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- [00:00]
A
This is Andrew Kass with the Becker's Healthcare Podcast. I'm thrilled to be joined today by Jan Grigsby, the new CFO at AnMed. Jan, it's a pleasure to have you on the podcast.
- [00:10]
B
Well, thank you for inviting me. I sure appreciate the time. Of course.
- [00:15]
A
And before we begin, why don't you tell us a little bit about your background.
- [00:19]
B
Well, I've been a CFO for about 20 years, and prior to that, I was on the clinical side in the beginning of my career.
- [00:26]
A
I.
- [00:27]
B
For about 10 years. It was there I learned, I think, how to be a better leader, a better cfo. And based in many ways from those early, early years as a cfo, I have worked in several different hospital systems. Not for profit, for profit. Large facility, small facility, independent system, large system. So a little bit of everything. And I have recently come to AnMed, and I am absolutely thrilled to be here. It's a. It's a special, special place. Yeah.
- [01:05]
A
Why don't we talk a little bit about your beginnings at AnMed? How have your first few months gone and what are you most proud of so far?
- [01:13]
B
The first few months have been amazing. Just a little under four months now. The culture here at ANMED has been such a large part of its success, and it's infectious all across the landscape. Additionally, the upstate region of South Carolina is special. The people have been so warm and inviting. My colleagues here at Ann Med have made me feel at home since day one. Things I'm most proud of since I've been here, or. Absolutely. The combination of dedication, loyalty, and talent I've experienced here at anmed. This is an organization that truly represents the community it serves. It's a 501C that does it the right way. Yeah.
- [02:01]
A
And you have a lot of experience as a cfo. And so when you come to a new system, what are the most important things to do first? And how do you get to know your new team?
- [02:14]
B
Well, the most important thing I can do as a new CFO arriving here at EMED is very simple. Listen. The most important part of communication, you know, if you know the comings and goings of one hospital, you know the comings and goings of one hospital. It's impossible to have a magic formula that works each and every place that you go. So you have to stop, listen, pay attention to the culture, to the processes, to the personalities, to the different players, whether it be your colleagues, whether it be the medical staff or the folks that report to you. I really feel strongly that all organizations are unique. Cultures are Unique physician groups are unique, especially physician groups. The needs of each region that you're in can be very specific to only that region or only that state. So learning the financial statements and the KPIs are a given upon arrival. But understanding what your organization means to your community. Going Back to the 501c3 mission statement, how you can best grow and innovate for your service area. This hospital and Med is the sole community provider that has that status. And as such we receive about $800 million in net revenue each year. What that means, that's $800 million of precious resources from the primary, secondary areas that we serve. And it's my responsibility as a steward of those resources to, to monitor usage and efficiencies and investments to protect those resources. And that's really what the lucky thing for me is. ANMED represents all those things, which is exactly, exactly lines up with my personal mission statement of why I do what I do. As far as getting to know the team, I made sure that I flooded my calendar initially with as many appearances as possible. I don't want to be that CFO that's stuck in the office with the door closed with smoke coming out from underneath the door and he's in there calculating things that no one will understand. That's not who I am. Especially considering my clinical background earlier in my career. I want everyone to know how excited I am to be a part of the special and med story. Setting up routine but frequent meetings with my reports and also my colleagues on the executive team. Also taking advantage of all physician meetings as possible to get my face out there so that I help so I can gauge the culture and physician preferences. To be quite honest, basically my first few months is dedicated to listening culture and a full immersion into the revenue cycle, treasury management and financial reporting, of course.
- [05:25]
A
And do you think that clinical background you had is that. Do you find that especially helpful when you are getting to know the new physician groups?
- [05:33]
B
Yeah, I believe when they realize that I'm not just a bean counter from an accounting firm or an investment firm or some other far off financial building just calculating numbers that are dispassionate, that I started my career as a telemetry technician, I started my career as a unit secretary. I was on an open heart team, on an open heart surgical team. I was an auto transfusionist as I was getting my graduate degree. Those things that I don't throw in their face, but I want them to know that I come from a place of service, that I believe that it's My job to make sure that the patient and the patient's family is number one in my sights. That at the end of the day, if I'm not making the job easier for my reports and making it life easier for the patient and the patient's family, I'm not doing my job. I need to go find somewhere else to play in a different sandbox.
- [06:39]
A
What made you switch from the clinical to the financial side?
- [06:42]
B
Well, just a. It, it's based on more so when I was growing up than when, when I was coming of age of 18, 19, 20, there were two things I wanted to be in my life. One was a surgeon and number two was the starting center fielder for the Cincinnati Reds. Well, neither one of those things happened. I was going to go to med school, but all the doctors at the time, at that time, the HMOs were starting to proliferate and when I was working on the clinical side, all the doctors were pulling me aside and saying, jan, don't do it. It's not the same. You have no say. We're powerless. Now of course that's not 100% true, but it helped me to align myself where I, I can combine my, my passion for numbers and my passion for health care. And I can honestly say that the first couple of days that I found myself in the MHA program, I knew that this is what I wanted to do with the rest of my life. And how lucky is that, that that you're able to fall into a job that you're passionate about and you like it as much as you love it. And so that's that, that's how I fell into this line and, and very, very lucky that I did. Yeah.
- [08:04]
A
Now we just need to tie in baseball somehow.
- [08:07]
B
Well, you know, those, those, those days of summer are long gone by, but. Yeah, yeah, but I'm, I'm exactly where I need to be right now.
