Latest / Becker’s Healthcare - Clinical Leadership Podcast / Reimagining the Safety Net with Tesa Anewishki of Loretto Hospital

Transcript

Reimagining the Safety Net with Tesa Anewishki of Loretto Hospital · Becker’s Healthcare - Clinical Leadership Podcast

• 0:01
  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
• 0:10
  speakers to Chicago
• 0:12
  April.
• 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,
• 0:22
  visit beckershospitalreview.com
• 0:25
  and click on the events tab in the
• 0:26
  upper right. We're looking forward to hosting you
• 0:29
  in
• 0:30
  Chicago.
• 0:31
  This is Laura Dirda with the Becker's Healthcare
• 0:33
  podcast.
• 0:34
  I'm thrilled today to be joined by Tessa
• 0:36
  Inouisky,
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  CEO and president of Loreto Hospital. Tessa, it's
• 0:40
  a pleasure to have you on the podcast
• 0:41
  today. Thank you, Laura. I'm excited to be
• 0:44
  here.
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  Absolutely. Now I'm looking forward to our conversation
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  because it's covering a an extremely important topic
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  today, thinking about health equity, safety net hospitals,
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  and how they're preparing for some of the
• 0:55
  coverage losses that are coming, down the pipe
• 0:57
  over the next year or two. So,
• 1:00
  I think this will be a very valuable
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  discussion, and I'm looking forward to digging in.
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  But before we do, can you tell us
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  a little bit more about yourself as well
• 1:07
  as Loreto Hospital?
• 1:08
  Oh, absolutely. Loreto
• 1:10
  Hospital is a community safety net,
• 1:12
  hospital located on the West Side Of Chicago
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  in the Austin community.
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  We serve a very high Medicaid population.
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  Our current,
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  status about 84%
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  Medicaid with another 11%
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  that struggle with,
• 1:28
  self pay or and or charity care.
• 1:31
  We've been around for over one hundred years.
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  We are a full service hospital. We do
• 1:36
  not do trauma, but we do
• 1:38
  general and acute care at the hospital.
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  I've been with the organization,
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  for fifteen and a half years.
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  In the current capacity, the last three and
• 1:48
  a half,
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  I'm very excited to have,
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  been home quote, unquote homegrown,
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  and was able to be elevated into this
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  role having served a number of roles throughout,
• 2:01
  my time here at Loretto Hospital, but very
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  excited about the current role that I'm in
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  and all of the,
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  impacts that we can that I believe that
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  we can make as an institution in terms
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  of redefining
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  and rebranding,
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  the role and reputation of safety nets, not
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  just in Chicago, but throughout the country.
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  Absolutely. I love that. And, you know, clearly,
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  Loreto Hospital is a,
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  is a very special place for you.
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  What do you see as being something that,
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  you know, has really kept you there for
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  fifteen years? What about Loretto Hospital is so
• 2:35
  important and, you know, how, have you been
• 2:37
  able to grow your passion for safety net
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  hospitals?
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  Absolutely. Well, I come from a family who,
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  has been involved in social service for over,
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  forty five years. And so I think it
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  just runs through my veins.
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  But more importantly, I think I've I've had
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  some personal experiences in terms of the health
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  care system,
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  and dealing with some of the social disparities,
• 3:01
  that are impacted by vulnerable populations.
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  I myself in my younger years had
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  encountered or experienced several challenges and so for
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  me it is very personal,
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  very passionate about making sure that
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  you know, health care inequities
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  are addressed in at risk and vulnerable communities.
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  And so,
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  again, it just it's it I was born
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  for this.
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  My family happens to run one of the
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  largest outreach
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  homeless agencies in the city of Chicago. And
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  so,
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  my mother is an executive director. My both
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  of my sisters are COOs. My daughter's the
• 3:37
  LCSW.
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  So we we are all heavily embedded in
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  the space of social service, host social and
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  human services.
