Latest / Becker’s Healthcare Podcast / Nick Stavros on Growth, AI, and Leadership in Addiction Treatment

Transcript

Nick Stavros on Growth, AI, and Leadership in Addiction Treatment · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
• 0:04
  - understand what it takes to lead a health
• 0:05
  - system right now. The decisions are enormous.
• 0:08
  - The variables are constantly shifting, and the stakes
• 0:11
  - of getting a call wrong don't stay contained.
• 0:14
  - That's not a complaint. It's a structural reality.
• 0:17
  - And it's why the most effective c suite
• 0:19
  - leaders are deliberate about where they go to
• 0:21
  - pressure test their thinking.
• 0:22
  - Becker's fourteenth annual CEO and CFO roundtable
• 0:26
  - brings together more than 1,500
• 0:28
  - executive level attendees
• 0:30
  - and nearly 400 speakers for four days built
• 0:32
  - around growth, financial sustainability,
• 0:35
  - workforce strategy, and the leadership questions that don't
• 0:38
  - have easy answers.
• 0:39
  - Join us November second through the fifth in
• 0:41
  - Chicago.
• 0:42
  - For the agenda and event details,
• 0:45
  - visit beckershospitalreview.com
• 0:47
  - and click on the events tab in the
• 0:49
  - upper right.
• 0:50
  - This is Laura Dirdo with the Becker's Healthcare
• 0:53
  - podcast. I'm thrilled today to be joined by
• 0:55
  - Nick Stavos, chief executive officer of Community Medical
• 0:58
  - Services. Nick, it's a pleasure to have you
• 0:59
  - on the podcast today. Yeah. It's a pleasure
• 1:01
  - to be here. Thanks for having me. Absolutely.
• 1:03
  - Now I'm excited for our discussion. I know
• 1:05
  - we're gonna be going through a lot of,
• 1:07
  - the things that you're up to right now
• 1:09
  - as well as how you think about the
• 1:10
  - future. But before we dive in, can you
• 1:11
  - tell us a little bit more about yourself
• 1:12
  - and Community Medical Services?
• 1:15
  - Yeah. Sure.
• 1:16
  - I've been at community medical services for, I
• 1:18
  - think, about thirteen years, and,
• 1:21
  - I was just prior military officer in the
• 1:23
  - army, prior to that. Community medical services is,
• 1:27
  - opioid treatment programs,
• 1:29
  - so outpatient,
• 1:31
  - treatment programs, and we treat primary diagnosis of
• 1:34
  - opioid use disorder.
• 1:35
  - And we have,
• 1:37
  - over 80 clinics in 14 states,
• 1:41
  - primarily Medicaid population treating about
• 1:44
  - 28,000,
• 1:46
  - patients in, like I said, all outpatient settings.
• 1:48
  - So we use,
• 1:50
  - MAT,
• 1:51
  - medications
• 1:52
  - to treat opioid use disorder
• 1:54
  - in conjunction with psychosocial
• 1:56
  - therapies.
• 1:58
  - That's fascinating to hear about, you know, truly
• 2:00
  - important services within so many communities today.
• 2:03
  - So
• 2:04
  - I'm curious. Could you give us a quick
• 2:05
  - state of the union of community medical services?
• 2:08
  - What's gone well from the last year or
• 2:10
  - so, and and what are you planning and
• 2:11
  - focused on for the rest of 2026?
• 2:14
  - Yeah. It's been I'd say it's been a
• 2:16
  - really good year. It's been a good year
• 2:18
  - this year and a good year last year.
• 2:20
  - Thinking back
• 2:21
  - to the kind of reasoning
• 2:24
  - behind that and the momentum that's
• 2:26
  - led to Goodyear's. You know, we,
• 2:28
  - I think, you know, in spite of interest
• 2:30
  - rates going up, we've not taken on,
• 2:32
  - as much debt as some of other, players
• 2:35
  - in the industry, and so that's,
• 2:37
  - you know, that's been good. So we've been
• 2:39
  - less cash constrained just because,
• 2:41
  - debt hasn't been as much of an issue.
