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Becker’s Healthcare Podcast
Dr. Adam Breslow, President and CEO of Children's Primary Care Medical Group
00:17:37
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- [00:00]
A
This is Laura Dardo with the Becker's Healthcare Podcast. I'm thrilled today to be joined by Dr. Adam Breslow, President and Chief Executive Officer at Children's Primary Care Medical Group. Dr. Breslow, it's a pleasure to have you on the podcast today.
- [00:13]
B
It's a pleasure to be here.
- [00:15]
A
Now I'm excited for our discussion because I know there's so much happening in healthcare today and particularly pediatric and children's care is just such an important population to be serving. And so I am looking forward to our conversation. But before we dig in, could you introduce yourself and tell us a little bit more about Children's Primary Care Medical Group?
- [00:34]
B
Thanks. Appreciate that. Personally, I'm a general pediatrician by training and I just started my 40th year of patient care. Even though I'm a CEO, I still see patients. I've been the CEO of CPCMG, that's our acronym, since January 1st of 2016. Our group was founded on November 1st, 1995, and we're planning a killer anniversary. It happens to be a Saturday. November 1st is a Saturday this year. So we're planning a killer party. So if you'd like to join us, it's going to be a really nice event. We're Currently, we have 29 sites with 175. I've hired six in the last couple of weeks. So we're going to be probably closer to 180 clinicians with 32 advanced practice providers. Our patient base is about 280,000. We see just under 600,000 visits a year. We're open seven days a week for both office access and video visit access. And we have integrated mental health therapists at many of our sites. Cpcmg, we're an accredited organization. We're the anchor of something called RCHN Brady Children's Health Network, which is an integrated delivery system. We are the largest safety net provider for children in a single medical group in California. We're the second largest in the country. Our group is a safety net provider. We see 46% of our patients are Medicaid and we have very deep and long standing affiliations with Rady Children's Hospital San Diego, University of California San Diego and Sanford World Health. So that's kind of who we are.
- [02:25]
A
That's amazing to hear. And you know what a huge network of patients that you're serving and organizations that you're partnered with. I mean, it's just such an impressive network that you built out. And so I'm excited to learn more. What do you see as being the Biggest winner success story from the last year or so.
- [02:42]
B
Yeah, that we actually had lots of wins, so but since I can only say the biggest. So our biggest win, but one of many has been the building and installation of our population health care coordinator teams within our entire facility. We've hired a team of 18 mostly RNs, but some non RNs to manage all of our clinician in basket messages and communications. It's removed about 80% of in basket work from the electronic records from, from our clinicians and they are really happy. I mean it's made them really happy. It took about two years to build it and about a year to install it and optimize it. But over the last year we've really optimized it beautifully and we can kind of prove that because our AMA wellness scores and our Gallup engagement scores over the past year have really improved significantly. We do have a close second though would be our HEDIS initiative. We have dramatically improved quality scores. So from my standpoint, the in basket management that we've done and the population healthcare coordination has enhanced clinician wellness and the latter of the HEDIS metrics has really enhanced our group's financial health. So it's all a win, win kind of one of these positive reinforcement, positive feedback loops.
- [04:23]
A
I love that. And what amazing results, not only for the clinicians and thinking about their administrative work and being able to give them more time back with their patients, but also to see, as you were mentioning, the quality scores that have made a big difference for the organization as well. I think that is really, really critical. And so hitting all cylinders there in terms of quality financial and clinician wellness. I love it. When you think about what's happening in healthcare today, what are the top two to three issues that you're focused on right now?