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  That's amazing to hear. And, you know, what
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  an important service that all of those things
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  are in in Loretta Hospital too, to the
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  Chicago community. And,
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  just really, really grateful to have you and
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  your family
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  having great deep roots here in Chicago.
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  Now from your perspective, when you think about
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  safety net hospitals,
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  how are you preparing for the increased patient
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  demand in 2026?
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  I know some of the legislative changes,
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  will impact
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  the way, you know, that patients are, finding
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  access to care, coverage, and more. And so
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  could you talk to us a little bit
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  about the things you're watching most closely and
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  how you're preparing for the next couple of
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  years?
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  Absolutely. Well, obviously, the proposed Medicaid cuts would
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  significantly impact our patient population.
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  Again, we serve, 84%,
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  Medicaid population again with another 11%
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  charity care and self pay. And so one
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  thing that we're looking very closely at is
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  is seeing that whether that self pay number
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  starts to arrive, and and we've actually started
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  to see that trend. So we're monitoring that
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  very closely. As a safety net institution,
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  having that designation means that we serve patients
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  regardless of their ability to pay.
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  Anyone who walks through our emergency room door
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  doors gets service. And so we are, deeply
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  committed to that mission
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  to making sure that anyone who needs,
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  access to care gets the care they need
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  when they need it most.
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  And, so we're looking at contrary to what
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  other people,
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  are likely talking about is, you know, layoffs
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  and cuts. That's the first thing that you,
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  you know, comes to mind when you're talking
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  about,
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  resources and dollars being stretched. But on the
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  other hand, we're looking at it as how
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  can we reimagine
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  our service delivery? How can we reimagine health
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  care in this community so that the twin
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  ten to twenty year death gap that
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  these are are well, our communities experience
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  when you talk about seven miles away
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  that, you know, people are living at the
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  80 and and, you know, on the West
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  Side Of Chicago or on the Southwest Side,
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  you're looking at a twenty year difference. And
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  so looking at really growing our service line
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  and how can we be a better partner
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  to
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  other, community based organizations and health care providers
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  in the community,
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  and how can we be a better partner
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  with some of the larger public and private
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  institutions that
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  have capacity issues. Currently, we're seeing
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  upwards of five to six months just to
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  get a a diagnostic test procedure to,
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  determine what's wrong with you even before you
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  can begin treatment. And so I think,
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  that plays a tremendous burden on on a
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  person's,
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  quality of life, their mental well-being,
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  not knowing what's happening or what's going on
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  with with their bodies, and,
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  having to wait long periods of time. And
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  I think there's an opportunity for,
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  larger institutions to really partner with their local
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  safety nets to decrease those capacity issues so
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  that,
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  health care inequities and access to care doesn't
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  continue to diminish.
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  That makes a lot of sense. It is
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  helpful to understand. I think, you know, looking
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  at it and having that mindset shift of
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  not, you know, hey. How are we cutting?
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  But, really, what do we need to do
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  in order to,
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  continue to provide these services and thinking differently
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  and creating different models of care. And in
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  those partnerships that you mentioned,
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  I think are are so critical. Are there
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  any that, you know, you've been able to
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  enter into that have been particularly fruitful or
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  or something that is kind of in the
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  works that you can talk a little bit
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  about, you know, to to dig a little
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  bit deeper into the ways that you're working
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  with the community in in really finding solutions,
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  you know, in different ways than you have
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  in the past?
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  Oh, absolutely. So Colorado Hospital is a partner
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  with two,
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  HFS,
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  transformation
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  collaboratives in the state of Illinois.
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  One is Wellness West. The other is Collaborative
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  Bridges.
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  So we partner with those,
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  institutions
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  that bring in a number of community partners
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  and, again, community based organizations to really enhance
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  service delivery and access for those in the
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  community.
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  So that if we don't have the current
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  capacity,
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  then we can do some very warm handoffs
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  to one of our partners
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  because I think the we don't want to
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  lose patients and individuals that need care because
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  there's no immediate access. And so I think
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  in times when resources are strained,
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  we we tend to go into survival mode.
