Latest / Becker’s Healthcare Podcast / Dr. James McCarthy, Executive Vice President and Chief Physician Executive at Memorial Hermann Health System

Transcript

Dr. James McCarthy, Executive Vice President and Chief Physician Executive at Memorial Hermann Health System · Becker’s Healthcare Podcast

• 0:02
  This is where health care leadership comes together.
• 0:04
  Becker's sixteenth annual meeting brings more than 3,500
• 0:07
  hospital and health system executives and nearly 800
• 0:11
  speakers to Chicago, April 13 through the sixteenth.
• 0:14
  This year's event includes keynote conversations with Dallas
• 0:17
  Cowboys legend Troy Aikman and former president George
• 0:20
  w Bush. For the agenda and event details,
• 0:23
  visit beckershospitalreview.com
• 0:25
  and click on the events tab in the
• 0:27
  upper right. We're looking forward to hosting you
• 0:29
  in Chicago.
• 0:32
  This is Laura Dierdahl with the Becker's Healthcare
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  podcast. I'm thrilled today to be joined by
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  doctor James McCarthy, executive vice president and chief
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  physician executive at Memorial Hermann Health System. Doctor
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  McCarthy, it's a pleasure to have you on
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  the podcast today. Thank you very much. Pleasure
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  to be here. Absolutely. Now, sorry for our
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  conversation because I know there's so much happening
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  in health care today, and particularly Memorial Hermann
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  is always an innovative health system, a place
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  where there's, you know, very much on the
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  forefront of health care in care delivery. So
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  I'm looking forward to getting your perspective on
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  that. But before we dive in, could you
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  tell us a little bit more about yourself
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  in in the health system?
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  Sure. So,
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  emergency medicine physician by training and background,
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  and I've been in this role as the
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  chief physician,
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  executive for the Memorial Hermann Health System since
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  March 2018.
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  Prior to that, I was a full time
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  practicing physician in emergency medicine at the University
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  of Texas working in our academic medical center
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  in the Texas Medical Center and,
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  the the academic arm of Memorial Hermann.
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  That's amazing to hear. Now, what do you
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  say from last year is the most important
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  initiative that you led? What did you do
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  and what were the results?
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  Yeah. So our last year, we actually can
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  really be very succinctly summarized
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  is being completely dominated by
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  ingesting Epic. We made the decision
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  after a careful analysis to switch EMR vendors.
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  And for us, it wasn't just the clinical
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  facing part of the the EMR, the parts
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  our clinicians all touch, but also our entire
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  back end office, the revenue cycle in Aldo.
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  So we are really taking the entire organization
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  and modernizing its digital footprint
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  and putting in systems that we think will
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  enable us to be successful for the future.
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  I was the,
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  executive sponsor for this project, and one of
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  the real kind of challenges we had
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  resulted,
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  from or because of, I guess, our pluralistic
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  physician group practices. We have multiple of the
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  different provider groups that are critical for our
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  success of over 6,000 physicians affiliated us. We
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  have our academic partners at the University of
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  Texas. We have an employee group in, in
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  within the Moore Hermann system, and we have
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  clinical affiliates of 3,200
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  physicians that are affiliated with us.
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  So organizing,
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  training,
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  template builds with all of these different physicians,
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  all with different leadership structures took a huge
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  amount of, collaboration
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  across the practices,
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  bringing docs in together from different practices to
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  help them really organize and be prepared,
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  particularly with our independent physicians who don't have
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  the same level of support that some of
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  our employed or academic partners do and making
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  sure we're able to make training accessible and
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  available to them so they could be successful
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  when we moved into this new system.
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  I love that. And I think, you know,
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  definitely easier said than done. I appreciate all
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  the advantages of having that more cohesive system,
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  and additional capabilities. But I know sometimes,
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  you know, that,
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  integration and then actual adoption and and maximization
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  is easier said than done. So is there
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  anything that you did within your, especially, physician
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  organization that you're,
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  was helpful in terms of
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  gaining additional adoption or or really, buying from
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  physicians across the board to make these changes
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  and, get it up and running as quickly
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  and efficiently as possible?
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  I mean, so, obviously, Epic's got a great
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  playbook that we work with, and our goal
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  from the onset was to stay as close
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  to foundation as possible and something we were
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  successfully able to do.
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  One of the really important parts for us
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  is the
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  data transfer of information between our hospital health
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  system and our independent practices, employed practices.
