:19
  - primary care overall.
• 6:21
  - We've we've done a lot of things to
• 6:24
  - change primary care. We've worked a lot on
• 6:25
  - in basket, the workload on the physician so
• 6:27
  - that they can focus on some of these
• 6:29
  - things.
• 6:30
  - We've done a lot
• 6:31
  - at a local level with trying to work
• 6:33
  - with the referral system.
• 6:35
  - And, you know, we do tend to be
• 6:36
  - a place where a lot of,
• 6:38
  - initial pilots and etcetera do take place. So
• 6:40
  - it is nice to be in the front
• 6:41
  - line and being having an opportunity to have
• 6:43
  - some input into that. Yeah. And I think,
• 6:45
  - you know, going I mean, what's going forward
• 6:47
  - as far as what we see coming is
• 6:49
  - the ability to bring some other service lines
• 6:51
  - to our area.
• 6:52
  - And, you know, Sutter adopting a service line
• 6:54
  - approach has made it a lot more palatable
• 6:56
  - for us to be able to bring some
• 6:58
  - services to rural communities that probably weren't
• 7:01
  - viable or easily viable maybe five to ten
• 7:04
  - years ago.
• 7:05
  - That makes a lot of sense. And, you
• 7:07
  - know, I really appreciate you digging deeper into
• 7:09
  - that, and talking through how you're thinking about
• 7:11
  - value based care right now.
• 7:13
  - And looking ahead, what are some of the
• 7:15
  - headwinds that you are keeping an eye out
• 7:17
  - for and planning around?
• 7:19
  - Yeah. I think I think the biggest problem
• 7:21
  - is for us, is gonna
• 7:23
  - be growth. I mean, we tend to be
• 7:25
  - in an area, I would say,
• 7:27
  - because, you know, as much as, much as
• 7:29
  - it's just a matter of, you know, where
• 7:30
  - are the patients who need need care, that's,
• 7:32
  - you know, that's part of the equation. The
• 7:34
  - other part of the equation is how do
• 7:35
  - you deliver that care because you've gotta be
• 7:36
  - able to pay for it. In California, as
• 7:38
  - you may know,
• 7:40
  - you know, whether it's Medicare and other areas,
• 7:42
  - the cost of delivery of care is quite
• 7:44
  - high.
• 7:44
  - You know? It is whether that you know,
• 7:46
  - that's, you know, to this to the physicians,
• 7:48
  - through the staff, through the buildings. You know,
• 7:50
  - building a building in California is a lot
• 7:51
  - more expensive than most places.
• 7:53
  - But all those,
• 7:55
  - fixed and
• 7:56
  - non fixed cost of going to delivery of
• 7:58
  - care are much higher here. So we do
• 8:00
  - have to take into consideration
• 8:02
  - how are we gonna manage the population when
• 8:04
  - we get there. And so,
• 8:05
  - you know, the one of the concerns obviously
• 8:07
  - is, you know, the the big bill that
• 8:10
  - passed a year ago,
• 8:11
  - and how that will impact some of rural
• 8:13
  - California.
• 8:14
  - So not too far from us as you
• 8:16
  - go Northeast
• 8:18
  - you know, basically, if you North Northeast or
• 8:20
  - West, you're gonna start to run into populations
• 8:22
  - where
• 8:23
  - the amount of commercial insurance drops dramatically off
• 8:26
  - from, you know, the forties to the twenties.
