Latest / Becker’s Healthcare Podcast / Miguel "Mike" Vigo IV, MBA, Chief Revenue Cycle Officer at UC San Diego Health

Transcript

Miguel "Mike" Vigo IV, MBA, Chief Revenue Cycle Officer at UC San Diego Health · Becker’s Healthcare Podcast

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  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where do they go
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  - to pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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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.
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  - This is Laura Dirdo with the Becker's Healthcare
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  - podcast. I'm thrilled today to be joined by
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  - Austin Jones, senior vice president and chief financial
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  - officer at MKC Health. Austin, it's a pleasure
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  - to have you on the podcast today.
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  - Pleasure to be here. Thank you, Laura.
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  - Absolutely. Now I'm excited for our conversation. I
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  - know we'll be talking through a lot of
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  - the cool things you're doing at MKC Health
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  - as well as your perspective on the future.
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  - But before we dive in, can you tell
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  - us just a little bit more about yourself
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  - and your background?
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  - Yeah. I'd be glad to. So I have
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  - served as the chief financial officer here at
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  - NKC Health,
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  - for the last five years. Prior to that,
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  - I
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  - served in various faith based and, for profit,
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  - health care organizations down in Texas. So,
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  - been going at this for about twelve years.
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  - Fantastic. That's great to hear. And, you know,
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  - definitely,
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  - a strong, strong foundation,
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  - which is critical for the times we're in
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  - in health care today. So,
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  - could we start off giving a quick state
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  - of the union? What's going well this year,
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  - and what do you focus on for the
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  - rest of 2026?
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  - Yeah. So,
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  - when we reflect, you know, we did most
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  - recently reflect on the last fiscal year, which
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  - were June 30 fiscal year. But, really, what
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  - we saw trends in f y twenty or
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  - in calendar year '26
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  - were similar to what we had seen in
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  - the the months prior,
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  - and that's really just growth in some of
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  - our strong service lines that we've invested in.
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  - So a lot of the outpatient service lines
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  - we're seeing grow across the industry. We have
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  - realized growth in those as well.
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  - Inpatient is kinda staying
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  - as it was,
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  - not tremendous growth, but still kinda steadily
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  - moving forward,
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  - which is actually a little bit of a
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  - reprieve,
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  - just because of the labor constraints. So
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  - having growth in the outpatient has allowed us
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  - to accommodate it.
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  - But yeah. So that's that's really what we've
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  - seen here. In addition to that, we've seen
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  - some improvement in our bottom line from expense
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  - management.
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  - I I think the thing that sticks out
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  - the most is our health benefits expense.
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  - So as a health care provider, we're on
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  - both sides of that equation for the most
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  - part.
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  - But about a year ago, we,
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  - moved into, the space of kind of health
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  - network development.
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  - And we had looked up several years ago
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  - and realized, hey. We have a clinically integrated
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  - network that serves this region.
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  - We provide great care.
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  - We have partners in other facilities that provide
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  - great care as well.
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  - Why would
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  - we outsource
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  - this network development,
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  - to to one of the large commercial carriers?
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  - So we actually created a narrow network. And
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  - in January, all of our employees
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  - and beneficiaries
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  - as well as those of
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  - a couple other large health systems here in
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  - town,
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  - went into this network. And we've actually seen
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  - tremendous savings. It's always a little bit bumpy
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  - when you start a new network, have a
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  - new TPA, and reprice her, but we've seen,
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  - pretty tremendous
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  - fiscal savings from it, and we're just getting
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  - started there. So that's been great
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  - to to see hit the bottom line over
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  - the last few months.
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  - Oh, that's amazing. And, you know, really cool
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  - to have that,
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  - type of organization where you've got the clinically
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  - integrated network and now, you know, being able
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  - to develop more and build on top of
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  - that.
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  - And seeing those savings too is really, really,
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  - a good sign and I can imagine,
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  - helpful for the organization overall.
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  - I'm curious. What are some of the headwinds
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  - that you're thinking about when you look at
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  - the future, and what are you keeping your
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  - eye on and preparing for?
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  - You know, I'd say the biggest headwind that
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  - we're faced with, I I don't think is
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  - unique to us, but it it's really just
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  - maintaining that balance of physician investment.
