Lung Nodule Pathways to Profit: Aligning Clinical and Financial Leadership

Summary

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Podcast Summary

Episode Overview

Podcast: Becker’s Healthcare Podcast
Episode: Lung Nodule Pathways to Profit: Aligning Clinical and Financial Leadership
Date: November 14, 2025
Host: Lucas Voss (Becker’s Healthcare)
Guest: Jason Keller (President, Rayler Share Medical Respite; former COO, University of Chicago Medicine)

In this episode, Lucas Voss interviews Jason Keller about the strategic and operational importance of lung nodule management. The conversation delves into the intersection of clinical and financial leadership in creating profitable yet patient-centered lung cancer pathways, emphasizing early detection, cross-disciplinary collaboration, and technology-enabled care.

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Key Discussion Points and Insights

The Importance of Lung Nodule Management in Healthcare

• Magnitude of the Issue:
  • Keller underscores the enormous global spend on lung cancer treatment, projected to reach $89 billion by 2030.

    "I think the estimates are that $89 billion will be spent globally on cancer treatment, for lung cancer in particular, by 2030."
    (Keller, 01:29)

• Early Detection as the Key Driver:
  • Early detection, diagnosis, and timely treatment lead to better patient outcomes, higher margins for health systems (due to surgical candidacy), and reduced reliance on resource-intensive late-stage care.

    "If you find cancer early ... get them to treatment, people have better outcomes... much improved outcomes... The alternative is late detection of cancer, which ends up being high utilization of hospital resources, long hospitalizations, and unfortunately, palliative care."
    (Keller, 01:33–02:25)

Collaboration and Aligning Clinical and Financial Leadership

• Dyad Relationships:
  • Keller highlights the critical importance of partnerships between clinical champions and administrative leaders.

    "In my mind, dyad relationships are absolutely critical in this space. Finding someone who is as passionate about this as I am was absolutely critical."
    (Keller, 02:58)

• Roles and Responsibilities:
  • Administrators bring resources, capital, and care continuum coordination.
  • Clinical leaders (physician champions) drive referral pathways, advocate for patients, educate peers, and focus on outcomes.

    "Set up the program, hand off the reins to my clinical partner, and they're the ones who have really driven the success."
    (Keller, 03:50)

Proven Strategies for Effective Lung Nodule Management

• 1. Expanding Screening Access:

  • Keller recommends routine lung cancer screening at all care sites—not just academic centers—by maximizing CT scanner capacity and accessibility.

    "Offer screening at every site across their care continuum... setting aside time to ensure patients can get timely, timely screening."
    (Keller, 04:55)

• 2. Dedicated Lung Nodule Clinics:

  • Establishing nurse practitioner-led lung nodule clinics is vital for tracking and managing patients post-screening, particularly those who require a ‘watch and wait’ approach.

    "Once you screen, you will get a pipeline of patients who have nodules... setting up generally nurse practitioner-led lung nodule clinics is absolutely critical."
    (Keller, 05:22–05:31)

• 3. Harnessing Technology and AI for Incidental Findings:

  • Many lung nodules are discovered incidentally (e.g., during cardiac CT scans or trauma evaluations). AI tools can help radiologists spot these nodules and trigger necessary follow-up.

    "There are now tools with AI that can detect these nodules... ensure that the patient actually was followed up on it."
    (Keller, 06:29–07:06)

• 4. Continuum of Care and Multiple Touchpoints:

  • Patients may touch numerous teams: radiology, interventional pulmonology, primary care, nodule clinics, surgical and oncology services.

    "So many touch points... that's where collaboration between the administrative leader... and that clinical leader... is so important."
    (Keller, 07:39–08:06)

Impact & Broader Significance

• Clinical & Financial Outcomes:

  • Early detection creates a dual benefit: improved survival for patients and higher-margin procedures for hospitals.
  • The conversation consistently emphasizes patient benefit over profit, despite discussion of financial metrics.

• Call to Action:

  • Keller concludes by urging healthcare leaders to prioritize early detection and proactive lung nodule management as essential for reducing lung cancer mortality.

