Latest / Becker’s Healthcare Podcast / Parinda Khatri, PhD, Chief Executive Officer of River Valley Health

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Parinda Khatri, PhD, Chief Executive Officer of River Valley Health · Becker’s Healthcare Podcast

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This is Alan Condon back with another episode
0:49
of the Becker's Healthcare Podcast.
0:52
And today, I'm delighted to be joined by
0:54
doctor Parinda Khatri, CEO
0:57
of River Valley Health
0:59
That's headquartered in Knoxville, Tennessee
1:01
and recently rebranded
1:03
last summer, if I'm not mistaken,
1:05
from Cherokee Health Systems
1:07
to River Valley Health. Doctor Katri, a real
1:10
pleasure to have you on the podcast with
1:12
us today.
1:13
For those of our listeners who might be
1:15
as familiar with you or the newly rebranded
1:18
River Valley Health, I'd love to hand it
1:19
over to you to hear a little bit
1:21
more about yourself and your role at the
1:22
health system.
1:24
Yes.
1:25
Thank you, Alan.
1:27
Yes. So I'm Parinda Katri. I'm chief executive
1:29
officer of River Valley Health and,
1:33
formerly Cherokee Health Systems.
1:35
We are a,
1:37
integrated community health care organization.
1:41
We have a span of about 25 counties.
1:45
In East Tennessee, we also have some patients
1:48
who come over from Georgia and Kentucky,
1:52
to, see us for care. We're a federally
1:55
qualified health center
1:57
and a licensed community mental health center as
2:00
well as a licensed alcohol drug and treatment
2:02
center. So we really are,
2:06
an integrated,
2:08
community health care organization
2:10
that has a mission to provide access to
2:13
high quality care
2:15
to everyone
2:16
regardless of ability to pay. So, you know,
2:19
as you go into the mountains of East
2:21
Tennessee,
2:22
as well as into the city in in
2:24
Knoxville and Chattanooga.
2:26
What you'll see is we're the a a
2:28
preferred health care provider,
2:31
for many, but also we have a number
2:33
of patients
2:35
for whom, we are the only health care
2:37
provider who will see them. We are in
2:39
some very small rural communities where we are
2:41
the only provider of care,
2:44
and,
2:45
it's just a real privilege and an honor
2:47
for us to be in this space.
2:50
Fantastic. Doctor Kachare, really excited to have you
2:52
on and excited to dive right in. So
2:54
23 counties are serving in East Tennessee.
2:57
See some patients indeed from Georgia, from Kentucky
3:01
as well, like you'd mentioned.
3:03
A real integrated community health organization has that
3:05
mission like you alluded to to provide care,
3:08
access to care regardless
3:10
of patient's ability to pay. I guess before
3:13
we dive in, the immediate question that jumps
3:16
off to mind for me, for many of
3:18
our hospital executive listeners, provider listeners out there,
3:22
just exactly on that in terms of providing
3:25
that access to care to patients regardless of
3:28
ability to pay in the current
3:30
age, in 2026,
3:31
when we see we hear about a lot
3:32
of the financial challenges, a lot of the
3:34
potential cuts coming down the pipeline, and this
3:36
year and next, specifically around Medicaid and whatnot.
3:40
Is it arguably
3:41
the more the most challenging the the payer
3:44
reimbursement environment that we've had for organizations like
3:47
yours? And how are you really working to
3:50
provide that access to care despite, to your
3:53
point, maybe some patients' lack of ability to
3:55
to pay?
3:56
Well, certainly, I've been at, River Valley Health
4:00
for twenty five years.
4:02
And certainly in my twenty five year tenure,
4:05
this is the most challenging,
4:08
not only because of, as you had mentioned,
4:10
funding cliffs, cuts,
4:12
but in general, the entire landscape
4:15
you know,
4:16
volatile. What do they say? It's vuca.
4:19
Volatile, uncertain,
4:20
complex, and ambiguous.
4:22
And,
4:24
so we have really absorbed that as,
4:27
you know,
4:28
as kind of the frame in our thinking.
4:31
And and it is challenging,
4:33
for for us. And I think one thing
4:35
we have realized is we are just gonna
4:39
remain
4:40
laser focused on our mission,
4:42
and
4:43
we actually hope and plan to come out
4:46
of this period stronger.
4:48
We had been planning for this
4:51
for many years. We built up reserves.
4:54
We have streamlined
4:56
processes.
