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Becker’s Healthcare Podcast
Stuart Levine, MD, FACP, President of MedStar Franklin Square Medical Center and Senior Vice President at MedStar Health
00:29:44
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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.
- [00:46]
B
This is Alan Condon with the Beckers Healthcare Podcast and today I'm thrilled to be joined by Dr. Stuart Levine and President of MedStar Franklin Square Medical center and also senior vice president of MedStar Health. That's an integrated health system that includes 10 hospitals, I believe, across Maryland and across Washington, D.C. Dr. Levine, fantastic to have you make your debut appearance on the podcast with us today. For those listeners who might be as well acquainted with yourself, MedStar Health, and the fantastic work that you and your colleagues do, do you mind giving us a little bit more insight into your role and your background at the health system? Well, sure.
- [01:25]
C
So first of all, thanks so much for having me. Thanks for inviting me and I just appreciate all the work that Beckers does on behalf of the healthcare industry. You're one of my go to early morning reads to understand what's happening in the industry across the country. So just appreciate the organization and the opportunity to speak with you today. So you know, you stole a little bit of my thunder in your introduction. You mentioned MedStar Health in our organization. So we are the largest integrated health system in the Mid Atlantic, touching over 1 in 5 folks in the Mid Atlantic covering Maryland, DC, Northern Virginia. We do have 10 hospitals, over 300 care sites, and just a lot of connect points in between. Over 6 million outpatient visits a year, 37,000 associates. So we're a big integrated health system. My little piece of it. So I am the president of MedStar Franklin Square Medical center, so one of our four Baltimore area hospitals. It is the largest of our Maryland hospital portfolio. So I'm really proud of that. We're up here in eastern Baltimore county, kind of midway between sort of Baltimore and the Delaware line. And so we have a very, very large service area that that we treat bordering on the Chesapeake, the northern Chesapeake Bay, and then up in northern Baltimore county to Delaware. I'm a physician by training. I'm actually the first physician president of this organization, which has been around for over 100 years, my medical staff loves that fact and they're really happy about that. Franklin Square, we've got about 3,000 associates, kind of a large, increasingly tertiary care, a medical center in this local community. And I know we'll talk more about some of our programs. I'm a rheumatologist by training. I was an academic rheumatologist in the Johns Hopkins system before coming to MedStar back in 2010. And I've served a variety of roles at MedStar since joining. I've been a chief medical officer of two of our hospitals, including Franklin Square. And I've been the president of two of our hospitals. One in Baltimore City, MedStar Harbor Hospital. And then starting almost six years ago, as the pandemic was getting underway, I started as the president here at Franklin Square.
- [03:53]
B
Fantastic. So no, I think really important to kind of a little bit more background context, kind of about the makeup of your health system. Obviously your tenure at the health system as well, wearing many different hats. But I guess in that role that you sit in now, that dual role, obviously you're president of Franklin Square Medical center and senior vice president of the health system more broadly. No doubt there are many different paths we could go down here with this question. No doubt there are very ton of initiatives you want to highlight. But looking back over 2025, was there one standout initiative that you led last year that you're particularly proud of and maybe if you could kind of give us some insight into what the initiative was and maybe some of the results?
