Josephine Wilton, Chief Business Development Officer, CHCB

Summary

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Episode Overview

This episode features Josephine Wilton, Chief Business Development Officer at CHCB, in a conversation with Grace Linkeller at the 13th annual CEO and CFO Roundtable. Josephine shares her career journey, insights into growth strategies for Federally Qualified Health Centers (FQHCs), current impactful projects—especially around maternal health—and offers advice for healthcare leaders to ensure future organizational success.

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Guest Introduction and Background

Timestamps: 00:32 – 03:27

• Josephine Wilton describes her "quilted, patchwork" career, moving from paralegal work into legal operations, health plan legal departments, network provider development, and finally leadership at an FQHC.
• Quote:

  "I pride myself as being maybe a jack of all trades, master of none... Once I got in there about three years, I realized I want to learn more about the business of healthcare."
  — Josephine Wilton [00:52]

• Spent nearly 9 years with Blue Cross in western New York, then transitioned to a startup Accountable Care Organization (ACO), gaining experience in contracting, network recruitment, and claims issues.
• Worked across states (New York, Georgia, Illinois), which deepened her understanding of diverse provider challenges and opportunities.
• Now at an FQHC, she finds alignment with her desire to provide on-the-ground community care.

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Growth Strategy for CHCB

Timestamps: 03:37 – 06:08

• CHCB’s growth has centered initially on foundational work like renegotiating health plan contracts to align reimbursement with care delivery and evolving community needs.
  • Quote:

    "Get the fee for service right. Make sure it aligns with your delivery of service and care, which should continue to evolve based on community needs."
    — Josephine Wilton [03:44]

• Sees a hybrid future of fee-for-service and value-based payment (VBP), especially since many FQHCs can't take on downside risk.
  • Quote:

    "A lot of organizations do need to catch up to the VBP world, including especially FQHCs who can't typically take downside risk. So then we gotta get creative, right?"
    — Josephine Wilton [04:32]

• Brick-and-mortar expansion: CHCB is opening a new site in the southern tier of western New York, funded by the state, to address persistent access issues.
• Recognizes that proximity to care doesn’t guarantee access due to local traumas (e.g., winter storms, community violence) and behavioral health needs.
• Dental care highlighted as another critical focus, aiming to reduce avoidable hospital visits stemming from dental issues.

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Most Impactful Current Project: Expanding Maternal Health Access

Timestamps: 06:15 – 08:38

• Josephine is especially passionate about a new maternal health initiative, which seeks to decrease disparities and improve outcomes—a response to personal experience and broader societal need.
  • Quote:

    "Through the health center, we had an opportunity to request some funding to expand access to maternal care...incorporating social determinants of health. What are they experiencing that's causing them to end up at risk, potentially losing their lives or their child's life?"
    — Josephine Wilton [06:21]

• Her personal testimony played a role in securing state funding for the effort.
• Plans include infrastructure and workflow changes, leveraging their ACO and IPA partnership to do the work.
• Emphasizes the goal of sustainable, incremental change:
  • Quote:

    "We're in the infancy planning stage...It's not a ton of money and our goal is to keep it going. But I'm really excited about that work because I think it's just so meaningful..."
    — Josephine Wilton [07:54]

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Advice to Healthcare Executives: Focus on Infrastructure and Execution

Timestamps: 08:47 – 10:50

• Josephine asserts the top priority for healthcare leaders is focusing on operational execution and infrastructure—ensuring contracts are not just signed, but fully operationalized.
  • Quote:

    "The entire C suite boards need to be focused on operations and execution. I've done contracting for a living...But then what happens after that?"
    — Josephine Wilton [08:54]

• Stresses the importance of a deep, mutual understanding between providers and payers to bridge operational gaps and correct misconceptions.
  • Quote:

    "The first thing before you even start to talk about operationalizing and execution is getting that deep understanding on both sides."
    — Josephine Wilton [09:41]

• Recommends tight tracking, monitoring, and collaborative adjustments to make progress toward success.

