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

Summary

Podcast Summary: Becker’s Healthcare Podcast

Guest: Dr. Alexander Rakul, MHA, PhD, Chief Administration Officer, Kaiser Permanente Central Valley Service Area
Host: Laura Deardo, Becker's Healthcare
Date: February 7, 2026

---

Episode Overview

This episode spotlights Dr. Alexander Rakul, Chief Administration Officer for Kaiser Permanente’s Central Valley Service Area. The conversation delves into leadership strategies post-pandemic, recruitment and retention challenges, innovation in care delivery, and future growth opportunities within Kaiser Permanente’s extensive healthcare system. Dr. Rakul offers a detailed look at operational improvements and organizational priorities impacting both patients and staff in the Central Valley and beyond.

---

Key Discussion Points & Insights

1. Dr. Rakul’s Role and Scope at Kaiser Permanente

• Dr. Rakul oversees operations for Kaiser Permanente’s Central Valley Service Area, directly supporting care for 453,000 members across three hospitals and more than ten medical office buildings.
• Kaiser Permanente operates as a fully integrated healthcare system with a unique alignment of health plan, hospitals, and physician groups.

  "I'm overseeing medical group operations, supporting physicians and support staff that provide care to 453,000 members in the vast territory of our California Central Valley." — Dr. Rakul [01:10]

---

2. Most Impactful Recent Project: Operations Leadership Team (OLT)

• Post-pandemic, Dr. Rakul identified a gap in connectivity and alignment among VP-level leaders in Northern California.
• With 120 VPs across the region, the OLT was developed to enhance collaboration, knowledge sharing, and consistency across diverse service lines.
• Established conferences and subgroup structures to facilitate ongoing best practice implementation.

  "We worked to make sure that we're connecting people better and also investing in their leadership development... we've heard a lot of great feedback and it definitely did bring people closer together, overcoming some of the challenges that we face during and post pandemic." — Dr. Rakul [02:09–04:09]

---

3. Organizational Priorities & Headwinds for the Coming Year

• Top Priority: People
  • Recruitment and retention of top clinical talent is paramount, particularly given labor shortages.
  • Expansion of training programs: New allied health school branch to educate 20 psychologists annually; exploration of residency programs for physicians.
  • Emphasis on the power of training locally: “About 80% of providers stay where they receive their training.”

  "Recruitment and retention of top talent continues to be our top priority... Our turnover rate is very small, very small percent of our people are leaving." — Dr. Rakul [04:28]

• Affordability & Financial Uncertainty
  • Need to maintain affordability amid challenges such as uncertainty around ACA subsidies.
  • Streamlining operations and implementing proven best practices top of mind.
• Care for Younger Adults
  • Recognized the need to better support young adults who interact less frequently with the healthcare system and may be confused by its complexities.
• Growing Medicare Population
  • Strategic focus on optimizing care delivery and service for older adults as their percentage within the population grows.

---

4. Innovations and Initiatives: What’s Challenging and What’s Next

Dr. Rakul highlights current and upcoming initiatives that he believes will define the next year:

• Ambulatory Treatment Center (ATC) Expansion

  • Opened in Modesto Hospital, the ATC department frees up hospital beds by managing patients not requiring full admission, with notable success for CHF (congestive heart failure) care.
  • Project showed significant cost savings and better patient convenience.
  • Plans to expand ATC to two additional hospitals in the region.

  "We saw savings of millions of dollars last year with opening of this ATC. And this year we're planning to expand it to our other two hospitals as well." — Dr. Rakul [07:48–09:12]

• ‘Care Plus’ Program for High-Need Medicare Patients

  • Utilizes AI to predict patients at risk for multiple hospitalizations.
  • Multidisciplinary teams (social worker, pharmacist, nurse, case manager) support primary care doctors.
  • Positive early impact: reduced hospital and emergency utilization for sickest Medicare patients.

