← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Michele Volpe, Chief Operating Officer of the University of Pennsylvania Health System
00:26:02
Loading summary
Transcript16 lines
- [00:02]
A
@ Athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams, and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom Practicing medicine is complex, but running a practice can be that much simpler. With Athenahealth, see how simpler is healthier at athenahealth.com this is Laura Deardo with.
- [00:45]
B
The Beckers Healthcare Podcast. I'm thrilled today to be joined by Michelle Volpe, Chief Operating Officer at University of Pennsylvania Health System. Michelle, it's a pleasure to have you on the podcast today.
- [00:55]
C
Thank you.
- [00:56]
B
Now, I'm excited for our conversation because I know that there's so much happening within the healthcare field today and so I'm looking forward to getting a sen the different things you're doing at University of Pennsylvania Health System. But before we dive in, I'm wondering, could you introduce yourself and just tell us a little bit more about the organization? What's your biggest winner success story from the last year?
- [01:16]
C
Sure, yeah. I'd love to do that. I'd love to talk about Penn. So as you know, my name is Michelle Volpe. I'm the Senior Vice President and Chief Operating Officer for the University of Pennsylvania Health System. So first, just a little bit about the health system, Penn Medicine, as we call it. Penn Medicine is comprised of the University of Pennsylvania Health System and Penn's Perelman School of Medicine, which is the nation's first medical school. And I would also like to add we have the first hospital with Pennsylvania Hospital opening in 1756. Our health system today has expanded to seven hospitals and a very large division of ambulatory facilities that stretch from the Susquehanna river in Pennsylvania to the New Jersey shore. We also have a very, very expansive home care enterprise that has grown in many new ways over the recent years. For example, we deliver chemotherapy and services that were traditionally acute care. We are now doing them through home care and so many more patients today than even last year or several years ago no longer need to be admitted to the hospital. We also have several behavioral health facilities and a rehabilitation joint venture that provides both outpatient and inpatient care. We are the very proud organization of a number of medical firsts, including car T cell therapy and the Nobel winning MRNA technology used in the COVID 19 vaccines. In terms of the size of our organization, to just provide you a sense of size, for fiscal year 25, our net patient revenues were 10.2 billion DOL. Our total operating revenue was 12 billion and our net margin was 2.1 million. We do quite a bit with our school of medicine and so the 2.1% operating margin is before any transfers to our school. And then on the patient care side, we have almost 4,000 licensed beds across our whole enterprise, 154,000 annual admissions and 500,000 annual emergency room visits. Our physician size, in terms of our employed physicians, we have over 3,500 employed physicians and that is in both our academic and non academic practices. And of course we have very strong relationships with a very significant number of independent physicians that primarily focus in our regional hospitals. Added to that is a very Large complement over 1300 of apps or advanced practice providers. So I hope that gives you a sense of the size and the scope of our health system. But you also asked what was the biggest win or success story from this last year. We've had many at Penn, but because of whom we are our academic roots, our tremendous research program are many firsts. One that I would like to share as our biggest win is our ability to continue this past year to notch major clinical breakthroughs that stem from our integr academic medical center model providing advanced therapies pioneered at our main campus at our hospital of the University of Pennsylvania to patients at our regional entities like CAR T cell therapy and proton therapy. We have moved these therapies to Lancaster General. Lancaster General is about an hour and a half or just under an hour and a half from our center city academic medical center. But we able to bring these therapies to a rural hospital that has a community that no longer needs to seek that level of care in the big city. And so they're able to stay in their own hometown and be able to benefit from the very high end treatments that we have available in our downtown or our academic hospitals.
- [06:33]
B
That's amazing to hear. And you know what a great success story. I know there's hospitals across the country and more of a community hospital setting, a rural hospital setting that it's a challenge to find some of these specialty services and bringing it local benefits patients as well as the broader community. So that's a really amazing success story. When you look at where we're at today. What are the top two to three issues you're focused on right now? What do you consider most strongly as you're going to make decisions about the future.