- [04:34]
C
Yeah, it's a great question. And we talked obviously in the introduction and then in my introduction speaking about the integrated nature of our system. And we have a favorite term in our system, we call it systemness. And I know that that's a term that' increasingly being used across the country to describe system integration. As you know, as initially hospital systems integrate ambulatory and value based care arrangements and the like. We were kind of an early adopter of this concept going back over 20 years. And so what I've been really proud to help lead over these last several years is cross system integration of service lines. So we have one of the largest medical groups and the employed medical groups in the country with over nearly 4,500 employed providers. So huge, huge chassis. And over these last five years we've really developed system service lines cutting across our entire, not just region, but entire system. So one of the projects that I've been involved with, based here at Franklin, but leveraging the incredible talent, skill and experience of our academic partners in our system. In the Washington D.C. area, the MedStar Washington Hospital center and our academic anchor, MedStar Georgetown University Hospital, we developed and implemented and opened and in this last year were redesignated by Joint Commission as a comprehensive stroke center. We were the newest comprehensive stroke center in the state of Maryland. We are now one of the busiest. I employ four full time neurointensivists. We have grown dramatically over the last few years. We accepted over 300 inbound transfers for complex stroke care from all over the state of Maryland, Delaware and the whole mid Atlantic region. And remember, you know, we were a primary stroke center when I started in this role six years ago. And in just a three and a half year period of time, leveraging our system resources, significant capital and human resource and physician investment, I mean all of the support that comes with that, we, we were able to within a few years move from a primary stroke center to a thrombectomy capable stroke center to a comprehensive stroke center. And just over the last few months we were redesignated by both the Joint Commission and the Maryland Emergency Medical System which runs the statewide EMS system. So when I look at developing these types of really tertiary and in some cases even quaternary services out here in a large community hospital, that kind kind of project wouldn't be possible if we weren't part of a large integrated system with common electronic health records or a common revenue cycle platforms, common purchasing, you know, platforms, quality and safety infrastructure, all of, and of course the talent of the physicians and leveraging of course our academic partners to be able to recruit world class physicians to come and practice in this area. When I kind of look at all of that and I see what we're able to provide to patients with these advanced needs from this region. It's pretty easy to walk through the door every morning. It's a pretty proud moment.
- [08:01]
B
Yeah, no, I mean fantastic to hear about the growth of the comprehensive Stroke center, that redesignation. To your point, I'm wondering if you could maybe just going back to your earlier point in terms of that quote unquote systemness, it's kind of a term that we hear kind of more frequently amongst other systems, other CEOs, executive C suite leaders across the country. Been a big focus at MedStar Health for quite some time to your point, in terms of that cross system integration of service lines. Can you kind of walk us through maybe where you stand currently there and what's the big focus going forward as we continue to leverage that system at MedStar Health?
- [08:39]
C
Yeah, so, you know, we came to be as a system, like many integrated health systems, right, by partnership and acquisition over a long period of time. And, you know, community hospitals have very strong traditions, very strong roots, and frequently, and especially in the early days of systems coming together, a lot of those systems sort of become, you know, integrated into the system. But you don't really have kind of standard operating procedures that cut across all of those entities. We've done a really, really nice job and really accelerating over the last five, six years to do a little bit more horizontal integration across our entire system. You mentioned in my introduction that I hold two titles. Every hospital president in the system holds a local title, that we are the leader, the CEO of our local entity, but we also are a vice president, senior vice president of the system. We often talk about putting on our two hats. Stu, you got to put your system hat on to think about this. I have a stake in what's happening in our Southern Maryland region and developing service lines. If we're developing ambulatory surgical centers, it might be several physicians who are affiliated with several hospitals coming together in a new regional ambulatory center to develop that off hospital campus resource. Because, of course, patients prefer to be in the community and to have care closer to home and not to have to navigate large hospital campuses. So when we talk system is, yes, we have integrated system operation structures and pharmacy and supply chain and legal and compliance and all of the back, you know, the office functions that keep a system going. We've got central functions with local deployment. So. And then within regions, you know, I'm very close friends with the other hospital presidents in this region and we meet all the time to talk about how we can optimize each of our campuses, how we can specialize each of our campuses to really be able to operate at scale and to avoid duplication and waste and to be as efficient as we can so that we can put all of those resources back into capital investment and really be strategic about how we operate. So we have now functional service lines across the really everything we do. So our individual hospitals don't employ physicians anymore. All of our physician contracting is now through one system medical group. And that medical group then deploys physicians to all the hospitals after just, you know, after I finish speaking with you, I will be meeting with all of the system service line leads. I have monthly meetings with my chief medical officer. And all of the, we call them pillars, but the pillars are broadly medical specialty based in surgical services, in hospital based services, et cetera. And we meet and we have discussions about strategic priorities, about staffing, about recruiting, about technical, all the technical wraparound services that new physicians or current physicians will need to do their jobs. And in there, I'm wearing both my hats as a hospital president, but also thinking what is in the best interest of our system in our region and then how can we work together to break down those silos, be much more horizontally integrated and ultimately so we can provide the best service for our patients?
