Becker’s Healthcare Podcast: Robert Chestnut, SVP & CFO, LMH Health

Date: December 1, 2025
Host: Will Riley, R1
Guest: Rob Chestnut, CFO, LMH Health, Lawrence, KS

Episode Overview

This episode features a candid conversation between Will Riley and Rob Chestnut, CFO of LMH Health, a community hospital in Lawrence, Kansas. The discussion centers on how a mid-sized health system is navigating increased competition, technology adoption — particularly AI — and changing patient and workforce expectations, while seeking to build efficiency and maintain the hospital’s founding mission of equity.

Key Discussion Points & Insights

1. LMH Health: Community, Competition & Mission

• Community Profile: LMH Health serves a 100,000-person university community, operating as a sole hospital with 174 beds and employing about 160 providers — “specialists, primary care, internal medicine, really, really pretty much around the horn.” (01:00)
• Strategic Partnerships: The hospital collaborates with the University of Kansas Health System (Kumed) to provide advanced care transfers but has a strong focus on providing local care:

  "We think that's really important for our patients to get care at home." (01:30)

• Founding Values: The hospital’s mission of equity was established by founder Elizabeth Watkins a century ago and “we still try to stay true to that mission to this day.” (01:55)

2. Challenges: Rising Competition & Organizational Complexity

• Historic Setting, New Realities:

  "Up until about 10 years ago, not in a really competitive environment...now, as the greater Kansas City area started to expand… we've had to become more competitive." (02:48)

• Transformation & Efficiency: Increased complexity with employing more physicians pushed the organization to become “much more efficient in revenue cycle, much more efficient in the way we run our physician enterprise.” (03:00)
• Economic Pressure: Reimbursement compression means “figuring out how to do more with less.” (03:33)

3. Technology & Innovation: The Shift to AI

Provider-Facing Technologies

• AI in Clinical Documentation:

  “We're doing a lot in AI with...documentation for our providers...we're moving through all our practices to implement that.” (04:35)

• Adoption Drivers: Early physician “champions” accelerate AI adoption:

  “In any particular specialty, when you have a physician that really is a champion, it sort of becomes infectious...” (04:50)

Revenue Cycle

• Automation for Efficiency:

  “On the revenue cycle side...we've done some things in our coding to automate a lot of the codes, the DRGs and CPTs that are very standard… returns are fabulous...great experience with AI implementation.” (05:18–06:00)

• AI Levelling the Field:

  “Technology levels the playing field...even as a 174-bed community hospital versus a very large system.” (06:04)

4. The “Battle of the Bots”: Payer-Provider Dynamics

• AI on Both Sides:

  “You have AI on their end and AI in our end and they're fighting each other in the middle...We know...if we have a certain level of claims and everything’s going swimmingly then all of a sudden we start having denials...our cynical side says somebody’s figured out...the clean claims rate’s too high, so they start denying things.” (06:25–06:56)

• Improved Transparency:

  “Over time technology is going to create the kind of transparency where you don't have as much opacity...it’s fairly clear, you can see a pattern.” (07:41)

• Medicare Advantage: LMH chose not to renew two Medicare Advantage plans due to challenges, impacting patients but necessary for financial stability. (08:28)

5. Partnering for Innovation & Change Management

• Third-Party Innovation:

  “I find that the solutions typically don't come from the big players. They come from some disruptor that has figured out...They’re trying to create and innovate in those spaces, but a lot of times it'll be in small pieces...” (09:18–09:35)

• Continuous Improvement:

  “Continuous improvement is going to be the watchword and we'll do revenue cycle with less people. Going to be the future.” (10:11)

• Cautious Change Management:

  “Sometimes you have to be cautious not to introduce too much change...if you don’t get people adapting to it...then it becomes just a wasted investment.” (10:30–10:41)
  Collaboration with providers is key for successful adoption.

6. Technology’s Impact in Finance & Supply Chain

• Shift from Labor-Led to Tech-Led:

  “It’s going to be a space that is technology led with labor playing a supporting role or an expert role...those groups will be smaller...it’s just the way of the world.” (11:49–12:20)

• Evolving Workforce Needs: New hires are expected to have stronger business intelligence and technical skills.