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  The immediate thing is
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  competition and not collaboration. And I think when
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  you're talking about
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  the lives of human beings and then and
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  and their health care needs, it has to
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  always
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  be collaboration. We cannot
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  continue to move in terms of putting profit
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  over people. And so I think we do
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  a great job of partnering with,
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  all of our partners in in both of
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  those collaboratives.
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  Collaborative Bridges tends to focus more on the
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  behavior health aspect,
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  and then Wellness West does, some behavior health,
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  but, addresses a lot of the primary care
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  issues that the community and our patients are
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  faced with. So I think, again, we need
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  to continue to build on those collaborations
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  to make sure that we are keeping patients
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  within our bandwidth.
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  No one should have to travel
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  more than a couple miles to get care.
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  Community,
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  based hospitals and community based organizations
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  are critical to that effort.
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  That makes a lot of sense. And, you
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  know, it is really important to have those
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  access points and,
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  additional support.
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  I'm curious. When you look at the community
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  overall, how do you see it shifting and
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  changing? Who is being most impacted by some
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  of these coverage losses? And,
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  where do you anticipate,
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  you know, needing to,
• 9:27
  shift in order to fill some of those
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  gaps?
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  Oh goodness. Yes. The reality is clear.
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  Now more than ever, it's expensive,
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  to be poor in America.
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  And we are really looking at how looking
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  at ways that if these Medicaid cuts go
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  through
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  and and those,
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  requirements that are now needed in terms of
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  workforce,
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  the workforce requirement, that we are doing what
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  we can to partner with our patients to
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  address those needs. And so we have a
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  free we will be the first,
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  hospital based free grocery store in the country.
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  And we're looking forward to,
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  partnering with our patients so that they can
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  volunteer
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  and fulfill their work requirements in our,
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  free grocery stores. So we're looking at a
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  number of ways on how we can partner
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  with our community to make sure that they
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  are not impacted, the food insecurities and some
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  of the other,
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  things that the community is facing.
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  That's amazing to hear. And I I love
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  that idea of the free grocery store and
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  and providing that type of resource because those
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  food insecurities are very real and have such
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  a huge impact on the health of individuals
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  as well as families,
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  and how they're,
• 10:40
  really wellness journey,
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  moves forward. So when you think about that,
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  the free grocery store, can you tell us
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  a little bit more about that and, how
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  you set it up and and where you
• 10:49
  see it headed and and growing?
• 10:51
  Oh my goodness. We are super excited.
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  We we are now looking at probably early
• 10:56
  summer before,
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  we are able to open our doors and
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  and launch that initiative. But the West Side
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  Of Chicago is is impacted with food insecurities.
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  We're in a health care, well, we're in
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  a health care desert, but we're in a
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  food desert,
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  and a healthy food desert. And so we
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  want to make sure that based on the
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  health care,
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  needs of the communities, a lot of patients
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  have diabetes
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  and do deal with cardiovascular
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  issues. And so we want to make sure
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  that we not only are providing food, but
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  we're also providing healthy food alternatives
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  to the patients in the community. And so
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  we hope to launch that
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  initiative
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  again in the summer, and there'll be an
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  educational component tied to that. So we just
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  don't want to supply,
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  you know, food.
• 11:43
  We want to help individuals,
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  and educate individuals on the importance of eating
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  healthy to kinda
• 11:50
  decrease some of the comorbidities that the community
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  is faced with.
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  So we're, you know, super excited about that
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  effort.
• 11:58
  Got it. That's helpful to understand it. You
• 12:00
  know, we'll be looking forward to learning more
• 12:02
  as we're able to launch in that following
• 12:04
  on its success.
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  I'm curious,
• 12:07
  in general, where hospitals are feeling a lot
• 12:09
  of strain right now is looking at staffing
• 12:11
  pressures.