4:57
We have about eight strategic drivers that we
5:00
have been relentless
5:02
relentlessly focused on.
5:04
And,
5:05
the the reality is is it's it's gonna
5:07
it's been a tough environment. It will continue
5:10
to be a tough environment,
5:12
but we are taking a very proactive approach.
5:16
And, frankly,
5:17
we're we're just gonna be doggedly optimistic,
5:21
that no matter what happens,
5:24
we are gonna find a way of taking
5:26
care of our patients and,
5:29
continuing to serve our mission.
5:32
Yeah. No. Fantastic. I know for twenty five
5:34
years at the one organization, I know you've
5:36
held multiple leadership roles and you're staying up
5:38
to,
5:39
CEO, director of integrated care, chief clinical officer,
5:42
and I believe sitting in that CEO seat
5:44
for a little over four years now, if
5:46
I'm not mistaken. So,
5:49
fantastic to hear, I guess, how you're addressing
5:51
this VUCA environment, like you mentioned. First time
5:54
I've heard that acronym, but I'm gonna have
5:55
to keep a hold of that one.
5:57
Focusing in on this year and last, I
5:59
guess I'd love to hear,
6:02
no doubt there are many initials, but I
6:04
guess, was there one maybe most important initiative
6:06
that you led in the last year? Anything
6:08
you'd like to highlight? What did you do
6:10
and what were the results?
6:12
So, well, last year was a big year.
6:14
As you mentioned, we rebranded.
6:17
We celebrated sixty five years
6:20
of serving the East Tennessee community. So it
6:22
was time for us to
6:24
update,
6:25
our brand,
6:27
from a one small little community mental health
6:30
center in Hamblin County in Tennessee to, you
6:33
know, over 22 sites,
6:37
across multiple counties, as you said,
6:39
and,
6:40
two mobile clinics, another 20 odd telehealth sites.
6:44
So, that that was a big year. I
6:47
I would say just growth
6:49
was the hallmark of last year, and
6:52
I,
6:54
it wasn't really even on our agenda many
6:57
of the opportunities,
6:58
but I think, you know, in this,
7:01
landscape, in this day and age, when an
7:03
opportunity presents itself, it's we have to move.
7:06
We cannot,
7:08
be slow and,
7:10
you know, wait for the
7:13
the the perfect. The perfect is the enemy
7:15
of the good. So we actually opened,
7:19
several,
7:20
walk in urgent care for both medical and
7:23
behavioral health services.
7:26
We opened them in response to community need.
7:29
We expanded our optometry
7:33
dental services. We have independent,
7:36
placement and support services that helps people with,
7:41
employment,
7:43
particularly those who've had chronic mental health conditions.
7:46
We want to get them back in the
7:47
workforce and to provide the supports they need
7:50
to help them do that.
7:51
So it it was a year of growth,
7:55
looking back, and it was just systematically
7:58
and thoughtfully
7:59
as opportunities presented themselves, listening to our community
8:03
and responding.
8:05
Fantastic. Well, congrats on the the sixty fifth
8:07
celebration year last year and into your sixty
8:10
six this year. I I mean, fantastic to
8:12
hear, I guess, some of that growth that
8:13
you had alluded to, opening several walk in
8:16
urgent cares for for both medical and behavioral,
8:18
expanding dental, expanding optometry, and and kind of
8:21
adding services around helping people secure employment.
8:26
You'd said earlier that you're kind of relentless
8:29
focused on your mission, and you actually anticipate
8:32
coming out of this year,
8:34
stronger
8:35
than than than last.
8:37
You've mentioned streamlining your processes, really building up
8:40
cash reserves.
8:42
I'm curious kind of any any pieces of
8:44
advice for other community health care organizations out
8:47
there. No doubt you've come off such a
8:49
fantastic year of growth last year and expecting
8:51
to do the same this year. What were
8:52
the kind of keys to your success, do
8:54
you think?
8:55
You know,
8:56
if I had to say one thing, it
8:59
was alignment.
9:00
As an organization
9:02
grows
9:03
and becomes much more complex, and we're a
9:05
complex organization, there are many organizations that are
9:09
even bigger and more complex.
9:11
It is so
9:13
easy for all the different departments and divisions
9:17
and services
9:18
to be doing their own thing.