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  So in addition to the practices we had
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  to bring online,
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  through our employee structures or through community connect
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  with some of our independents,
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  a number of them are still on very
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  different EMRs
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  and building the integration with those practices so
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  they would have access
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  to the epic data that we had so
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  they could easily order within our system to
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  kinda keep the continuity with our patients required
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  several very important working groups. We're fortunate in
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  the Moore Hermon Health System that we have
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  a clinical programs committee.
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  These programs are all organized by specialty,
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  and encompass over 800 practicing physician to get
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  together to help work on problems unique to
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  cardiology, emergency medicine, critical care, primary care. So
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  we channeled those working groups as anchors and
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  leads to help us build out all these
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  programs to make sure we had everybody's perspective
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  as we built these connect this connectivity,
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  and made sure that we didn't leave anybody
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  behind
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  or or unmet needs. We've had tremendous
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  positive reaction from the accessibility of records and
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  the ease of data exchange that we have
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  as a result of this process.
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  That's amazing to hear. Thank you for taking
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  us a little bit deeper behind the scenes,
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  to understand your strategy and and what you
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  really focused on with the team. Now looking
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  ahead, what do you see as being some
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  of the big priorities as well as headwinds
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  that you're focused on for twenty twenty six?
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  So
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  part of the the core,
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  mission, vision, and values for Memorial Hermann is
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  our commitment to our community. Right? We are
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  a a nonprofit health care system in Southeast
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  Texas. We are the largest nonprofit itself health
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  care system in our region with a true
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  lay board that has a
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  volunteer board that has a deep commitment to
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  our community. So one of the challenges we're
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  facing for is how we can tackle the
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  health care disparities we see within our region.
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  We have the highest uninsured rate, of any
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  large metropolitan area in Texas.
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  We do know we're gonna have some impact
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  with some of the changes in subsidies that
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  are happening with the ACA. So understanding how
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  we pivot to meet those communities and try
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  to keep them healthier to decrease their health
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  care cost is a critical part of our
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  strategy moving forward as well as reducing cost
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  in all of health care. Right? The trajectory
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  of spend we've talked about for decades now
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  is not sustainable.
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  It's compounding currently
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  with all of the new pharmaceuticals that we're
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  seeing, all these new high cost, highly effective
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  medications we wanna be make available means we
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  have to figure out how to compress the
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  system and compress cost in different areas. So
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  a huge amount of our strategy
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  moving forward for the next several years is
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  going to be on increased efficiency
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  and increased value proposition for our patients, for
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  our employees,
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  for the employers we work with so we
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  can try to bend this cost curve and
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  keep things from accelerating
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  at the rate that they are. We think
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  that
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  the value based initiatives
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  are going to be essential for us to
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  be successful and to keep our communities healthy
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  now and for generations to come.
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  Got it. That's fascinating to hear. And absolutely,
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  you know, looking at, the the cost as
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  well as the spend on the health care
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  side, I know it's something that so many
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  organizations are really reviewing and closely monitoring, especially
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  in the next year, you know, when
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  margins will continue to be tight for many
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  hospitals and health systems across the board. So
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  when you look at the the overall,
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  potential for growth and and strategy,
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  what do you think is the hardest thing
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  you're gonna have to do in the coming
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  year,
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  given all the factors
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  and things happening in the health care space?
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  So I I can break it into two
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  two kinda areas. Right? So what's gonna be
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  hard,
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  and what's gonna be essential? And
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  as one of the challenge that we're facing
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  in Houston is Houston, which is a a
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  blessing
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  actually at the same time, is Houston's growing.
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  Our population has been steadily growing.
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  All, projections are will continue to grow. We
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  may see a slight slowing at the rate
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  of growth, but we're continuing to grow.
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  But importantly, we're growing outside of the more
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  traditional dense urban areas we've had. We're growing
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  significantly north. We're growing to the West, Northwest,
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  and South,
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  and we're going to need to expand our
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  footprint to meet our patients where they are.
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  We know that parts of rural Texas are
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  really going to struggle,
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  with health care access as smaller hospitals struggles
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  for,
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  to stay open and viable. So we're gonna
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  have to expand our geographic
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  footprint, and we look forward to kind of
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  expanding those over the next several years. That
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  that's requires careful thoughts on strategic,
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  land purchases, capital,
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  thinking carefully about where the market's gonna need
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  and what services we need to put into
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  those areas first. We see those as, as
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  real opportunities for us.
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  Internally in challenges, one of the things we
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  do is one of the largest employers in
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  the region. We're very cognizant also of our
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  employee health care costs. We're cognizant of how
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  we can drive cost effective behavior and that's
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  a major initiative for us, which is hard
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  to do. Health care employees
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  utilize health care at a higher rate than
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  non health care employees. We utilize expensive care
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  because we know what we want and we
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  want it now. So getting our employees to
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  the right level of care at the right
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  time is a major initiative for us as
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  well as things like pharmaceutical costs. So we
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  have implemented what we think are really important
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  and novel pathways,
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  GLP ones for example.
