← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
David Goldberg, President & CEO of Mon Health System and Davis Health System and Executive Vice President at Vandalia Health
00:13:58
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- [00:00]
A
This is Scott Becker with the Becker's Healthcare podcast. I am thrilled today to be joined by a leader who's a magnificent leader we love getting to visit with. We're joined today by David Goldberg. David's the president and CEO of Mon Health. He's also his executive vice president, Vandalia Health, and he'll help me make sure I'm pronouncing that correctly. David, I love getting a chance to visit with you. Can you take a moment to introduce yourself to the audience and tell people a little bit about Mon Health, about Vandalia Health and healthcare in West Virginia?
- [00:35]
B
Well, Scott, it's always a pleasure to be with you and to do this after the holiday weekend is great. Vandalia Health was created in 2022 as the merger of Charleston Area Medical Center Health System, based in Charleston, West Virginia, and Mont Health System, anchored in Morgantown, West Virginia. We came together, formed the second largest health system in the state. We were blessed to have the Davis Health system join us two years ago. So now we're a 17 hospital system, more than 200ambulatory locations covering parts of Ohio, southwest Pennsylvania, western Maryland, a little bit of Virginia, and of course, West Virginia. 13,000 employees. And thrilled that we're able to keep community care close to home, laser focused with our board of directors of West Virginia residents taking care of West Virginians. Thank you.
- [01:28]
A
And what's the largest town in West Virginia? Tell us a little bit more about the geography of West Virginia. I know it still is a very impoverished state, but it's got these crown jewels of the state like Mont Health and Vandalia. Tell us a little bit about sort of West Virginia.
- [01:41]
B
So West Virginia as a whole, we're about 1.8 million residents. The largest cities of note would be Charleston, which is our state capital, as well as Huntington, West Virginia, Wheeling, Weirton, are all large cities. Morgantown, we call it the University City, is about an hour and 20 minutes south of Pittsburgh, where I sit. And, you know, we're a very proud group. I'm a WVU graduate. I joke. We've been socially distancing since 1857. We're very loyal to our state. We're very humble, we work hard. And, you know, Vandalia was brought together to make sure that access quality care service is the forefront of what we do. Each and every patient, one patient at a time. Thank you.
- [02:24]
A
And talk a little bit about. When you look at the trends you're watching in healthcare, it seems like West Virginia is doing a better job than other states in getting Its physicians back there. So many challenges in rural healthcare today. What are some of the trends you're watching in West Virginia? It seems like West Virginia is just moving in the right direction versus so many other places. What's your sense that and what trends are you watching?
- [02:50]
B
Well, I think that's a great question. I mean we're 1.8 million people and you know, you talked about our rural nature. West Virginia has pockets of greatness and pockets of good access. I'm talking from the northern part of the state where you can get to Baltimore or Washington or Pittsburgh or Ohio pretty easily for higher level care you may not be able to get at home the more southwest you go in pockets or east. Yeah, you think east, you're close to D.C. well, you could be in a very rural community without a major interstate or access road and you have to wind around to get out up and over. So our goal at Vandalia Health has been able to bring care close to home. We've been very lucky this year in physician recruitment across our enterprise. We've brought in nearly 200 doctors, nurse practitioners, physician assistants, CRNAs, you name the allied health professional, onto our campuses to be able to take care of our patients. Many of our doctors travel to some of these rural communities to offer oncology or pulmonary care or neurology care or urological care because we can't get people to live right in those little rural communities. And most of us know if you don't make it easy to access healthcare, patients aren't going to go. And if they don't go, they're going to get sicker. Healthcare is gonna get more expensive and families are gonna suffer because their loved one gets sicker. So our goal is be able to get care close to home through telehealth, through making sure we have specialists close, and also to make sure that we recruit into the communities and hopefully get people to live there. Some trends, pharmaceutical expenses on everybody's radar last year, the year before it was the GLPS. Well this year it's the 340B and making sure that the costs are reduced to get access to care and pharmaceuticals to our patients. Labor costs are still some a driver for us. While we're rural. We have to pay competitively like the states around us to get people to live in our state. And while they'll come to a rural state, they still want to get paid what the going rate is and we want to be competitive to do that. Health benefits is another area. While our employees and colleagues might be healthy, some of their Dependents, where we call them beneficiaries on the health plans, are a little costly and we want to take care of our families, but it's also a cost that we're trying to manage. And then lastly, the trend on it, the fastest growing part of our budget in most healthcare providers, besides the medicines and the benefits, is the investment in technology. Whether it be artificial intelligence or electronic medical records or other investments, they're very costly. And if you're a mostly Medicare, Medicaid state, like West Virginia, where your rates are fixed, the costs are high and we have to manage our costs, manage our revenue, our expenses and our levels of investment to be very proactive.
- [05:43]
A
Thank you. No, that, that makes sense. I mean, so much of the dollars that are coming in Medicaid, Medicare, some commercial, but so many of those different dollars are not going up in any significant way or they're fixed dollars. At the same time, the expenses continue to rise and continue to try and innovate and provide better and better cure. You got rising costs and relatively flat reimbursement. Talk for a second, David, as you look at 2026, what are you most focused on and excited about as you move towards this next year?