9:20
And I think,
9:23
and feel very good about it. However, in
9:25
this day and age,
9:27
we have
9:28
zero
9:29
degrees of freedom
9:31
for a misalignment
9:33
in what we're doing. So
9:35
I have been intentional. Our executive leadership has
9:38
been very intentional
9:40
about communication,
9:42
engagement,
9:44
with our mid level leadership, our frontline
9:48
staff. So everybody is aligned
9:51
in what we're doing and where we're going.
9:54
And,
9:55
that will continue to be a challenge and
9:57
something that we have to be intentional
10:00
about because it is so easy
10:03
to to drift. And and I call it
10:06
drift. Maybe other folks may say, no. We're
10:08
letting people do their own thing, and they're
10:11
independent and autonomous. But,
10:14
our scale
10:15
is,
10:16
is a strength,
10:18
and, we want everyone to be aligned.
10:22
So I think that's really the key. It's
10:24
been the key for us, and it is
10:26
something that we're gonna prioritize for the coming
10:28
year.
10:30
Fantastic. Yeah. I love that. Some great key
10:32
key insights for for other community health care
10:34
organizations across the board there. You'd alluded to
10:38
some of your big kind of priorities, core
10:39
areas of growth.
10:41
Looking ahead to
10:43
true this year and into next, what are
10:44
the kind of big priorities that you're really
10:46
gonna be focusing on? Maybe silly question in
10:48
terms of headwinds. I think I have them
10:50
in top of mind, but in case there's
10:51
anything on my mind. Are there any is
10:53
there anything else at this point? Right. Right.
10:57
Yeah.
10:58
Yeah.
10:59
So, this is gonna be another big year
11:01
for us. We will be after twenty two
11:05
plus years,
11:07
changing our EHR.
11:09
And, you know, if you wanna talk to
11:12
any health care executive, even front you know,
11:14
frontline clinician,
11:16
front desk staff, they'll they will tell you
11:18
how painful that can be. But for us,
11:21
it's a even bigger challenge or a bigger
11:24
goal in that we are very,
11:28
dedicated to building a technology ecosystem
11:31
as an organization.
11:33
Right now, we have had the same EHR
11:36
for over twenty years. We have added
11:41
numerous, too many than to count,
11:44
technology solutions
11:46
to address independent
11:47
one or two functions,
11:49
patient engagement, patient texting,
11:52
referrals management,
11:53
scheduling,
11:55
population health, another analytics tool,
11:59
and with varying degrees of success,
12:02
and in some cases, no success,
12:06
interfacing with each other. It is clunky.
12:09
It is inefficient.
12:11
It is not optimized.
12:14
And
12:15
so this year, we said, you know what?
12:18
Not only are we going to change our
12:20
EHR,
12:21
we are going to build an entire technology
12:25
e ecosystem, a platform
12:27
where
12:29
as many technology solutions, a lot of the
12:32
key,
12:34
patient facing, patient serving technology solutions from
12:38
scheduling, virtual health, our patient contact and navigate,
12:43
navigation system,
12:44
our,
12:46
registration
12:47
processes, referrals, revenue cycle management, population health
12:51
are all
12:52
as part of one platform.
12:55
And so we're not just looking at, oh,
12:57
we're implementing an EHR. We really are transforming,
13:02
the organization's
13:04
technology platform.
13:05
And so, that's very big. And,
13:07
that's very big. And,
13:09
I don't know why we picked it on
13:11
this year, but it's way past time. And
13:14
I think, you know, when there's a lot
13:16
of flux already, why not, you know,
13:18
add more? But,
13:20
I think positioning ourselves from a technology perspective
13:21
to to really optimize,
13:28
position where we can engage in real
13:31
redesign,
13:32
not just doing things more efficiently because I
13:35
don't think
13:36
we can continue just to do what we've
13:38
been doing, but do it faster, cheaper,
13:41
more efficiently. I we have to throw that
13:44
out throw that playbook out
13:46
and do things differently. So I have challenged
13:48
every one of our leaders and and our
13:51
staff to say,
13:53
don't think about this as just taking what
13:55
we used to do and just finding you
13:58
know, making this technology solution fit that. Take
14:01
a step back and say, if we were
14:03
gonna build this from scratch now,
14:06
what is the best way we would build
14:08
it? And so it is really that design
14:11
simplification,
14:12
redesign,
14:14
that is, I think, a unique component and
14:17
then really leveraging the power of
14:20
as seamless as as as possible integration with
14:24
our technology solutions.