- [12:18]
B
Yeah, no, Fascinating. I really appreciate you kind of diving a little bit deeper into what that term, breaking down that term for me and kind of how you work with the other hospital leaders within MedStar. Really fascinating to kind of hear that one bit deeper. So, Dr. Levine, the challenges facing hospitals and health systems are well documented. You talked about some of your key priorities, some of your growth there initially already 20, 26 for this year. Can you kind of give me a breakdown? How is MedStar coming up, tackling or pushing back against some of these headwinds? What are your key priorities, I guess for this year? No doubt a challenging year, arguably more challenging than we've seen in recent years given the impending cuts coming down the pipeline. When you think about Medicaid, aca, subsidies still up in the air, likely not to be here, so much going on, your play. But I guess kind of what are the key kind of areas that you're looking to tackle, Push back against some of these challenges and headwinds.
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C
Yeah, well, you certainly mentioned, I mean, I think this is a period of high anxiety for the healthcare community and especially hospital based systems. Right. As more and more care is moving into the ambulatory space, as cost pressures and inflation, certainly for labor and really especially for supplies and especially sort of high cost supplies such as chemotherapeutics and biologics therapies and some of the more advanced technical robotic platforms and the like, managing, you know, all of those, all of those pressures with a growing population, who is more discerning and yes, more, more demanding of a full plate of services in the setting of all of the, the headwinds that you described, I think is, is our challenge. And we're not certainly unique at MedStar in facing those down, you know, so that those things are in the background. But as our CEO Ken Salmon always likes to say, you know, over the last 20 years, as we move from strategic plan to strategic plan, right. Pre aca, we had a strategic plan. We never designed our strategic plan based on sort of the anxiety of the day. It was, they're always looking forward, always really looking at what is happening in the market? What is happening with the way that people and communities want to receive their care and will expect to receive their care. And we develop a set of integrated strategies based on those factors. There are always going to be headwinds regarding health care financing. And you know, we had developed strategies before Medicaid. Maryland is a large Medicaid expansion state as you know, but our strategic plans predated Medicaid expansion so we had to adjust operationally for that. But we didn't have to do any large strategic pivots and that is true today as we, as we look at the headwinds. Our service line model development was one of the strategies to buttress against some of these kind of whiplash effects of changes in health care financing. We are deeply involved in value based care. We do have a Medicaid managed career organization both in the district and in, in the state of Maryland. So we're very familiar and savvy. We've been part of several ACOs. So we are very well positioned for increasing value based arrangements across our system. And that is part of the DNA of our system. And because we have, you know, a significant foothold in the state of Maryland, which is your, you're likely aware, has a unique healthcare financing model amongst the 50 states. We literally are a few weeks into the new AHEAD model. AHEAD is a demonstration project. It's the evolution of the Maryland Global Budgeting model that we just entered a new tenure agreement with cms. AHEAD stands for achieving healthcare efficiency through accountable design. And we are. So as you say, well, what are we looking at in this next year? Certainly planning now that we are in this new model for increased focus on value based care, increased out migration of lower complexity service from hospitals into the ambulatory space, much more primary care investment and primary care partnership and then thinking about how we continue to expand value based arrangements from a system perspective. Perspective, those are a significant set of priorities for us. On the. You know, since I'm a rheumatologist, you know, my team always jokes that I can't do a town hall without mentioning connective tissue, but the connective tissue. And so I'm not going to break my streak now. We're going to talk tissue. But one of the obvious and most important enablers of being able to be an integrated system is having an IT platform and IT chassis that allows you to seamlessly share and pass information across the organization. And so as Beckers has reported, MedStar Health is one of the systems that has made the decision to transition from Oracle Cerner Electronic Health Record to the EPIC Electronic Health Record. We just kicked off that process just last week and we will be implementing a fully going live with epic in approximately 18 months. So the EPIC deployment work groups, I am proud to be co chairing the clinical steering committee for this, this pro, this project. So it's going to take a lot of my time as we build this system, but we will have a fully, fully integrated health record revenue cycle management system and then all of the decision supports and AI enabled tools that that EPIC has available. That's going to be a major, major enabler for us to, we think, add a little, add some tailwinds to tackle some of those headwinds to become even better integrated and even better and more efficient than we, we have been up to this time.
