← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Parinda Khatri, PhD, Chief Executive Officer of River Valley Health
00:23:27
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- [00:02]
A
The most important healthcare decisions don't happen in isolation. They happen when leaders come together. Becker's 16th annual meeting brings together more than 3,500 hospital and health system executives this April in Chicago. With 800 speakers from Ascension, Cleveland Clinic, Common Spirit and more, the conversations get real. Leaders will share how their scenario planning for policy shifts brief breaking through value based care barriers and building clinical teams that translate new ideas into real world care. Join top decision makers in the room April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.
- [00:47]
B
This is Alan Condon, back with another episode of the Becker's Healthcare Podcast. And today I'm delighted to be joined by Dr. Parinda Khatri, Sarah, CEO of River Valley Health that's headquartered in Knoxville, Tennessee and recently rebranded last summer, if I'm not mistaken, from Cherokee Health Systems to river Valley Health. Dr. Khatri, a real pleasure to have you on the podcast with us today. For those of our listeners who might be as familiar with you or the newly rebranded River Valley Health, I'd love to hand it over to you to hear a little bit more about yourself on your role at the health system.
- [01:24]
C
Yes, thank you, Ellen. Yes. So I'm Parinda Khatri. I'm chief executive officer of River Valley Health and formerly Cherokee Health Systems. We are a integrated community healthcare organization. We have a span of about 25 counties in East Tennessee. We also have some patients who come over from Georgia and Kentucky to see us for care. We're a federally qualified health center and a licensed community mental health center, as well as a licensed alcohol, drug and treatment center. So we really are an integrated community health care organization that has a mission to provide access to high quality care to everyone, regardless of ability to pay. So as you go into the mountains of East Tennessee, as well as into the city in Knoxville and Chettle, Chattanooga, what you'll see is we're the preferred health care provider for many, but also we have a number of patients for whom we are the only healthcare provider who will see them. We are in some very small rural communities where we are the only provider of care and it's just a real privilege and an honor for us to be in this space.
- [02:50]
B
Fantastic. Dr. Katri, really excited to have you on and excited to dive right in. So 23 counties are serving in East Tennessee, see some patients indeed from Georgia, from Kentucky as well. Like you'd mentioned, a real integrated community health care organization has that mission. Like you alluded to provide care, access to care regardless of patients ability to pay. I guess before we kind of dive in, the immediate question that kind of jumps off to mind for me, for many of our hospital executive listeners, provider listeners out there, just exactly on that in terms of providing that access to care to patients regardless of ability to pay in the current age in 2026, when we see we hear about a lot of the financial challenges, a lot of the potential cuts coming down the pipeline and this year and next, specifically around Medicaid and whatnot, is it arguably the most challenging payer reimbursement environment that we've had for organizations like yours? And how are you really working to provide that access to care despite to your point, maybe some patients lack of ability to pay?
- [03:57]
C
Well, certainly I've been at River Valley Health for 25 years and certainly in my 25 year tenure this is the most challenging not only because of, as you had mentioned, funding cliffs, cuts, but in general the entire landscape is, you know, volatile. What do they say Vuca? Volatile, uncertain, complex and ambiguous. And so we have really absorbed that as, you know, as kind of the frame in our thinking and it is challenging for us. And I think one thing we have realized is we are just going to remain laser focused on our mission and we actually hope and plan to come out of this period stronger. We had been planning for this for many years. We built up reserves, we have streamlined processes, we have about eight strategic drivers that we have been relentlessly focused on. And the reality is it's been a tough environment, it will continue to be a tough environment, but we are taking a very proactive approach. And frankly we're just going to be doggedly optimistic that no matter what happens, we are going to find a way of taking care of our patients and continuing to serve our mission.
- [05:32]
B
Yeah, no, fantastic. I know for 25 years at the one organization, I know you've held multiple leadership roles in your stint up to CEO, director of Integrated Care, Chief Clinical Officer and I believe sitting in that CEO seat for a little over four years now, if I'm not mistaken. So fantastic to hear, I guess how you're addressing this VUCA environment like you'd mentioned, first time I've heard that acronym. But I'm going to have to keep a hold of that one focusing in on this year and last I guess I'd love to hear, no doubt there are many initiatives, but I guess was there one maybe most important initiative that you led in the last year? Anything you'd like to highlight? What did you do and what were the results?
- [06:12]
C
So, well, last year was a big year, as you mentioned. We rebranded. We celebrated 65 years of serving the East Tennessee community. So it was time for us to update our brand from one small little community mental health center in Hamblin county in Tennessee to, you know, over 22 sites across the. Across multiple counties, as you said, and two mobile clinics, another 20 odd telehealth sites. So that, that was a big year. I would say just growth was the hallmark of last year and I. It wasn't really even on our agenda, many of the opportunities. But I think, you know, in this landscape, in this day and age, when an opportunity presents itself, it's. We have to move, we cannot slow and you know, wait for the. The. The perfect. The perfect is the enemy of the good. So we actually opened several walk in urgent care for both medical and behavioral health services. We opened them in response to community need. We expanded our optometry services, expanded dental services. We have independent placement and support services that helps provide people with employment, particularly those who've had chronic mental health conditions. We want to get them back in the workforce and to provide the supports they need to help them do that. So it was a year of growth. Looking back and it was just systematically and thoughtfully as opportunities presented themselves, listening to our community and responding.