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  - We have a fairly decent sized physician enterprise
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  - that we support and invest in in order
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  - to care for the community.
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  - And that's just grown as, more and more
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  - of our independent
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  - partner physicians
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  - have had to,
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  - seek employment
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  - really for financial reasons. So we we are
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  - seeing the effects of the downward pressures on
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  - their reimbursement
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  - and the increases in cost just to run
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  - a practice.
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  - So we're we're kind of feeling that effect
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  - just as a safety net hospital, the community
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  - hospital that we are.
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  - So we're we're seeing that come through.
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  - In addition, you know, there is sustained inflationary
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  - pressures on wages in general, and
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  - health care will never get away from being
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  - a
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  - labor heavy industry.
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  - So that requires us to keep up with
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  - the market demands for wages,
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  - and, that certainly continues to take its toll.
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  - We've seen a little bit of a reprieve
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  - from the year over year increases we had
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  - seen over the last maybe four years,
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  - but it's still there, and it's still outpacing
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  - those increases we're getting from,
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  - commercial and and certainly governmental,
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  - payers.
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  - That it's fascinating to hear. I think you're
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  - right. You know, it's definitely something a lot
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  - of CEOs and executives are having top of
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  - mind for themselves as they're thinking about, you
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  - know, what's their budgets are, what their workforce
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  - is gonna be, and what they're gonna need
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  - for the future. And, you know, when you
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  - look at, all of those those things and
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  - the pressure especially,
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  - on some of the the wages,
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  - how are you looking at the future? What
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  - is, you know, the the future of the
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  - workforce look like given all of these things?
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  - And I know other factors too. But from
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  - your seat as CFO, what kind of,
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  - is top of mind if you're thinking through
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  - and planning, the workforce for the next few
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  - years?
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  - Yeah. We've spent a lot of time in
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  - that space, both looking at, our service offering,
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  - the providers being the primary
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  - support system to
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  - to offer those services, and then secondly, our
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  - facilities. And so we've really started to map
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  - out and invest a lot of time and
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  - money into
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  - mapping out where we're gonna provide services and
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  - what,
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  - amount of service we can provide
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  - in those key service areas, in service lines,
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  - such as oncology,
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  - surgical services in the outpatient environment,
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  - gastroenterology,
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  - and cardiology,
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  - as well as women's health.
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  - So we've we've really kind of laid out
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  - a, a multiyear map,
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  - of where we wanna be,
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  - and we're starting to put the pieces together
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  - to see how we're gonna get there.
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  - But, really, it's just driven by patient demand.
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  - And,
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  - as a community hospital, that's where we start.
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  - You know, we don't always start with what
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  - is the most profitable service line. We really
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  - start with what does the community need, and
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  - then how can we,
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  - accomplish our mission to provide hope and healing
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  - to the community
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  - and do so in a fiscally responsible way.
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  - So that's that's what we're looking at, just
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  - keeping up with the demands, continuing to provide
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  - access,
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  - for those key service lines.
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  - And that's helpful to understand. It definitely makes
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  - a lot of sense when you think about
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  - all the different,
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  - ways that, you know, you you can figure
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  - out the those services and
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  - sustainability of the organization as well. And, you
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  - know, I can imagine there's some spaces where
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  - you're primed for growth too. Can you talk
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  - a little bit about that? What are some
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  - of the opportunities in the next two to
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  - three years or so?
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  - Yeah. I mean, like I said, in in
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  - those key service line areas,
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  - we're primed for growth by, aggressively recruiting top
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  - talent physicians
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  - and other, support staff in in the provider
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  - realm.
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  - And,
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  - just meeting our community
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  - where they are in terms of geographic locations
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  - and as well as creating convenience.
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  - So
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  - that's that's really what's primed us for growth
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  - is just finding the right providers, being selective
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  - about that, and then retaining that top talent.
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  - Absolutely. That is helpful to understand and, great
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  - to know. And, you know, too, I'm curious
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  - as you're looking at the future and,
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  - see,
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  - you know,
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  - especially thinking about financial sustainability and all of
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  - those things. Is there anything that you're
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  - doing now that,
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  - might be a little bit different or or
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  - planning to do in the future as you're
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  - trying to figure out how to continue to,
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  - transform and become that organization of the future?