• 2:43
  - And that's primarily because we're
• 2:45
  - we're,
• 2:46
  - we're primarily focused on,
• 2:48
  - organic growth, open de novos. It's called, like,
• 2:50
  - opening new clinics rather than,
• 2:53
  - just doing a lot of m and a,
• 2:55
  - which, in our space, there's kind of a
• 2:57
  - consolidation happening, and so there's been lots of
• 2:58
  - m and a. So
• 3:00
  - that's been that's been positive.
• 3:02
  - You know, ACA
• 3:04
  - cuts
• 3:05
  - have not,
• 3:06
  - not impacted,
• 3:08
  - us as much just because we're in,
• 3:11
  - mostly in Medicaid expansion states, and I think
• 3:13
  - the cuts hit, non expansion states
• 3:15
  - a little bit more. And so I'd say
• 3:17
  - we've we've had some tailwinds that maybe have
• 3:19
  - been headwinds to other providers.
• 3:21
  - And so that's been you know, it's
• 3:24
  - I don't know. It's given us a bit
• 3:25
  - of a break.
• 3:26
  - And, you know, there's a lot of volatility,
• 3:28
  - obviously, going on right now with,
• 3:30
  - with with with Medicaid, with,
• 3:33
  - with different payers, with,
• 3:35
  - you know, regulatory oversight and stuff like that.
• 3:38
  - And so there's plenty of other things to
• 3:41
  - navigate, but for us,
• 3:43
  - it's been strong. I mean, we've had we
• 3:45
  - continue, like, month after month to have the
• 3:47
  - strongest month we've ever had. We're we're we're
• 3:50
  - always in a growth mode, so we open,
• 3:53
  - about,
• 3:55
  - eight to 10 new clinics every year. And
• 3:57
  - so it's it's just kinda like a steady
• 3:59
  - growth story, and then we're just constantly trying
• 4:01
  - to optimize,
• 4:02
  - you know, gain the ground that we,
• 4:04
  - keep keep the ground that we gain, I
• 4:06
  - should say. And so,
• 4:08
  - yeah, it's been a it's been a positive,
• 4:10
  - last two years.
• 4:12
  - That's great to hear. I know, especially thinking
• 4:15
  - through all the volatility in the marketplace, having
• 4:17
  - that,
• 4:18
  - ability, especially on the financial side, to to
• 4:21
  - be in a a good space going into
• 4:23
  - 2027
• 4:24
  - will be,
• 4:25
  - very helpful. And, you know, speaking of that
• 4:27
  - Mhmm. What are some of the headwinds that
• 4:29
  - you're keeping an eye on and preparing for?
• 4:32
  - Yeah. So, I mean, the the the biggest
• 4:33
  - headwind is just the volatility. Like,
• 4:36
  - it's it's not knowing what to expect. You
• 4:38
  - know, we we might get some executive order,
• 4:41
  - like, overnight
• 4:42
  - canceling, you know, grant funding that gets reinstated,
• 4:45
  - like, two days later.
• 4:47
  - And so it's not it's not a lot
• 4:49
  - of
• 4:50
  - actual
• 4:51
  - negative headwinds other than the volatility, like, not
• 4:54
  - knowing what to expect, and then it always
• 4:56
  - makes just planning a little bit more difficult.
• 5:00
  - You know, there's there's obviously Medicaid cuts coming.
• 5:03
  - We're primarily Medicaid funded. But,
• 5:06
  - you know, it's not something that that keeps
• 5:09
  - me up at night, I don't think, just
• 5:11
  - because,
• 5:12
  - you know, we had the whole redeterminations
• 5:14
  - after COVID,
• 5:16
  - which was supposed to which did cut Medicaid
• 5:18
  - roles in a lot of states, but
• 5:20
  - for whatever reason, it didn't really affect our
• 5:22
  - patient population.
• 5:23
  - So we've kind of we've kind of weathered
• 5:25
  - the storm already.