- [08:05]
B
Fantastic. Well, congrats on the 65th celebration year last year and into your 66 this year. I mean, fantastic to hear, I guess, some of that growth that you had alluded to. Opening several walk in urgent cares for both medical and behavioral, expanding dental, expanding optometry and kind of adding services around, helping people secure employment. You said earlier that your kind of relentless focus on your mission and you actually anticipate coming out of this year stronger than last. You mentioned streamlining your processes, really building up cash reserves. I'm curious, kind of any pieces of advice for other community healthcare organizations out there? No doubt you've come off such a fantastic year of growth last year and expecting to do the same this year. What were the kind of keys to your success, do you think?
- [08:56]
C
If I had to say one thing, it was alignment. As an organization grows and becomes much more complex, and we're a complex organization, there are many organizations that are even bigger and more complex. It is so easy for all the different departments and divisions and services to be doing their own thing. And I think and feel very good about it. However, in this day and age, we have zero degrees of freedom for a misalignment in what we're doing. So I have been intentional. Our Executive leadership has been very intentional about communication, engagement with our mid level leadership, our frontline staff. So everybody is aligned in what we're doing and where we're going and that will continue to be a challenge and something that we have to be intentional about because it is so easy to drift and I call it drift. Maybe other folks may say no, we're letting people do their own thing and they're independent and autonomous. But our scale is a strength and we want everyone to be aligned. So I think that's really the key. It's been the key for us and it is something that we're going to prioritize for the coming year.
- [10:30]
B
Fantastic. Yeah, I love that. Some great key insights for other community healthcare organizations across the board there. You alluded to some of your big kind of priorities, core areas of growth, looking ahead to true this year and into next. What are the kind of big priorities that you're really going to be focusing on? Maybe a silly question in terms of headwinds, I think I have them and top of mind but in case there's anything I might.
- [10:52]
C
Are there any, is there anything else at this point?
- [10:56]
B
Right, right. Yeah.
- [11:00]
C
So this is going to be another big year for us. We will be after 22 plus years changing our EHR. And you know, if you want to talk to any healthcare executive, even front, you know, frontline clinician, front desk staff, they will tell you how painful that can be. But for us it's an even bigger challenge or bigger goal in that we are very dedicated to building a technology ecosystem as an organization Right now we have had the same ehr for over 20 years. We have added numerous too many than to count technology solutions to address independent one or two functions. Patient engagement, patient texting, referrals, management, scheduling, population health, another analytics tool and with varying degrees of success and in some cases no success interfacing with each other. It is clunky, it is inefficient, it is, it is not optimized. And so this year we said, you know what, not only are we going to change our ehr, we are going to build an entire technology ecosystem. A platform where as many technology solutions, a lot of the key patient facing, patient serving technology solutions from scheduling, virtual health, our patient contact and navigation system, our registration processes, referrals, revenue cycle management, population health are all as part of one platform. And so we're not just looking at oh, we're implementing an ehr, we really are transforming the organization's technology platform. And so that's very big and I don't know why we picked it on this year, but it's way past time. And I think, you know, when there's a lot of flux already, why not add more? But I think positioning ourselves from a technology perspective to really optimize and be in a position where we can engage in real redesign, not just doing things more efficiently, because I don't think we can continue just to do what we've been doing, but do it faster, cheaper, more efficiently. We have to throw that out, throw that playbook out and do things differently. So I have challenged every one of our leaders and our staff to say, don't think about this as just taking what we used to do and just finding making this technology solution fit that. Take a step back and say, if we were going to build this from scratch now, what is the best way we would build is really that design, simplification, redesign that is, I think, a unique component and then really leveraging the power of as seamless as possible integration with our technology solutions. It's been very clunky though, thus far, and we need to get better.
- [14:31]
B
Yeah, it's fascinating. It kind of just on a recent interview I'd had with Trinity Health, CEO Michael Slabowski said something pretty much exactly the same, I guess, encouraging folks, market leaders, obviously very different organizations, but it's similar strategy in terms of encouraging this quote unquote, beginner's mindset. If we could build this from the ground up, if we could do things differently, take this approach, could you maybe elaborate maybe just one bit deeper on that? And is there anything early doors that has kind of come out of this new mindset shift at your organization that you're quite proud of?
