← Becker’s Healthcare Podcast
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- [00:00]
A
This is Laura Deardo with the Beckers Healthcare podcast. I'm thrilled today to be joined by Dr. Claire Raab, President and CEO of Temple Faculty Physicians. Dr. Robb, it's a pleasure to have you on the podcast today.
- [00:11]
B
Thank you so much for having me.
- [00:13]
A
Now I'm excited for our conversation because I know there's so much happening in the healthcare space and in particular we'll highlight some of the cool things you're doing at Temple. But before we dive in, can you introduce yourself? Tell us a bit more about yourself as well as the health system.
- [00:25]
B
Sure. Hello, my name is Claire Robb. As you mentioned, I am the CEO and president of Temple Faculty Phys. We have about 650 faculty in our practice plan and about 150 apps. We serve Temple hospitals, which we have our mothership, if you will, Temple, Maine, and we have four other community hospitals surrounding us. We are a $2.7 billion health system. We are located in North Philadelphia, which is an inner city, very underserved area of Philadelphia. We are about 87% government pay. So it's, it's a tough place to be situated, but it's exactly what we want to do in serving this community.
- [01:19]
A
That makes a lot of sense. You know, a unique community, but like you mentioned, a really important, you know, one to serve in population that has a lot of needs in the healthcare space. So from the last year or so, what's the biggest win or success story they want to share with us?
- [01:35]
B
I think we have a lot. I mean, I think first of all, we have been narrowly focused on our mission, which as we both said, is serving the health of this community. That translates into everything that we do. I would say the first success is that we've been able to meet our budget, meet our capital projects. Just being able to succeed from a business standpoint when we're 87% government pay, that's a challenge in and of itself. So I am really proud of really everybody here that we've been able to do that. Because as we say here, sort of tongue in cheek, but really true. No money, no mission. And so if we can run our business really well, then we can make sure that we serve our mission. If you want some specific examples, Laura, I'm happy to go into some wins that we've had for the community and speak to those.
- [02:33]
A
Yeah, definitely. I think it's always interesting to hear some of those specifics and really be able to share those things that potentially could be scalable to other communities as well.
- [02:42]
B
So one thing I'm really proud of here is that we have a new clinic here that serves patients who have findings that are concerning for malignancy. So they are not necessarily all have malignancy, but as you know, people will often have a scan, often for something else, and they are found to have a lesion that is suspicious. So we have sort of taken that and said to ourselves, like, how can we help people who we think in this early stage we have a potential to catch something that we may have found as an incidental to ensure that we get the patients the follow up that they need. We have a clinic now where we take all of those findings and then we obviously the patient and we organize around all the specialists that need to weigh in on that particular finding for next steps. Okay, do you need a bronchoscopy? Do you need a different kind of CAT scan? Do you need a biopsy? And we bring them all together virtually in short order to look at the imaging and discuss with the patient what kind of care they need. So that sort of expedites the care of the patient instead of the patient having to go from this doc and then that doc says, go to that doc, and so on and so forth. And for somebody in the community that has the social determinants of health and some barriers to accessing health care, despite our best efforts, sort of that coordination is really helpful. We've been able, we started this program in May, and we have been able to identify over 400 patients who needed this service, 50% of which roughly ended up actually having cancer. And we were able to get them into our cancer clinic. But, you know, these patients are normally patients who may not have fully understood that they have cancer or a potential cancer, or couldn't get an appointment or whatever. They could have potentially been missed or had a delayed diagnosis. In the past, the impetus for starting this really special clinic was we looked at our cancer rates in this community. We said, how do we compare to the stage cancer that people have a patient may have in our community and our surrounding zip codes, compared to other more affluent areas in the suburbs, we found there's four stages of cancer and they're largely incurable. After stage three. We found on average, patients here in the vicinity of our main flagship temple, main in North Philadelphia, present at stage 2.6. And in other suburban areas, they're presenting at stage 1.4. When we looked at those patients who were presenting at stage 2.6, we saw that probably there was some other point where they were found they could have intervened before it was that delayed not everybody, but a lot of them. That was really the reason we put this clinic together. We're really proud of it.
- [05:47]
A
That's amazing to hear. And what a great resource for the community to make a big difference in people's lives and ideally extend their lives in a meaningful way. That's just fascinating to hear. And what a great use of resources and identifying a challenge and then actually solving it in many ways. I'm curious, you know, when you look at kind of the broader scope of what's happening in healthcare today, what are the top two or three issues that you're focused on right now and thinking about?
- [06:14]
B
Oh, I mean, I feel like it'd be remiss if I didn't comment on sort of the obvious. Right. I've stated a few Times that we're 87% government pay, which is Medicaid and Medicare, but 67, 67 to 70% of all of our business is real Medicaid. And so, you know, with the changes in Medicaid and the new requirements to meet Medicaid to be a beneficiary, we are increasingly concerned about, you know, increases in potential and compensated care and not just sort of for our bottom line, which is obviously something we need to consider, but really for the community. Right. We've always been the kind of place where people can just walk in. We treat people as, as best as we are able to. And so this makes it a particular challenge.
- [07:05]
A
Absolutely. I think there are a lot of different hospitals and systems across the country that are facing similar challenges, although likely not as heavily government pay as you are, but do rely significantly on Medicaid in Medicare as well. And so when you look ahead and see some of the changes likely coming down the pipe for Medicaid and understanding, you know, access to care could be a challenge in the future. What are you doing today to try to prepare for that or how are you thinking about that when you are looking at long term planning?