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  Many health care systems have simply said we're
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  not providing those for weight loss.
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  That's not been our approach. We believe these
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  are a valuable tool to improve our employees'
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  health. So we've come up with a comprehensive
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  program where we bring them in metabolic weight
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  loss management, get them enrolled for the healthy
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  lifestyle, the things we know are essential for
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  long term success as a part of that
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  program. It's a condition for participation using the
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  GLP ones have to be enrolled in our
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  program so that we can maximize the success
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  and the value that we get and our
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  employees get from being involved in program like
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  this.
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  I love that. I think that's, you know,
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  so amazing. And think about that growth, think
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  about that development, and, you know, even though
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  there are some, challenges with it, I think
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  especially,
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  having that opportunity to
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  spread the, coverage that you have and treat
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  those patient populations is critical. And I know
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  you talked about value based initiatives earlier as
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  well. How are you looking at at that?
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  Where where do you see some of the
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  ability for, transitioning to more value based care,
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  really presenting itself as a opportunity or even
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  a growth opportunity next year? Yeah. So a
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  key initiative for us in this space is
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  direct to employer. So we think by working
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  directly with employers, we can help them
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  design targets around their employees, around specific pain
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  points they have related to cost and drive
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  more efficient models. We've rolled out a health
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  care navigator program with several large employers where
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  we embed a resource
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  into their organization to help navigate their high
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  spend, high cost patients. We've been able to
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  demonstrate
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  significant decrease in downstream cost for them in
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  diabetes, in heart failure,
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  looking at several other targets now where we
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  know that if we actively navigate those patients,
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  we can reduce their rate of hospitalization, their
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  days lost from work, and we're seeing significant
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  benefit in these programs. So we think that's
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  gonna be a key anchor for us as
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  we move forward,
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  working with employers to help them keep their
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  cost down and maintain our role as their
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  trusted health care partner when they do need
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  to access health care resources.
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  Got it. That makes a lot of sense.
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  You know, it's really helpful to understand, especially
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  thinking about that direct to employer market. Now
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  is there anything else that you see as
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  being, really important for your growth next year?
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  Well, so kinda growth, but also just initiatives.
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  You know? So we've talked about value based
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  care, which we are think critical, but we're
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  also,
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  also critically involved in what I would call
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  the high acuity parts of care health care
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  are gonna move to move to values that
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  are the slowest. So we have one of
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  the busiest trauma centers in the program, and
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  one of our key initiatives this year is
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  the complete replacement of our life life fleet.
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  We have the second oldest aeromedical,
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  program in the country.
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  We have the largest aeromedical program,
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  related to a hospital based program like ours.
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  We have six aircraft, five are in permanent
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  circulation with one as a permanent backup
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  station geographically
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  around the city so that we can have
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  these assets close to patients who need to
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  come in for care,
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  and we're replacing the entire fleet this year.
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  We've got several of them already on board,
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  but by the next summer, we'll have the
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  entire fleet replaced. And importantly, that's all been
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  done with philanthropy,
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  all of this by donations from the community
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  to replace the fleet. So no capital dollars
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  involved in replacing all these aircraft so that
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  we can have the most sophisticated,
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  highest functional
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  aircraft and medical teams available to transport these
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  critically injured patients.
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  And they'll come online all this spring, including
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  one we think is a critical resource,
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  at h one 60, which will be a
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  much larger helicopter.
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  Will be able to push our range out
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  to 200 miles out, which will allow us
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  much better access to bring patients back from
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  further geographic reasons out into Louisiana
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  down into South Texas where we have patients
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  who don't have access
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  to some of the high acuity care that
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  we can provide in the Texas Medical Center,
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  and we'll be able to bring that home.
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  So getting that fleet all up and running
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  is a critical,
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  part of our first, first calendar year for,
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  '26.
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  Got it. That's fantastic to hear. Doctor McCarthy,
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  thank you so much for joining us on
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  the podcast today. This has been an amazing
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  conversation and very, very inspiring, and I look
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  forward to seeing you in April at our
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  annual meeting. I know you'll be speaking on
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  a panel and truly helping to dig deeper
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  into some of these themes,
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  in in understanding what greatness looks like and
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  what, you're looking at ahead. So, doctor McCarthy,
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  thank you so much for your time. Thank
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  you very much. Pleasure speaking with you.