Latest / Becker’s Healthcare Podcast / Alexander Rakul, MHA, PhD, Chief Administration Officer for Kaiser Permanente’s Central Valley Service Area

Transcript

Alexander Rakul, MHA, PhD, Chief Administration Officer for Kaiser Permanente’s Central Valley Service Area · Becker’s Healthcare Podcast

0:02
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in isolation.
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visit beckershospitalreview.com
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and click on the events tab in the
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upper right.
0:46
This is Laura Dirdo with the Becker's Healthcare
0:48
podcast.
0:49
I'm thrilled today to be joined by doctor
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Alexander Raccoole, chief administration officer at Central Valley
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Service Area of Kaiser Permanente. Doctor Raccoole, it's
0:56
a pleasure to have you on the podcast
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today.
0:59
Thank you. Thank you.
1:01
I'm excited to have you on the podcast
1:03
today. But before we dive into our discussion,
1:05
can you tell us a little bit more
1:06
about yourself and,
1:08
Kaiser Permanente?
1:10
Absolutely.
1:11
So, my name is Alexander Rapu. I'm chief
1:13
administrative officer in, the Central Valley service area
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of Kaiser Permanente.
1:19
As you probably know, Kaiser Permanente is a
1:21
fully integrated
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healthcare system,
1:24
which includes
1:25
our, health plan, hospital,
1:28
and medical group. And I'm overseeing medical group
1:32
operations,
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supporting,
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physicians and support staff that provide care to
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453,000
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members
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in the vast
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territory of, our California Central Valley.
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We're located just East of,
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Bay Area Main Bay Area.
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And, we're providing care in, three hospitals and,
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over 10 medical office buildings here.
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That's, you know, incredible to hear. Now,
2:01
I I'm curious when you think about the
2:02
last year or so, what was the one
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project you worked on that was most important?
2:07
What did you do, and what were the
2:08
results?
2:10
Probably the most important project we worked on
2:13
was something we call operations leadership team or
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OLG.
2:17
And I did this in very close contact
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with my regional leader, Lawrence Hamilton.
2:23
We realized that,
2:25
during the years of the pandemic,
2:28
the executive leaders kept,
2:30
the,
2:31
connection pretty tight.
2:32
Yet our VP level leaders, and we have
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about 120 of them,
2:37
in the, in the Northern California region, they
2:40
were not as connected and not as aligned.
2:43
And last year, we worked to make sure
2:45
that,
2:46
we're connecting people better and also investing in
2:50
their leadership development.
2:51
So with that in mind, we had several
2:54
conferences bringing them together, and we're taking care
2:58
of about half a million,
3:00
400 sorry.
3:01
We're taking care of about 4,000,000 people here
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in Northern California.
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So it's it's an extensive operation.
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And, our vice president level leaders, they
3:12
are definitely much more connected to the frontline
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operations.
3:16
And we want to make sure that best
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practices are shared as well as there's consistency
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in providing
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care in different service lines.
3:25
And,
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with that in mind, we deployed,
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this, operations leadership group and also the
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subgroups
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per each service line
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where,
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all these, VP level leaders can connect with
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our regional VP level leaders and,
3:44
can work on on improving practices,
3:47
implementing best practices,
3:49
and also fully leveraging our integrated health care
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system. So that was an quite an incredible
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project.
3:57
And, we've heard a lot of great feedback,
4:00
and it definitely did bring people closer together,
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overcoming some of the challenges that we faced
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during and post pandemic.
4:09
You know, there were so many challenges post
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pandemic. So to be able to turn some
4:14
of those things around and,
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really have great results is impressive to see.
4:20
Now looking ahead for the next year or
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so, what do you are your biggest priorities?
4:24
Where do you see,
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some of the headwinds coming from as well?
4:28
Absolutely. And,
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let me answer
4:31
it together because our priority
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are based on those headwinds.
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And, from the priorities,
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I always put people as our top priority.
4:41
We work in health care,
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and working with people and for people is
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the most important thing. So,
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the recruitment and retention of top talent is
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our continues to be our top priority.