    "Lung cancer is the deadliest cancer that we face... It's absolutely important that we, as leaders of health systems, focus on detection and management of lung nodules... Because we know that early stage one, stage two cancer... outcomes are much improved. And in the end, that's what this is all about..."
    (Keller, 08:30–09:19)

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Notable Quotes & Memorable Moments

• On the stakes of early detection:

  “Early detection and early treatment is the difference between life and death.”
  (Keller, 04:30)

• On collaboration:

  “Administrative support brings the resources necessary... but it’s equally — actually more — important to have that clinical champion.”
  (Keller, 03:30)

• On action for listeners:

  “We can talk about money all day long, but the most important thing is improving outcomes... Lung nodule detection management is absolutely... critical to improving outcomes.”
  (Keller, 09:17)

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Timestamps for Important Segments

• 00:26–00:58 — Jason Keller’s introduction and background in hospital ops
• 01:03–02:27 — The scope and impact of lung cancer and nodules
• 02:31–04:21 — Value of collaboration between clinical and financial leaders
• 04:37–07:31 — Strategies: screening expansion, dedicated clinics, AI for incidental findings
• 07:39–08:21 — The patient journey and multi-disciplinary care pathways
• 08:30–09:19 — Final advice: urgency of lung cancer as a healthcare focus

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Summary Takeaways

• Lung nodule management—especially early detection—is vital for both optimal patient outcomes and health system sustainability.
• Effective programs require robust, cross-campus screening, dedicated follow-up clinics, technology to close care gaps, and deep collaboration between clinical and financial leaders.
• Focusing on early intervention delivers both life-saving clinical results and strong financial returns, but ultimate emphasis should always be on patient benefit.

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Transcript

[A]

Hi, everyone. This is Lucas Voss with Becker's Healthcare. Thanks so much for tuning in to the Becker's Healthcare podcast series. It's fantastic to have you. Very exciting topic today. We're talking about lung nodule pathways to profit, aligning clinical and financial leadership. And joining me for today's discussion, so excited to have him, Jason Keller. He's the president of Rayler Share Medical Respite and former CEO at ucmc. Jason, it's great to have you. Thanks for being here.

[B]

Thank you. It's great to be here.

[A]

Absolutely. I want to start off with introductions for those that might not know you. You're welcome yet, at least if you want to just give us a little bit of your background and your work in healthcare so far. Sure.

[B]

Yeah. So come to you with about 23 years of hospital operations experience, most recently for the past 10 years, the Chief operating officer, University of Chicago Medicine. Prior to that, started my career at Barnes Jewish hospital down in St. Louis. Have a long track record of spending time in and around operating rooms, both directly running them, but also in support of operating rooms and procedural spaces.

[A]

And I'm excited to have you because you have so much background. Again, from the operational side. You see everything from. From. From the ground floor, so to speak. And respiratory conditions account for. For a big share of healthcare spending and resources, certainly. Where do lung cancer and lung nodules fit into that bigger picture? And what does their management mean for patients specifically, but also operations and certainly the financial side for health systems.

[B]

Yeah. So when you talk about lung nodules and treatment of lung nodules and lun. I think the estimates are that $89 billion will be spent globally on cancer treatment, for lung cancer in particular, by 2030. So a lot of expenditures. Right. I think for me, one of the exciting opportunities in the treatment of lung cancer is the. Is early detection, early detection, diagnosis and time to treatment. Right. So what we know is that if you find cancer early, find nodules early, get them to treatment, that people have better outcomes. Right. So they're candidates for surgery, which end up having sort of higher margins for health systems, but also much improved outcomes. Right. And so the alternative is late detection of cancer, which ends up being high utilization of hospital resources, long hospitalizations, and unfortunately, palliative care.

[A]

Yeah. Again, we talk so much about the outcomes, and that certainly leads to worse outcomes.

[B]

Right.

[A]

We talk a lot about collaboration and we talk about partnership, and we talk about the importance of talking to each other and communication. This certainly applies in this space as well, I think. I'd love to know from your perspective, what role do collaboration and shared decision making between clinical leaders, but then also again from the financial side, financial executives play in advancing lung nodule care? And what are some of the steps that organizations can take to foster some of that alignment, some of that collaboration?

[B]

Yeah, I would say I've spent the entirety of my career building relationships with my clinical colleagues. I mean, in the end, I'm just the business guy running the hospital, not the one providing the care. And so in my mind, dyad relationships are absolutely critical in this space. Finding someone who is as passionate about this as I am was absolutely critical. And was able to partner with the medical director at University of Chicago for the pulmonology lab to really think differently about how we screened for, monitored and treated these patients. Right. And so I think it's critically important to have the administrative support. The administrative support brings the resources necessary, brings the capital forward, brings the people across the continuum of care that's required forward. But it's equally actually more important to have that clinical champion. Right. And so in this space, you know, referrals to don't often come directly from the patients. They come from referring physicians. And so having that physician champion who will get out there, talk about the programs, build the relationships, and then the outcomes are absolutely critical. So from my perspective, set up the program, hand off the reins to my clinical partner, and they're the ones who have really driven the success.

