Latest / Becker’s Healthcare Podcast / Transformation, AI, and Community Health at Ballad Health with Tony Keck

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Transformation, AI, and Community Health at Ballad Health with Tony Keck · Becker’s Healthcare Podcast

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  upper right.
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  Hello, everyone. Welcome to the Becker's Healthcare Podcast.
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  I'm Scott King, thrilled today to be joined
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  by a very special guest, Tony Keck,
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  chief transformation officer with Ballad Health. Tony, how
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  are you? Thanks so much for joining us.
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  I'm doing well. I really appreciate the the
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  invitation to talk.
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  Of course. You know, we're gonna need your
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  expertise on on a lot of topics here.
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  Always a lot going on in health care,
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  but especially now. But before we do that,
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  Tony, I was wondering if you could please
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  just tell us a little bit about yourself
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  and your, you know, your journey in in
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  health care.
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  Jerry, you mentioned,
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  my my chief transformation
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  officer title. That that's just a couple weeks
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  old. I, I now have responsibility for strategy
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  and analytics and IT and digital services and
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  operational excellence and project management and our research
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  department. That's a big change from,
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  just a few weeks ago when I was
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  our chief population health officer
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  at our growth group,
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  also had behavioral health. But, you know, every
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  few years in Ballad Health,
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  we switch around executive responsibilities.
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  It's a succession planning
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  exercise, which gets us exposed, you know, to
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  the entire organization, but it also brings new
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  blood, new ideas into
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  different parts of the the system. So,
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  been with Ballad Health since its inception, was
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  with one of its predecessor groups,
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  Mountain States Health Alliance, for three or four
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  years before that.
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  And prior to that, I was in government
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  for about seven years working for Bobby Jindal
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  and Nikki Haley. So,
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  I I've been really honored to be able
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  to work with communities for a long time.
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  You don't really hear about a lot of
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  providers or or health systems doing that. Is
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  that right? They're just, like, switching up the,
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  executive responsibilities every now and then?
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  Yeah. We we put a lot of time
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  into succession planning
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  because we we know it's a tough business
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  that,
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  increasingly, you need to have a lot of
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  specialization, but at the same time, you have
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  to have a broad view of what's
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  what's going on in the world. And so
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  if if you're looking at the trends that
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  affect,
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  health systems,
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  you gotta under be able to understand and
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  work in the government space, the payer relations
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  space. You have to understand strategy.
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  Increasingly, you really have to, be able to
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  operate in the IT space as a leader.
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  So unless you're getting
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  exposure to all of those,
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  we we just don't think it's,
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  it it it's possible to to develop a
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  leadership team over time that's sustainable, not just
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  for five or ten years, but for thirty,
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  forty, fifty years.
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  Yeah. I I think it's so interesting and
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  so great that, you know, everyone, when they
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  switch, kinda understands or gets a sense for
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  what everyone else has been doing and what
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  it takes to keep the system going. So
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  I think that's wonderful.
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  And now let let me ask you about
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  trends in health care. Which ones are you
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  paying attention to right now, Tony?
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  Well, I I hate to start out with
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  probably the answer of the day, but certainly
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  AI and and cybersecurity.
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  I think they probably
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  go hand in hand.
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  You know, we wanna be able to focus
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  on AI as a tool to improve our
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  clinical outcomes and patient experience, but I think
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  we will be just as busy
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  fending off the bad actor threats that AI
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  is,
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  increasingly make making possible.
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  You know, separately from that, we have to
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  be able to keep up with the payers'
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  use of AI that goes beyond
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  what we think is reasonable to control
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  fraud, waste, and abuse.
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  In that sense, we're really, in many cases,
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  also the patient's advocate
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  because,
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  you know, many of these payer decisions increasingly
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  being made
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  with with AI impact patient health and and
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  what they ultimately pay.
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  I think,
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  more more broadly, affordability.
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  You know, I've been around long enough to
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  have seen
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  several major shifts in payment and practice starting
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  with DRGs. That's how I got my start
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  in health care.
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  And we're in the middle of, I think,
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  one of these big shifts right now.
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  But no matter how much
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  technology and and how many payment incentives and
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  how many legislative
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  programs we seem to throw at health care,
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  it's still outgrowing the ability
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  of many families to to pay for it.
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  And it sort of feels like a
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  big Jenga tower right now. And it's a
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  you you know, and the problem is it's
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  a zero sum game. We try to save
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  money in one sector
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  by shifting it to another sector, and and
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  that just doesn't
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  work,
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  or it hasn't worked.
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  It doesn't reduce cost to consumer ultimately, and
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  maybe we just need
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  to to start start over.