- [08:18]
A
That's great. And so what are some, what are three of the top trends you're following in healthcare right now?
- [08:24]
B
Oh, goodness gracious. I think it's one that has hit the whole country at the same time. The big beautiful bill. That's one of the items. One of the things that really keeps me up at night is the migration of services from inpatient to outpatient. You know, they recently came out with the outpatient proposal for 2026, where they're effectively getting rid of the inpatient only list. And if that passes, there are well over 250 musculoskeletal procedures that are effectively moving away from the inpatient site, which is fine. But you have to understand that there are the, the. In a state that has no con like South Carolina, there are going to be ASCs popping up everywhere. If you read Becker's, and of course you do, we all do. And you read the ASC portion of Becker's, they're all singing Happy Days are here Again. And so we have to be nimble as a system to join in that migration and make sure our outpatient facilities and our outpatient sites are easily as competitive, if not more so, that we can still best serve our community and those procedures that are making a transition. That's one thing. The other thing is the big beautiful bill. We talked a lot about Medicaid reductions over the next 10 years and those self state directed payments specifically is very concerning. Worst case scenario, you're looking at possibly 5 to 10 percentage points off of everyone's operating margin. And so you're going to have to find ways to make up for that, find ways to continue to be more competitive even with an environment, like I said, that's migrating from inpatient to outpatient. Inpatient. Outpatient really signifies a reduction in payment overall, which is exactly why they're doing it, why CMS is moving things off of that list. But the big beautiful bill, there's a lot more to be seen on, on how it gets enacted because as you know, administrations change and some things that are passed, the deadlines get kicked down the road. Just like the Medicaid dish reduction of $8 billion they kept with every reconciliation act, they keep kicking it down year after year after year. Now I'm going to prepare for the worst and hope for the best. The other, you said ask for three. The third is a fantastic opportunity of explosion of population growth in my area. The upstate South Carolina area of Clemson, Anderson and Greenville are one of the top areas in the south, if not the country in percentage growth over the next 10 years. Each one of those is at least is double digits in low double digits. And there's a lot of competition. In our area we have three or four very engaged systems, if you will, that are already trying to put flags down in our, in our local area. And so that, that really sharpens the sword where we have to be nimble. We have to have the efficiencies on board to give us the balance sheets that we need to compete and to win. Just in our primary service area, you know, we're not out there trying to grab market share from other states. We want to, we want to do the true 501c3 mission of taking care of our primary and secondary service areas and wishing the rest of them well in their areas. So that's, that's the best way for us, for me as a cfo, to invest in the precious resources that we derive from our customers.
- [12:27]
A
And what is the biggest headwind you're facing right now as a finance leader? And how are you tackling that challenge?
- [12:33]
B
Well, number one, preparing for that inevitable migration to the outpatient arena and the reduced state directed payment assistance over the coming years. How are we attacking that challenge? Intentional growth. Intentional growth. And we're lucky at amed that. Oh, not lucky, but we've been determined over many years to develop what I consider a strong balance sheet that has given us the war chest, if you will, to compete in our areas. And we have strong market leadership now, but there's a lot of competition trying to peck away at the market share that we have even in our own backyard. And so to utilize our balance sheet strength to expand access to our organization in the upstate South Carolina region, but at the same time to leverage our talented staff and technology to maximize operational efficiencies and optimize our revenue cycle capability to retrieve every dollar we are owed for the services we provide. We are a partner with epic. I believe that it's a wonderful platform, highly innovative, utilizing now AI. And AI is a scary word for everybody, but if you are smart about it and you're, and you're intentional and, and you go at it at a pace that you can control and make sure that AI isn't taking over the conversation, but being a tool to use for some of the more mundane services that save time and make things easier for the patient, the patient's family, and then very carefully increase the quality of care for everyone involved. And also to continue to grow our culture of quality, patient satisfaction and expand recognition of our brand throughout the region and beyond. Admed has gone through a transformation over the last four or five years that has become a symbol of pride for this area. And I'm very proud and lucky to be there to be here.
- [14:53]
A
And what are you most excited about in healthcare right now?
- [14:57]
B
To be in the financial position that we're in, to invest in the quality of life for our patients and our dedicated employees, to expand access, to spread a culture of quality, serve our community and intentional, with intentional growth. All of this that I'm talking about is really a dream come true for me. I've been in other places that I've dearly loved and I wouldn't say that I admit that I'm on the back nine of my career at this point, but maybe on hole number 11. But this is a wonderful place to, to continue challenges until I face the end of my career. It's, it's, it's, it's a fantastic system.
- [15:44]
A
And you're only on hole number 11. So how are you thinking about growth over the next 12 to 24 months?
- [15:52]
B
Well, I'm, I'm going to enjoy the ride and hold on to the guardrails and make sure that we make smart, determined decisions based on the strength of our balance sheet, the strength of our cash position, making sure that quality drives the bottom line and not the other way around. And I think if you can have that in your heart, that it's not no margin, no mission, but it's no mission, no margin. And those that think it's otherwise are in for a losing game. But I am continuing to grow and learn even at this ripe old age, and I feel so lucky and blessed to be asked to come along for this journey.
- [16:43]
A
And so those are all the questions I had for you today. Thank you so much for joining us and it's been a pleasure speaking with you and I hope we can talk again.
- [16:51]
B
Well, thank you. I appreciate the time and have a great holiday.