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- [00:02]
A
@ Athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams, and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom Practicing medicine is complex, but running a practice can be that much simpler with Athenahealth. See how simpler is healthier@athenahealth.com.
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B
This is Madeline Ashley with the Becker CFO and Revenue Cycle Podcast, and I'm excited to be joined today by Jerry Etzel, CFO of Temple Health. Jerry, thanks so much for joining me.
- [00:55]
C
Thank you, Madeline, for the opportunity to speak to you and the your audience. I've listened to many of the Becker's podcasts in the past and they're truly wonderful.
- [01:07]
B
That is so great to hear. We're so glad that you tune in to us and are here to connect with me and our listeners. So before we kick things off, Jerry, do you mind sharing just a little bit more about yourself, your background, and more on Temple Health?
- [01:21]
C
Oh yeah, of course. So I have almost 40 years of healthcare experience and I served as a CFO at various hospitals of 25 of those 40 years. So I only take it back maybe 15 years. Madeline where I was the chief financial officer at Temple University Hospital. That's the academic medical center at Temple Health. I left Temple to join the Gunderson Health System located in Wisconsin, and I spent five years at Gunderson. I was part of the team that merged Gunderson with the Bellin Health System and was appointed their first cfo. The Gunderson Health System was renamed Emplify. That's how you would know them. Today they're 11 hospitals across five states and have over a 100 clinics and very large medical staff with 1200 physicians. And about two years ago I left Emplify to return to Temple Health because Temple is just a very, very special place. Very special to me, my family and the Philadelphia community. And it's special because we serve one of the poorest communities in the country. It's largely based in Philadelphia, Temples largely based in Philadelphia. And you probably don't know this, but Philadelphia is the largest urban area in our country without a public hospital. So de facto Temple is that public hospital without all the special funding that the public hospital receives. So what I love about Temple is That, that commitment to Philadelphia and those underserved communities. And we thrive in our mission because part of our DNA is daily operation improvement. Every single day we look at ways of doing things better. So, so delighted to be back. To be back to Philadelphia and working at Temple as the chief financial officer. A little bit about Temple. We have almost $4 billion in revenues, 11,000 employees, and over a thousand physicians.
- [04:06]
B
Thank you so much for sharing that background there. It's wonderful to hear the passion in your voice when you speak, speak about the system, and it's also great to hear. It's kind of neat. You kind of have come full circle almost, if you will. You, you started there. Well, you were there a couple of years ago and then you made your way back.
- [04:22]
C
Yeah, yeah. And just truly love what I do, you know, just maybe just for the younger members of the audience. Yeah, I never look back on my, my career choice of the healthcare findings. It does love working with groups of talented individuals trying to solve the complex problems. And, you know, there's never been no shortages of complex problems to be solved over the last throughout my career. And I suspect for those younger members of the audience, there is going to be no shortages in the, you know, the years to come. So that's what I loved about working in healthcare.
- [05:08]
B
No, you, you are correct in that there is always something going on in healthcare. There's always some form of trend or something that people are following. And that actually kind of takes me into my question for you here. Could you share with our listeners two to three things that you're closely monitoring right now in the, in the industry and why these trends are so important to you?
- [05:30]
C
Sure. So, Madeline, the first trend that comes to mind is the rising cost of health care, especially as it relates to the overall economy. This is not a new issue. We've been talking about it for at least the last 10 years. As you know, health care consumes almost 20% of the GDP, far higher than any other industrial nation, which puts our country at a significant disadvantage in global trade. I believe we're going to continue seeing the policy shift out of Washington, take an aim at health care costs. Sort of saw this a little bit with the recent passing of HR1, but that trend, taking aim at health care costs, bringing down the cost, it's going to really limit our ability to move up in the payment scales. So that was the first trend that comes to mind. Most of us believe, especially at Tempo, that AI will help us mitigate some of the rising costs in health care. I don't know if you saw the paper that was recently issued by the Economic Forum on Artificial Intelligence and Data Analytics. But if you haven't, it's a fascinating read and it shows you how far AI is, how quickly it's moving throughout the world, rural in the area of healthcare. At Temple we have it as we're investing heavily in advanced analytics and artificial intelligence in the clinical areas and also in the financial back office areas. So to mitigate that rising cost that we know that's going to be a focus of, of the insurers and of the governmental payers, we believe AI will help us bridge the gap. So that would be the second trend. And when I think about the third trend, it would be the continuation of a shift fee for service type of reimbursement to bundle payments and shared saving programs that link the financial incentives and outcomes with outcomes. We have pay for performance elements of all of our managed care contracts, payer relations. But we believe just based on, informed by conversations, almost daily conversations with the payers, that percent is going to continue growing. So Madeline, when I think about the trends, or at least the trends that I just spoke of, all three are interconnected, they're not new. But I do believe that it's going to accelerate over the next several years. These three.
- [08:51]
B
Right. And just because they're not new doesn't mean they're not important. Could you kind of. I just want to circle back quickly on the AI. Now you mentioned that Temple is investing heavily there and you mentioned just kind of how you're using it in the back office space. How, how are you leaning on these types of tools to help out from a financial aspect with your team?
- [09:14]
C
Yeah. So if I just think narrowly about the finance team, you know, we started this two years ago. We started with identifying those tasks that are manual and predictable, making them ideal candidates for automation. And then after we spend a lot of time and many of these tasks are in the revenue cycle area, we started with the identification of those tasks and then we focused on investing in the ehr, which is epic, as our revenue cycle ehr. And our focus was on becoming the very best user of the revenue cycle application. So today we started with that. EPIC measures your performance or how well are you using their products through their star system. I think Madeline 2, 3 years ago we had 3 out of 10 stars which put us probably in like the 30th percentile of all EPIC users. Today, based on that focus and based on that mindset of automating task, we have 9 out of 10 stars which puts us in terms of according to ethic in the top 10 percentile in terms of deploying their technology and using that technology. So it's two areas of revenue cycle. Well, that's one area that we really focused on, or that was our efforts were wrapped around. Now we're applying that same type of thinking in all the other areas of finance.
