Becker’s Healthcare Podcast: James Heilsberg, CFO, Tri State Health

Release Date: January 7, 2026
Host: Will Riley (R1)
Guest: Jim Heilsberg, Chief Financial Officer, Tri State Health

Episode Overview

This episode features Jim Heilsberg, CFO of Tri State Health, a rural critical access hospital in Clarkston, Washington. Jim provides insights into the challenges and opportunities facing rural healthcare providers, including expanding services, embracing technological innovation (notably AI), workforce dynamics, and a strong focus on patient experience. He shares Tri State Health’s strategies for growth, adapting to competition, and maintaining a community-centered approach amidst industry disruption.

Key Discussion Points and Insights

1. About Tri State Health and Its Community

• Tri State Health is an independent, entrepreneurial critical access hospital serving the agricultural Lewiston-Clarkston Valley on the Idaho-Washington border.
  • Serves a primarily rural, agricultural community with a long local history.
  • Provides full hospital services, extensive primary care, and specialty practices.
  • “The hospital has been there since the mid-50s and continues to be a very independent, entrepreneurial type facility.” (C, 00:56)

2. 2026 Priorities & Service Expansion

• Maintaining and Expanding Services:
  • Key objective is to continue providing as many services as possible to meet evolving community needs, especially as competing hospitals change ownership and services.
  • Recent expansion into orthopedics after a local group was acquired by a for-profit competitor; Tri State is developing its own orthopedic group.
  • Increase in general surgery capacity and absorbing OB/GYN providers who opted not to join the for-profit system.
  • Investment in clinic remodeling and consideration of updates to surgical and sterilization infrastructure.
  • Facing the challenge of funding capital projects amid uncertain healthcare revenues and Medicaid changes.
  • “We are investing in infrastructure...trying to figure out how do we fund all that. Some of our big challenges are saying how do we fund in this time where there’s nothing that’s certain. All our revenue streams are at risk.” (C, 04:24)

3. Embracing Technology and AI

• Tech Integration Focus Areas:
  • Revenue cycle modernization: Leveraging AI and automation to streamline processes and reduce overhead.
  • Workflow improvements: Using technology to let clinicians “work up to their license,” eliminating unnecessary clerical tasks.
  • Recent tech rollouts include Experian (for revenue cycle AI and automation) and Meditech Expanse as the core EHR.
  • Adoption of Denial AI to address claims issues before submission and continuously improve financial operations with feedback loops.
  • Recognition that AI is in its “infancy” in healthcare, but expects “major changes in the next 24 months.”
  • “Technology is going to have to solve not only the revenue cycle, it has to solve all of our issues.” (C, 05:37)
  • “What I think we really have to find ways to deal with is how do we help all of our clinicians work up to license to eliminate those tasks that they don’t have to be doing anymore that the AI can do for them?” (C, 07:55)

4. Revenue Cycle Transformation

• Moving from labor-centric to technology-driven models; using bots and automation to handle repetitive tasks.
• Example: Introduction of a payment posting bot that “eliminated 40, 50% of a workflow,” freeing up human staff for more value-added work.
• Recognizes the fragility of older automation tools (breakage with new data), but AI/machine learning may bring robustness and scalability.
• “We’re experimenting with old tools in a new way. AI in theory is going to provide a different set—machine learning...the ability to merge bots with AI in the future can make it much more efficient.” (C, 09:41)

5. Improving Clinician Experience

• Focused on optimizing workflows through technology to reduce clinician administrative burden.
• Predicts advances in dictation, automatic coding, and passive documentation using language models.
• Goal is for providers to spend more time on clinical care and less on clerical work.
• “We can eliminate manual work that they do to allow them to be much more efficient, see more patients, allow for our nurses to actually work up to their license.” (C, 11:23)

6. Enhancing the Patient Experience

• Measures patient satisfaction with Press Ganey and CMS star ratings; Tri State is a five-star hospital in Washington.
• Utilizes tech and AI (e.g., proactive calls, schedule optimization) to improve patient access and reduce wait times.
• Stresses a personal touch and flexible access (minor care clinics, attentive staff) as differentiators.
• “We work at trying to get that connection now. It’s what allows us to have our ratings that we do.” (C, 12:19)
• “There’s many different ways that we continue to work to try to get, allow the patients to be seen when they’re most ill, when they need to see somebody...” (C, 12:56)

7. Personal Reflections & Mission in Healthcare

• Emphasizes the “personal” nature of healthcare and the privilege of impacting lives.
• “I fell into healthcare. I never sought it out. It’s been a great journey that’s allowed me to actually make a difference where I don’t see that I would have in other industries... I don’t know of a greater career than you could have than doing that.” (C, 13:35)

Notable Quotes & Memorable Moments

• “Technology is going to have to solve not only the revenue cycle, it has to solve all of our issues.” (C, 05:37)
• “Our main focus is to continue to provide for those needs that are in the valley as best as we can...Our real goals are to continue to be able to provide all the services possible, expand where appropriate so that we can meet the needs of the community.” (C, 01:49)
• “I think we’re starting to see the opportunity where we can help our physicians, where we can help our nurses. We can eliminate manual work that they do to allow them to be much more efficient...” (C, 11:17)
• “As we look at healthcare, we always have to make it personal. If we don’t experience healthcare individually, it’s hard to make it personal.” (C, 13:26)

Important Segment Timestamps

• [00:56] — Tri State Health overview and community served
• [01:49] — Key services and future expansion priorities
• [04:24] — Capital investment challenges and funding
• [05:26–08:04] — Role of technology and early AI adoption
• [08:44] — Automation in revenue cycle management
• [10:43] — Technology for clinician workflow improvement
• [12:04] — Patient experience initiatives and tech tools
• [13:26] — Making healthcare personal and concluding thoughts

Tone & Style

Jim Heilsberg is practical, community-minded, and hopeful about the future. He’s grounded in local realities but optimistic about technology’s ability to transform healthcare—while never losing sight of the personal, human dimension.

This episode offers an honest, forward-looking perspective on how a rural provider navigates growth, technology, and patient-centered care in a changing healthcare landscape.