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As you know, as our listeners know, it's
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challenging to
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hire
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both primary and specialty care providers as well
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as many of the,
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other providers as
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psychologists, CRNAs, optometrists,
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etcetera.
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So we're putting a lot of innovative
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efforts into recruitment
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of,
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new talent as well as we always paid
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tremendous attention to retention.
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Our,
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turnover rate is is very small. Very small
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percent of our people, are leaving.
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We're known for that as Kaiser Permanente and
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this medical group in particular.
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And also we're developing new opportunities,
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opening, for example, a branch of our school
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of allied health,
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in,
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Central Valley where we'll be preparing,
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20 psychologists
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every year.
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We're looking into new internship pro residency programs
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as well for physicians,
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because it's known that about 80% of,
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providers, they stay where they,
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receive their training at.
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As a second priority, I would, say,
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also headwind
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is,
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affordability
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and financial situation, especially as there's still uncertainty
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around the ACA subsidies.
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We do need to stay affordable, and we're
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continuously looking at,
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opportunities how to,
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streamline and,
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operations
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and find,
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those best proven best best practices
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to, ensure that we're providing
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not just high quality, but also affordable health
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care to our members.
6:35
And next priority is looking at our younger
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adults.
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As a system, we always were providing very
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high quality care to,
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our,
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people with chronic conditions and and sick patients.
6:51
But those who visit us once or twice
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a year, they might be confused. It's a
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complex environment, and,
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we need to help them to navigate our
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system and also understand what their needs are.
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And the last thing I wanted to point
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out is,
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as a as a headwind and priorities,
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an increasing percent of Medicare population,
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and we're actively working to
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find how we can,
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optimize care for our,
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older people and,
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and address,
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and optimize the Medicare, population
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service.
7:28
Got it. Wow. That that's a lot going
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on and definitely,
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you know,
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super, super helpful to understand and think about
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all the different ways that you're recruiting and
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and retaining folks.
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I'm curious.
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What do you think the hardest thing you'll
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do in the next year will be?
7:48
Well,
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I'm always reluctant to project what the hardest
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thing will be. I'm in my current role
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for six years, so I started,
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just two months before,
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COVID pandemic. So we never know what the
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hardest thing will be next year.
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And
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with that in mind, we have quite a
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few things going on. And and, really, it's,
8:13
most interesting things that we'll implement. They're really
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related to the to us leveraging the
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opportunities
8:21
that our integrated health care system is providing
8:24
us.
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And,
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we did start few of them last year
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and continue expanding them this year. First thing
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I wanted to mention is ambulatory treatment center.
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We did open one in our, Modesto Hospital
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last year, and ambulatory treatment center is
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in nursing and hospitalist based,
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department that
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is,
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taking care of the patients who are in
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the hospital and are in the emergency department,
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but they can be discharged, but they just
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have few things
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to be done. And so they so we're
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freeing up a lot of hospital beds,
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with help of this ambulatory treatment center.
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And,
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probably the most prominent,
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area of intervention is, CHF.
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Our patients with CHF, they they just receive
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much more convenient care there. And, overall, we
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saw savings of millions of dollars last year,
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with opening of this, ATC.
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And this year, we're planning to expand it
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to our other two hospitals as well here
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in the Central Valley.
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Another thing
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is, as I mentioned, the Medicare population is
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top of mind. So last year, we started,
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care plus program,
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and,
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this year, we're planning to expand it. So
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care plus program is
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built around primary care, and it's addressing
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or helping primary care doctors to take care
9:55
of the sickest or the sick patients.
9:58
And,
10:00
with help of AI, we're identifying,
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those, people who
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we can predict that they will be hospitalized
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multiple times.
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And, we support primary care doctor with social
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worker,
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pharmacist,
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RN, and case manager,
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to to really have a complex approach to
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these patients with hope that they will,
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and and we know that there will be
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significant decline in their hospital utilization as well
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as
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less emergency room utilization.
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And last thing I wanted to mention is,
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last week, we opened our first urgent care.
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We're always,
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we're always investing in connection of,
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with of patients or our members with their
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primary care provider.
