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Becker’s Healthcare Podcast
Expanding Neighborhood Hospitals to Improve Access and Affordability in Healthcare with Vic Schmerbeck
00:17:08
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- [00:02]
A
Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit Beckershospitalview.com and click on the Events tab in the upper right.
- [00:38]
B
This is Scott Becker with the Becker Healthcare Podcast. I'm thrilled today to be joined by a leader, a CEO, Vic Schmerbach and Vic and Ameris Health. Ameris holdings have helped to solve one of the most critical problems in healthcare. They've had this tremendous growth trajectory over the last decade or so. To talk to Vic about how they've done that, what they do, where they see themselves fitting into the healthcare ecosystem and why the market has been so responsive to what they do and how well it's going. Vic, can you take a moment and introduce yourself and tell us a little bit about Emeris?
- [01:16]
C
Sure. Thanks for having me, Scott. It's great to be here today. So as Scott said, I'm CEO of Ameris. Ameris partners with leading health systems around the country to co own, manage and operate small format healthcare facilities. We like to call them neighborhood hospitals. They're typically located in underserved suburban community settings. In the vast majority of the cases when we partner with our health systems, we're bringing a broader suite of services from an ambulatory standpoint as well. So think primary care, specialty care, pediatrics, women's services, outpatient rehab, PTOT clinics, and more recently our partners are looking at adding ambulatory surgery centers and even cancer focused services, getting those care settings closer to communities and where people, as we say, kind of work, live and play. The original business was founded by a handful of physicians really with a pretty simple task which was looking for a better care environment not only for patients but caregivers. And as you alluded to just about a decade ago, we really started partnering with health Systems and really isolating into access and affordability as we think about care settings. Just to give you a couple of context, look, we've been really blessed to have great partners like Baylor, Scott and White, Common Spirit, Ascension Baptist Health Hospitals of Providence. We are kind of all throughout Pennsylvania now with Christiana Care, Wellspan Health, Allegheny Health Network and the like. But to give you a couple of points of reference on average, people in the US travel 30 minutes for care. And our setting, it's eight minutes on average. And when they walk into our building, they're seen by a physician in a room, not a waiting room, inside of 15 minutes. And so it's bringing care closer to home. It's providing access and we believe driving affordability as well.
- [03:26]
B
And Vic, at a time where average wait times in ERs have moved from, you know, they were advertising 30 minutes a decade ago on billboards. Get into our ER in 30 minutes. Now the average wait time in a health system ER might be three hours. You know, in many places become the access point for so many people. You're also seeing throughout the country so many small and mid sized hospitals in smaller communities really struggle financially. We're at a spot where 60% of health systems have some margin, 40% are not making any margin at all. Talk about how critical it is, what Emeris does and how it fills that sort of gap in the ER market and plus the neighborhood hospital market. I mean, how important is it that what you do?
- [04:10]
C
I'm biased obviously, but I think it's really important. I think action often speaks louder than words, Scott. And so in really every market we're in with the partners I named, we're adding locations today. So the partner, the health systems are really seeing the value. And I do want to distinguish one thing for anybody that's listening. Every facility that we co own and operate with our partner is branded our hot our health system partner. It's branded Baylor, Scott and White, it's branded Wellspan Health. And we're integrated on EMR from a patient record perspective. But our ultimate goal is to get the right care to the right place at the right time. And so many of those people that are waiting three hours in an ER in a downtown facility don't need to be at that level one trauma center, if they do need to be there, we can capture them in their community. We can treat the vast majority of their services. If they need a super high end on cardiac neuro, something more significant, we directly admit them to our partner. It's a unified emr. It's a direct admission. So you're capturing more in the community and we're leveraging technology heavily to do that on the affordability side. And so there's a decompression aspect to the wait times you're talking about by providing better access.
- [05:33]
B
Let me ask you this question. When Amiris really got started and you mentioned the sort of the origin story of a few physicians trying to work with this. It was sort of an out of the box concept of sort of freestanding ERs, freestanding small hospitals. Then I remember several years ago me being on the phone with some health system leaders in I believe it was West Virginia partnering with, I thought, you folks to build some short stay hospitals and, and it was really eye opening to me how much what you had started with has evolved to be something that Celsus was viewed as a really important positive impact. Are you ever surprised at the amount of growth that you've seen in the market, reception to what you've done?