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  - Yeah. I mean, that's a good question. I
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  - I think some things that
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  - that we're doing are very typical, and so
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  - you see them in every organization
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  - such as creating greater efficiencies,
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  - trying to reduce overhead that isn't direct patient
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  - care.
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  - So we're certainly participating in those activities, but
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  - I think maybe what's unique is we've stepped
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  - into the the space,
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  - of kind of vertical integration. I mentioned earlier
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  - the savings we've achieved with creating
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  - our own,
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  - narrow network of care to reduce our health
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  - care expense. We've also,
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  - stepped into the space of pharmacy benefit management,
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  - so we've brought that in house as well.
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  - We realized such huge savings, and I'm talking,
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  - 40%
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  - savings on on drug expense cost by managing
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  - it ourselves
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  - and and kind of cutting out that middleman
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  - space,
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  - that we're now looking at how can we
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  - offer this as a service
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  - to those local employers,
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  - that are,
• 10:17
  - you know, that are needing this service, but
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  - also would like to
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  - to harvest some of those savings as well.
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  - So that's maybe one unique way that we're
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  - we're looking at vertically integrating and just taking
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  - advantage of untapped value that our health system
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  - brings to the community.
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  - That's great to hear and and very exciting
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  - to think about the future potential.
• 10:42
  - Now before we wrap up here, I wanted
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  - to ask you about leadership. Who is a
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  - leader you admire really from any industry and
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  - why?
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  - You know, there's a lot of people I
• 10:52
  - admire, you know, people that I work with
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  - every day, but one that comes to mind
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  - that I don't work with and I've actually
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  - never met, but I listen to him. He
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  - has a podcast. His name's Ben Sass.
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  - He's a former senator from Nebraska
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  - and former president of a couple universities, most
• 11:08
  - recently, the University of Florida in Gainesville.
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  - But I I admire him because he
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  - has
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  - excelled and honorably served in two of the
• 11:18
  - most challenging
• 11:20
  - environments. One being, of course,
• 11:23
  - the US senate and the other being in
• 11:25
  - a university. They're highly political. They're highly charged
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  - with,
• 11:30
  - with, you know, challenges where you just have
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  - to,
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  - help move something forward that's not easy to
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  - move. And I think sometimes we find that
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  - in health care as well. Health care, government,
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  - education, you know, academia,
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  - they all share a lot of things in
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  - common. They're kinda slow to change.
• 11:47
  - They can feel bureaucratic at times.
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  - And so I I look to leaders like
• 11:53
  - that because they have positive attitude. They speak
• 11:55
  - truth. They, move things forward with integrity.
• 11:59
  - And,
• 12:00
  - in his podcast so he he was diagnosed
• 12:02
  - with cancer back in December of last year,
• 12:04
  - and he started this podcast called Not Dead
• 12:06
  - Yet where he interviews,
• 12:08
  - really amazing people. And I think that's also
• 12:11
  - just a reflection of a leader is the
• 12:14
  - type of people that,
• 12:16
  - are around them, the the type of people
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  - they surround themselves with,
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  - especially those that aren't in their immediate circle
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  - of kind of where they work or things
• 12:24
  - like that. So it's been neat to see
• 12:26
  - the people that interview
• 12:27
  - with him, the questions, the thoughts.
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  - So he I I'd say Ben Sasse is
• 12:32
  - is the leader that I admire the most
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  - right now.
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  - I love it. Wow. What a great, idea
• 12:39
  - and podcast recommendation too. It seems like, as
• 12:42
  - you mentioned, lots of parallels within the healthcare
• 12:44
  - space and certainly,
• 12:46
  - within leadership.
• 12:47
  - Thank you so much for joining us on
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  - the podcast today, Austin. This has been a
• 12:50
  - really fun conversation and I'm excited to see
• 12:53
  - you as well at our CEO CFO roundtable.
• 12:55
  - I know you'll be speaking on a panel
• 12:57
  - and I'm sure we'll be digging into many
• 12:59
  - of the themes you talked about today. But
• 13:01
  - thanks again for your time, and look forward
• 13:02
  - to seeing you soon.
• 13:04
  - I look forward to it. Thank you, Laura.