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Notable Quotes and Memorable Moments

• Career Reflection:

  "I had tremendous support from my executive and other executives throughout the organization and found my way into the network team provider network..."
  — Josephine Wilton [01:46]

• On Access:

  "When we talk about access, folks could be like five blocks away from a hospital provider. That doesn't mean they're able to get there for many different reasons."
  — Josephine Wilton [05:14]

• Doing Incremental, Impactful Work:

  "We've got to make a difference somehow and it's just incremental wherever we can."
  — Josephine Wilton [08:30]

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Key Takeaways

• FQHCs are embracing strategic contract negotiations as a growth foundation, while seeking new models and creative funding to expand care.
• Innovative projects (like maternal health) embody population-centric care and focus on reducing health disparities by considering social determinants.
• True organizational advancement requires leadership attention to robust infrastructure, strong operational execution, and cultivated payer-provider understanding.

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For Further Information:
The full episode and further details can be found at Becker’s Healthcare Podcast archives.

Transcript

[A]

This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.

[B]

This is Grace Linkeller with the Becker's Healthcare Podcast and we are recording live at the 13th annual CEO and CFO Roundtable. I'm currently joined by Josephine Wilton, who is the Chief Business Development Officer at chcb. So Josephine, thanks for being here. I'm going to have you start off by just introducing yourself a little bit further and telling us more about your background.

[C]

Terrific. So, Josephine Wilton My background is pretty, I refer to it as like quilted in a patchwork. So I pride myself as being maybe a jack of all trades, master of none. I started out my academic and professional career in a legal track, actually worked as a paralegal for many years, moved transition into legal operations and then about 15, almost 20 years ago, ended up taking a job with a Blue Cross plan in western New York and started naturally the legal department, legal operations. And once I got in there about three years, I realized I want to learn more about the business of healthcare. Right? Everybody goes to legal when there's a problem, so you get a little sense of, you know, the ins and outs, some at a very high level. Bird's eye. But I had tremendous support from my executive and other executives throughout the organization and found my way into the network team provider network and ended up negotiating and doing contracting with facilities and ancillary providers and really learning the business, even sides of it that I didn't like. Like we could probably do a whole podcast on claims issues with hospitals from there, you know. After eight and a half year tenure with Blue Cross, I ended up transitioning to a startup aco. And that was awesome, right? Because then I had the perspective of that middle entity that there to bridge and support payer. So for ACO reach, you've got CMS as a government payer bridging with providers and I got to go back to my old stomping ground, if you will, of doing network development, recruitment and that ACO also established an IPA in New York, Georgia and right here in Illinois shortly after I left. But I had an opportunity to travel and really get to see a lot of the similarities with different provider types, those claims and operational issues that I disliked and disdained. On the plan side, those experiences really came into play and were helpful when I was on the ground and working with those provider organizations. And then I ended up, of course, where I am now, working for an fqhc, a federally qualified health center. And that was my foray into working for a provider. I think it's a natural fit with my background and I'm glad that I had the opportunity to do that.

[B]

So wonderful. Well, thanks for that rundown and I'm glad you're here with us. So let's start our conversation talking about your growth strategy in the next year or two.

[C]

Yeah. So growth even since I've been here at this conference, I've been on the phone with members of the executive team, including the CEO and we're still strategizing. There's definitely, when we talk about growth, we are, I would say more foundationally embarked almost two years ago on a path of renegotiating our contracts just with the, with the health plans. Like that's just fundamental. Right. Get the fee for service. Right. Make sure it aligns with your delivery of service and care, which should continue to evolve based off of community needs. It's not just fee for service from there. You know, it's a building block. Here at the conference you're hearing people talking about fee for services still here. I remember in my career where everybody thought it was going to go away and value based payment arrangements, we're going to take over. It's kind of been split and I, I think I agree with others that it's going to be that way for a while. However, a lot of organizations do need to catch up to the VBP world, including especially FQHCs who can't typically take downside risk. So then we got to get creative, right? And there's still a lot of opportunity. So that's been a part of our growth strategy is kind of stabilizing, but also kind of leaning in and leveraging those different revenue opportunities which will give us more of an advantage to expand into the community. We are opening a new brick and mortar which this was already in the works. Through state funding, we're expanding to more southern tier of western New York. The fqhc, we have five locations right now in a mobile unit. But access is still an issue. When we talk about access, folks could be like five blocks away from a hospital provider. That doesn't mean they're able to get there for many different reasons. Western New York community has gone Through a lot of trauma because of a lot of events. You know, winter storm, we had unfortunately a tops massacre. The community at large was impacted and a lot of folks are dealing with behavioral health issues. So when we talk about growth and expansion, it's access to care. In particular, there's behavioral health, but also dental. There's a great need. A lot of avoidable hospital visits are due to dental issues and you really can't, there's not much they can do unless it's trauma related. So we're looking into expanding our dental delivery of Carol.