- [06:14]
B
Well, then there's the macro and the micro. I'll start with the micro. We're still merging all of our assets into an integrated delivery system. And as many of us know, when you build scale, you want to take out waste of the system, reduce your costs so you can take those excess dollars that you generate, invest them into your people, invest them into technology, invest them into programs that benefit our community. As a 501 or a tax exempt organization, we want to be very careful with the dollars we invest so we could benefit our communities and make them more livable and healthy. From a macro perspective, there's a lot of, you know, trials and tribulations related to what is or isn't coming out of Washington related to Medicaid reimbursement reductions that will come from that. 340B the I love what I'm seeing. I think just today we saw Eli Lilly is dropping the cost of GLP1s if you pay cash. So we're seeing a lot of things change in the market which should improve care, improve access and reduce cost. We still need to make ourselves frictionless, make it easier for patients to get in to see their doctors or their healthcare professionals and take care of them in the moment. They need our care so we can reduce cost and improve our outcomes. The nation is moving to value. That means we have to be Johnny on the spot related to getting those people that need care in getting them timely taken care of, following up with them timely and getting to own their health care and make it a less difficult environment. Those prices, if you will, are relatively fixed. But whether it be a tariff, whether it be inflation, are going up and we have to make sure that we're being good stewards of the dollars that we get from for fee, for service and or arrangements with our payers. But we also have to be good stewards of those dollars. Yes.
- [08:02]
A
No, no, absolutely. And David, you've had this fantastic career. You spent a lot of time at Allegheny General Health before moving to West Virginia or taking a position here. Talk a bit about what advice would you give to emerging leaders in what do you tell somebody's an emerging leader who wants to have an impactful and great career.
- [08:23]
B
So I've been blessed. I've lived in Northern Virginia. I worked at Inova Health System. I've worked in Texas with Baptist Health System, part of Tenant Allegheny Health Network as you mentioned in Pittsburgh and then here with Vandalia. And what I say with everybody. Health care is probably the most giving profession back to a community you can take on. We cover pretty much every profession or career that you would need, whether you're in safety, security, IT finance, healthcare delivery, cybersecurity security as a whole. I joke. Healthcare systems and hospitals are like little cities. So it's imperative that we give back to our communities and stay focused on what the local communities need. Not all of us could be all things to all people, but when it comes for people coming up the ranks, you know, it's pretty easy. Don't take yourself too seriously even though it's a serious job. Be into the details enough that you understand it and can make a difference and then hopefully lead your next level leaders to the next level to be successful for the communities we serve. Partner with your clinicians. It's very easy to get into, I'll say, a combative situation. Nothing. Everyone is coming to the table wanting to do the best thing for the place they work, for the communities they serve, for the patients we take care of, et cetera. And God gave us two ears and a mouth for a reason. I talk a lot, so I try to slow down to listen more, understand what's being said and then try to galvanize our group to come to good solutions. And then at the end of the day, we're dealing with people's lives. Come to work. I had a boss many years ago say to me, if you don't strive for perfection. You'll never get there. And that's a high bar. Anything less in healthcare could mean a terrible outcome or a defect or a variation that can cause a bad outcome to a patient or to a colleague. So we want to make sure we have systems and structures in place to remove variability, but have a just culture where if people see things that aren't making sense, raise the flag or raise the idea for us to be better. Because at the end of the day, it's all about harnessing the strength of, in our case, 13,000 people to row in the same direction. And then also make sure at the end of the day that our patients are well taken care of and that our colleagues are well supported.
- [10:41]
A
Thank you. And then just taking us back one more second. As you look at 20, 26, if you look at sort of the what you're most excited about, you've got the integration going on. I don't know how the Mountaineers are doing right now, but what are you, when you look at this next year coming up, what gets you going in the morning that gets you like, oh my God, am I excited to get to work? Because here's what I'm working on.
- [11:05]
B
Well, I have an outstanding group of colleagues that I work with this year. Our longtime CEO, David Ramsey is retiring this summer of 26. Jeff Sandin, our long term CFO, will ascend to the CEO chair. There are two great guys who had the vision of bringing Vandalia together. And the three of us, along with 13,000 colleagues, are forming what we think is an integral part of the West Virginia fabric. So I'm excited about what more we can do to continue the trend as you started off with that, we're improving the healthcare trajectory of those we serve. I think this year is going to be a lot going on. Like I said, on the IT spectrum related to artificial intelligence and how we could put tools into the hands of our clinicians and our colleagues to make it that much easier to do the work that our patients expect, which is easily accessible. Lower cost, higher quality. West Virginia has a lot of benefits. The Mountaineers this year did not have a great year, but I'm on the basketball, so I'm already moving forward into March Madness. I hope and will be there, but we need to make sure that we are making it easy and we improve our outcomes. We're the number one state for smoking. We have some of the highest obesity, diabetes, heart disease that you'll see around the country, lots of Parkinson's, lots of lung cancer. We need to work on those and make it easy for us to work with the other providers in the state and around our region to make it easier. We hope that the president's $50 billion rural health care Transformation Grant we're going to get our piece of it really makes a dent in the way health care was to where we need to drive health care into the future. So 26 is going to be an incredible year. I'm excited for it and what keeps me going every day is no matter what any of us do in healthcare, we're improving people's lives and the trajectory of their healthcare. That's exciting to be able to help people in need, make sure we stay true to who we are and make people more healthy and hopefully give people a little bit more spring in their step.
- [13:08]
A
David, it's always great to visit with you. It always lifts my spirits. Thank you for joining us today on the Beckers Healthcare podcast. Congratulations on what you've accomplished and what Mon Health and Vandalia Health is accomplishing, accomplishing. Thank you so much for joining us.
- [13:24]
B
Thanks for all you do, Scott. I can't wait to get your book and thank you for the opportunity.
- [13:28]
A
God bless you. Thank you for buying. Thank you so much. Take care. Thank you, sir.
- [13:33]
B
Thank you, Sam.