← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Sowmya Viswanathan, Chief Physician Executive at BayCare Health System
00:23:14
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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.
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B
This is Laura Dearda with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Soumya Viswanathan, who is a chief physician executive at BayCare Health System. Dr. Viswanathan, it's a pleasure to have you on the podcast today.
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C
Thank you so much for the invitation. Looking forward to a great discussion.
- [01:04]
B
Absolutely. Now I'm excited for our conversation because I know there's so much happening right now in healthcare and particularly I'm excited to learn more about what you're doing at baycare. I know there's just such a unique community that you serve down there and a lot of innovation. You're in growth mode. So we'll be excited to learn more about that. But before we dig in, can you tell us a little bit more about yourself and bake your health system?
- [01:26]
C
Absolutely. I'm an internal medicine physician and I spent the bulk of my career in Northeast. I was in Massachusetts, I was clinical for the longest period of time and then I did a whole bunch of leadership roles. I was with various health systems including UMass and the partners Healthcare System and then I was at Dartmouth Hitchcock. Spent some time with the for profit world with Tennant Health before I landed in baycare Health System and I've been here a little over three years. It's been a wonderful journey. At baycare we are located on the Gulf coast and on the west coast of Florida. We are the largest health system in west Central Florida with 16 hospitals. We are building our 17th. We have 34,000 employees and more than 6,000 physicians who are deeply engaged in some form of relationship with us or the other including employment and clinically integrated network, aco, et cetera. We provide all kinds of services as an integrated health delivery model so it's end to end services. Hospitals ambulatory footprint including ambulatory surgery center. We have urgent care clinics, we have multiple specialty clinics including multi specialty and primary care clinics. We have Imaging centers. We also have virtual care. We provide telehealth services. We also have our own health plan. It's a small health plan, but this is where, you know, this whole spectrum of value based care comes into play. We kind of provide all kinds of services within our own system. And we are also an academic medical center.
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B
Absolutely. Wow, that is an incredible amount of services that you provide in ways that you are integrating within the community to continue to boost the health and access to care. Now I'm curious, when you think back in the last year or so, what was the most important initiative that you led? What did you do and what were the results?
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C
So academics, I would say in one word was the biggest initiative that I have led since I've landed here. I'll share a little bit of the historical perspective. Baycare as a health system came together as a group of community hospitals that decided they were going to become a health system and an integrated health delivery model. At that time, we were not heavy into academics. When I came here, we did not have a robust GME program. We had two very small residency programs in pediatrics and psychiatry with no plans whatsoever to enhance or expand that. And we also had leadership changes at the same time where new leadership came on board around the same time that I came as when we had Stephanie Connors who joined us as CEO of BayCare. So both of us coming from academic backgrounds in our past, we said, hey, you know what, for us to really address the physician shortages as we move forward into the next decade, we have to look at why can't we provide academia here? Because we have all of the necessary aspects of what goes into an academic medical center in daycare. We have the infrastructure that's needed, so we should become an amc. And so we went down the path of starting up GME programs. We have significant, we have made significant headway in our GME program. We went from the two small programs of 20 resident, 29 residents total, to our plans now of having almost 650 residents graduating by 2029. That's a robust and very aggressive goal. But we are steadily moving forward. We have gone from the two small programs, as I mentioned, to establishing 16 programs. Currently we already have 300 residents who are with us today. In a span of two and a half years, we have made that achievement and we are not looking back. We are going to continue to enhance a GME program. And in our attempt to really become an amc, our biggest achievement was definitely our collaboration with Northwestern up in Chicago. So you must have read in all of the news articles and the press releases that Northwestern collaboration with Baker has been a significant milestone for us. Super excited about all of the work that we'll be doing with Northwestern, including research endeavors, including faculty development programs, and really enhancing the academic footprint in Florida.
- [06:13]
B
That's amazing to hear. And you know, what a great foresight in order to be able to start an academic program and have those seeds planted and foundations built for growth. I think as you mentioned, it is an aggressive goal going from the two initial programs and 29 residents to having 650 by 2029. But I can imagine you've got a great plan to get there. What types of resources do you need? And expertise is important when you're setting up an academic program and trying to transform a community system into an academic system.