• 5:27
  - And, but but it's something we're paying close
• 5:29
  - attention to, you know, making sure that we're
• 5:31
  - making you know, have plans in place to
• 5:33
  - to communicate with patients. They're gonna have to
• 5:36
  - start reenrolling
• 5:37
  - more regularly and and, you know, with,
• 5:40
  - community engagement requirements. Like, that could take some
• 5:43
  - work on behalf of our patients. And,
• 5:46
  - we just need to make sure as a
• 5:47
  - provider, like, we're
• 5:49
  - geared up to support,
• 5:52
  - our patients as those regulations, like, take place.
• 5:55
  - And it's, I mean, it's state by state,
• 5:57
  - so different states can do different things. And
• 5:59
  - so we have to make sure that we
• 6:01
  - have a plan in place for our patients
• 6:03
  - in each state
• 6:05
  - to accommodate their needs.
• 6:07
  - That makes a lot of sense and is
• 6:09
  - helpful to understand. From that vantage point of,
• 6:11
  - you know,
• 6:12
  - thinking through the changes the last few years
• 6:14
  - and being able to continue to connect with
• 6:16
  - your patient population, have that communication, and really
• 6:19
  - continue
• 6:20
  - to serve them in a meaningful way.
• 6:22
  - What have you noticed about,
• 6:24
  - the patient population you work with over the
• 6:26
  - past few years? What's worked well,
• 6:28
  - to to really be able to make sure
• 6:30
  - they have access to care, and then,
• 6:33
  - any trends or anything that,
• 6:35
  - you've seen
• 6:36
  - evolve over the past couple years as well.
• 6:38
  - I'd just be curious what you're seeing out
• 6:40
  - there with the patient population that you serve.
• 6:44
  - Well, we primarily treat yeah. We we we
• 6:47
  - we treat patients who have an opioid use
• 6:48
  - disorder. So we're always paying very close attention
• 6:52
  - to drug trends.
• 6:53
  - You know, there's I mean,
• 6:55
  - in a in addiction, there's,
• 6:58
  - there's, you know, there's been exponential growth in
• 7:00
  - overdose death rates since, like, the nineteen sixties,
• 7:03
  - but
• 7:04
  - the drug of choice changes,
• 7:06
  - you know, sometimes a few times in a
• 7:08
  - decade. And so we play we pay really
• 7:11
  - close attention to that. I mean, you know,
• 7:13
  - fentanyl is decreasing now, but a lot of
• 7:17
  - the the zines like nidazine
• 7:19
  - are,
• 7:20
  - are becoming more more prevalent. And thenratom
• 7:23
  - is a big one and seven o h,
• 7:25
  - those are some drug trends that are you
• 7:27
  - know, they all have different impacts on on
• 7:29
  - our patients and on their
• 7:31
  - and on their desire
• 7:33
  - to get treatment or not get treatment or
• 7:36
  - whatever they're struggling with.
• 7:38
  - So we pay a lot of attention to
• 7:40
  - drug trends. We also, you know, as an
• 7:43
  - OTP provider,
• 7:44
  - our our treatment is is more cumbersome than
• 7:47
  - just, like, going into a doctor's office once
• 7:49
  - every 90 days to get a prescription.
• 7:51
  - So what that means is that we have
• 7:53
  - a lot of touch points with our patients,
• 7:55
  - and that's always just just an opportunity to
• 7:59
  - address more than just their substance use.
• 8:02
  - And so that's not really been a change.
• 8:04
  - That's been a consistent theme just in our
• 8:05
  - industry. You know, we have a we have
• 8:08
  - a we're in a position to
• 8:10
  - make a pretty big impact on our patients'
• 8:12
  - lives. And so, you know, you think about
• 8:14
  - things like value based purchasing.