  "With help of AI, we're identifying those people who we can predict that they will be hospitalized multiple times... significant decline in their hospital utilization as well as less emergency room utilization." — Dr. Rakul [09:34–10:27]

• Urgent Care Expansion for Young Adults

  • Recognizing younger patients’ desire for quick and accessible care, the first urgent care site just opened, with plans for more.
  • Designed for after-hours and weekend needs, while still reinforcing the primary care relationship.

  "We clearly understood that that's something that they want... after hours and on the weekends. So last week we opened one and we're hoping to open another one within a year or so." — Dr. Rakul [10:38–11:29]

---

5. Growth Opportunities for Kaiser Permanente’s Central Valley

• Demographic Shifts from Bay Area
  • Central Valley is experiencing a population boom from Bay Area transplants, necessitating increased capacity and service adaptation.
• Operational Excellence through Best Practice Sharing
  • Ongoing effort to compare performance across 15 service areas and implement the most effective, evidence-based strategies—without losing the organization’s “secret sauce.”
  • OLT facilitates these direct VP-to-VP exchanges.

  "Our biggest opportunity is in identifying best practices and comparing performance between different service areas... that learning from each other and implementing those best practices without losing the secret sauce, because... the secret sauce is lost at times." — Dr. Rakul [12:12–14:20]

• Consistent Experience Across Facilities
  • Central goal: Ensure patients experience consistency in quality and outcomes no matter which facility they access.

---

Notable Quotes & Memorable Moments

• On Post-Pandemic Collaboration:

  "...during the years of the pandemic, the executive leaders kept the connection pretty tight. Yet our VP level leaders... were not as connected and not as aligned." — Dr. Rakul [02:12]

• On Recruitment and Retention:

  "Our turnover rate is very small, very small percent of our people are leaving. We're known for that as Kaiser Permanente and as medical group in particular." — Dr. Rakul [05:05]

• On Predicting Challenges:

  "I'm always reluctant to project what the hardest thing will be... we never know what the hardest thing will be next year." — Dr. Rakul [07:49]

• On Sharing Best Practices:

  "Sometimes people are twisting... during the implementation, twisting the processes and the secret sauce is lost at times." — Dr. Rakul [13:24]

---

Key Timestamps

• [01:10] Dr. Rakul introduction and overview of Kaiser Permanente Central Valley operations.
• [02:09–04:09] Detailed description of the Operations Leadership Team initiative and its impact.
• [04:28–07:28] Discussion of recruitment, retention, affordability, and care for special populations.
• [07:48–11:29] Three key innovations: ATC expansion, Care Plus for Medicare patients, urgent care access for younger adults.
• [12:12–14:20] Growth strategies: demographic trends, best practice sharing, and ensuring clinical consistency.

---

Tone and Takeaway

The conversation is pragmatic yet optimistic, characterized by Dr. Rakul’s focus on integrating people-centric strategies with operational excellence. He highlights both the challenges and opportunities posed by changing demographics, financial pressures, and evolving patient needs, and sees collaboration—not just within facilities but across regions—as essential to the health system’s continued success.

---

This episode provides a detailed roadmap of how a major healthcare institution adapts, innovates, and grows in a post-pandemic landscape, balancing immediate challenges with long-term vision.

Transcript

[A]

The most important healthcare decisions don't happen in isolation. They happen when leaders come together. Becker's 16th annual meeting brings together more than 3,500 hospital and health system executives this April in Chicago. With 800 speakers from Ascension, Cleveland Clinic, Common Spirit, and more, the conversations get real. Leaders will share how their scenario, planning for policy shifts brief, breaking through value based care barriers and building clinical teams that translate new ideas into real world care. Join top decision makers in the room April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the events tab in the upper right.

[B]

This is Laura Deardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Alexander Rakul, Chief Administration Officer at Central Valley service area of Kaiser Permanente. Dr. Rakul, it's a pleasure to have you on the podcast today. Today.

[C]

Thank you. Thank you.

[B]

I'm excited to have you on the podcast today. But before we dive into our discussion, can you tell us a little bit more about yourself and Kaiser Permanente?