- [06:44]
C
So the definitely the two aspects are the teaching or the educational environment as well as research facilities. So we were doing some amount of research. I'll start with research. We were doing some level of research mostly by community grants. But we were not like the the big AMCs up north where there's a lot of NIH funding, lot of NSF funding. It was a lot of community focused grants and state grants. Our goal was to really enhance the environment in which research is being done so that we are fostering the different aspects of research, including we were doing sponsored research. For example, we need to do something which is BayCare Original Research and we hadn't been doing that. So we'll be focusing heavily on how do we start up clinical trials. And this Northwestern collaboration is going to help us with that because it helps us think differently in terms of can we have a multicenter trial if there is like a cardiac procedure that we are doing differently or a new innovative method of doing an electrophysiology or EP study, et cetera. So that is the aspect of research that we are going to enhance while we continue to gain from the community grants. The second piece is teaching. We had been dabbling a little bit in teaching because we used to get apps like the physician assistant and the RN nursing students who used to come over from the local universities. We also had residents and students coming over from our local partners here, USF and Florida State University, University of Florida. We have engaged deeply with USF and FSU and we just needed to increase the amount of teaching that we are doing. What was beautiful to see is there was significant appetite in the physicians to really go in that direction. Our physicians felt, well, we have so much talent here. We are some of the best in class with high Quality care. We provide clinically excellent care. How do we continue to nurture this environment where we groom the next generation of residents who will be taking care of us in the future? Because 68% of residents who graduate from GME programs stay in the area where they graduated from for at least three years after. If that's a statistic, then I will gain significantly from at least 3/4 of the 650 residents graduating who will become physicians at BayCare. They'll be taking care of all of us as we get older. That's what we want is high quality residents coming from our own programs who our physicians have taught and they will service the community. We have pretty much the infrastructure. The system is also something that's important because the system was committed to making that kind of investment.
- [09:38]
B
That's great to hear and definitely so important to have that leadership and the executive team committed to those types of transformations. I know Stephanie Connors is such a dynamic leader and so inspiring and gets things done too. So that's incredible to hear and thank you for digging a little bit deeper there. Now, looking ahead for 2026, what are some of your big priorities as well as headwinds that you'? Facing?
- [10:00]
C
Well, some of the priorities are definitely not different than many other health systems. It's basically moving care upstream. And I can share with you with having looked at some of the other parts of the country, definitely Florida, southern states, I think especially Florida has been a little bit late in moving forward with value based care. We have not had a lot of payment model shifts until recently. The payment models have been a little late other than the federal and the regulatory volatility that's going on, which is also influencing some of the decisions we are making. But let's say the central the CMS funded grants that are coming our way, those we have already started moving in similar to others. But then it is a state payment model shift. We haven't really moved very aggressively in value based care. So my biggest priority will be to start moving physicians in that direction where we have traditionally done so much of fee for service type of model of care delivery. We now to start training and we have been training but we have to start enhancing the training of the physicians and the whole care team model to really deliver on look at the total cost of care of patients. How do you look at utilization metrics, how do you continue to enhance quality while you're controlling the utilization of services. So that'll be a big focus truly moving us in value based care model. Now as we do this I mentioned to you how BayCare is a 16 hospital system. We have large facilities that cannot have empty beds. We need heads in beds because that's the way we sustain our whole integrated health system. So for that to happen, as we move care into ambulatory, we need to ramp up the types of services in the hospitals. Right now we provide a lot of primary and secondary level of care, we provide some tertiary care. Our goal for 2026 is to move the entire health system forward to provide high end tertiary care as well as start working on quaternary care services which is going to be big amount, big ticket items, high acuity, severe cases, very complex cases, including looking at transplants. So that will be a big driver for us in 2026. The other big thing that we are working on is recruitment of specialties. As you know, private equity firms had nationally had looked at health care, they had invested in healthcare. But now as some of the PE firms are backing off from some of these specialties, we're struggling because these specialties are coming to us and saying well we're going under or we are going to be collapsing and we are no longer going to have a job. So we don't know whether we'll be in the area. It started last year with anesthesiology where we had anesthesiologists in the market because we were contracted with them, they were not employed by us. They came to us and they said, well we're not sure if we're going to stay in the state and we may have to move somewhere, we may have to go to an amc. So we started looking at a non traditional methodology of employing specialties which usually are not employed unless you're an academic medical system. So anesthesia for example, usually because they don't have their own panel of patients, many health systems don't employ them if they are not an amc. So we have gone down the path. Since we are already becoming an amc, we said, well this is time for us to look at that specialty and say we need to employ anesthesiologist. So that's a big headwind for us that we were able to walk into last year. We have done tremendous, had great progress in that in employing anesthesiology and we're making a lot of headway there. The third aspect is population. Population has grown tremendously in the Florida market. As you know, through Covid. Many people who could work remotely, they migrated from the northern colder states and they came and settled down in the southern states. So Tampa and Austin, Texas I think were the fastest growing cities in the country. That said, when the people moved down here, the types of generations, the types of people, the demographics of the people who came here were the younger generation. So what ended up happening is Florida being usually a state of like retirees. You know, it's a haven for retirees. Our health system was not prepared for the number of young people settling in Tampa market. So the whole this bay care market is now having huge numbers of young population settling here. The need for those specialties has gone up, which is pediatrics for children and women's care, ob GYN to take care of all the pregnancies and taking care of the women who are settling here. So these are some of the big priorities that we'll be working on from a population and specialty perspective. Peds and women's care. Anesthesia is a specialty that we'll continue to work on and just moving care upstream with payment models and enhancing tertiary care in the hospital while moving towards value based care aggressively in our outpatient centers.