- [06:20]
C
Look, I think we provide an incredible service and it's not to say that big health systems can't do this on their own. I think what they find in partnering with us is that they have a turnkey solution, someone that's going to deploy capital with them, someone that understands how to operate, manage, someone who understands where to locate facilities for the right reasons. But there's a lot of opportunities for health systems and I think, as, I think we're going to talk about trends here in a minute potentially. But you know, this whole notion of access and affordability is very, very real. And you mentioned, you know, profitable or unprofitable from a health system standpoint. We as a, as a, I think healthcare community have to figure out how to drive better access and lower cost. And so I think we have a very, without going into a ton of details, we have a very team oriented approach inside of our building. It's a very, you know, it's a 16 to 22,000 square foot facility, it's very efficient. And so I think it's driving patient experience to a higher level, it's driving readmission rates lower, it's driving better clinical outcomes. But most importantly, it's getting the patient to where they can and should be served instead of where they don't necessarily
- [07:42]
B
need to be, right to where they would default to otherwise if they can't get into the regular doctor's office and end up in the error. And so instead of that you have this middle point where they're really effectively and efficiently sort of taken care of. Talk for a second about trends that you're watching as we talk about the triple aim often cost quality access in many part of the countries that is just going in the wrong direction on all three. It used to be common knowledge or common wisdom, I should say, not knowledge that you could do really well in two out of the three. But you sacrifice something, now it feels like costs are going up throughout the country. Access is getting worse. Quality becomes more challenging as access points are limited and we're limited on doctors and physicians. What trends are you watching and how does this start help offset some of those trends that are so challenging?
- [08:29]
C
I think broadly everyone understands we need to transform the healthcare landscape and you're seeing a big move to outpatient. We've been on this path for a couple of years. How do we get care closer to to home? It's been central to everything we've done for the last decade in terms of creating access points. We're leaning further into expanding our clinical capabilities with technology and care solutions that we think can drive more utilization. Not, I don't mean more utilization in the wrong way, but taking care of patients in a lower cost setting with a better outcome and experience closer to home. It's been interesting to me. I've been at a number of CEO councils, forums, JP Morgan, what have you. You can't really get five minutes into a discussion without AI and then it quickly kind of goes to access and affordability. And on the cost side, I think there's a prevailing wisdom that we can take cost out of the system with technology and AI. Most of it today is kind of the back end. It eventually will come, I believe in the clinical setting, but just efficiency of care. We've been able to drive lower length of stay. CMS reports something not getting too far in the weeds called geometric lean mean length of stay, meaning the same patient set. And we're seeing 35, 40% reductions in length to stay and our observation and inpatient side that drives lower cost.
- [10:05]
B
Just remarkable. And take a second, Vic. When you look at this coming year, we're going to talk for a second about where you're most focused and also about leadership. You spend a lot of time talking and thinking about how to be an effective leader and what you do as an effective leader. Let's start there for a second. When you talk to emerging leaders, what advice would you give to emerging leaders about being effective leaders?
- [10:31]
C
I'm a pretty keep it simple, stupid kind of guy, Scott, as you probably know. But I think the number one thing for evolving leaders, whether it's your middle managers, your senior leadership team, your executive leadership team, or someone that's trying, you know, stepping into a CEO role is you've got to build your team with smarter people than you and then you have to invest in them. From a coaching and leadership development standpoint, I think it's really imperative that you set very clear strategic direction and don't bounce around and then you go Let them fly. Right. And so I'm a firm believer that the number one job of a CEO or a leader is to find and nurture talent.
- [11:13]
B
Take a second. Vic, you said something I think is so important. You talked about setting clear direction and not constantly bouncing around. And you see so many leaders that are constantly chasing the next opportunity, the next this, the next that. How disruptive is that for a team in leadership when there's not clarity about, here's what we're trying to do, here are the three big goals this year. Whatever the numbers they are, how important is that not to be bouncing around and constantly pivoting?