• 8:29
  - And with that comes, you know, some,
• 8:31
  - some difficulty in how you deliver that care
• 8:33
  - while still maintaining the ability to deliver it
• 8:36
  - in a in a relatively good fashion while
• 8:39
  - being able to afford the staffing and everything
• 8:41
  - else that goes into that care. So there
• 8:43
  - that's probably one of the bigger ones, and
• 8:44
  - I think,
• 8:45
  - I think value based care is a way
• 8:47
  - for us to do that. Yeah. If we
• 8:48
  - can manage to maintain
• 8:50
  - the ability to generate revenues
• 8:53
  - through value based care, then we have the
• 8:55
  - ability to
• 8:57
  - gradually
• 8:57
  - do more and more,
• 9:00
  - care that's, you know, not necessarily
• 9:02
  - doesn't have quite the same margin on it,
• 9:05
  - but is necessary. And and, you know, and
• 9:07
  - and I am proud to be in a
• 9:08
  - group or in a
• 9:10
  - in a system where,
• 9:11
  - and Sutter is well known to have they
• 9:14
  - do deliver a lot of underserved care, a
• 9:17
  - lot of underfunded care,
• 9:18
  - and a lot of, you know, free care.
• 9:20
  - And so I think, that's that's something that
• 9:22
  - we're very proud of at this other system,
• 9:23
  - but I also think that our group is
• 9:25
  - very proud of that.
• 9:27
  - The example in our community, we're the only
• 9:29
  - delivery of,
• 9:30
  - generally of women's health as far as OBGYNs.
• 9:34
  - And so we manage
• 9:35
  - and we deliver about ninety percent of the
• 9:37
  - women's health and deliver about ninety percent of
• 9:38
  - the babies in our area. So it's, it's
• 9:41
  - something that there's a mission to do it,
• 9:42
  - and, we just have to figure out ways
• 9:44
  - to do it. But I think using value
• 9:45
  - based care and some of the other mechanisms
• 9:47
  - to,
• 9:48
  - you know, manage population health will, allow us
• 9:51
  - to do more and more of those things
• 9:53
  - that, we all feel good about.
• 9:55
  - That makes a ton of sense and I
• 9:57
  - think is really important to remember and keep
• 9:59
  - in mind. I know there's a lot of
• 10:00
  - communities with similar situations and trying to figure
• 10:03
  - out how to keep their service lines,
• 10:06
  - running and making sure they can keep those
• 10:08
  - services and access, within their communities and,
• 10:12
  - turning to a variety of different,
• 10:14
  - mechanisms to try to make that work. And
• 10:16
  - so it's interesting to hear what you're doing
• 10:18
  - at Southern and definitely helpful to understand,
• 10:20
  - how you're looking at the future. And I
• 10:22
  - can imagine there's also some areas where you're
• 10:24
  - looking at growth too. Can you talk a
• 10:25
  - little bit more about that? Where are you
• 10:27
  - seeing some opportunities for growth in the next
• 10:28
  - two to three years?
• 10:30
  - Yeah. I mean, I think, one, the the
• 10:32
  - the population where we live is growing. We're
• 10:34
  - in a more affordable area of California, so
• 10:36
  - it is growing. It is not necessarily the
• 10:38
  - fastest growing
• 10:40
  - large city. It's, but of the smaller and
• 10:42
  - moderate cities,
• 10:43
  - some of the communities we live in along
• 10:46
  - the 65 Corridor and 80 Corridor have, significantly
• 10:50
  - grown over the last few years and continue
• 10:51
  - to grow.
• 10:52
  - Obviously, places like the Bay Area and, you
• 10:54
  - know, Southern California, Los Angeles, San Diego, etcetera,
• 10:57
  - you know, those are places where, you know,
• 10:59
  - people have been leaving and moving into,
• 11:01
  - more affordable living in California. Most people don't
• 11:03
  - wanna leave leave California, actually. You'll hear people
• 11:06
  - talk about leaving, but,
• 11:07
  - you know, once you live here, it's, the
• 11:09
  - weather's pretty nice and the life is chilling
• 11:12
  - pretty nice. I mean, it's, but, you know,
• 11:14
  - they're definitely more affordable areas. And so as
• 11:16
  - that happens,
• 11:17
  - we're gonna wanna make make sure we can
• 11:18
  - meet the demand.
• 11:20
  - First, I mean, the the first one's primary
• 11:21
  - care, and then the second one is making
• 11:23
  - sure that we can,
• 11:24
  - manage to either through our own group or
• 11:27
  - through partnering with our,
• 11:29
  - I would say, our sister groups. I guess
• 11:31
  - we would call them, we have Southern Medical
• 11:32
  - Group to the south in Sacramento.