- [07:02]
C
So the environment right now is difficult. It's challenging. I know those of us who have been in healthcare for a long period of time have probably said this maybe every five years or so, but this particular period of time is quite challenging. And so when we here at Penn have considered what we need to focus on, the first is operational efficiencies. All hospitals need to improve their margins. And although Penn is doing well in comparison to a number of our peers, we still want to see a 2 to a 2 and 2.5% improvement over our margin, over what we are currently doing in our operating margin. We need to grow to support plans that we have to build other programs for the future, for the current, but also for the future. And as we look ahead, we need to invest in new facilities. We need to invest in, and by new facilities, we really want to grow our ambulatory surgical network. And so achieving operational efficiency is what our entire organization is focused on right now. What we have termed it is repair, refocus and reimagine, or the three Rs. And so, you know, just providing a few examples of that, we have a number of work streams, and those work streams are in very traditional areas, but with a new focus. Areas like revenue cycle management, supply chain, pharmacy, length of stay, Perry op efficiency, contract services, and organizational design. Organizational design includes spans and layers. Looking at how we do our work, can we improve how we do our work in terms of the size of our leadership, the level of our leadership? And so we've targeted over the next four years, $1 billion. And in fiscal year 25 and 26, we have actually budgeted 243 million to achieve out of that 1 billion. And I'm happy to say that in 25, the portion that we had budgeted for 25, we actually did achieve. And it's just so important, and we've been taking this message out on a fairly regular basis to our health care community here at Penn is that we're not looking for that money just to drop to our bottom line, but we want to reinvest. We want to reinvest. We need to reinvest. We need to reinvest in faculty compensation. We need to invest in keeping competitive with market adjustments for competitive job categories. And as I mentioned just a few minutes ago, facilities, facilities in our regional areas, in our regional areas that we service, particularly ambulatory surgery, bringing ambulatory surgery out from our Philadelphia location into the various regions. So operational efficiencies are a target for our organization. We have all seven of our CEOs focused on this, as well as our leaders on the ambulatory side, on the home care side, and of course, our system or corporate staff. The second area of tremendous focus is workforce. Post Covid, we still see a fair amount of turnover. I'm unhappy to say that, but we do. Part of the reason that we continue to see turnover are that there are so many other choices out there, whether they be in pharmaceutical companies, whether they be at pharmacies, just across the board. And so it's extremely important to emphasize our recruitment and retention efforts. Our workforce has choices. They have choices outside of patient care, and I would say choices that, you know, in years past were not as significant as they are today. So we want to provide our people, our workforce, with opportunities to stay here. We want them to stay. We have a large system, and so those opportunities, you know, cut across a very large geographic area. We have opportunities that can span an individual's entire career. But we have to make sure on an ongoing basis that our workforce understands what those opportunities are. We've got to continue to make those opportunities attractive. And with that, we are hopeful that we will be able to compete, to continue to bring into our healthcare system the brightest and the best to, you know, provide the services that we need here at Penn Medicine.
- [12:48]
B
It's fascinating to hear, and, you know, I really appreciate you digging into both topics. Looking at the financial health of the organization, how you're thinking about the future, making sure that you're reaching those financial goals and then to the workforce is such an important aspect of any health system or hospital. It's just crucial to have them in a good spot and really a strong pipeline of leaders in order to make things work and actually provide the care. So I appreciate you digging in a little bit deeper into both of those areas. And when you look into the future, where do you see those big opportunities for growth in the next few years? How are you thinking about that, especially given these dynamics that we're talking about, some of the financial challenges as well as workforce shortages across the country.
- [13:33]
C
Yeah. So as we here at Pennsylvania look at what we feel are our opportunities for growth over the next few years, you know, we see the need to focus in our regional markets. We have several regional markets. These continue to be large opportunities for us, both in terms of volume. As an example that we can move, that we can encourage, move back into the community. I shared some of what we have done with bringing Car T and proton therapy to Lancaster General Hospital. That's an example of being able to focus on our regional communities through our regional hospitals and taking, not taking, but being able to say to patients who have been coming in from those regions to our Philadelphia market and say, you know, we can now offer this in your hometown. We feel that this is a huge opportunity for us. So not only in Lancaster General, but in other markets, other community markets that we have with our other regional hospitals, we are looking to do similar types of things. Not necessarily put proton therapy in every single one of them or CAR T therapy, but depending on their market. What makes most sense for us to develop there. We want to be a differentiator in our community markets. And so working with the hospital CEOs and the physicians in each of those markets, developing, expanding, developing and expanding upon strategies that we've already started to bring this higher level of care out to the community. So that's going to be a lot of our work, a lot of the focus of our work over the next couple of years. In addition to that is expansion on the ambulatory side, our ambulatory strategy. We have a number of large full service ambulatory facilities already. Some of these markets may. Not all of the listeners may know where these markets are. But in Cherry Hill, for example, which is one of our New Jersey suburban markets, we have a very large ambulatory site there. We have one in Radnor, which is not that far from our downtown hospital locations. But ambulatory is a strategy that we at Penn Medicine feel we want to double down on and we want to build larger and more facilities over the next several years. In fact, in the Montgomeryville area, we have broken ground for our next large ambulatory facility. And as we develop these facilities for some of them, we are actually looking at adding surgical capabilities along with specialized surgical programs and of course, oncology, so that individuals who need infusion, new need radiation, can stay in their own, again, hometown or in their own communities. Ambulatory surgery is a subcomponent of that. And ambulatory surgical facilities, ASCs are something that we have a few of them, but not as many as we see populating over the next several years.