[A]

Yeah. And it's dual fold. Right. We have better business outcomes, but in turn also better clinical outcomes, which is so crucial for patients.

[B]

Absolutely. And as I mentioned, in this space, early detection and early treatment is the difference between life and death.

[A]

Yeah. I want to dive into the strategic part of this too. What are some of the structure, programs and strategies that you've seen work really well around? Long module management that have both shown potential. Right. But also improve care and strengthen that financial performance that we just talked about.

[B]

Yeah. So there's really two main ways to detect lung nodules that may lead to lung cancer. The first being screening. So robust screening. So what I would encourage those that are interested and passionate about this is that they offer screening at every site across their care continuum. Right. So not just the academic hub or the large quaternary hospital, but across all of their ambulatory sites. So taking the time to really look at your CT capacity, setting up your CTs to be screening capable, and then setting aside time to ensure that patients can get timely, timely screening. So once screening occurs, follow up is absolutely critical. Right. And so we talk about lung nodule clinics. And so in my experience, setting up generally nurse practitioner led lung nodule clinics is absolutely critical. Right. Because once you screen, you will get a pipeline of patients who have nodules. And then the challenge is determining which of those individuals really need to move forward to an interventional type of diagnostic clinical setting versus just sort of the wait and watch. Right. And so you need to have a CT again in six months. Right. And so as you build robust screening programs and you get a large number of individuals on the wait and see list, you start to have a lot of patients that you have to keep track of.

[A]

Right.

[B]

So robust lung nodule clinics, I think are important. The other way that lung nodules are detected is, are through incidental findings from chest ct. So every day thousands and thousands of patients are getting a chest CT not to look for lung nodules, but to look for cardiac conditions or they were in a car accident, they had a full body scan, and incidentally, people detect that they had a long nodule. Right. And so there are now tools out there with the use of AI that can detect these nodules. Right. And so if you're a radiologist and you're looking for a cardiac condition, you may miss a lung nodule. Right. And so there are now tools with AI to detect the nodule, set the patient up for follow up, send it to the clinical care team and ensure that the patient actually was followed up on it. Right. And so between screening and incidental findings, there's a large number of potential patients who may progress and need things like interventional bronchoscopy and then advanced treatments like surgery, chemotherapy and radiation therapy.

[A]

And again, I think it culminates in what we just talked about. Right. That's why collaboration is so important, because there are so many touch points and so many different pieces.

[B]

Correct. So many touch points. If you think about the treatment of individuals who have lung nodules who then may have cancer, they may touch, certainly radiology for the imaging. They will touch an interventional pulmonologist, they may touch their primary care physician, a lung nodule clinic, the bronchoscopy suite, if they're determined to need a bronchoscopy and then likely an operating room or IV therapy or radiation oncology. So there's many, many touch points. And so I think that's where that collaboration between the administrative leader who has sort of that holistic view of the entire continuum and that clinical leader who is passionate about driving better results. So important.

[A]

Jason, it's so great to have you. Thanks for being here. I want to turn the floor over to you. Anything else that you want to add for our listeners that that might be important for them to remember from our conversation today?

[B]

So I would just encourage individuals to understand that, you know, lung cancer is the deadliest cancer that we face. Right. So, number one, in terms of death, also, the second highest incidence of cancer is lung cancer, and that 25% of overall cancer deaths are from cancer. So are from lung cancer. And so I think it's absolutely important that we, as leaders of health systems, focus on detection and management of lung nodules and treating those patients that need to be treated earlier. Because we know that early stage one, stage two cancer, lung cancer, when treated early, the outcomes are much improved. And in the end, that's what this is all about, right? We can talk about money all day long, but the most important thing is improving, improving outcomes. And so lung nodule detection management is absolutely, I think, critical to improving outcomes.

[A]

Jason, so great to have you. Thanks for taking some time for those.

[B]

Okay.

[A]

Thank you for being here. And we also want to thank our podcast sponsor, NOAA Medical. You can tune into more podcasts from Becker's Healthcare by visiting our podcast [e-mail].