• 11:35
  - And we've we've done some remote partnering with,
• 11:38
  - the group over in the Redwoods and, the
• 11:40
  - Sonoma region,
• 11:42
  - for endocrinology
• 11:43
  - availability. So I think we have to be
• 11:45
  - creative, and we just have to figure out
• 11:46
  - ways to make sure that we deliver the
• 11:48
  - care whether it's virtual or or in person.
• 11:51
  - And, you know, we grow the network. And
• 11:53
  - so part of that network is not just
• 11:55
  - within our group. It's within our system. And
• 11:57
  - so we are we do have a luxury
• 11:59
  - of having an amazingly vast system
• 12:01
  - that goes anywhere from basic primary care to
• 12:04
  - all the way to quaternary, you know, transplants,
• 12:07
  - extremely high level cardiac care and neurologic care.
• 12:11
  - And we have those resources available all within
• 12:12
  - two hours.
• 12:14
  - So it it is it's a it's a
• 12:16
  - great place to work. It's a great place
• 12:17
  - to practice.
• 12:19
  - And the main thing we have to do
• 12:20
  - is just make sure that we keep the
• 12:21
  - patient at the center of the conversation
• 12:23
  - and be really obsessed about the patients as
• 12:26
  - far as making sure that,
• 12:28
  - you know, and and I think the way
• 12:29
  - I look at it as a as a
• 12:31
  - leader is every one of those patients that
• 12:33
  - I run into and some of them it's
• 12:35
  - you run into them at the grocery store,
• 12:37
  - making sure that the way that they are
• 12:39
  - the way they perceive their care and the
• 12:40
  - way they feel like they're getting their care
• 12:42
  - is that it's the best care that they
• 12:43
  - could get anywhere in the world.
• 12:45
  - And really the
• 12:47
  - the measure of that is it's not so
• 12:48
  - much how well we think we are. It's
• 12:50
  - how well it's how well we do and
• 12:51
  - how much they think we do a good
• 12:53
  - job.
• 12:54
  - And I we really do take a lot
• 12:56
  - of, pride in the fact that our patients
• 12:58
  - do appreciate what we do. And, you you
• 13:01
  - really have started to hear the patient say,
• 13:03
  - you know, I'm all in on the Sutter
• 13:05
  - thing.
• 13:06
  - So it's it's interesting. It's a I don't
• 13:08
  - know I don't know that I'd say it's
• 13:09
  - Apple or something else, but it's it's kind
• 13:11
  - of like the brand is definitely carrying the
• 13:14
  - weight. And, that's something that I know that
• 13:16
  - the system has been looking at is trying
• 13:18
  - to really get the brand image out there
• 13:20
  - to,
• 13:21
  - you know, make people realize that it's it's
• 13:23
  - a Sutter system,
• 13:24
  - and we're an integrated network and that we're
• 13:27
  - here to make this easy.
• 13:29
  - And we want everybody to have really the
• 13:31
  - the best experience they can have no matter
• 13:32
  - where they are, whether it's San Francisco, Sacramento,
• 13:35
  - or in rural, you know, more rural Yuba
• 13:36
  - City.
• 13:38
  - Wow. Well, that that's really cool to hear
• 13:39
  - and definitely,
• 13:41
  - exciting to think about how the brand can
• 13:42
  - really drive things forward in in the way
• 13:44
  - that consumers appreciate what you do and and
• 13:47
  - really wanna come back. So,
• 13:49
  - thank you again for kind of sharing through
• 13:51
  - that with us and truly a a vision
• 13:53
  - of where the future is headed. Before we
• 13:55
  - wrap up, I wanted to ask you about
• 13:57
  - leadership. Where do you see
• 13:59
  - could you tell me about a a leader
• 14:00
  - that you admire really from any industry and
• 14:03
  - why?
• 14:04
  - Yeah. I mean, it's it's funny.