- [17:39]
B
Absolutely, that makes a lot of sense. And you know, it's fascinating to understand the expansion model and strategy with the surgery centers and with bringing more services in that, you know, then patients can have care at the appropriate site. And I think, you know, you're at such a unique vantage point where you can see, you know, the impact of all of the strategy across the broader organization, obviously to provide more access to care, but then to, you know, how are you balanced on the financial side is making sure that strategy aligns with the financial goals of the organization.
- [18:14]
C
Yeah, no, that's exactly right. Yeah. And so that is something that as a leadership team here at Penn, we are always evaluating, we are always looking at our priorities, looking at where we want to go or where we want to get to over the next three to five years, and reprior prioritizing, quite frankly. And so, you know, you know, had you spoken to me even two years ago, you know, some of the areas, some of what I spoke to, I'm speaking to today was not necessarily top on our list, but it is now. And that comes from balancing our financial position currently where we want to be in three to five years on the financial side, and, and also looking what is realistic in terms of what our organization can accomplish each of the next several years. So it's about prioritization and it's about, at least from my perspective, the fluidness of that prioritization, being able to take a broad look not just at one point during the year, but throughout the entire year and to continue to evaluate our effectiveness against what our priorities are and be willing to shift our priorities if we see changes in the market, if we see changes in governmental programs and changes in our communities.
- [20:02]
B
Absolutely, that makes a lot of sense and is a really smart way to think about and approach plans for the future. And speaking of, you know, that five year timeframe, looking at know the organization from a leadership perspective, is there anything else that it takes to lead that thriving organization? Obviously, as you mentioned, being able to be nimble, adapt to changes. Anything else you'd like to see from leadership teams just to make sure you're ready to take on whatever's thrown at you?
- [20:29]
C
Well, that's one of the great things I find working here at Penn Medicine. To a person, there is just a really strong commitment to driving the best possible health care that we can for the communities that we treat. And so, you know, throughout the year we work to stay very, very close to our workforce, to our leaders. In fact, my boss, Kevin Mahoney, who is our health system CEO on a fairly regular basis at least once a quarter, cuts across seven hospitals and holds a forum at each local hospital. And one, it enables him to hear directly each of those two. It places him closer to the communities that we serve. And then Kevin, along with the other leaders in the organization, or I should say Kevin with the leaders in our organization, he helps us with that prioritization. And so you asked, what do we need or what are our expectations in terms of our leaders. We expect our leaders to work very closely with us, to work with their colleagues. That is extremely important, particularly where hospitals share a market, to work with their colleagues in that, in that market. As we are working through the three Rs that I mentioned a little earlier, again, that is repair, refocus and reimagine, that provided us an opportunity to develop with the key leaders in the organization what those priorities were to be, what those priorities should be for our leadership. And then one of the things that I did as the chief operating officer actually broke down the areas that I was taking responsibility for and identified co physician sponsors for each of the work streams. And so my, my whole purpose behind that was not to have this be top down from myself, but for the CEOs to share the responsibility for driving an important work stream and for being able to take the opportunity to organize that across the entire health system, despite the fact that they are only running one of the hospitals. And it has been a tremendous learning opportunity, I think, for everyone involved. And by learning opportunity, I mean the leaders in our organization through this process, have learned a lot about not only their colleagues, but about the different communities in the Penn Medicine system. So I guess what I'm saying is that developing our leaders is something that we take very seriously and we spend a fair amount of time through a number of initiatives. We have a number of forums to pull leaders together so that as we prioritize our work for the system, that that prioritization is known and is supported across the leadership ranks. And I guess something else is that with our leaders, we feel that it's really important to keep very strong, very strong leaders. And so we have many strategies to encourage retention in our organization.
- [24:45]
B
It's amazing to hear and, you know, I can imagine we could do a whole episode on the retention strategies and pipeline building and more so to come in the future, perhaps. But thank you so much, Michelle, for diving in onto the podcast with me today. This has been a very inspiring conversation and super interesting to hear about some of the different things you're doing at Penn Medicine. So thank you so much for your time today and I look forward to seeing you as well at our CEO CFO Roundtable coming up in November. It'll be great to have you as a speaker and then see you in person in Chicago too.
- [25:15]
C
Thank you.
- [25:18]
A
At athenahealth, we know your ambulatory practice wants healthier, a healthier business, healthier care teams, and higher healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom lines. Practicing medicine is completely complex, but running a practice can be that much simpler with Athenahealth. See how simpler is healthier@athenahealth.com.