• 8:16
  - There's a lot of opportunity for value based
• 8:17
  - purchasing in our space because we do have
• 8:20
  - just, like, such significant interactions with our patients
• 8:23
  - that we could impact things,
• 8:25
  - like I said, more than just their substance
• 8:27
  - use disorder. You know, we could deal with
• 8:29
  - other behavioral health issues or mental health issues
• 8:31
  - or physical health issues. And so,
• 8:34
  - you know, we just I mean, I think
• 8:35
  - to succeed in our space, you have to
• 8:37
  - be
• 8:38
  - really attuned to the needs of our patients
• 8:42
  - and really responsive to those needs. And so
• 8:44
  - it's a,
• 8:45
  - you know, it's a great opportunity to to
• 8:48
  - really add value in our patients' lives.
• 8:51
  - That's helpful to understand. Thank you so much
• 8:53
  - for sharing a bit deeper there. Now looking
• 8:55
  - ahead, what are some of the best opportunities
• 8:57
  - for growth over the next two to three
• 8:58
  - years or so?
• 9:00
  - Yeah. So, I mean, obvious the like, the
• 9:02
  - obvious one is just on the technology front.
• 9:04
  - Right? Like, we're
• 9:06
  - we're always trying to balance
• 9:08
  - how much should we grow
• 9:10
  - versus how much should we optimize.
• 9:13
  - Because there's days when I'm like, we could
• 9:15
  - just top all growth and focus purely on
• 9:17
  - optimization
• 9:19
  - and
• 9:20
  - probably, I mean, generate better margins,
• 9:25
  - generate essentially more more revenue even just by
• 9:28
  - optimizing our existing operations.
• 9:30
  - And so that's that's always a balancing act.
• 9:33
  - You know, ideally, we'd say we wanna we
• 9:34
  - wanna balance perfectly so that you have just
• 9:37
  - the right amount of growth and just the
• 9:39
  - right amount of optimization.
• 9:40
  - But, I mean, AI, obviously, like, two to
• 9:43
  - three years. That's a long period of time
• 9:46
  - in the AI paradigm.
• 9:48
  - And so we're spending a lot of time
• 9:52
  - really, like, researching AI, figuring out how to
• 9:55
  - how to capitalize on it in each
• 9:57
  - function in the company.
• 9:59
  - And I know it's kind of a generic
• 10:01
  - answer. Everybody's talking about AI, but it is
• 10:03
  - really one of those things where
• 10:05
  - when you lead an organization, like,
• 10:07
  - you know, I could be
• 10:09
  - really gung ho about AI, but you need
• 10:11
  - to get all the leaders in the organization
• 10:13
  - gung ho, and then that needs to trickle
• 10:15
  - down
• 10:16
  - to all the tacticians
• 10:18
  - and, you know, clinicians and everything throughout the
• 10:21
  - organization. So that in and of itself, just
• 10:24
  - just this paradigm shift, getting people to think
• 10:26
  - more about
• 10:27
  - how can AI solve a problem, that's
• 10:31
  - that's undoubtedly gonna be the biggest
• 10:34
  - I'd say,
• 10:35
  - like, not just optimization lever, but growth lever
• 10:38
  - also
• 10:39
  - because, you know, AI should help with growth
• 10:41
  - as well. I mean, it should help us,
• 10:43
  - you know, on,
• 10:45
  - machine learning and, like, data analytics and stuff,
• 10:47
  - understanding
• 10:48
  - where to grow,
• 10:50
  - understanding how how to grow most efficiently, like,
• 10:53
  - all that stuff. So I think
• 10:54
  - I mean, I assume most CEOs answer that
• 10:57
  - question the same by saying, like, AI is,
• 11:00
  - like, by far the biggest disruptor.
• 11:02
  - Absolutely. I think that, you know, makes a
• 11:04
  - lot of sense. And especially when you look
• 11:06
  - at leadership is always changing and shifting and
• 11:08
  - is important to get right.
• 11:11
  - And so to that point, what do you
• 11:12
  - admire in a leader and why?
• 11:15
  - Yeah. That's a great question. And there's,
• 11:17
  - there are a lot of things I could
• 11:19
  - say here. I consider myself a student of
• 11:22
  - leadership, and so I'm I'm constantly trying to
• 11:24
  - evolve and and analyze, like, you know, what
• 11:27
  - does make a good leader and stuff. And
• 11:30
  - the I think the
• 11:31
  - the most
• 11:32
  - impactful trait of an effective leader is from
• 11:35
  - a it's from a Lao Tzu quote, actually.