- [15:09]
C
Yeah, I mean, it really is started already with even something as simple as patient scheduling, where we have had a central, central access department, everybody calls into one number. And then we had all, all kinds of separate teams. We had, you know, a nurse, central nurse, triage team. We had a crisis team. We had just different groups of people that if you called in, you would get tagged to I don't know how many different people. And it was, you know, it's a long process and it requires people to navigate multiple different pathways. It could be pharmacy and then, oh, let me ask the nurse. And then if you couldn't get that person, then they would say, okay, a nurse is going to call you back. Okay, our clinical pharmacist will call you back. But then when they call them back, guess what? The patient is not there. Then the patient, we leave a message and the patient calls back. Well then we've got to go back to that person. So what we were noticing with our immense call volume, and I'm sure that this is a very common issue across the board, was we were not handling the patients issues questions at the point of the first call. Once we shifted that mindset and we said we aren't going to just have a central access scheduling department that then just triaged, we're going to make this a patient navigation center where instead of sending multiple tasks in the electronic health record or a team's message or transferring a phone call, what kind of system do we need to build so when a patient calls before they get off the phone, they get their issue addressed. And that is an example of a way of we had to really shift the mindset of the central access team, the central schedulers and do a lot of training and not only that for our central, our nurse triage because they basically were there spending most of their days looking at the electronic task box saying okay, who are all the patients I have to call back versus let me just build it, let me take the call live and address the situation right then and there.
- [17:40]
B
Yeah, fascinating. I really appreciate the kind of level of specificity and the specific initiatives that you really honed in on there. And fascinating that the same kind of mindset shift can have equal if not more results at a community healthcare regional system like yours, as it also can for a multi state large giant like a Trinity Health as well. So I really, really appreciate it. Fascinating context there, Flipping the script a little bit. CEO River Valley Health 25 years, four years in that CEO seat. No doubt there's a ubiquitous challenges this year which we alluded to, but a ton of really fascinating growth. A lot of excitement, a lot of things to be proud of. What do you think the hardest that is the most difficult thing that you'll have to do this year as CEO of River Valley Health.
- [18:29]
C
It's really, it is a balance between being intentional and focused and on the task at hand, which is, you know, managing and navigating these external forces, this VUCA environment, implementing the, you know, our technology, new technology platform and being re and responding but not being reactive to all these market forces because it's, it is very natural to be subsumed in the tyranny of the urgent. This happened, this crisis happened, that crisis happened. And oh look, there's this opportunity over there. It's really the decision making about where to put the attention and what opportunities, what things do we pay attention to because we are in all an overload there are opportunities that are going to come. They're constantly people coming to us asking about, partner with this, do that, what about this? And we don't want to miss out on a potentially very productive and mutually rewarding opportunity for us or a partner or whatever opportunity could be there. We don't want to miss out on that. But we, we can't get so lost and reactive to everything that's going on. And so I think it is this decision making process and balancing focus and adaptability and responding to what's happening in the environment and I think in leadership positions, frankly, that's what we have to do all the time. It's just the tempo, the pace, the intensity has really ramped up this year and it will continue to ramp up this year. And we're not even into February and already we've had lots and lots of things thrown at us. So I think that's going to be the biggest challenge.
- [20:38]
B
Right. It doesn't feel like we're two weeks only into 2026. Dr. Khatri, last question. Question I have before I let you go. You talked about really growth. Last year was a, growth was a hallmark of last year. Excuse me, you talked about really building this technology ecosystem, expanding services in dental, behavioral, opening several urgent care centers. You talked a ton about this growth already. Where do you see the best opportunities for organizational growth this year? Is it more of the same or anything different that you'd like to highlight or add before we wrap up?
- [21:13]
C
No, I mean, I think we are going to focus on strengthening our core and strengthening our foundational processes. So whenever you have a period of growth, then you, you know, it's, you realize that you can't have the same infrastructure. You can't just keep. We've done it, we've made those mistakes where we grew very quickly. And then we just, you know, said, well, the current infrastructure, you just everybody do more. And so this is going to be a year where I think we, and I'm only saying this in January, so who knows even in July. But I think we want to, what we want to do is strengthen and reevaluate but like really crystallize some of the strengths and build a foundation of our infrastructure and processes. And that has to happen anyway because of our technology implementation, technology platform implementation. So we will be almost building up our internal reserves as an organization for the next iteration of growth. So you know, you can't keep going and going and going without just taking a step and saying, all right, let's prepare for that next, let's give ourselves a chance to prepare for the next iteration of growth. And so this is a year, I don't want to say of contraction is not the word, but it's going to be a year, we hope, of looking inward and preparing for kind of growing for the next step.
- [22:54]
B
Yeah. Fascinating. I think so. So much to be proud of. No doubt there are some challenges coming down the pipeline, but seem like you're very well equipped to tackle them head on. Dr. Khatri, a real pleasure to have you on the podcast here today. Can't tell you how much I enjoyed this conversation, how much I lear and so greatly appreciate, so greatly respect the work that you that your team does at River Valley Health, and look forward to catching up with you again down the line.
- [23:17]
C
All right. Thank you so much.