← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Karen Janousek, Chief Population Health and Growth Officer at Sinai Chicago
00:17:12
Loading summary
Transcript17 lines
- [00:02]
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.
- [00:33]
B
This is Laura Dirdo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Karen Janicek, Vice President and Chief Population Health Growth Officer at Sinai Chicago. Karen, it's a pleasure to have you on the podcast today.
- [00:45]
C
Thank you, Laura, for inviting me. I'm very excited to be here and happy New Year to you and your audience.
- [00:50]
B
Thank you. Happy New Year. Well, I'm excited for our conversation today because I know, you know, in healthcare there's so much happening and so much changing in this time. So it's so important to get perspective from you and other healthcare leaders on how they're navigating things in their perspective on the future. But before we dive in, can you tell us a little bit more about yourself as well as Sinai Chicago?
- [01:11]
C
Certainly. Thank you, Laura. Here at Sinai, I am the chief Population Health and Growth officer. And so tucked under all of that is everything that has to do with our value based and managed care work here for the system. So it's a value based partnerships with the payers. It's everything to do with our work with our Accountable Care organization, our physician hospital organization, as well as all of the work that is tied to the Illinois Healthcare Transformation Collaboratives, of which Sinai participates in two of them. And then finally, as I like to jokingly say, all other duties is assigned, which includes special projects that come up whether it's within the value Based care space or not. And so that's a little bit about the role within our organization here.
- [01:58]
B
Well, that's fantastic to know a little bit more about it and what an important role you play in Chicago in keeping the community healthy and safe. Now, you know, when you think back about the last year or so, what was the most important initiative you led, what did you do, and what were the results?
- [02:13]
C
Very good. Thanks, Laurel, for that. I think it splits in two different ways as I think about it. The first one certainly is in the value based care space. And here I would say it leans in very heavily on the work and the success we have had within our ACO Reach product in the area of completing annual wellness visits. Within racl, we are one of the star providers for that metric. Why that is important is simply because it becomes the gateway in which our patients become affiliated with and work with our primary care physicians and our specialist physicians. Sinai Chicago, as many of your listeners may be aware of, is Chicago's largest and oldest private safety net. That translates into serving the south and the west sides of Chicago with a very heavily concentration of ambulance runs. So we serve about 76,000 patients in the ER. 28,000 are coming from ambulance runs. I say all that to say that often our ER is the front door into, into our work. And our emphasis on connecting with the patients and getting them in for annual, well, you know, annual wellness visits begins to start creating the connectivity between the patient and the provider. So we're very, very thrilled with that, particularly in the, in the ACO reach population. I credit a lot of success. I credit the success to the teamwork specifically with both our providers and our frontline caregivers or CHWs who have been trained up in how to work with, with the patients to get them in for annual wellness visits and just a tenacity to continue to work with them and get, get the patients and the providers educated. The other thing I would credit is having a good data system to be able to know if we are actually achieving the goal. And then finally it's daily leadership. I credit my management team for being able to work the reports and see how progress is going, all in service of the patient. So that's the first one I was very, very excited about. The second one falls under that all other duties is kind of assigned. So back in the fall of 2024, our CEO, Dr. Z.K. asked several of us to kind of weigh in on how do we bring even more of a service line philosophy and approach to clinical drug tr. Here at Sinai, we have Sinai Community Health Institute, which is our research arm, our epidemiological research arm. However, we have had physicians and we have participated in clinical drug trials before. Now, however, we want to fully expand this where it makes sense to the different specialties that could serve our community. And so we spent 25 working on the plan of action, the strategic plan, identifying the partners in the clinical research organizations that we want to work with, identifying the actual medical specialties, identifying what we actually need to do to our emr, which is epic, through the community connect model that allows us to operate the clinical trials. And so as we come into 2026, we know who our first partners will be. Yay. And we know which, which kind of clinical areas we want to focus on and we're going to start probably early Q2 the implementation of what we need to do within Epic. So those are two big wins I think for 2025 that will continue to inform our work for 26.
- [06:18]
B
That's amazing to hear in all big undertakings for any hospital organization, but especially looking at everything else that you're trying to do right now in the patients that you're serving. So that' impressive. How do you kind of transform your teams and keep people focused, especially when you've got a lot of different projects and initiatives going on.
- [06:38]
C
Great, great question. We have a small but mighty team, as I always like to say, and I think it always comes back to communication and communication and explaining what is the, what is the purpose of the project, what is your role in it, what is the goals? And then always checking back in and how are we doing on achieving the goals or on achieving the goals? What are the barriers to success that I can work to remove or bring the right resources across the institution together to help remove? And so I think it's that constant repetitiveness of the communication cycle and the issue resolution cycle that allows us to advance any initiative that we're involved with in our value based care space forward.
- [07:27]
B
That's fantastic to hear. Now looking ahead, what are some of the big priorities and headwinds you're focused on for 2026?
