Latest / Becker’s Healthcare Podcast / Zachary Yoder on Expanding Rural Care, Financial Sustainability and Health System Growth

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Zachary Yoder on Expanding Rural Care, Financial Sustainability and Health System Growth · Becker’s Healthcare Podcast

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  - The strategic agenda facing hospital and health system
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  - This is Laura Dierda with the Becker's Healthcare
• 1:00
  - podcast.
• 1:01
  - I'm thrilled today to be joined by Zachary
• 1:02
  - Yoder, president of Saint Mary Medical Center, Holy
• 1:05
  - Family Medical Center, and Saint Luke Medical Center,
• 1:07
  - all part of OSF Health Care. Zachary, it's
• 1:09
  - a pleasure to have you on the podcast
• 1:11
  - today. It's a pleasure to be here. I
• 1:13
  - appreciate the opportunity.
• 1:14
  - Absolutely. Now I'm excited for our conversation. I
• 1:17
  - know we're gonna talk a lot about how
• 1:19
  - things are going today, some of the cool
• 1:21
  - things that you're doing at the hospitals, as
• 1:22
  - well as how you're looking at the future.
• 1:24
  - But before we dive in, can you tell
• 1:26
  - us a little bit more about yourself and
• 1:27
  - your background?
• 1:29
  - Yeah. So, I've been at OSF for a
• 1:31
  - little over a year and a half now.
• 1:32
  - I started my career at Orange Jewish Hospital,
• 1:35
  - almost twenty years ago now, as a patient
• 1:38
  - care tech, was in nursing school and went
• 1:41
  - to nursing school and and got out in,
• 1:43
  - about four or five years into my, staff
• 1:46
  - nurse position. So started some,
• 1:49
  - charge nurse leadership positions and supervisor positions and
• 1:52
  - then just kind of
• 1:53
  - took off from there and and got more
• 1:56
  - involved into,
• 1:57
  - leadership across the hospital and then into executive
• 2:00
  - leadership,
• 2:01
  - as a chief nursing officer.
• 2:03
  - And then from there,
• 2:05
  - got into more operations as a COO, and
• 2:07
  - I've been a president now for,
• 2:09
  - almost two years. So
• 2:12
  - Wow. That's amazing. And, you know, what a
• 2:14
  - a great career journey in terms of being
• 2:16
  - able to,
• 2:17
  - you know, start in health care and and
• 2:19
  - experience so many different aspects of it before
• 2:22
  - becoming a a top leader at the hospitals
• 2:24
  - today. And and, you know, when you think
• 2:26
  - about that position, what is the state of
• 2:28
  - the union for you?
• 2:30
  - Could you tell us how things are going
• 2:31
  - right now and what you're focused on for
• 2:33
  - the rest of 2026?
• 2:35
  - Yeah. So this this year's really been about,
• 2:37
  - building momentum,
• 2:39
  - and investing in our communities and our people.
• 2:41
  - We've really continued to grow,
• 2:44
  - a lot when it comes to
• 2:45
  - our capacity,
• 2:47
  - both on the outpatient and the inpatient side.
• 2:50
  - We've grown in robotics this year, so Saint
• 2:52
  - Mary Medical Center, here in Galesburg, Illinois, which
• 2:55
  - is about about two hours south of Chicago,
• 2:58
  - in between Peoria, Illinois and, Iowa, the Quad
• 3:01
  - Cities area. We've we've done robotic surgeries here.
• 3:04
  - So we have a da Vinci, and we
• 3:06
  - just got our ion bronchoscopy
• 3:07
  - robot this year as well, which we've kind
• 3:10
  - of exceeded expectations so far on that too.
• 3:12
  - So,
• 3:13
  - we've really grown in the robotic space, which
• 3:16
  - I think is
• 3:17
  - not necessarily rare in rural medicine, but it's,
• 3:19
  - you know, it's not exactly common either to
• 3:22
  - have
• 3:23
  - multiple robots in a rural space and so
• 3:25
  - keeping that care local, close to home is
• 3:27
  - really important for us.
• 3:29
  - We've also invested in our capacity through the
• 3:32
  - ED.