[C]

Absolutely. So my name is Alexander Akua. I'm Chief Administrative Officer in the Central Valley service area of Kaiser Permanente. As you probably know, Kaiser Permanente is a fully integrated healthcare system which includes our health plan, hospital and medical group. And I'm overseeing medical group operations, supporting physicians and support staff that provide care to 453,000 members in the vast territory of our California Central Valley. We're located just east of Bay Area, Maine Bay area, and we're providing care in three hospitals and over 10 medical office buildings here.

[B]

That's, you know, incredible to hear. Now, I'm curious, when you think about the last year or so, what was the one project you worked on that was most important? What did you do and what were the results?

[C]

Probably the most important project we worked on was something we call Operations Leadership Team, or olg. And I did this in very close contact with my regional leader, Lawrence Hamilton. We realized that during the years of the pandemic, the executive leaders kept the connection pretty tight. Yet our VP level leaders, and we have about 120 of them in the Northern California region, they were not as connected and not as aligned. And last year we worked to make sure that we're connecting people better and also investing in their leadership development. So with that in mind, we had several conferences bringing them together. And we're taking care of about half a million. 400. Sorry, we're taking care of about 4 million people here in Northern California. So it's, it's an Extensive operation and our vice president level leaders, they are definitely much more connected to the frontline operations and we want to make sure that best practices are shared as well as there's consistency in providing care in different service lines. And with that in mind, we deployed this operations leadership group and also the subgroups per each service line where all these VP level leaders can connect with our regional VP level leaders and can work on improving practices, implementing best practices and also fully leveraging our integrated healthcare system. So that was quite an incredible project and we've heard a lot of great feedback and it definitely did bring people closer together, overcoming some of the challenges that we face during and post pandemic.

[B]

You know, there were so many challenges post pandemic, so to be able to turn some of those things around and really, really have great results is impressive to see. Now, looking ahead for the next year or so, what are your biggest priorities? Where do you see some of the headwinds coming from as well?

[C]

Absolutely. And let me answer it together, because our priority are based on those headwinds and from the priorities, I always put people as our top priority. We work in healthcare and working with people and for people is the most important thing. So the recruitment and retention of top talent continues to be our top priority. As you know, as our listeners know, it's challenging to hire both primary and specialty care providers as well as many of the other providers as psychologists, CRNAs, optometrists, et cetera. So we're putting a lot of innovative efforts into recruitment of new talent as well. As we always paid tremendous attention to retention. Our turnover rate is very small, very small percent of our people are leaving. We're known for that as Kaiser Permanente and as medical group in particular. And also we're developing new opportunities, opening for example, a branch of our School of Allied Health in Central Valley where we'll be preparing 20 psychologists every year. We're looking into new internship residency programs as well for physicians because it's known that about 80% of providers they stay where they receive their training at. As a second priority, I would say also headwind is affordability and financial situation, especially as there's still uncertainty around the ACA subsidies. We do need to staff affordable and we're continuously looking at opportunities, how to streamline operations and find those best proven best practices to ensure that we're providing not just high quality but also affordable healthcare to our members. And next priority is looking at our younger adults. As a system, we always were providing very high quality care to our people with chronic conditions and sick patients. But those who visit us once or twice a year, they might be confused. It's a complex environment and we need to help them to navigate our system and also understand what their needs are. The last thing I wanted to point out is as a headwind and priorities, an increasing percent of Medicare population. And we're actively working to find how we can optimize care for our older people and address and optimize the Medicare population service.

[B]

Wow, that's a lot going on and definitely, you know, super, super helpful to understand and think about all the different ways that you're recruiting and retaining Folks. I'm curious, what do you think the hardest thing you'll do in the next year will be?