- [04:55]
B
Well, pretty much similar to what we just mentioned. Number one is Team Wellness. If you don't support high quality teams, high functioning teams, everything else, you can't do anything else. Everything else falls apart. So over the last year we've partnered with Steve Beeson and his team at Practicing Excellence and we've worked to really recommit ourselves to becoming premier team based care. Our organization is not just doctors and nurse practitioners and physician assistants. We have over 700 employees of our management service organization and they need to be, well, the medical assistants, the nurses, the IT team, the HR team, the finance team. If they're not well, you can't get anything done. So Team Wellness is pretty much the alpha and the omega of what we're trying to accomplish. Number two, which hopefully by getting that access, access, access. Our patients are only happy when they can access the care. And we've done a really nice job of redesigning our templates, getting rid of the non clinical work like we mentioned, with the in basket and care coordination management automating processes as possible. And we've really improved our third next available metric which is a huge driver for patient quality and patient satisfaction. And the final piece, I mean there's a hundred things you can focus on, but finances. The reality is as a safety net provider, very high medi cal provider, we're really concerned about the implications and the effects of HR. One, we've already lost access in California. We were supposed to get access to something called Prop $35, which was enhanced payment for Medicaid providers, specifically primary care, mental health care and emergency room care. And that's disappeared. And we really have no clarity as to what's going to happen because many of the effects of will not be instituted until the end of 2026 or 2027. So we're okay for this year and maybe through early mid next year. But I'm very nervous about what's going to happen in 2027. And we really need to be on top of, you know, working with as many people we work with, the California Medical association to see if we can advocate for our patients and ourselves.
- [07:40]
A
Absolutely. That is such an important call out because I know, especially as you mentioned, those hospitals and systems that are safety net providers that are really dependent on some of the different funding types to serve their underserved communities. It's really a lot of uncertainties out there over the next few years as they're looking out and seeing some of those funding mechanisms drying up. I'm curious, how do you ensure that your team is focused, focused on and doing the right things to, you know, amid some of these uncertainties and, and financial challenges as are, you know, well, well documented on what's coming down the pipe. And then secondly, you know, when you look at your strategy going forward, how do you think about trying to start mitigating some of these impacts, you know, assuming things will go forward as they are planned to currently?
- [08:36]
B
Well, I mean, pediatrics is not exactly the forefront of political power, whether it's in San Diego, whether it's in California, the West coast or nationally. So we can only control what we can control. So we do the best job that we can. And the general philosophy is just do the right thing, take care of your patients, do the best you can. And things have historically worked out the Cuts, you know, really sad to say, are affecting, you know, the people who can least afford to accept cuts in their lives. You know, the poor, children, disabled. So what we do here, what we've been trying to do is we've spent a lot of time working on giving, giving and getting good feedback and just making sure that we keep our teams aligned and we all know what exactly we're pulling for. We really do our best to plan a year or two in advance, but it's really hard right now. So loss of communication, lots of open educational meetings, open business meetings, feedback to the clinicians, from the clinicians to the executive team, feedback, feedback. Feedback is what keeps everybody on the same page.
- [10:00]
A
I love that. Thank you so much for digging a little bit deeper there. Now I wanted to ask you on the flip side, what are some of the growth opportunities that you see on the next year? How do you see the organization continuing to expand and thrive?
- [10:14]
B
Well, we're actually pretty fortunate that we are financially stable right now and so we do have some money to invest and we don't think short sighted. So we do think about growth opportunities over the years. And I don't think this is any different than almost any other organization. But we are very steadily moving into the AI world. Specifically, we're making big investments into ambient notes, chart summarization, patient education. We've invested heavily in technology for revamping our entire phone system. Our chief digital officer calls it omnichannel. I mean, you can access us in eight different ways to really make ourselves more efficient. But none of that puts any increased burdens on the clinicians and it makes life much easier for patients and their families to access their care. So our biggest opportunity is to build, to continue. We have really, really, really good access to, I'd say excellent access, but we want to be, you know, premier access. And that's the only way that you can grow if people know they can come to see you. So artificial intelligence and technology, we're making very significant financial investments in that.
- [11:42]
A
Absolutely. That makes a lot of sense, you know, and it's exciting to hear, I love that tank line or kind of thought process on how you can grow and providing that premier access versus just, you know, continuing on with what you've always done. Because it does seem like access is an issue that so many organizations are trying to understand today and figure out in their own communities.