• 3:33
  - We've expanded,
• 3:34
  - six more beds here at Saint Mary, which
• 3:36
  - they were full the day we got them,
• 3:39
  - because we are just overran with, patients in
• 3:41
  - the area. We we take care of, between
• 3:44
  - these three hospitals, roughly a 100,000 patients,
• 3:47
  - with a little over a 100 bed capacity.
• 3:49
  - So, you know, that that's quite a bit
• 3:51
  - of,
• 3:52
  - of geography and and patients to take care
• 3:55
  - of, and our our ED is frequently overran.
• 3:58
  - And so we're always looking for ways to
• 3:59
  - kinda take the steam off the ED and
• 4:01
  - make sure we're getting our patients through,
• 4:03
  - the continuum of care appropriately.
• 4:06
  - But we've done a lot around expansion, a
• 4:08
  - lot around, you know, just building momentum, growth.
• 4:11
  - Our biggest thing is keeping care local.
• 4:14
  - If it can be done as close to
• 4:16
  - home as possible, we want to do that
• 4:18
  - and then as we get, you know, a
• 4:20
  - little higher complexity in our patients, we will
• 4:23
  - get them to the next level of care,
• 4:24
  - typically to our flagship hospital, Saint Francis in
• 4:27
  - Peoria,
• 4:28
  - which is our, tertiary quaternary center.
• 4:31
  - Got it. That you know, it it's helpful
• 4:33
  - to understand, and I think the success that
• 4:35
  - you mentioned in terms of making sure you've
• 4:38
  - got the right capacity and,
• 4:40
  - moving patients through quickly is is certainly
• 4:43
  - so important. I know many hospitals and and
• 4:45
  - organizations,
• 4:47
  - struggle with that and and we're trying to
• 4:49
  - find ways to optimize
• 4:51
  - the way their patient journey through the hospital
• 4:54
  - and those kinds of things. And so, you
• 4:55
  - know, what has led to the success that
• 4:57
  - you have? How do you really
• 5:00
  - structure the teams in in data and information
• 5:03
  - and technology to all work together to achieve
• 5:05
  - these results?
• 5:07
  - So OSF in general is really big on
• 5:10
  - technology and innovation.
• 5:12
  - You know, we've we've done a a lot
• 5:14
  - around our on call center with our telehealth
• 5:16
  - components and,
• 5:18
  - sharing resources with our system as far as
• 5:21
  - referrals, and, we have a care hub that,
• 5:24
  - we funnel patients through so that way, we
• 5:27
  - can make sure that they're getting to the
• 5:29
  - right
• 5:29
  - resources in a in a timely manner. But
• 5:32
  - I think more importantly in our area, we've
• 5:35
  - really focused on
• 5:36
  - optimizing what we have,
• 5:39
  - and working on our culture of our team
• 5:41
  - to to continue taking care of patients locally.
• 5:44
  - And so we have, increased our leadership
• 5:47
  - across all three hospitals,
• 5:49
  - to be shared.
• 5:51
  - And so I think that's a big thing,
• 5:52
  - where our leaders and staff are are being
• 5:55
  - shared across all three hospitals, and so that's
• 5:57
  - providing some continuity.
• 5:59
  - We've set the three hospitals up in kind
• 6:01
  - of a hub and spoke pattern over here
• 6:03
  - in the West Central,
• 6:05
  - region. And so our hub being Saint Mary,
• 6:08
  - but a lot of our patients don't necessarily
• 6:10
  - need the
• 6:11
  - complexity that comes with the larger hospital, and
• 6:15
  - so we can send them to our critical
• 6:16
  - access hospitals to receive the appropriate care there,
• 6:20
  - which takes the steam off of the larger
• 6:22
  - hospital that's
• 6:23
  - frequently at capacity for beds. And so, we've
• 6:27
  - also put our surgeries in some of those
• 6:29
  - locations.
• 6:30
  - We've increased,
• 6:32
  - some of our abilities to to do radiology
• 6:34
  - and scans, and and we've put, specialty providers
• 6:37
  - in each location more frequently so
• 6:40
  - our patients can seek this care closer to
• 6:42
  - home and not have to come to one
• 6:44
  - location.