[C]

Well, I'm always reluctant to project what the hardest thing will be. I'm in my current role for six years, so I started just two months before COVID pandemic. So we never know what the hardest thing will be next year. And with that in mind, we have quite a few things going on and really it's most interesting things that we'll implement. They're really related to the, to us leveraging the opportunities that our integrated healthcare system is providing us. And we did start few of them last year and continue expanding them this year. First thing I wanted to mention is ambulatory treatment center. We did open one in our Modesta Hospital last year and ambulatory treatment center is a nursing and hospitalist based department that is taking care of the patients who are in the hospital and are in the emergency department, but they can be discharged, but they just have few things to be done. And so they. So we're freeing up a lot of hospital beds with help of this ambulatory treatment center. And probably the most prominent area of intervention is chf. Our patients with chf, they just receive much more convenient care there. And overall we saw savings of millions of dollars last year with opening of this atc. And this year we're planning to expand it to our other two hospitals as well here in the Central Valley. Another thing is, as I mentioned, the Medicare population is top of mind. So last year we started Care plus program and this year we're planning to expand it. So Care plus program is built around primary care and it's addressing or helping primary care doctors to take care of the sickest of the sick patients. And with help of AI, we're identifying those people who we can predict that they will be hospitalized multiple times. And we support primary care doctor with social worker, pharmacist, RN and case manager to really have A complex approach to these patients with hope that they will. And we know that there will be significant decline in their hospital utilization as well as less emergency room utilization. And last thing I wanted to mention is last week we opened our first urgent care. We were always investing in connection of patients or our members with their primary care provider. But as I mentioned, we are very much looking forward to improve care to our younger people or young adults. And we clearly understood that that's something that they want, the urgent care and just this more transactional connection with the physician, especially after hours and on the weekends. So last week we opened one and we're hoping to open another one within a year or so. We have a very large territory, so hopefully it will help them to navigate care effectively. And definitely we still feel that connection with primary care provider is the most important connection for the member and trust that they built over years is very important. So those three things are probably the most engaging areas that I'll pay attention to next year. Not sure which one will be the hardest, but yeah, we'll see.

[B]

There's a lot going on right now, so, you know, I appreciate you sharing all of those elements with us and then looking forward to, you know, seeing all of that play out. Before we wrap up here, let's talk about growth. Where do you see some of the biggest opportunities for growth in the next 12 months?

[C]

Absolutely, we in the Central Valley, we're located close to the Bay Area and we see a lot of growth, growth by just people moving from the, from the San Francisco Bay Area. So we, we receive for years now, we receive a lot of patients who are just transplants from there. And we're making sure that we accommodate them and, and continue caring for them. Overall, I think as an organization and as a whole, I think our biggest opportunity is in identifying best practices and comparing performance between different service areas. As I mentioned, we have 15 service areas here in Northern California and we have a lot of smart people who figure things out. So we just need to continue working on identifying those best practices and proven best practices. So looking at both financial performance and goals performance and see where this golden middle is and what are those proven best practices. And frankly, those projects that I mentioned, Care plus, for example, those were proven and implemented in other service areas as well. And we just learned from them. So that learning from each other and implementing those best practices without losing the secret sauce, because sometimes people are twisting, you know, during the implementation, twisting the processes and, and the secret sauce is lost at times. So it's important to, to really understand how those best practices work and and we can share them. And actually going back to my initial kind of conversation about the project from last year, the operations leadership team, it can truly help us in just connected VP level operational leaders making sure that from patient perspective we have consistency in service and consistency in quality no matter which Kaiser Permanente facility they go to.

[B]

I love that goal. Having that kind of consistent in quality experience and outcomes makes a big difference. And so to hear all the different efforts and initiatives you have going on to care for that population and make sure patients are coming out in a strong position possible, it is incredible to hear. Thank you so much Dr. Rakul for joining us on the podcast today. This has been an amazing conversation and I look forward to connecting with you again soon.

[C]

Thank you so much Laura. I really appreciate it and love working with Beckers and looking forward to attending your annual meeting as well.

[B]

Absolutely. It'll be great to have you there. I know you'll be speaking on a panel and truly looking forward to learning more and digging deep, deeper into many of the themes you talked about today.

[C]

Thank you.