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  What are you most focused on and excited
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  about right now in health care?
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  Well,
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  you know, going forward, I'm really am excited
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  about what what AI is gonna be able
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  to bring
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  bring to the to the table. And so,
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  you know, in my previous population health
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  role, we were focused on one of our
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  North Star goals,
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  which is to reduce the years of potential
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  life lost in our community.
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  And,
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  you know,
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  that's a statistic that's tracked worldwide and in
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  The United States county by county.
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  And it it basically is a a measure
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  of early death. And not surprisingly in the
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  Appalachian Highlands,
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  we have more early death than in most
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  of the rest of the rest of the
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  country. And and
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  so,
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  so we got a goal to to reduce
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  a 100,000
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  years
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  of early life lost over the,
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  the next next decade. So,
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  to do that,
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  we we've been really doubling down on the
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  things that we do well and then trying
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  to do do more of that. And so
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  a good example is screenings.
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  We do a pretty good job of screenings
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  right now.
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  But if we can go the extra mile
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  and, you know, increase our screening rates by
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  five, ten, fifteen percent, we know that we're
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  gonna
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  save lives. We've made a heavy investment in
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  smoking cessation,
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  You know,
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  COPD, pulmonary disease,
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  lung disease is it's a it's a big
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  deal in this region. One, because we have
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  really high smoking rates, two, because,
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  of black lung from from the coal mining
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  industry.
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  And so
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  we've been putting a lot of investment into
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  catching lung disease early, helping,
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  prevent it, and we're really seeing that gain
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  a lot of traction. So,
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  you know, I'm I'm excited about what,
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  AI is gonna continue to bring to the
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  table to be able to to better
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  do all that. And it's not just AI.
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  It's it's really some of the new biotechnologies
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  that are coming out and so on. I
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  mean, we're really at a, I think, a
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  pivotal
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  point
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  where,
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  we we finally have the technology
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  to do a better job, a more personalized
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  job,
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  getting down to the genetic level,
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  in improving people's health. And so that's a,
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  you know, that's a huge sea change. And,
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  I think you're starting to see some of
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  it with,
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  GLP ones.
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  That's you know, most of our admissions are
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  due to heart disease,
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  or some aspect of it. And, you know,
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  you trace that back to obesity and diabetes
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  and so on. And,
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  by fundamentally changing that through GOP ones,
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  from a population health perspective,
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  it it it it could be as as
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  big of an intervention as we've ever made
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  in public health. So that's, I think, I
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  think pretty exciting.
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  You know,
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  something I'm proud of that we've done in
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  in this organization is
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  we we've really improved our balance sheet over
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  the years and our operational efficiency.
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  But at the same time, we've been making
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  these really heavy investments
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  in in not only access,
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  which lots of people are doing. You see,
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  you know, cranes in the sky in almost
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  every major city around the country. We don't
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  have major cities. We have small cities, but
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  we're still,
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  investing in access.
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  We just built a brand new,
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  addition onto our children's hospital. Our our NICU
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  programs
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  expanded and modernized.
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  We're expanding our ED at our level one
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  trauma center where we just added new beds
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  to one of our hospitals that was, you
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  know, full to the top. That's all great,
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  but we're also investing in sort of going
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  beyond beds and thinking about being a true
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  community health improvement organization.
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  And so the major investments we've made in
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  behavioral health moving from a hospital based program
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  to a community based program,
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  has has been, I think, really impactful.
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  We've invested lots of money in in our
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  nurses, and and, you know, our turnover is
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  now the lowest that it's ever been.
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  We're reaching out to people who are most
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  vulnerable and enrolling them in,
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  care programs that have shown,
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  three to four return times return on investment,
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  in terms of, the the money that we
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  spend on on uninsured folks who,
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  frequently visit the ED,
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  and we've gotten ninety 1% of them connected
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  with primary care on a regular basis. So
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  it's a win win for everybody. So
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  those are some of the things that we've
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  really been working on, and we're just gonna
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  build on them in the future going forward.
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  What are some of the things that that
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  helped yield that kind of growth, Tony, where
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  you can help there's so much expansion and
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  and so many more patients can be helped
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  now.
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  Well, I think the the the merger between,
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  Wellmont and Mountain States was a big contributor
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  to that. We had a lot of unnecessary
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  duplication
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  in the region. We had hospitals that were
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  two to three miles apart that were 20
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  to 30% full,
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  losing,
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  tens of millions of dollars a year,
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  that just went out the door and didn't
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  benefit patients at all.