• 6:44
  - And we've really just focused on trying to
• 6:47
  - push and pull our resources that we have
• 6:49
  - to the appropriate
• 6:50
  - spot.
• 6:51
  - And I think that really has set us
• 6:53
  - up for a much better year this year.
• 6:56
  - And we're really excited for what 2027 is
• 6:58
  - gonna bring as well because we have,
• 7:01
  - you know, more outpatient services coming.
• 7:04
  - We're continuing to grow in robotics.
• 7:06
  - We'll be growing in cancer care as well.
• 7:09
  - And then across the market, you know, our
• 7:10
  - focus is really,
• 7:12
  - to continue to bring those access points as
• 7:14
  - needed, to to where the patients are.
• 7:18
  - That's fascinating to hear. Thank you so much
• 7:20
  - for digging a bit deeper and sharing the
• 7:22
  - strategy behind how you're looking at the different
• 7:24
  - hospitals and the ways that they can truly
• 7:27
  - work together in order to benefit community and
• 7:29
  - provide care close to home.
• 7:31
  - Now in looking at the future too, I
• 7:33
  - wanted to ask,
• 7:35
  - about some of the headwinds. What are some
• 7:37
  - of the big things that you've got your
• 7:38
  - eye on and that you're preparing for for
• 7:40
  - the next year or so?
• 7:42
  - So I think, you know, very similar to
• 7:44
  - what others are dealing with with Medicaid and
• 7:46
  - reimbursement pressure. I mean, that that's definitely a
• 7:48
  - big one. I think when I think about
• 7:50
  - our our biggest external headwind,
• 7:53
  - especially in the state of Illinois, it comes
• 7:55
  - in two categories. I think in one, it's
• 7:57
  - it's the,
• 7:59
  - the Medicaid and reimbursement pressures, like I mentioned,
• 8:01
  - but then another is the,
• 8:03
  - the trial lawyers and the and the things
• 8:06
  - that come with that.
• 8:07
  - There's a lot of, liability and litigation that
• 8:10
  - happens in the state too, which is very
• 8:12
  - costly and very expensive,
• 8:14
  - for everybody involved. And I think that, you
• 8:16
  - know, that that can be a major issue
• 8:18
  - when it comes to cost of care.
• 8:20
  - It it's harder to recruit physicians to those
• 8:23
  - areas as well because of the known liability
• 8:25
  - cost associated with it. And so when we
• 8:27
  - look at a couple of those different things,
• 8:29
  - they're they're two or three buckets, but they're
• 8:31
  - very, very expensive buckets.
• 8:34
  - And, you know, OSF, we take care of
• 8:36
  - the majority of the Medicaid patients, in the
• 8:38
  - state of Illinois. So when you look at
• 8:40
  - outpatient and inpatient combined,
• 8:43
  - Medicaid patients,
• 8:45
  - seek OSF at a higher rate. And so,
• 8:48
  - you know, this this headwind specifically is going
• 8:50
  - to impact us
• 8:51
  - disproportionately,
• 8:53
  - and I think that that's something that we
• 8:55
  - really need to,
• 8:56
  - to continue to pursue.
• 8:59
  - Another piece is specialty recruitment. You know, most
• 9:01
  - of our hospitals are in rural markets or
• 9:03
  - in, you know, smaller cities.
• 9:05
  - And so specialty recruitment and keeping
• 9:08
  - those physicians there is is difficult,
• 9:11
  - especially when we have specialists that are traveling
• 9:14
  - to multiple sites.
• 9:15
  - Sometimes you only need one or two of
• 9:17
  - a specialty provider, which comes with an increased
• 9:20
  - call burden and other kinds of things. And
• 9:22
  - so, you know, that's very difficult model to
• 9:25
  - recruit to as well. And so we have
• 9:27
  - a handful of specialty,
• 9:29
  - positions right now we've been recruiting for for
• 9:31
  - a while, and it's a very difficult space
• 9:33
  - to be in, I think, when it comes
• 9:34
  - to those,
• 9:36
  - specifically around, like, GI, urology, and some cardiology
• 9:38
  - services that we're focused on.