- [11:43]
C
I believe it's probably the. I mean, it is critical, using a football analogy, if you constantly move the end zone, nobody knows where to run a play. And so you have to set a clear direction. And you have to be my. At least in my opinion, you have to be myopically focused on making sure you're not chasing squirrels in the middle of the game.
- [12:06]
B
No, I think that's right on. And take one more moment. Vic, we're so thrilled for you to be with us today. I've loved watching the growth of Emera. It's just remarkable. Take a second on what are you most focused on and excited about for the rest of this year? For 2026?
- [12:21]
C
I think there's a number. Look, I'm most proud of our leadership team and what we've built over the last handful of years. We've had a lot of growth, significant growth. I refer to it as good growth internally. Not all growth is good growth, if that makes sense. And so we've really focused on team orientations. Our teams take a great pride in serving their neighbors and we kind of often use this. Our mission statement is providing the care patients need in the neighborhoods they live by, teams they trust. We oftentimes narrow that down to neighbors treating neighbors, if you think about a community based setting. And so we've taken a lot of pride in growing our team and our leadership team to accomplish those goals. Now that's affected itself in the sense that we've more than doubled the business over the last three or four years. You know, almost any metric you want to look at. So that's what I'm most proud of when I look ahead. We continue to invest heavily, Scott, in expanding clinical capabilities and leveraging technology via virtual nurse support for admission and discharge, be it bringing incremental specialists into the setting to provide better, more efficient, timely care. But our goal at the end of the day is we want our bedside caregivers to spend 90% of their time on taking care of a patient, not 50% of their time on administrative tasks.
- [13:53]
B
What does it look like? You mentioned neighborhood care, neighbors taking care of neighbors, being in the communities. How hard is recruitment today of physicians and is that a bottleneck or are you, how are you managing that?
- [14:08]
C
Look, recruitment, we focus a lot on retention. I mean, you have to focus on recruitment to get people in the door. We've done a lot of things God given our format is a little bit different, that we won't hire someone like a nurse, for example, if they don't shadow shift first. We'll pay for them to shadow shift. But we want them to experience the environment, the team orientation, how we do cross training so that they have, we have eyes wide open. They have eyes wide open as it relates to working in kind of the environment that's a little different than a bigger hospital. And I think what you'll find is whether it's physicians or nurses or techs or go down the list of allied staff, it works really well for many. If you want to be, you know, if you're inclinated to be an ICU trauma nurse only and that you want to do it every day or you want to read MRI every day, it may not be the right place, but that's what we have to figure out together on the front end. And then ultimately you invest in them from a clinical development, you invest in them from a career development. You find out who wants to be a leader, who's happy where they are, and you develop plans for them to stay with the organization such that we're not. Recruitment becomes a function of not retaining. And so we, we have to do a better job of retaining to ensure that recruitment doesn't become your, your headwind 100%.
- [15:35]
B
If you could do a much better job, everybody, not you, but in general on retention, then you're not constantly on this flywheel of trying to recruit and, and like you talk about constantly being at that. So you're always recruiting, but, but hopefully you, you make it a little bit more easy to work through and to keep stability and so forth by really focusing on great retention and great hiring.
- [15:59]
C
The one thing I would add to that on the technology front, and I didn't get into it specifically, but we've invested heavily in making our, our rooms smart rooms so that we can leverage technology. You know, if we need a cardiology consult, if we need an infectious disease consult, we need a critical care consult, we can bring those physicians in via the smart room with the care team that's on site to make that assessment from both a timeliness and clinical outcome standpoint to better that care, which also allows you, frankly, to bring in a family member that may be in Florida with somebody who's being treated in Dallas, and they can be part of that care setting even though they're not in the room.
- [16:43]
B
It's phenomenal. It's been amazing to me to watch the growth of Ameris and what you've done in terms of leadership. I want to thank you for taking a few minutes with us today on the Becker's Healthcare podcast. It's a remarkable story and remarkable how you're really filling a critical gap in healthcare. So thank you so much for what you do and for joining us today.
- [17:02]
C
Absolutely. Always good to see you, Scott.