7. Provider Adoption & Generational Dynamics

• Generational Perspectives: Younger clinicians drive adoption; early “technology champions” speed culture change:

  “If you get a physician leader in there, in a practice to go, it’s gonna happen fast...” (14:00)

• Challenges for Established Staff: There is some resistance—“a little bit of a struggle”— but the majority recognize tech is the future. (14:44)

8. Competitive Edge for Rural Hospitals

• Tech as Equalizer:

  “It is, it’s everything...when you really get AI working on physician notes...I have not met a provider yet that said...I wish I could go back to what I was doing before...the only way they’re really going to achieve [work-life balance]...is to adopt some of these technologies.” (15:16–15:50)

9. Patient Experience & Expectations

• Consumer-Driven Experience:

  “Healthcare has also traditionally not been a patient-centered environment...That’s changing.” (16:15)

• Demographic Shift:

  “Generationally people interface with healthcare differently. If you’re under 40...our portal, the apps that we have, the...doing everything online, that is becoming critical and that's the expectation.” (16:24–16:54)

• Ease of Access as Differentiator:

  “If we don't make this easy, we’ll lose these patients. This is just the expectation and relationships are still important...but that interface as they come into the system has to be through technology.” (16:54–17:25)

10. Workforce & Organizational Culture

• Talent Scarcity and Engagement:

  “We’re competing for, for less people and...we realize that it’s not all about compensation...sometimes it’s just about creating a great environment where people can flourish.” (17:37)

Notable Quotes

• On Increasing Competition:

  “We used to be a bit of an island...but we’ve had to become more competitive.” - Rob Chestnut (02:48)

• On AI Adoption:

  “Technology levels the playing field...returns are fabulous.” - Rob Chestnut (06:04, 06:11)

• On Revenue Cycle Management:

  “On the revenue cycle side...we've done some things in our coding to automate...our revenue cycle...has gotten a lot more efficient, and it's essential...” - Rob Chestnut (05:18–05:39)

• On the Role of Disruptors:

  “Solutions typically don’t come from the big players...they come from some disruptor who’s figured out...” - Rob Chestnut (09:18)

• On Provider Satisfaction with AI:

  “I have not met a provider yet...that said, I wish I could go back to what I was doing before.” - Rob Chestnut (15:31)

• On Patient Expectations:

  “If we don't make this easy, we'll lose these patients. This is just the expectation.” - Rob Chestnut (16:54)

Key Timestamps

• 00:56–02:33: Rob introduces LMH Health, its mission, community, and connection to the University of Kansas Health System.
• 02:48–03:59: Discussion of increased competition and the drive for efficiency and complexity management.
• 04:32–06:13: Deep dive into AI adoption in clinical and revenue cycle workflows.
• 06:24–08:28: The impact of technology on payer dynamics, AI “battles,” and Medicare Advantage challenges.
• 09:15–11:21: Innovation partnerships, adoption hurdles, and strategies for change management.
• 11:48–12:53: How technology is reshaping finance, supply chain, and workforce composition.
• 13:30–15:04: Provider adoption patterns driven by generational differences and tech champions.
• 15:04–16:06: The role of technology in maintaining competitive edge and enabling work-life balance.
• 16:14–17:29: Shifting to patient-centered care and meeting digital expectations.
• 17:36–17:58: The challenge of workforce engagement and culture amidst talent scarcity.

Memorable Moments

• “If you walk into the...big ballroom up there with all the vendors, you know, and you shout revenue cycle, you'll have 1700 people come running at you.” (Rob Chestnut, 09:21)
• “You have AI on their end and AI in our end and they're fighting each other in the middle...” (Rob Chestnut, 06:25)
• “I have not met a provider yet that said...I wish I could go back to what I was doing before.” (Rob Chestnut, 15:31)

Summary:
Rob Chestnut provides a rich, practical perspective on how a community hospital leverages technology—particularly AI—to address competitive pressures, complex payer landscapes, and changing workforce and patient expectations. The conversation emphasizes incremental, collaborative change; the rise of disruptor partnerships; and the pivotal role of technology in leveling the playing field for non-urban health systems.