• 9:41
  - And then I think the other real big
• 9:42
  - one is kind of the cost pressure.
• 9:44
  - I think when we talk about what are
• 9:46
  - we doing for cost of not only labor
• 9:49
  - but supplies and everything else, you know,
• 9:51
  - A really large portion of our cost obviously
• 9:54
  - goes to to our labor force,
• 9:56
  - which, you know,
• 9:58
  - it continues to go up every year. And
• 10:00
  - as we,
• 10:01
  - focus on retention efforts and things like that
• 10:04
  - to keep our
• 10:05
  - employees happy,
• 10:06
  - and keep them here at our locations, it
• 10:09
  - it does become increasingly more difficult as,
• 10:12
  - staff are pushed and pulled to different,
• 10:14
  - areas and seeking higher reimbursement and things like
• 10:17
  - that too. So there's a lot of different
• 10:19
  - areas, but I think a lot of it
• 10:20
  - stems around the financial viability of the organizations
• 10:23
  - and the ability to get,
• 10:26
  - reimbursement dollars for the work that we're doing.
• 10:29
  - Absolutely. That makes a ton of sense. And
• 10:32
  - I think, you know, when you talk about
• 10:33
  - that financial viability, being able
• 10:36
  - to find a sustainable strategy going forward knowing
• 10:40
  - some of the Medicaid cuts and reimbursement,
• 10:44
  - policies that are upcoming
• 10:46
  - and taking effect next year.
• 10:49
  - So when you look at that, how are
• 10:50
  - you
• 10:51
  - really
• 10:52
  - what are the conversations like, I guess, with
• 10:54
  - your executive team about what you need to
• 10:56
  - do in order to keep that financial viability
• 11:00
  - and and, plan for,
• 11:02
  - the next couple of years knowing that those
• 11:04
  - cups cuts are coming? Are there other places
• 11:06
  - that you're looking to bring in additional revenue,
• 11:09
  - or how do you think about that?
• 11:11
  - Yeah. So our growth in our our certain
• 11:14
  - areas around, you know, surgery,
• 11:16
  - cancer care,
• 11:18
  - outpatient services, we have a lot of initiative
• 11:20
  - to to continue to bring more outpatient services
• 11:22
  - when it comes to,
• 11:24
  - scans and different testing in the area. We
• 11:26
  - have, you know, low dose CTU testing and
• 11:28
  - rapid diagnostic clinics. We have, a new CTA
• 11:31
  - coming, which is gonna help us with some
• 11:33
  - of our,
• 11:34
  - patients that are,
• 11:36
  - needing, scans when it comes to their cardiac
• 11:39
  - issues or,
• 11:40
  - potential stroke diagnoses.
• 11:42
  - There's a lot of things we can be
• 11:44
  - doing in that space, which we're going to
• 11:46
  - continue to push,
• 11:47
  - but then a lot of it comes with
• 11:49
  - the pieces that we can control,
• 11:52
  - making sure we're controlling our,
• 11:54
  - efficiencies when it comes to the cost of
• 11:57
  - our
• 11:58
  - teams, what it costs to do business every
• 12:00
  - day,
• 12:01
  - making sure that we're being good stewards of
• 12:03
  - our resources. We're growing in the right areas,
• 12:06
  - that our that our community needs.
• 12:08
  - You know, we're not an organization that's going
• 12:11
  - to to chase the almighty dollar. We're we're
• 12:13
  - going to really focus on our mission, and
• 12:15
  - our mission is to take care of of
• 12:17
  - those that are that are vulnerable in the
• 12:19
  - communities that we're in. And so, you know,
• 12:22
  - that comes with a high cost. And so
• 12:23
  - we have to be very careful with how
• 12:25
  - we structure things to make sure that it's
• 12:27
  - a service we can continue into the future.
• 12:30
  - But I think the biggest thing that we're
• 12:32
  - focused on over the next ten years is
• 12:33
  - what we're calling destination OSF.
• 12:36
  - And destination OSF is an opportunity for us
• 12:39
  - to
• 12:39
  - to grow,
• 12:41
  - across our,
• 12:42
  - markets. It's an umbrella opportunity, essentially.