- [07:34]
C
Another great question and there is a lot of them out there. I don't think any 2026 conversation or headwinds conversation would be complete without an homage to HR1. Beckers and many other organizations out there have written a lot about the impact of what's coming out of Washington with HR1. But some of the headwinds that will impact us on the value based care side can range from anywhere from, you know, loss of Medicaid eligibility, the loss of any of the ACA add ons to it patients who then if, if they've lost eligibility or if there is a work requirement for Medicaid on the eligibility, it's a strong possibility some patients may not seek care. If they don't seek care, then we're going end up seeing a greater disease burden which then ends up running through all of our systems and impacts overall, the expense and more importantly the quality of the patient's life. So with that kind of a backdrop on everything, you know, we, the headwinds that we expect to see continue to see is just rising costs across any business, but especially in the health care sector, labor Costs, tech costs, acquisition costs, whatever costs, we're continuing to see it increasing the premium expense and going up, you know, care utilization is going up as well. That then translates into quite a bit of volatility when you think about it in a value based or a shared savings way. If you've got raising rising costs and you're not quite sure how that's going to be managed or how much the rise will be and you're trying to manage to a medical loss ratio of acts, it makes the challenge of that even, even greater than the other thing to keep in mind is some of the forthcoming, at least in Illinois, some of the forthcoming regulatory complexity changes that will, will occur starting in July. It has been passed here In Illinois, the 72 hour rule and the Gold card rule, which will be implemented in July. And so very soon we're starting to see more and more of what that's going to look like, how that's going to feel. In some instances it will help to the providers and it may be, but it may be more of a burden to get it stood up and understood how to work between the payer and the provider with the, with these roles. I think the other comment that I make on Headwinds again continues with workforce and here keeping, you know, we're still all dealing with some shortages. You're dealing with provider burnout, you're dealing again with labor costs. But all of that bringing it back into the value based world threatens the delivery capacity as well as it threatens the overall quality here I think quality of HEDIs, completing some of the hedis studies that have to, that have to be done. So I think simply put, there will always be the ongoing challenge to work on. How do you balance the near term financial priorities versus the investments that one needs to make in value based care, be it at a personnel level, a technology level, a partnership level, a data level. And so there's a push pull in anywhere when doing value based care in this current climate. And so to sum up on the priorities, it's the balance between achieving the clinical and achieving the financial. One of the ways we're trying to do that is by limiting the number of measures that we're participating in. Like not 19, he just measures. Let's get it down to a more manageable number and let's see if in fact it can be pretty much standardized across the health plans. I'll give a shout out to The Illinois Medicaid MCOs who have started to move along those lines. Still work to be done in Medicare and in commercial but it's coming along and then it's, it's always paying attention to what are the, what are the new value based care programs that are out there? During 2025, we were introduced to three new programs. Some we accepted, some we did not for complexity. And then literally just this week we're introduced to another one from another payer for activation in 2020. So I say all that to say that the question will become how do you go deep or do you go wide when thinking about value based care? When you're trying to manage the near term financial performance versus the benefit of what value based care should bring in.
- [12:25]
B
The future, that's fascinating to hear a lot of different elements that you're dealing with and trying to move forward. Whether it's, as you mentioned, looking at the HEDIS measures, looking at some of the policy changes and shifts in how demographics as well for your patient population are moving. So that's really interesting to hear a lot of different things on your plate in headwinds. But when you think about next year, what do you think the hardest thing you'll have to do will be?
- [12:52]
C
So I think there's, I'll answer that in kind of two ways from the hardest thing. One of the things we're going through right now, working with our actuarial firm, is taking a look at what we're calling the left on the table or stated simply in the value based care world, how much money did we not earn in terms of performance in the quality HEDIS measures or performance in the shared savings measures? And so it's a little early to do the finalization of the 2025 performance, but we're working, we're working on it to get a good read to set us up for further significant success in 2026. And so one of the hardest things will be to narrow that gap of what total potential is versus what was actually earned. What other strategies do we think about then? When we think about lowering length of stay, working on readmissions with some of our partners, what do we do when we're thinking about more of the quality studies? We've used, you know, all proper communic channels out there, social media to remind patients to come in for an annual wellness or get your mammogram screening completed when it, when it's possible. But are there other avenues out there that we need to further consider in order to promote population health within our community? I think the next challenge with all that will be to continue to keep all the providers engaged in value based care and for Them to continue to get excited with value based care. So completing the care gap, seeing the patient, documenting accordingly, that is mission critical to getting everything completed in a value based care world. And then I would finally say here in Illinois, we will be dealing with the introduction or we are now dealing with the introduction of the D SNP, the FIDI, you know, the FIDI SNP programs they started 11 Sinai Chicago participates in. All of them in service again in the community. However, we're not. I mean, they should work out very, very well. But we'll have to pay attention to what, what does that look like when they actually get up and running more than seven days into the new year?
- [15:21]
B
Yeah, absolutely. That's such a good point. You know, a lot of things coming up for this next year, you know, that will be helpful, I think, overall. But there's always, you know, unexpected things that arise. And so being nimble and in pivot and having that strong team that I know you have there at Sinai Chicago will be extremely helpful. Thank you for running through some of those challenges for us. I think, you know, so many of them are echoed and faced by other organizations across the country too. So to hear how you're thinking about them and positioning for the future is great. Before we wrap up here, I'm curious, where do you see some of the best opportunities for growth and development at Sinai Chicago as well?
- [16:02]
C
I think one of the key areas of growth will continue to be the project of the clinical drug trials. I think because of the vision of our CEO and wanting to bring novel drug therapeutics to our community, I think that will have an impact, an impact and a support of the mission of what we're trying to do here. We're using a crawl walk run strategy, so it's not going to be a lot of trials at any one point in time. That's going to allow us to bring these clinical drug trials in a phase three and a phase four perspective that have not necessarily always been made available to our west and our south side. So very, very excited about that and very energized to continue to see that transform and become even more than the smaller scale we've been working at.
- [16:55]
B
Absolutely. Got it. Well, thank you so much for joining us on the podcast today, Karen. This has been a really fun discussion and I look forward to connecting with you again soon and seeing you at our annual meeting as well in April.
- [17:07]
C
Very good. Look forward to it. Thank you, Laura, very much.