← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Mary Frances Southerland, Chief Administrative Officer at UVA Health
00:14:03
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Transcript18 lines
- [00:00]
A
This is Madeline Ashley with the Beckers Healthcare podcast. And I'm excited to be joined today by Jawad Shah, MD, and CEO of Insight Health System. Jawad, thank you so much for being on with me.
- [00:12]
B
So nice to invite me, of course.
- [00:15]
A
I'm so excited to get into our discussion today, but before we do so, do you mind sharing with our listeners a little bit about yourself and your background and more about Insight Health?
- [00:25]
B
Yes, my background, I would say, really is more as a provider. I'm a physician myself. I am a neurosurgeon. And much of my work prior to getting into more administrative elements of what I'm doing currently was really to be a practicing neurosurgeon, building a practice and treating my patients and so on. That then led to at some point an idea that I was more interested in building institutions or an institution that would serve all the things that I really wanted to serve, whether it's patients and communities, science, academia, and started to build an institution around that. That journey, of course, then led me to acquire and develop practices, hospitals, surgical centers and things of that nature to build out all the different elements of what INSIGHT has now become.
- [01:21]
A
Amazing. I truly appreciate you kind of sharing some background there. So I'd love to dive into the discussion here. Just concern concerning two of your hospitals in Warren, Ohio. So in early August, Insight announced plans to reopen these two hospitals. That would be Insite Hospital and Medical Center Trumbull and Hillside Rehabilitation Hospital, which have been temporarily closed, excuse me, since late March. So could you maybe share a little bit more on what led to the decision to move forward with the reopening of these hospitals and maybe any updates or progress so far?
- [01:59]
B
You know, this was not a new decision. In August, we had intended to open the hospitals or reopen the hospitals from the time that we had to downsize and shut them down. And so the idea was that in the assessment of our organization, the hospitals are very important for the community. They're needed. There's a history related to them. There is a need for medical care in the beds, for taking care of the community. So being now those, those that are responsible for the hospital, we didn't feel that this is something that the community could really do without. So we always felt that this is something that, that has to exist and the circumstances leading to its closure actually were the things that surprised us. But we've always felt that this is something we are committed to establishing and allowing to really do great work in the community.
- [02:57]
A
Could you share your long term vision for these two hospitals? And how you see them continuing to evolve under Insights leadership.
- [03:05]
B
The long term vision for both Trumbull and Hillside is that they're fully functional hospitals. In the case of Trumbull is a general hospital, of course, which takes care of all patients for acute illnesses. And we would continue to grow that, grow it clinically, we would add to it the graduate medical education and residencies, and then continue to expand on service lines, particularly those that we find to be deficient within the community and to grow them and grow them. So the idea to make it a full fledged hospital, fully functioning, flourishing would be the idea. Hillside, of course, is a rehab hospital and that is working very much in conjunction with the Trumbull Hospital where our rehab needs then are served there. And again, we find there's a really excellent path forward to establishing it and growing it, both clinically and financially. We're very much wanting to see both hospitals flourish in the time to come.
- [04:03]
A
Now, just to circle back a tiny bit here, when we recently covered the news of the reopening plans, it said in the coming weeks. Do you have any updates on a specific date or timeframe there?
- [04:16]
B
We don't have a specific date today. Internally, of course, we're very close to reopening and I think that at this point all the final touches are being done in the ed, a little bit of paint and that sort of stuff. But we're very close and there's just a few minor elements of coming up with exact date and then to make that public announcement. But we're very close to making that public announcement now.
- [04:43]
A
That's exciting to hear. And you know, the hospitals were previously under Stored Healthcare's ownership prior to Insight purchasing them. And I'm sure many of our listeners have heard of Stored Healthcare and seen some of our coverage, but they filed for Chapter 11 bankruptcy last May, so they've kind of been working to offload some of their hospitals. So with that in mind, could you maybe share some lessons learned following the hospital transition, maybe how this has shaped your leadership approach just moving forward?