- [15:34]
B
Wow, that's fascinating. That's a lot to think about in a lot of transitions that are happening all at the same time, but also really fascinating to think about the puzzle and complexity of how you're running healthcare system, making these transformations into an academic center and then really changing with how the market's changing, the economics, the demographics even of what's coming into the Tampa market and around in that region of Florida. So that's fascinating. What do you think out of all of these things will be the hardest thing you have to do in the coming year?
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C
The hardest thing, probably the most work will be around the value based care movement, ramping up our physicians to understand total cost of care. Because we have to amplify what we are doing in the ambulatory setting. We need to enhance the work, not just the brick and mortar, but the availability of services in ambulatory care. We need more virtual care. We need to be able to support more telehealth services, more technology and innovation so that the physicians feel they can offload to the ambulatory footprint for doing this value based care model and of course enhancing the tertiary and quaternary care on the back end. Because if you don't do that financially, the sustainability is not there. One of the aspects of this movement that we are doing to help physicians and prevent burnout of any cause is because physicians need to be available to provide that access. And our health system has traditionally not done a lot of work with app integration into practices. We are moving in that direction. This Year there'll be heavy integration of allied health professionals and providers who will be supporting both PAs and NPs will be supporting our physicians in practices as well as in the hospitals. That is a big movement that I'm really looking forward to. It took a lot of education and continuous education of physicians to see how they can embrace apps in the practices. So this is going to be a beautiful journey as we build the teams to support that movement in value based care and improving access.
- [17:52]
B
That's helpful to understand and I think, you know, it's so fascinating to see how you're looking at value based care and where some of the holes are. I think when you're looking at the clinical side as well as the financial side, I mean, there's a lot of big changes overall. But for the clinical team, for the physicians and nurses already on board, what types of things are they having to adjust about the way they think about practices or their standards or protocols? How are they being affected by the transition of value based care and what are you doing to make it as seamless as possible?
- [18:23]
C
Yeah, absolutely. So we are changing the model to support the value based care model. One is a long team based care really looking at services. We have for example, a value based care team that has a population health services division, the team of care coordinators, clinical pharmacists, quality folks, they all sit in one location. Now what we are looking at doing is enhancing and embedding them in the practices so they are there in real time for physicians so that they are part of the, that's providing that team based care because that's how you move towards value is when you're able to get the physician, get the patient, the physician and their patients, caretakers, all involved in the care of the patient, then you can reduce the readmission rate, you're able to better care for them in the home environment. We have also involved in hospital at home programs. So for all that to happen, we really need to enhance the services at the ground level, which is in the practices. The second thing that we are doing is a lot of work around AI innovation. I know AI and tech is like a big buzzword these days. We're actually looking at all of the practical implications of inputting these AI tools in our practices. If it's going to help the patient, if it's going to help with delivery models that's going to take care of the patient when they are at home. We are definitely evaluating all of those tools and we have looked at multiple platforms that's going to help the patients with not just the patient navigation into practices, but taking care of them in their home so that they are not heading back into the hospital and increasing the complexity of their problems by delaying care. So we really want them to have the best available services. Access is critical, whether in the form of physicians and apps, having access to the teams. So the value Based care team will provide all of those support services and with technology we feel like we can improve the operational efficiency and effectiveness of the care that we are delivering. So a lot of great work that's going on in this tremendous growth mode.
- [20:42]
B
That's super helpful. Thank you so much for digging a bit deeper. Before we wrap up, I want to talk about growth as well. Where do you see some of the best opportunities for organizational growth.
- [20:53]
C
For us? Specifically, I had mentioned some of the services which is growing much more rapidly than others, which is women's care services and pediatric growth. To help with that, we are not only just looking at the ambulatory footprint, we're actually building our own freestanding children's hospital. We already have a children's hospital. We're building a freestanding children's hospital that's going to be, it's slated for in the next three years. So that is the timeline where we need to enhance it of services we are providing. It'll provide every aspect of pediatric care that's possible from end to end, whether it's going to be early stages of primary pediatric services to end stages of transplants for pediatrics, bmt, CAR T and all of that. Then we are looking at the app integration. As I said, that's where the organizational growth will occur because it's the types of people we have in our team. We need more, not just physicians who are providing the care. We need more nurses, we need more allied health professionals, we need more techs and we need more PCLs who are on the ground level providing the care for these patients. So along with the growth of the population, we are matching the growth with the types of people who can provide that level of care. These are two big areas we are focusing on. But as every other health system is doing, we are not doing this without or ignoring the enhancements in technology and innovation. We need to input. We are integrating that into the practices as well as.
- [22:24]
B
Fascinating. Thank you so much for joining us on the podcast today. This has been such a fantastic conversation. I'm really excited to learn more about what you're doing at baycare and you know, continue to dig deeper. At the annual meeting, I know you'll be speaking on a panel and really, truly, you know, sharing some of these great insights and learnings that you've had. So I'm looking forward to that. And it'll be a great opportunity to grow and connect with others. So thank you so much for your time today and looking forward to April.
- [22:51]
C
Thank you. And when you come. Thank you so much, Laura. Really looking forward to it.