14:26
It's been very clunky though thus far,
14:29
and we need to get better.
14:31
Yeah. That's it's fascinating.
14:33
It kind of,
14:35
just on a recent interview I'd I'd had
14:37
with, Trinity Health CEO, Michael Slabowski, said something
14:42
pretty much exactly the same, I guess, encouraging
14:45
folks, market leaders,
14:47
obviously very different organizations, but it's similar strategy
14:50
in terms of encouraging this, quote, unquote, beginner's
14:53
mindset if we could build this from the
14:54
ground up, if we could do things differently,
14:56
take this approach.
14:58
Could you maybe elaborate maybe just just one
15:00
bit deeper on that? And is there anything,
15:03
early doors that has kind of come out
15:04
of this new mindset shift at your organization
15:07
that you're quite proud of? Yeah. I mean,
15:09
it really has started already with even something
15:12
as simple as patient scheduling,
15:14
where we have had a central,
15:17
central access department. Everybody calls into one number.
15:21
And then we had all
15:23
all kinds of separate teams. We had, you
15:26
know, a nurse central nurse triage team.
15:29
We had a crisis
15:30
team. We had,
15:32
just different groups of people that if you
15:35
called in, you would get tagged
15:38
to, I don't know, how many different people.
15:41
And it was you know, it's a longer
15:43
process, and it requires
15:47
people to,
15:49
navigate
15:50
multiple different pathways. It could be pharmacy and
15:54
then, oh, let me ask the the nurse.
15:56
And then,
15:58
if you, you know, couldn't get that person,
16:00
then they would say, okay. A nurse is
16:02
gonna call you back. Okay. Our clinical pharmacist
16:04
will call you back. But then when they
16:06
call them back, guess what? The patient is
16:09
not there. Then the patient we leave a
16:11
message and the patient calls back. Well, then
16:13
we've gotta go back to that person.
16:16
So what we were noticing with our immense
16:19
call volume, and I'm sure that this is
16:21
a very common,
16:23
issue across the board, was we were not
16:26
handling the patient's
16:28
issues, questions
16:30
at the point of the first call.
16:34
And once we shifted that mindset and we
16:36
said, we aren't gonna just have
16:39
a central access scheduling department that then just
16:42
triaged.
16:43
We're going to make this a patient navigation
16:47
center
16:48
where,
16:49
instead of sending multiple tasks in the electronic
16:53
health record or a team's message or transferring
16:56
a phone call,
16:57
What kind of system do we need to
16:59
build so when a patient calls
17:01
before they get off the phone, they get
17:03
their issue addressed?
17:05
And that is an example
17:07
of
17:08
a a way of we had to really
17:10
shift the mindset
17:12
of the central access team, the central,
17:15
schedulers, and do a lot of training. And
17:18
not only that, too, for our central our
17:20
nurse triage because they basically were there
17:24
spending most of their days looking at the,
17:27
electronic task box saying, okay. Who are all
17:29
the patients I have to call back? Versus
17:32
let me just build it. Let me take
17:34
the call live and address the situation,
17:37
you know, right then and there.
17:39
Yeah.
17:40
Fascinating. I really appreciate the the the kind
17:42
of level of specificity and the the specific
17:45
initiatives that you really honed in on there.
17:46
And and fascinating that the same kind of
17:48
mindset shift can have equal, if not more,
17:51
results at a community health care regional system
17:53
like yours as it also can for a
17:55
multistate
17:56
large giant like a Trinity Health as well.
17:58
So I really, really appreciate it. Fascinating context
18:00
there.
18:02
Flipping the script a little bit,
18:05
CEO of River Valley Health, twenty five
18:08
years,
18:09
four years in that CEO seat. No doubt
18:11
there's a ubiquitous challenges this year, which we
18:13
alluded to, but a ton of really fascinating
18:16
growth, a lot of excitement, a lot of
18:17
things to be proud of.
18:19
What do you think
18:21
the the hardest, I e, the most difficult
18:23
thing that you'll have to do this year
18:25
as CEO over of Volley Health?
18:28
It's
18:29
really
18:32
it it is a balance
18:34
between
18:35
being,
18:36
intentional and focused
18:38
and,
18:40
on the task at hand, which is, you
18:42
know, managing and navigating
18:45
these external forces, this VUCA environment, implementing the
18:49
you know,
18:50
our technology,
18:52
new technology platform,
18:54
and
18:55
being,
18:57
re and,
18:59
responding
19:00
but not being reactive
19:02
to all these market forces
19:04
because it's it is very,
19:07
natural to be subsumed in the tyranny of
19:10
the urgent.