- [05:13]
B
Yeah, you know, it's very interesting, to be honest. For me, it's been a learning experience working with, you know, the previous leadership and everything that's happened with them, but it's been an experience that hasn't been a pleasant one. You know, what's happened is that the hospitals were shut down and of course the bankruptcy and so on that they were going through for whatever reasons as a for profit entity led to, of course, the jeopardy of the asset now for the community. So we were you know, in discussions for helping and coming in. And it wasn't until September 8th of 2024 where we were, we said, okay, you know, we will jump in, because there really, there was no one to really help. And at that point we were in discussions with a variety of different groups, but in particular mpt. And so we said, you know what, we'll do this. You know, we'll bite the bullet, we'll jump in and we'll do it, but not with very clean and proper terms. But the idea was though, that one of the things I really try and assess is how aligned everybody is with the vision. The government and various layers of the government were very much wanting to see the hospital succeed. The public was very aligned, NPT was aligned. I was assuming the steward was aligned as well, in the sense that the hospitals now won't help them much, but given the history that they would be wanting to see them succeed under new leadership, what I was surprised was that the back end of the elements of a hospital that really were critical rev cycle, some of the backend work that needs to be done for patient access and security and all those other elements were still under their control. And that's because there was 33 hospitals. So there's a cross collateralization of some of these activities. But we were expecting that we'd be dealt with favorably and there would be no issues just because everyone's aligned. So we weren't forensic in terms of trying to figure out exactly what everybody does, but we were rather surprised at is that once we came into the contract, I believe that that alignment completely vanished. And so there was no special concern for our accounts. The transfer of cash was something which we disputed repeatedly. And the back end processes that were being done were not adequate and not sufficient. And so we did not feel we were actually managing the hospital on that back end. On the front end, which was the patient volumes, the inpatient volumes, the operating rooms, the graduate medical education, the expansion of services, that's what we had control over. And that was really going spectacularly well. And we were very proud of some of the work that we did as we expanded, not only maintained clinical service lines, but expanded them. But of course, we were crippled because of those other elements. And being in chapter 11, we are left with very little options as to how to extract the right behaviors. And over the course of the next several months, we were unable to really, you know, get any of the corrections that I wanted. And it further crippled us, hurt us, until a decision had to be made that we cannot continue with this type, type of disjointed leadership. And therefore we made the decision that we were going to extricate ourselves from them and that's where we are today, that we really are independently working, independent of steward and you know, whatever they have to offer. We just have reached a point that we're really not, if I can use the word, trusting that anything that they have to offer will be in our favor. So we've made that bold decision. That's unfortunately what I believe we had to do and I'm very comfortable that we had no choice.
- [09:07]
A
And now that you've made it to this point where you will be reopening these hospitals in the near future, how does that feel to you as a maybe sigh of relief as the CEO at Insight, how are you feeling right now?
- [09:21]
B
Well, definitely I feel very, very elated in the sense that we can now start working with the chains off, where it's our own systems, our own softwares, no backend support, we're doing everything on our own, you know, establishing all the contracts and relationships and we've been very open with the public and with government to tell them this is where we are and then getting a lot of support, you know, now, now it's, it's not that we are a massive, you know, healthcare system, we are a medium to small size system and we can only tolerate so much in terms of inefficiencies. So we've made that, you know, clear and we've seen that we've gotten a lot of support, you know, where people are really jumping in and helping. We're particularly indebted to different layers of the government that helped us expedite certain things in terms of regulatory issues and so on and licensing. That's all helped us get to where we want to at the end. This is a 501C3. It isn't owned by Dr. Shah, it's a community owned project. We felt that was extremely important to transition from a for profit entity to not for profit in that in our assessment that would allow it then to breathe and live with the further supports it would get. So now we're asking everyone to jump in and, you know, to help, to do, you know, what we started to do and sacrifice and our team sacrificed that we're asking everyone to come and help and they are. And I'm excited to say that with all that energy we have a fully licensed hospital, a facility that's ready to go, equipment ready, ready to go, and now we're opening up and we're just planning to build it right back up to where it was and beyond.
- [11:05]
A
And in that same vein, could you share maybe how these reopenings align with Insight's broader mission and maybe what this means for impactful growth, what that looks like to you?
- [11:17]
B
I think that the, you know, the broader mission of Insight really revolves around the idea of delivering healthcare to communities that really need it. You know, that's our primary motive. It's not that we're looking for financial opportunities, we're looking for places that really need the medical care and then bring all of our expertise and energy into ensuring that happens in a financially solvent and solvent manner. So it very much aligns with our overall vision of delivering healthcare. At the same time, I'd point out that our definition of healthcare, I think, is a little broader than simply end of life issues. Someone coming to the ED and being resuscitated. Our definition of health care, I think, goes beyond the idea of preventative care or personalized medicine. I think that our definition goes deep into the communities and assessing the social determinants of health. And I believe that's the hospital of the future, that it's not enough simply to take care of patients that come through your doors and provide the medicines and all the different things that they're required in those difficulties, medically difficult circumstances, end of life circumstances, but we should be really looking at the factors that lead to health within our communities, recognizing that the hospital is perhaps, you know, one of the most important institutions any community has. So looking deep into the social determinants of health and what leads to position where a young person or a family doesn't have the equipment necessary to get the proper health care, financial and economic and so on, like assessing all of that, addressing all of that, giving people an opportunity to potentially overcome those barriers, enter into the economy, kids getting the right education, these are all elements to me of healthcare that I believe we should really be paying attention to as a community, as a medical community. And if we can address those issues with our voice, with the access we have to government and the public, I think that's really what's going to transform communities. So the idea that Insight is in the middle of that and we want to see that succeed even at that level, deep into the communities and the preventative care that'll come from that, I think that's part of our mission and we see what we're doing in Trumbull. We feel that this is a big part of that.
- [13:37]
A
Well, Dr. Shah, I truly appreciate you sharing more information with us here. Just on the reopening plans for these two hospitals, and we'll keep our eyes peeled for some updates on some more concrete dates there. But again, it's truly been a pleasure speaking with you and excited to connect again down the line about all the exciting things happening at Insight.
- [13:58]
B
Thank you so much, Madeleine. Very nice to speak to you.