- [11:13]
B
Yeah, definitely. And I mean, it's exciting to hear the investments that you guys are putting into this and this will help you out down the line as these tools continue to evolve.
- [11:26]
C
We believe so.
- [11:27]
B
Yeah.
- [11:27]
C
Believe. It's a very rational bet.
- [11:31]
B
Right. Investment, for sure. And could you share with me, maybe just shifting gears a tiny bit, some things that you're most excited about right now at Temple Health? I know we touched on that AI technology aspect. Anything else?
- [11:44]
C
Yeah, there's a lot of exciting happenings at Temple today, but if I had it, just pick one. I would say it's our big, bold move to build a new women's hospital. Well, it's a new hospital dedicated for women's and family. Now, Madeline, it's a big, bold move because across the Philadelphia area, 13 out of 19 maternity centers or programs have closed since 1997. Create a regional access crisis. Now the closing of all these programs is starting to show up, or it is showing up in our infant mortality rates across Philadelphia. If you look at infant mortality rates in poorer communities within the greater Philadelphia area, they're three times higher than the national average. So you have all these programs closing and patients are traveling to having to travel sometimes pretty great distances to deliver their babies. Now at Temple Main, that's the academic medical center, we provide care to over 5,000 pregnant women each year. Only about a third of those patients, it's actually a little less than a third, deliver their babies at our hospital at the main campus. So the vast majority of our patients go elsewhere, have to travel elsewhere to deliver their babies. So, big, bold move, we decided to invest and build a new hospital, women's and family hospital, located in the center where our patients, maternity patients, moms and families are coming from. That hospital will have enough capacity to serve all the patients that we see. Plus, we also are going to be invested heavily in wraparound services for prenatal and postpartum care. And at the end, we're betting that our program is going to be. Our women's maternity program is going to be a model that could be duplicated by other communities, other cities when defining what outcome driven maternity care should look like.
- [14:32]
B
This is such an important investment because, I mean, I Just did a quick double check. I cover our maternity care closure roundup here at Beckers. And so far this year I've covered 22. And a lot of these are in, you know, ruler areas that truly need these services. So it's great to hear of this type of investment. What would you say to maybe other financial leaders, hospital or health system financial leaders that are considering similar moves or similar investments?
- [15:06]
C
Well, we're doing the right thing for our patients.
- [15:08]
B
Yeah.
- [15:09]
C
The reason why all these programs close, you know, think about most programs, 3/4 of them close, 13 of 19 close is the financial drink. But we looked at outcomes and they just weren't acceptable for the Philadelphia community. In fact, they were probably in the round. What a third world nation runs at in terms of brutality rates. Put our dollars where our mouth is. We were investing heavily in outcome driven programs and I believe the dollars will follow.
- [15:51]
B
Right. Identifying where the need is. Yeah. Well, I appreciate you sharing that. Could you expand a little and share with me how you're looking at, you know, apart from growth in this area for women's health and maternity care, how is Temple Health looking to grow in the next maybe two to three years? What's that look like to you?
- [16:10]
C
Well, if I look at the last two to the last three to five years, our top four line has been growing by 7, 8, 9% per year. I think those trends, we expect those trends to continue. There is big demand for patient demand to see our providers. I just spoke about the family and women's services and building the the new hospital that'll be part of our future growth. Expanding our cancer service is another priority for Temple and it's going to be expanded under the philosophy of bringing cancer care closer to patients homes, largely through the continued development of high tech diagnostic and treatment sites located out in the community. I don't know if you know this, Madeline, but the Temple Cancer brand includes the Fox Chase Cancer center, which was one of the nation's first cancer hospitals and a founding member of the comprehensive Cancer Network. We also expect to see growth or continuation of growth in our transplant programs, led by the lung program. Lung transplant program, which is the busiest program in the country, but also across the other specialties, neurosurgery, urology. We invested heavily in physician recruitment in these programs. We'll be adding bed capacity today. We run at most days 100% occupancy. We'll be adding bed capacity, especially critical care beds and step down beds over the next year that service these new patients demand to see our providers in their office is booming. Most of our providers have wait lists that go back that run two, three, four weeks. We are hired. As I mentioned, we hired a significant number of new providers over the last six months and we're investing in scheduling technology, investing significant dollars in scheduling technology, making it easier for patients to see their physicians. This project alone, since we have over 1,000 physicians and physician extenders, this project will touch on they'll be touching many of our employees, administrative and physician employees. It's a big, big initiative of Temple.
- [19:15]
B
Yeah, I was going to say it is so exciting to hear all of the investments that Temple is making right now. You can really tell that your system is obviously listening to the community, thinking, you know, being forward, thinking about providing care and access to people. So I truly appreciate you sharing. Yeah Jerry, well listen, I would love to have you back on the podcast again sometime soon, but we truly appreciate having you share just more about the exciting things happening at Temple. And I look forward to chatting with you again sometime soon.
- [19:47]
C
I am here. Have a good day.
- [19:51]
A
At athenahealth. We know your ambulatory practice wants healthier a healthier business, healthier care teams and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments payments and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom lines. Practicing medicine is complex, but running a practice can be that much simpler with Athenahealth. See how simpler is healthier@athenahealth.com.