- [12:09]
B
Yeah, that, you know, the general rule is when patients get to see us, they get super duper, high quality care. We can prove that we're an accredited organization we have sky high hedis metrics. We can prove that the patients who actually see us get great care. The question is, the patients who don't get to see us, what kind of care do they get? And we don't know. And so because of that, we work very hard to be what's called a friction free environment. It's really hard to do that in these days of clinician burnout, of staff shortages, of Medicaid reimbursement cuts. But we try and once again we just try to do the right thing and it tends to work out, but it's work. And our clinicians get tired, our staff gets tired. We're open seven days a week. It's hard getting all these things covered. So you have to show appreciation for people. You have to give them the tools and the resources to get this stuff done. I didn't say it's easy, I just said but it is what we're working towards.
- [13:18]
A
Absolutely. That is fantastic to hear and an inspiring message for sure as you continue to apply that technology and apply the philosophy with your clinicians and care team. Now, looking a little bit further into the future, what do you think it will take to lead a thriving organization over the next five years? Especially given some of the things we've talked about today in terms of how technology is rapidly changing and evolving, how there are certain challenges that are facing the healthcare industry. What does it take to be a great leader in these times?
- [13:52]
B
Well, I'm a total luddite. I'd still be happy to be on a paper chart, sitting in a room with a patient with my scribbly, scrawly notes and paper. I mean, but you have to be willing to change, you have to be willing to adapt. So a thriving organization, if you're change averse, risk averse, you're not going to be a thriving organization. But what we're doing is really as well, is not unique to us. I did go back many years ago when I got an MBA and there was a quote from a CEO, a computer CEO, his name is Jim Goodnight and his quote is, at the end of the day, 90% of my assets walk out the door. And that's true. I mean, we don't have a lot of hard assets in our organization. Our people are our assets. So it's no different here. Way. To have a thriving organization now, three years from now, five years from now, 10 years from now is to take good care of your people. You don't take good care of your people in healthcare. We're a service Organization, we're a service industry. So when our clinicians specifically put our staff and all of the front office, back office, central office, central services, when they're engaged and they're doing really mission oriented, meaningful work, I'm very confident our organization will thrive. My personal philosophy, and I think I do it. I mean, I would leave it to others to say if it's true or not, but my philosophy has been, you know, take care of the people who take care of you and you'll be well taken care of. It hasn't failed me yet. We've had good finances. You know, people are very respectful to me and the organization, and I have a lot of people willing to work very hard for this organization, and so I do my utmost to take care of them. I think people would say that's true. The ones who don't feel that way, they tend to leave. But we have exceptionally low turnover. I mean, really, really, really low turnover. So I take care of people and I think any good leader, to have a thriving organization, just take care of your people. It's not that hard. I don't. I'm not that bright. So I need to just do simple things. And I do. The simple, basic things tend to not fail me. So that's what I do.
- [16:27]
A
I love that. Dr. Breslow, thank you so much for joining us on the podcast today. This has been such a fun conversation path and certainly inspired by, you know, your energy and passion and drive to serve your patient population well. And I look forward to continuing this conversation too at the CEO CFO Roundtable in November. I know you'll be a speaker with us, and so it'll be great to elevate your story on a broader platform and really, you know, be able to connect more deeply with you and your fellow CEO colleagues.
- [16:57]
B
And you can congratulate me in November because I will 100% guaranteed be a grandfather by then. I should be a grandfather within the next seven to ten days. So. So you can ask me for pictures of my granddaughter. Her name is going to be Juniper Marie. So feel free to ask and see pictures.
- [17:16]
A
Oh, what a beautiful name. And congratulations. How amazing. It's such a wonderful time when you're expanding your family and becoming a grandparent, especially for the first time. So that's amazing to hear and I really appreciate your time today.
- [17:32]
B
All right, great talking to you. Thank you for your time.