• 14:06
  - You know, thinking about that, it's,
• 14:09
  - I mean, there's a whole bunch of them
• 14:10
  - that,
• 14:11
  - kinda go around and give a lot of
• 14:12
  - talks. I've written a lot of books, and,
• 14:14
  - you know, people will quote them all the
• 14:16
  - time. Yeah. The I grew up in the
• 14:17
  - Midwest, so I grew up in Kansas City,
• 14:19
  - which I it's it's a wonderful place to
• 14:21
  - live. I it's,
• 14:23
  - it's been nice moving to California, but I
• 14:25
  - do miss the people at Kansas City. And
• 14:26
  - it's, but, you know, when you grow up
• 14:27
  - there, you definitely hear about Harry Truman, like,
• 14:29
  - your entire life. Right?
• 14:31
  - So I can't tell you how many times
• 14:33
  - that, there's a field trip to the Truman
• 14:34
  - Library. But, you know, that that idea of
• 14:37
  - being a guy who kinda stepped into, you
• 14:39
  - know, a difficult situation,
• 14:41
  - being being a leader of the president,
• 14:44
  - leading, you know, through, you know, a very
• 14:46
  - tumultuous time. And then, you know, the just
• 14:49
  - the fact that, you know, you'd see that
• 14:50
  - I remember as a kid seeing that,
• 14:53
  - he had the little little little piece of,
• 14:55
  - little piece of, memorabilia on his desk that,
• 14:57
  - you know, talks about the buck stops here.
• 14:58
  - And so I think as a leader, I
• 15:00
  - think that there really is an element of
• 15:03
  - you have to realize that,
• 15:05
  - you're not in the job just to watch
• 15:07
  - things happen and make them and and see
• 15:09
  - how wonderful it is and it's, all roses
• 15:11
  - and, you know, sunshine. I mean, you really
• 15:13
  - have to be ready to make those difficult
• 15:15
  - decisions when it's time to make them, and
• 15:17
  - you have
• 15:18
  - to have resources to do that. And sometimes
• 15:20
  - that is other people,
• 15:22
  - whether, you know, in my case, whether it's
• 15:23
  - my colleagues in the South, you know, you
• 15:25
  - know, the other of the other medical group
• 15:27
  - leaders, whether it's, you know, the leadership of
• 15:29
  - the system, including Warner Thomas. I mean and
• 15:31
  - I think within the health care world, I
• 15:33
  - would say Warner is, proven to
• 15:36
  - definitely show that you can make your health
• 15:38
  - care very exciting, and you can grow health
• 15:39
  - care very well. And if you do it
• 15:41
  - right,
• 15:41
  - a lot of good things will happen. And
• 15:43
  - so, it's been a blessing to have him
• 15:45
  - at the leadership of the system.
• 15:47
  - But I, you know, I think as a
• 15:48
  - child, you know, growing up, it was kind
• 15:50
  - of the Harry's Truman
• 15:52
  - input that, really something I think about a
• 15:54
  - lot. And then there's obviously,
• 15:55
  - as we all do, we probably think back
• 15:57
  - to,
• 15:58
  - the leadership and the things we learned from
• 16:00
  - our parents too. So
• 16:01
  - it's a mix.
• 16:03
  - And that's really inspiring to hear about and
• 16:05
  - and definitely,
• 16:07
  - you know, a great way to think about
• 16:08
  - health care and about leading across the board.
• 16:11
  - Thank you so much for joining us on
• 16:12
  - the podcast today. This has been such a
• 16:14
  - fun conversation. I really appreciate you talking through
• 16:17
  - everything that you're doing,
• 16:19
  - with the medical group there and value based
• 16:21
  - care and all other things. And doctor Blair,
• 16:23
  - I know you'll be speaking at our CEO
• 16:25
  - CFO roundtable coming up in November. So it'll
• 16:27
  - be great to see you in person and
• 16:28
  - catch up there. Okay. Good to talk with
• 16:30
  - you.