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  And and by eliminating that wasteful duplication, we
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  were able to take those dollars and reinvest
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  them in these programs. By the time we
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  get through the first ten years of our
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  merger,
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  we'll have invested well over 300,000,000
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  of incremental dollars in,
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  in these new new programs that, again, go
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  beyond putting
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  heads in heads in beds. I think,
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  we've also done a lot of,
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  work
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  just generally becoming
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  more efficient. We are a Medicare breakeven organization.
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  A lot of organizations around the country set
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  that as
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  a goal many years ago, but very, very
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  few have actually been able to attain it,
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  and and we have. We have to be
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  because we we're
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  reimbursed
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  less than almost every region in the in
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  the country from Medicare and other payers, and
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  so we have to be incredibly efficient. And
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  and we are,
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  and so, again, when,
• 11:45
  when you're able to to build on,
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  that efficiency,
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  you're able to potentially invest some of it
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  in in,
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  some of these these new ideas and new
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  new services.
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  Absolutely. And, Tony, the last question I have
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  for you,
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  how have you evolved as a leader, and
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  what advice would you give to to leaders
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  that are evolving now?
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  Well, I always look at myself, you know,
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  ten years in the past and think, man,
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  you just did not know what you thought,
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  you know, back then. Right? So it it
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  never
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  it never it never stops. And, I,
• 12:23
  I just took an AI course with my
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  my son at the University of Michigan. Both
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  of us took it together because he's at
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  the beginning of his career. And I said,
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  you know what? AI might be threatening your
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  career,
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  path as a, you know, a a sort
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  of a young professional. And and me as
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  a, you know, an older professional, I need
• 12:41
  to keep up with what's going on. So
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  we both took that course. And I think
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  being lifelong
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  learner and making it fun,
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  is is really critical.
• 12:50
  I, you know, I work with a lot
• 12:52
  of students from
• 12:54
  the University of Michigan,
• 12:57
  and and the East Tennessee State University School
• 12:59
  of Public Health
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  and,
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  mentor
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  quite a quite a few of them.
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  And one of the things that I,
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  am always,
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  I'm full of all sorts of advice, but,
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  one of the things that I'm
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  always strongly suggesting
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  is is that they get experience
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  actually
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  laying hands on people.
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  You know, there's there's plenty of times as
• 13:27
  a as
• 13:28
  a management student or administrative student in health
• 13:32
  management, public health
• 13:34
  to get experience going to meetings and doing
• 13:36
  spreadsheets and all that stuff. But
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  but working as a CNA, a transporter, community
• 13:41
  health worker, EMT,
• 13:42
  even even in volunteer roles is really an
• 13:45
  incredible
• 13:46
  is incredibly important to
• 13:49
  understanding the constant stress and uncertainty
• 13:52
  that's present, not only in our patients' lives,
• 13:55
  but but our our team members'
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  lives. And
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  so I I say that,
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  you know, for that group, but it extends
• 14:05
  it extends to all of us as as
• 14:07
  professionals
• 14:08
  regardless of when we're in our career.
• 14:11
  We're putting a lot of effort internally
• 14:14
  into management rounding, into starting,
• 14:18
  every meeting with a mission moment,
• 14:21
  and system wide tiered
• 14:23
  system wide tiered safety huddles,
• 14:25
  where
• 14:26
  they start on the units, you know, early
• 14:28
  in the morning. And by 09:00,
• 14:31
  in in the morning, it reaches the executive
• 14:33
  level about what's going on in every single
• 14:36
  unit,
• 14:37
  in in the system that potentially is a
• 14:39
  safety issue. So those are all things that
• 14:42
  keep us really close
• 14:45
  to the work.
• 14:46
  And I think,
• 14:48
  it's easy
• 14:49
  as a manager with everything that's going on
• 14:52
  being constantly attacked,
• 14:54
  you know,
• 14:56
  under payment changes from the federal government, from
• 14:58
  the payers,
• 15:00
  cyber threats. I mean, all the things.
• 15:02
  It easy to get distracted
• 15:04
  from what's really happening on the ground with
• 15:06
  the people that are are basically generating all
• 15:09
  the outcomes for you. And, so that's probably
• 15:13
  one of the most important pieces of advice
• 15:15
  I can give is just to be consistent
• 15:17
  about that.
• 15:19
  Absolutely. And, look, that's fantastic advice. Really appreciate
• 15:22
  you sharing that with Evolving Leaders, and thanks
• 15:24
  for sharing all your insight with us on
• 15:25
  the podcast. It was a great conversation. I
• 15:27
  look forward to working with you again soon.
• 15:29
  Thanks for the time.