• 12:45
  - We're identifying those services where we can truly
• 12:48
  - be differentiated.
• 12:49
  - We're investing in our physicians, technology, our infrastructure,
• 12:54
  - and then we're making OSF a destination for
• 12:56
  - those services.
• 12:58
  - And so when you look at our services
• 12:59
  - across our markets that we
• 13:02
  - are focused on, we have a wonderful children's
• 13:05
  - hospital in Peoria that's,
• 13:07
  - doing amazing things,
• 13:09
  - and we have a cancer care institute, a
• 13:11
  - neurological
• 13:13
  - institute,
• 13:14
  - a cardiovascular
• 13:15
  - institute. And so when you look at all
• 13:17
  - of these things that we have in our
• 13:18
  - market,
• 13:19
  - we really can be a destination center for
• 13:22
  - those folks in the Central Illinois region,
• 13:25
  - and we're hoping to continue to provide those
• 13:27
  - services for years to come. But we want
• 13:30
  - to be the destination center that people come
• 13:32
  - to, and so, you know, offering those services
• 13:34
  - and making sure we're the very best quality
• 13:37
  - safe care, and provide the best experiences where
• 13:40
  - is where we're heading.
• 13:41
  - That's great to hear. And I think when
• 13:43
  - you talk about having that destination OS, bringing
• 13:46
  - patients in and, focusing on that patient experience,
• 13:50
  - what have you noticed about how things have
• 13:53
  - changed over the last few years? I know
• 13:54
  - technology obviously makes a lot more,
• 13:57
  - possible within the health care space when you
• 13:59
  - think about the patient experience. But how are
• 14:01
  - you seeing, you know, some of those trends
• 14:04
  - evolve, and and,
• 14:05
  - what do patients expect when they're coming in
• 14:07
  - these days?
• 14:09
  - Yeah. I think expectations themselves always change and
• 14:12
  - get get,
• 14:13
  - a little more difficult, I think, to attain
• 14:15
  - sometimes when, you know, health care can be
• 14:18
  - clunky and it can take time to do
• 14:20
  - things, whereas people are used to instantaneous
• 14:23
  - gratification,
• 14:24
  - with their phones and and being on social
• 14:26
  - media and things like that. And so, you
• 14:28
  - know, we're always,
• 14:29
  - you know, a little behind the eight ball
• 14:31
  - when it comes to to that in health
• 14:33
  - care.
• 14:34
  - And so I think what we can really
• 14:36
  - focus on is providing a good experience for
• 14:39
  - people, providing the right culture at our organization
• 14:42
  - where our patients feel valued and respected when
• 14:44
  - they come in.
• 14:46
  - We often say this on our team, but
• 14:47
  - if we we need to treat every single
• 14:50
  - patient as if it is our loved one.
• 14:52
  - Is it you know, if it's your child
• 14:53
  - or your mother or your husband or wife
• 14:55
  - or whoever you you really,
• 14:58
  - find to be the most important person to
• 15:00
  - you,
• 15:01
  - treat that patient in front of you like
• 15:03
  - that person. If everybody is doing that all
• 15:05
  - of the time and is here for the
• 15:07
  - right reason, mission focused,
• 15:10
  - we unite under the same values,
• 15:12
  - that will be a great experience for all
• 15:15
  - of our patients.