19:11
This happened. This crisis happened. That crisis happened.
19:14
And, oh, look. There's this opportunity
19:18
over there. It's really the decision making about
19:19
where to put the attention
19:22
and what opportunities,
19:23
what things do we pay attention to because
19:26
we are in all an overload.
19:28
There are opportunities that are gonna come. There
19:30
are constantly people coming to us asking about
19:34
partner with this, do that, what about this.
19:37
And we don't want to miss out on
19:40
a potentially,
19:42
very, you know,
19:44
productive
19:45
and mutually
19:46
rewarding opportunity
19:49
for us or a partner or whatever opportunity
19:51
could be there. We don't wanna miss out
19:53
on that, but we we can't get so
19:56
lost and reactive to everything that's going on.
19:59
And so I think it is this decision
20:02
making process and balancing
20:05
focus
20:06
and,
20:08
adaptability
20:09
and responding
20:10
to
20:11
what's happening in the environment. And I think
20:13
in leadership positions,
20:15
frankly, that's what we have to do all
20:16
the time. It's just the tempo, the pace,
20:20
the intensity
20:22
has really ramped up,
20:25
this year, and it will continue to ramp
20:27
up this year. And we're not even into
20:29
February.
20:30
And already, you know, we've had lots and
20:32
lots of things thrown at us. So,
20:35
I think that's gonna be the the biggest
20:37
challenge.
20:38
Right. I know. It doesn't feel like we're
20:40
two weeks only into 2026.
20:43
Yeah.
20:45
Doctor Catcher, last question I have before I
20:47
let you go. You talked about really growth
20:50
last year was a growth was a hallmark
20:52
of last year. Excuse me.
20:54
You talked about really building this technology ecosystem,
20:59
dental, behavioral,
21:00
opening several urgent care centers. You talked a
21:03
ton about this growth already.
21:05
Where do you see the best opportunities for
21:07
our organizational growth this year? Is it more
21:09
of the same or anything different that you'd
21:10
like to highlight around before we wrap up?
21:13
No. I mean, I think we are going
21:15
to focus on,
21:17
strengthening
21:18
our core and strengthening our foundational processes.
21:22
So whenever you have a period of growth,
21:26
then
21:27
you, you know, it's you you realize that
21:30
you can't have the same infrastructure. You can't
21:32
just keep we've done it. We've made those
21:33
mistakes where we grew very quickly.
21:36
And then we just, you know, said, well,
21:39
the current infrastructure, you just everybody do more.
21:42
And so this is gonna be a year
21:44
where I think we,
21:46
and I'm only saying this in January. So
21:48
who knows even in July? But,
21:50
I think we wanna what we wanna do
21:52
is
21:53
strengthen and,
21:56
reevaluate but,
21:58
like, really crystallize some of the strengths and
22:01
build a foundation of our infrastructure
22:03
and processes, and that has to happen anyway
22:06
because of our technology
22:08
implementation,
22:09
technology platform implementation.
22:12
So we will be
22:14
almost building up our internal reserves as an
22:17
organization
22:18
for the next iteration of growth.
22:21
So, you know, you can't keep going and
22:23
going and going without just taking a step
22:26
and saying, alright. Let's prepare for that next
22:29
let's
22:30
give ourselves
22:31
a chance to prepare for the next,
22:34
iteration of growth. And so this is a
22:36
year, I don't wanna say, of,
22:38
contraction is not the word, but it's it's
22:40
a it's gonna be a year, we hope,
22:43
of looking inward and preparing,
22:47
for,
22:49
kind of growing for the next,
22:51
step.
22:53
Mhmm. Yeah. Fascinating. I think so, so much
22:55
to be proud of. No doubt. There are
22:57
some challenges coming down the pipeline, but seem
22:58
like you're very well equipped to tackle them
23:00
head on.
23:01
Doctor Catri, a real pleasure to to have
23:04
you on the podcast this day. I can't
23:05
can't tell you how much I enjoyed this
23:07
conversation,
23:08
how much I learned, and, so greatly appreciate,
23:11
so greatly respect the work that you that
23:13
your team does at River Valley Health, and
23:14
look forward to catching up with you again
23:16
down the line. Alright. Thank you so much.