[B]

Absolutely. And tell us about the most exciting or impactful initiative or project that you're currently working on.

[C]

Oh wow. So many. So I would say something that kind of hits home at a personal level is maternal health. Obviously there's, there's a lot of focus on that in our country, I mean even globally, but certainly we'll talk about, we'll stay with the US we got enough to deal with there and certainly the health disparities around that. Through the health center, we had an opportunity to request some funding to expand access to maternal care. There's a lot of great statistics out there. Within each state, county level, they're gathering all sorts of statistics, but there's still a shortage at a more micro level and certainly incorporating social determinants of health. Like what's happening to those individuals, those persons, birthing persons who are. And also their support system. Right. It's not just them, it's their partners, family, what are they experiencing that's causing them to end up at, at risk, potentially losing their lives, their, you know, their child's life. So we went to the state and I was personally involved in that and was able to give personal testimony as to how, you know, I was impacted through the healthcare system negatively, but could have been a whole lot worse. And just to speak and be a voice and a face, you know, oftentimes we're working with people right next to them and we don't know how they've been impacted in their lives. And so hopefully if anything I was able to make it real and relatable in the ass. So we're looking forward to, to getting that going. It's going to be a complete, I guess, infrastructure build that we will augment our current care delivery system workflows and process to expand this maternal health. And we're going to leverage our aco, which also is an IPA partner to do that work. So I'm excited. It's like we're in the infancy planning stage and it's not a ton of money and our goal is to keep it going. But I'm really excited about that work because I think it's just so meaningful as well as all the work that we do at the health center. But we gotta make a difference somehow and it's just incremental wherever we can.

[B]

Absolutely. And then finally, what is the most important thing you think healthcare executives should be doing right now to make sure their organizations are successful in the future?

[C]

Infrastructure. So I heard. I was very pleased to hear some of your panelists in different sessions. Some value based sessions, others not. So not exactly that, but there was a little bit of a theme in focusing on operations and execution. And so I think that's exactly where executives should be. The entire C suite boards need to be focused on operations and execution. I've done contracting for a living, negotiations. It's great. I have a legal background. I'm excited by redlining and making sure the contract, contract, it's fully executed. But then what happens after that? Right? We sit in meetings, internal meetings with our partners, others, and health plans, et cetera, and we're talking about moving the needle and we're staring at scorecards, metrics and data and everybody's frustrated on all sides because things are just not progressing as expected. And I'll speak for FQHCs in particular. They're incredibly nimble, one of your most flexible provider types in the community. They have to be resilient inherently because of all what they endure despite whatever administration we have just in the landscape of healthcare. However, one of your panelists also mentioned the first thing before you even start to talk about operationalizing and execution is getting that deep understanding on both sides. And I've experienced that through negotiations where people say, yes, we understand your organization and your care delivery model, but usually there's a wide gap in that understanding. So starting there first on both sides, certainly there are a lot of myths from the providers based off of health plans and then moving into operational planning and execution and proper tracking and monitoring to ensure that all the great activities that are occurring are getting the parties moving them along, some sort of pathway to success.

[B]

Absolutely. Well, Josephine, thanks so much for being here today and joining me on the Backers Healthcare podcast. Again, we are recording live at the 13th annual CEO and CFO Roundtable.

[C]

Thank you so much.