• 15:16
  - You know, nobody wants to seek health care
• 15:18
  - services. Nobody wants to come to the hospital,
• 15:20
  - right? It's something that you're in a vulnerable
• 15:23
  - position. You're,
• 15:24
  - might be having the worst day of your
• 15:26
  - life, right? And so you're met with people
• 15:28
  - at the organization,
• 15:30
  - that are going to treat you,
• 15:32
  - with the dignity that you deserve. And so
• 15:35
  - I think that ultimately
• 15:36
  - having that experience,
• 15:38
  - communicating with people, involving their families,
• 15:41
  - having our providers, you know, sit on the
• 15:43
  - edge of the bed and talk to people
• 15:44
  - to take a moment to really treat them,
• 15:47
  - like the person they deserve to be treated,
• 15:49
  - that's really important. And then as leaders, we
• 15:51
  - have to be treating our employees the same
• 15:54
  - way. Right? So we have to be coming
• 15:56
  - to work,
• 15:58
  - to to be the best version of ourselves
• 16:00
  - for our teams. And so when we model
• 16:02
  - that behavior and our teams model that behavior,
• 16:05
  - then our patients feel that. And so, you
• 16:07
  - know, I I think we make it a
• 16:09
  - little difficult at times when we chase patient
• 16:11
  - experience scores and we talk about all of
• 16:13
  - these things. Because at the end of the
• 16:14
  - day, people want to feel special. They wanna
• 16:17
  - feel heard. They wanna be communicated to, and
• 16:20
  - they wanna feel safe. And I think at
• 16:22
  - the end of the day, that's really what
• 16:24
  - it is, is what would you want if
• 16:26
  - you were in that situation?
• 16:27
  - What would you want for your loved ones?
• 16:29
  - And so that is our culture that we
• 16:31
  - have been,
• 16:32
  - creating, and we're gonna continue to create until
• 16:35
  - probably forever. Right? It's a constant refinement.
• 16:38
  - Absolutely. That you know, thinking about culture, thinking
• 16:41
  - about the ways that, you know, you can
• 16:43
  - really make a difference, for folks coming into
• 16:46
  - the health system and that human to human
• 16:47
  - connection is so critical within the health care
• 16:50
  - space. I I really appreciate that. Now before
• 16:53
  - we wrap up here, I wanted to ask
• 16:55
  - you about leadership as well. Who's a leader
• 16:58
  - that you really admire from any industry and
• 17:01
  - why?
• 17:02
  - That's a good question. I've been, you know,
• 17:03
  - I've been coming to Becker's for,
• 17:06
  - five or six years now to the conferences,
• 17:08
  - and
• 17:09
  - I like them
• 17:10
  - because I I really enjoy spending time, like,
• 17:14
  - finding some of those leaders
• 17:16
  - to listen to,
• 17:17
  - and kind of listen to every year and
• 17:19
  - hear their story and progression
• 17:23
  - And one of the one of the guys
• 17:24
  - I've really come to like,
• 17:26
  - through my time at Becker's has been John
• 17:28
  - Koras.
• 17:29
  - He's the CEO at Tampa General.
• 17:32
  - I I really like how he puts culture
• 17:35
  - with execution
• 17:37
  - and also with the health system transformation that
• 17:40
  - he's been undergoing over the last few years
• 17:42
  - because I find that the way that he
• 17:45
  - approaches his work with not only be being
• 17:47
  - transformative,
• 17:49
  - but the way he really focuses on people
• 17:51
  - and creating the culture
• 17:53
  - and then and then getting everybody to a
• 17:55
  - point of ownership where they can execute,
• 17:57
  - and breaking down those barriers for people.
• 18:00
  - He said a lot of really great things
• 18:02
  - that I've come to admire over the years.
• 18:04
  - And so, you know, that's one individual I
• 18:07
  - think that I've I've really come to respect,
• 18:10
  - and somebody that I've I've really learned a
• 18:12
  - lot from just listening to, over the years
• 18:15
  - of coming to Becker's.
• 18:17
  - I 100%
• 18:18
  - agree. It's just fascinating and inspiring to hear
• 18:20
  - what John has to say every year and,
• 18:22
  - you know, thinking through what it takes to
• 18:24
  - have that type of transformation.
• 18:25
  - So I appreciate having your thoughts there, and,
• 18:28
  - you know, I'll be excited to see you
• 18:29
  - as well at our CEO CFO round table.
• 18:31
  - I know you'll be speaking on a panel
• 18:33
  - and I'm sure inspiring many folks who are
• 18:35
  - in the audience as well.
• 18:37
  - Absolutely. I'm always honored to to be involved
• 18:39
  - in that. I think,
• 18:41
  - any opportunity I can to to share,
• 18:44
  - my thoughts and insights and also just, learn
• 18:46
  - and be around other folks that are lifelong
• 18:49
  - learners is always a wonderful opportunity. So thank
• 18:51
  - you.