- [07:38]
B
A great question. I think there's really two parts. The first part is like, how are we as an institution going to sort of withstand this change in Medicaid and, or any kind of government reimbursement. Right. Our dish payment or otherwise. And then really like, how are we going to help the patients? So I'll start with the most important, which is how we're going to help the patients. I mean, we are partnering with a lot of federally qualified health centers. So for patients that would potentially lose Medicaid, they would still have access in the federally qualified health centers. Now, those are not Part of Temple, they're freestanding, part of, you know, HRSA and the government, but we certainly partner with them. And those are places where patients could get primary care. And if they needed a step up care, then we partner, you know, with the FQHC directly. I have not heard of any substantial risk to the fqhc. So we would still have potentially a place to send patients who go from having Medicaid to being uninsured. And we are already, like I said, in close contact with them and working with other up and coming federally qualified health centers so that there's more options for the patient. What are we doing in terms of our bottom line for this potential cut? I mean, I think we're doing what we always do, but which is, you know, look for opportunity for savings, whether it's in our supply chain, whether it's in our gpo, whether it's, you know, you know, other revenue producings or savings producings like 340B or, you know, our reimbursement from our payers, or thinking a lot about how we use AI to give us more impact in terms of our P and L for any potential shortfall.
- [09:25]
A
Got it. That makes a lot of sense. You know, I appreciate you digging a little bit deeper there to talk through some of those strategies and especially the partnership with FQHC I know will be critical and then trying to figure out other areas where it really makes sense to tighten as much as possible. Now, in addition to that, I know it's hard to think about growth, but what are some of those opportunities and spaces where you see additional potential for growth even during some of these challenging times?
- [09:58]
B
A great question. You know, everybody sort of has their challenges in how they're going to solve this problem. But I've been the president and CEO for about four years now. And when I took the job four years ago, I naturally thought that the biggest part of my job was trying to find patients to bring to temple to receive our wonderful care and that I was going to need some big strategy around gaining patience. But it really turns out that I don't need that at all because I am fortunate to be situated in a place where the need is great. And that's why we're here. I have tremendous wait lists for patients. The demand for our services, because our quality is so high, is very, very, very high. So I am focused on how do I increase access, how do I recruit more docs, how do we get more spaces where we can serve our patients. That is one benefit that I think that we have here. At Temple is there are lots of patients wanting our services. That's exactly what we want. We just need to spend the time to build around the needs of this community in terms of setting up an infrastructure for them to get care. Of course that gives them care. Our quality is great. And then obviously there's revenue associated with that.
- [11:28]
A
That makes a lot of sense. And I think really having that focus in bringing more patients in, figuring out how your services can expand in a natural way has a lot of problems. I can imagine there's never a decline in demand for healthcare services. And figuring out how to serve the community in a more holistic way, I can imagine is in some way fun challenge when you think about what you'll be able to do over the next few years.
- [11:57]
B
Yeah, I think that there are, there are though health systems that are more challenged than others. Right. So like rural healthcare or maybe oversaturated markets. But we don't specifically have that problem. We have our community, which again, needs our needs, our services in high volume. And then we also have a lot of marquee programs where people come near and far for our services.
- [12:26]
A
That's great to hear. And you know, I'm curious, when you think about leadership in the future, what will it take to make sure organizations are thriving in the next five years or so, especially given, you know, some of the changes that we've talked about in the payment models as well as looking at access to care. And I know in some ways technology is making a big splash in the health care space too. How do leaders make sure they're ready to guide their organizations in a meaningful way?
- [12:53]
B
I think you said it. I know you're interviewing me, but I think you said it, which is really like, how are we preparing? How well can an organization anticipate needs in the future? We know Medicaid will be cut in some way. What are we doing now? It's not going to be cut necessarily for at least a year and a half, two years. But we need a plan. Now. We are acutely aware of sort of that planning and getting ahead. The other thing I think that we benefit from is this is a fairly flat organization and we are very, very agile, we move quickly and we are very operations goal oriented. And I think that has served us well and will continue to serve us well as we look to opportunities to sort of improve upon present state.
- [13:48]
A
That's fascinating to hear. And you know, really having that agility, like you said, makes a big difference. And you know, when you think about that organization so focused on having that operations and goal oriented. How do you instill that within the broader team and just make sure that everybody is understanding of that mission and understanding of what you need. I know you said earlier, making sure you have the margin in order to meet the mission. You know, what does the culture look like? How do you do that from the CEO seat?
- [14:19]
B
So I think a couple things, you know, I. I've worked at other institutions, and people always ask me, like, why. Why do you like Temple so much? And I always give sort of the same answer, which is like, when I worked at another institution, I would go to my supervisor and be like, hey, I have this really great idea. It's going to help patients in this way, and it's going to save us, make us money. What do you think? And they would be like, yeah, Claire, you should do that. And it was a genuine like, yeah, Claire, you should do that. But it was like, also like, but then you should talk to this person and that. And then we should, like, think about it for a little bit. And it wasn't a no, but it was just like a slower pace. And now when I go to my boss, who is the health system CEO, and I say, you know, I think we should do this. It's going to help patients. It's gonna make us, save us money. He'll be like, well, why didn't you do it yesterday? And I'll be like, I thought of it this morning. Like, you know, like, we see an opportunity and we act on it. And so I like to stay here and set a culture of, like, if you're the person that comes to work, to accomplish things in work, not in, like, the work day and night, every minute kind of thing, but if you're motivated by impacting change, like, this is the best place to work.
- [15:44]
A
I love that. Dr. Rob, thank you so much for joining us on the podcast today. This has been a really fun conversation, and I look forward to connecting with you again soon.
- [15:52]
B
All right, thank you, Laura.