Podcast Summary

Episode Overview

Podcast: Becker’s Healthcare Podcast
Episode Title: Driving Growth and Financial Sustainability in Hospice Care with Lindsay Myers of Chapters Health System
Host: Laura Dirdo
Guest: Lindsay Myers, VP of Revenue Cycle and Health Information Management, Chapters Health System
Date: November 14, 2025
Theme:
This episode centers on the challenges and strategies behind scaling hospice care organizations sustainably, with a focus on financial health, innovation, workforce management, and the strategic growth of Chapters Health System. Lindsay Myers discusses the dual mandates of upholding exemplary patient care and ensuring financial viability amid industry-wide change.

Key Discussion Points & Insights

1. Introduction to Lindsay Myers & Chapters Health System

[01:18]

• Lindsay Myers summarizes her 25-year career in healthcare finance and operations, including leadership roles in hospital systems, multi-specialty medical practices, nonprofits, and consulting.
• Chapters Health System: Largest nonprofit hospice in the US, encompassing 30 companies across 7 states, serving 36,000+ hospice patients annually, a broad value-based care portfolio including PACE centers, Medicare Advantage, and consulting services.

2. Opportunities and Challenges in Hospice Care

Opportunities
[03:12]

• Value-Based Care:

  • Hospice care's decades-long experience with fixed per diem payments aligns closely with the principles of value-based care.
  • Emphasis on home-based, individualized, interdisciplinary care positions hospice as an ideal partner for ACOs and health plans.
  • Early upstream care reduces fragmentation, eases transitions to hospice, and improves patient/family experience.

  “Taking care of patients earlier on upstream is also an opportunity for less fragmentation of care and smoother and sooner transitions to hospice. And ultimately when you get patients into hospice earlier, it’s a win-win for everybody...”
  — Lindsay Myers [04:46]

• Strategic Affiliations:

  • Rapid affiliations with community hospices across the country build economies of scale and intellectual capital.
  • Expansion allows Chapters to offer MSO and consultative services to other providers.

  “Chapters has been able to amass a lot of intellectual capital through these affiliations, and that’s put us in a position to be able to offer consultative and MSO type services to other providers.”
  — Lindsay Myers [06:00]

Challenges (Headwinds)
[06:45]

• Increased Unfunded Patients:

  • Anticipated Medicaid changes (“Big Beautiful Bill act”) will increase the number of unfunded patients and strain operating margins.
  • National operations mean navigating multiple diverse state Medicaid programs.

• Workforce Shortages:

  • Industry-wide labor shortages and rising labor costs, exacerbated by mass retirements and rising demand.
  • Chapters leverages company culture and a compelling mission to attract and retain talent.

  “Even though this is a major challenge and a headwind, we do have an advantage in that the incoming workforce wants to feel a sense of purpose and a connection to mission.”
  — Lindsay Myers [07:50]

• Technology and Process Optimization:

  • Increased use of automation and timely reporting to maximize collections and adapt to frequent Medicaid eligibility changes.

3. Driving Growth & Strategic Vision

[09:02]

• Scaling Infrastructure:

  • Focus on building scalable, compliant, and automated revenue cycle and HIM systems to manage rapid expansion.
  • Standardizing processes and integrating affiliates despite complex, divergent state regulations.

• Collaborative Approach:

  • Success in revenue cycle depends on cross-functional collaboration (intake, billing, clinical teams).
  • Sequential billing in hospice means any small process bottleneck can impede large cash flows.

  “There’s so much that impacts collections that happens upstream from revenue cycle. Our success depends a lot on our collaboration with other areas like intake and admissions and clinical teams and medical services.”
  — Lindsay Myers [09:41]

• Value of Innovation:

  • Automation, upskilling teams, and continuous process improvement ensure financial sustainability and support for chronically ill and end-of-life populations.

4. Investments Worth Making in Uncertain Times

[11:13]

• People First:

  • Investing in workforce is paramount. Underinvestment leads to turnover, morale issues, and declining care/financial performance.
  • Chapters’ mission includes "taking care of those who do," reflected in multiple “Great Places to Work” designations and culture awards.

  “The risk is that if you underinvest in people, turnover rises, morale drops, the quality of care suffers, and ultimately the financial performance is going to deteriorate.”
  — Lindsay Myers [11:48]

• Technology and AI:

  • AI will be leveraged in revenue cycle and health information management to streamline and automate mundane tasks, freeing staff to engage in patient- and family-centered activities AI can’t replicate.

  “When we look at AI, the idea is to liberate our teams from the mundane, repetitive, and administratively burdensome tasks so that they can focus on connecting with patients and connecting with families, which is something that AI can’t do.”
  — Lindsay Myers [12:28]

5. Professional and Organizational Future Opportunities

[13:09]

• Continuing innovation in value-based care, strategic affiliations, and developing new aligned payment models.
• Enhancing analytical capacity and process sophistication in revenue cycle to support sustained double-digit growth.

Notable Quotes & Memorable Moments

• “Taking care of patients earlier on upstream is also an opportunity for less fragmentation of care and smoother and sooner transitions to hospice. And ultimately when you get patients into hospice earlier, it’s a win-win for everybody...”
  [04:46] — Lindsay Myers

• “We have a culture that’s earned numerous awards and recognition... it’s a testament to the great culture that we’ve developed that everyone is so aligned with our mission and...cohesive teams.”
  [08:16] — Lindsay Myers

• “There’s so much that impacts collections that happens upstream from revenue cycle. Our success depends a lot on our collaboration with other areas like intake and admissions and clinical teams and medical services.”
  [09:41] — Lindsay Myers

• “The risk is that if you underinvest in people, turnover rises, morale drops, the quality of care suffers, and ultimately the financial performance is going to deteriorate.”
  [11:48] — Lindsay Myers

• “When we look at AI, the idea is to liberate our teams from the mundane, repetitive, and administratively burdensome tasks so that they can focus on connecting with patients and connecting with families, which is something that AI can’t do...”
  [12:28] — Lindsay Myers

Timestamps for Key Segments

• [01:18] – Lindsay Myers’ Background & Introduction to Chapters Health System
• [03:12] – Opportunities in Value-Based Care & Strategic Affiliations
• [06:45] – Headwinds: Medicaid Changes, Unfunded Patients, Workforce Shortages
• [09:02] – Growth Strategies: Scaling Revenue Cycle, Process Standardization
• [11:13] – Investment Priorities: People & Technology
• [13:09] – Professional Opportunities & Future Focus

Conclusion

Lindsay Myers provided a comprehensive overview of the dynamic environment facing hospice providers, emphasizing the importance of adaptable infrastructure, mission-driven workforce investment, and embracing technology for efficiency. Chapters Health System’s approach—grounded in people, processes, and partnerships—reflects the organization’s commitment to growing sustainably while maintaining high-quality, patient-centered care in a changing healthcare landscape.