• 12:12
  Some are having to do cutbacks. Others are,
• 12:15
  you know, seeing shortages,
• 12:17
  just be exacerbated by the increased demand for
• 12:19
  care. And so what are you doing internally
• 12:22
  at Loretto Hospital, to really make sure, you
• 12:24
  know, you've got a a workforce that's stable
• 12:27
  and and addressing some of the wellness needs
• 12:29
  of the teen too. Oh oh, absolutely. No.
• 12:32
  We already deal safety net hospitals already deal
• 12:34
  with,
• 12:36
  live you know,
• 12:37
  working off of and operating off of,
• 12:40
  very lean margins.
• 12:43
  And we simply don't have the flexibility to
• 12:45
  absorb any level of reduction in in Medicaid
• 12:48
  funding because,
• 12:49
  you know, the it's a it's a greater
• 12:51
  conversation. It's not just our entities are not
• 12:54
  just vital to the communities because of the
• 12:56
  health care access,
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  but also because of the economic development that
• 13:00
  we do we give to the community. So
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  Loreto Hospital contributes,
• 13:05
  approximately $200,000,000
• 13:07
  to the local economy.
• 13:08
  If our doors were to close, you're talking
• 13:11
  about just shy of 500 individuals that could
• 13:14
  lose their jobs
• 13:15
  or and what does that do to the
• 13:17
  unemployment rates, and what does that do to,
• 13:21
  you know, the crime and violence that, you
• 13:23
  know, the trends tend to see when unemployment
• 13:26
  is,
• 13:27
  has skyrocketed.
• 13:28
  And so,
• 13:30
  the greater picture is looking at both the
• 13:32
  health care access and and being committed to
• 13:34
  addressing the health care inequity,
• 13:36
  but also understanding the value,
• 13:39
  that the our institutions bring to the communities
• 13:42
  that we serve. And so
• 13:43
  workforce,
• 13:44
  you know, for us, it's about reinvestment.
• 13:47
  I think I'm a true testimony and testament
• 13:50
  to
• 13:50
  having grown up within the organization
• 13:53
  and being able to move into this new
• 13:56
  leadership role. And so what we wanna do
• 13:59
  is we know our we know our team
• 14:00
  members are our greatest asset, and we want
• 14:02
  them to work at their highest level of
• 14:05
  of certifications
• 14:06
  and and capability.
• 14:07
  And we wanna we we want to invest
• 14:10
  in them. A lot of times, we see
• 14:12
  our workforce are in positions not, you know,
• 14:14
  out of necessity
• 14:16
  dream for their lives.
• 14:18
  And so we want to support our team,
• 14:20
  in that in every effort, in every phase,
• 14:24
  so that they can live,
• 14:25
  the the life that they dream for themselves
• 14:27
  and that they can move and grow within
• 14:29
  the organization like myself.
• 14:31
  I love that. I I think it's so
• 14:33
  critical to have that model, that you are
• 14:35
  of growing within the organization and, you know,
• 14:37
  achieving now the the highest position within the
• 14:40
  hospital, which is so so impressive and a
• 14:42
  meaningful journey.
• 14:44
  And, you know, when you think about that
• 14:45
  pipeline and uplifting your team and and making
• 14:48
  sure that, you know, talent continues to grow
• 14:51
  and flourish there, is what do you do,
• 14:53
  or how do you make sure you've got
• 14:55
  a a strong pipeline of leaders around you,
• 14:58
  so that, you know, no matter what, the
• 14:59
  organization can drive?
• 15:02
  Sure. I I think it's important to make
• 15:04
  sure that, you know, you you have a
• 15:05
  you set out, you know, always first, put
• 15:07
  the mission first. Right?
• 15:10
  What why are we here, and making sure
• 15:12
  that we maintain that several same level of
• 15:15
  commitment and dedication.
• 15:17
  And then really getting the buy in from
• 15:19
  not just your leadership team, but as well
• 15:21
  as your team members. Where are we going
• 15:24
  as as an organization and
• 15:27
  allowing,
• 15:28
  them to be a process
• 15:29
  to be a part of the process
• 15:31
  of us reimagining who we want to be
• 15:33
  in the future.