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But,
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as I mentioned, we we are very much
10:54
looking forward to improve care to our younger
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people or young adults.
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And, we clearly understood that that's something that
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they want,
11:03
the urgent care and just this,
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more transactional
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connection,
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with the with the with the physician,
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especially after hours and on the weekends.
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So,
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last week, we opened one and we're hoping
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to open another one within a year or
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so,
11:19
in,
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we have a very large territory. So hopefully,
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it will,
11:24
help them to navigate care effectively.
11:27
And,
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definitely, we still feel that connection with primary
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care provider is,
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the most important,
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connection for the for the member and, trust
11:38
that they built over years is is very
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important. So those three things are probably,
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the most,
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engaging
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areas that I'll pay attention to next year.
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Not sure which one will be the hardest,
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but,
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yeah, we'll see.
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There's a lot going on right now. So,
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you know, I appreciate you sharing all of
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those elements with us and then looking forward
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to, you know,
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seeing all of that play out. Before we
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wrap up here, let's talk about growth. Where
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do you see some of the biggest opportunities
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for growth in the next twelve
12:12
Absolutely. We,
12:14
in the Central Valley, we're located,
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close to the Bay Area, and we we
12:18
see a lot of,
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growth
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by just people moving from the from the
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San Francisco Bay Area.
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So we we receive for years now, we
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receive a lot of, patients who are just
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transplants from there.
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And,
12:34
we're making sure that, we accommodate them and
12:37
and continue caring for them.
12:40
Overall, I think as an organization
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and as a whole, I think our biggest
12:44
opportunity
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is,
12:46
in identifying
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best practices
12:49
and comparing performance,
12:53
between different service areas. As I mentioned, we
12:55
have 15 service areas here in Northern California,
12:59
and,
13:00
we have a lot of smart people who
13:02
figure things out. So we just need to
13:05
continue working on identifying those best practices and
13:09
proven best practices.
13:10
So looking at,
13:12
both financial performance
13:14
and goals performance and see where this,
13:17
golden middle is and what are what
13:21
what are those,
13:22
proven best practice. And, frankly, those,
13:26
those,
13:27
projects that I mentioned,
13:30
care plus, for example, those those were proven
13:33
and and implemented
13:34
in other service areas as well. And, we
13:37
just learned from them. So that learning from
13:40
each other
13:41
and implementing,
13:43
those best practices without
13:45
losing the secret sauce, because sometimes people are
13:48
twisting,
13:49
you know, during the implementation, twisting the
13:52
processes, and and the secret sauce is lost
13:55
at times. So it's important to to really
13:58
understand how,
13:59
those best practices work, and,
14:02
and we,
14:03
can share them. And, actually,
14:06
going back to my initial kind of,
14:09
conversation about the project from last year, the
14:11
operations leadership team, it can truly help us
14:15
in,
14:16
connect just connected v VP level operational leaders,
14:20
making sure that,
14:22
from patient perspective,
14:24
we have
14:25
consistency
14:26
in service and consistency in quality no matter
14:29
which Kaiser Permanente facility they go to.
14:33
I love that goal. Having that kind of
14:35
consistent
14:35
in quality
14:37
experience and outcomes makes a big difference. And
14:39
so to hear all the different efforts and
14:41
initiatives you have going on to care for
14:43
that population and make sure,
14:45
patients are coming out, you know, in a
14:47
strong position possible, it is incredible to hear.
14:50
Thank you so much, doctor Rokul, for joining
14:51
us on the podcast today. This has been
14:52
an amazing conversation, and I look forward to
14:54
connecting with you again soon.
14:56
Thank you so much, Laura. I really appreciate
14:57
it and,
14:59
love working with Becker's and,
15:01
looking forward to attending your annual meeting as
15:04
well.
15:05
Absolutely. It'll be great to have you there.
15:07
I know you'll be speaking on a panel
15:08
and truly truly,
15:10
you know, looking forward to learning more and
15:12
digging deeper into many of the themes you
15:14
talked about today.
15:15
Thank you.