• 11:37
  - And and, he says the leader is best
• 11:40
  - when people barely know that the leader exists.
• 11:43
  - And I love that.
• 11:44
  - So, actually, if there's a who,
• 11:47
  - if there's a like, what leader do I
• 11:49
  - admire most? Like, it's Ted Lasso is one
• 11:51
  - of them,
• 11:52
  - because I think it's such a good leadership
• 11:55
  - parable
• 11:56
  - where, you know, some somebody that's kinda behind
• 11:59
  - the scenes and makes everybody else
• 12:02
  - cognizant of their contribution
• 12:05
  - rather than the leader. A lot of leaders
• 12:06
  - today, they want you know, there's a lot
• 12:08
  - of ego driven leadership, and they wanna take
• 12:10
  - credit, and they wanna be recognized. And I
• 12:13
  - think in fairness, like,
• 12:15
  - early on, I kind of was like that
• 12:16
  - as a leader. I was the face of
• 12:18
  - the company. I was out there. Like, I
• 12:20
  - I kinda was the company for a period
• 12:22
  - of time. And
• 12:24
  - as I've evolved my thinking, I've realized, you
• 12:26
  - know what? Like, the best leaders are the
• 12:28
  - ones that behind the scenes
• 12:31
  - make everybody else feel so empowered
• 12:34
  - that the leader doesn't actually get acknowledged
• 12:37
  - as
• 12:38
  - being the reason for the success. Every individual
• 12:42
  - contributor thinks they're the ones
• 12:45
  - that
• 12:46
  - are contributing to the success, not the actual
• 12:48
  - leader. And I just love that. I mean,
• 12:50
  - it's in good to great. It's you know,
• 12:52
  - Jim Collins calls it a level five leader.
• 12:55
  - It's the type of leader
• 12:57
  - I strive to be, and it's so
• 13:00
  - counter to how
• 13:03
  - this industry and most industries think of leadership.
• 13:05
  - Typically, you know, investors wanna know which leader
• 13:08
  - is making the biggest impact, and then they're
• 13:10
  - sitting there trying to figure out, like, who's
• 13:13
  - contributing what. And so it's a setup to
• 13:16
  - try to
• 13:17
  - to to for leaders to almost, like, self
• 13:20
  - advocate for their effectiveness.
• 13:22
  - You know? I think the the best leaders
• 13:24
  - are the ones
• 13:25
  - that's like I said, they're just kinda steering
• 13:28
  - things in the right direction,
• 13:30
  - but making sure everybody else is getting the
• 13:32
  - credit for it.
• 13:34
  - I love that. I think it's such an
• 13:36
  - important thing to point out about leadership. I
• 13:38
  - know here at Becker's, we,
• 13:40
  - subscribe to Jim Collins' leadership style as well
• 13:43
  - and and truly, truly being able to have
• 13:44
  - that ability,
• 13:46
  - to to bring those up, along with you,
• 13:49
  - alongside you, and and leaders all around you,
• 13:52
  - to elevate their effectiveness and, truly, you know,
• 13:55
  - be that kind of leader who, as you
• 13:57
  - mentioned,
• 13:58
  - is behind the scenes, making everyone else great,
• 14:00
  - and I love that. So thank you so
• 14:02
  - much, Nick, for joining us on the podcast
• 14:04
  - today. This has been such a a fun
• 14:06
  - conversation, and I look forward to seeing you
• 14:07
  - as well in person at our CEO and
• 14:10
  - CFO roundtable. I know you'll be speaking on
• 14:12
  - a panel there, and it'll be great to
• 14:14
  - dig deeper into some of these themes we
• 14:15
  - talked about today.
• 14:17
  - Yeah. I'm excited to be there. And, yeah,
• 14:19
  - thanks again for having me.