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.

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.

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.

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]

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.

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]

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.

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