• 15:35
  I think that's how you get,
• 15:37
  individuals committed to the work,
• 15:40
  where you see longevity. We've been fortunate to
• 15:42
  have
• 15:43
  a number of team members that have been
• 15:45
  with our institution. One was here upwards of
• 15:47
  fifty years. He started when he was 18
• 15:50
  and retired after,
• 15:52
  just a little over fifty years. And so
• 15:54
  a lot of our employees,
• 15:56
  they love to to work where they live.
• 15:58
  I think that's important that we,
• 16:01
  hire from the community, that we're supporting the
• 16:03
  community
• 16:04
  in that, f in that vein as well.
• 16:07
  And so our workforce is critically important. Our
• 16:10
  leadership team is critically important to to the
• 16:14
  work that we're doing. And and, again, it's
• 16:16
  about being heard.
• 16:18
  It's about
• 16:19
  being a part of the process.
• 16:21
  This cannot happen,
• 16:23
  with one individual.
• 16:25
  The CEO does not have a wave of
• 16:27
  magic wand and everything works. It is the
• 16:30
  collective effort and collaboration,
• 16:33
  of a leadership team along with all the
• 16:35
  team members with the within the organization sharing
• 16:38
  that vision
• 16:39
  for,
• 16:40
  our service delivery
• 16:42
  and for our future goals and dreams.
• 16:45
  I love that. Thank you so much for
• 16:47
  for joining us on the podcast today. It's
• 16:49
  been such a fun conversation.
• 16:52
  Deysa, one more question for you.
• 16:55
  When you look into the future and as
• 16:57
  safety net hospitals continue to to grow and
• 17:00
  evolve, what advice do you have for other
• 17:02
  executives and leaders as they're trying to look
• 17:04
  out and and really seeing a lot of
• 17:06
  challenges in front of them? What do you,
• 17:08
  do to make sure that you are focused
• 17:11
  in in the right place? What advice do
• 17:12
  you have for them to kind of navigate
• 17:14
  these challenging waters?
• 17:16
  Oh, I I I think it's time for
• 17:18
  us to be intentional and innovative in health
• 17:20
  care reform for safety net, systems and community
• 17:23
  hospitals.
• 17:25
  Not just funding that gets us through the
• 17:26
  year, but support that allows us to stabilize
• 17:29
  our operations,
• 17:30
  to build sustainability
• 17:32
  and increase capacity.
• 17:34
  Doing some advocacy with your, local
• 17:37
  and and elected officials,
• 17:39
  making sure that they really understand the
• 17:41
  the operational
• 17:43
  of how safety nets are are one paid.
• 17:45
  We're paid on a very integrated,
• 17:48
  funding formula, which I think needs to be
• 17:50
  addressed, and we need to do some advocacy
• 17:52
  around that. But, again,
• 17:55
  doing the advocacy, telling your stories,
• 17:58
  sharing the data in terms of the lives
• 18:00
  that you've impacted,
• 18:02
  and, again, growing your your service lines. If
• 18:05
  we continue to cut and chop away,
• 18:08
  unfortunately,
• 18:09
  those health care disparities
• 18:12
  will will continue to grow. And so for
• 18:14
  me, I firmly believe that the antidote for
• 18:16
  communities in crisis is access and investment.
• 18:20
  I think transformative investment
• 18:22
  allows us
• 18:23
  to to really grow and to create a
• 18:26
  sustainability
• 18:27
  model that will see us for the next
• 18:29
  one hundred years, see us through the next
• 18:31
  one hundred years.
• 18:32
  I love that. Keesa, thank you so much
• 18:34
  for joining us on the podcast today. This
• 18:36
  has been such a a fun and inspiring
• 18:38
  conversation, and I look forward to connecting with
• 18:40
  you again soon. Thank you. Thank you, Laura.
• 18:42
  Thank you for having me.