- [18:21]
B
Yeah, I mean no doubt ties right back into what we were talking about earlier in terms of really leveraging and leaning more and more into that systemness. Like you said, that big switch from Cerner to the EPIC ehr, no doubt some substantial efficiencies on the administrative side, the clinical side. So great to see there. I guess just one quick follow up on that. As a physician leader yourself, is there one particular area that you're excited about when you think about making that transition and getting to the other side of the EPIC ehr? I know there's a ton of token tools there that comes with the EPIC platform. Physicians are really excited about it. But as a physician leader yourself, is there one particular area that you're particularly excited by?
- [19:02]
C
Yeah, I think, you know, I've had the pleasure of working clinically in both systems. I was part of the EPIC transition when the Johns Hopkins Health system went live with EPIC over a decade ago. And then as I was transitioning to MedStar, we were going live with Cerner at the time and then obviously it was purchased or acquired by Oracle. So I've actually worked in both systems clinically and what I'm most excited about for my physician of course, and nursing and all other colleagues. But the beauty of EPIC is how incredibly well integrated it is. And I think for physicians just the ease of documentation, ease of moving information between the ambulatory and inpatient spaces, ease of communicating with patients, the MyChart tools is certainly best in class, has been for a long time. And just that ease of being able to seamlessly communicate, decrease the number of clicks in your day, use all the ambient dictation and other tools that facilitate, but it's really having that ecosystem that is fully integrated that makes things just easier Nothing bothers physicians. And if we had my nursing colleagues on here, they would echo that for nurses as well. Right. It's the tyranny of the click and the number of clicks that people need to go through in their day. And I think that EPIC really, really has built a system that has that in mind and is constantly trying to minimize the busy work for clinicians so that they can actually get to the important work of taking care of their patients.
- [20:39]
B
Yeah, absolutely. And I think the other thing that I didn't even mention, I guess, is just how much of an impact that has on the patient experience as well, and physicians as well, getting that FaceTime back, that FaceTime back with your patients as well. So, so key and an area we constantly hear how nurses, our physicians are really, really excited by. Dr. Levine, you've talked about a bunch of really key projects in the pipeline at MedStar Health. You talked about that EPIC EHR implementation, ton of growth across the system, the CMS ahead model, MedStar in that, in that cohort, one of the CMS ahead model that kicked off this year. I just wanted to flip the script. There's a ton of big projects, a lot of excitement, but again, a lot of challenges as well this year. When you think about that, what do you anticipate the hardest or maybe most difficult thing you'll have to do in the coming year?
- [21:30]
C
Yeah. So maybe I'll surprise you by my answer. But it's not a secret. We talked about anxiety then the anxieties that are kind of out in the healthcare world. But I mean, let's not kid ourselves. There's a ton of anxiety and fear about, you know, many things happening on the local, regional, national and international levels and all of those dynamics and some of the fracturing that we have politically in our country. All of those things play out in hospital and health system walls. Right. We're not immune to any of those things. Our associates have strong views on all sides of the of political spectrum and that's what makes the world go around. It's one of the things that's beautiful about working in healthcare is you have this incredible diversity of thought and opinion and just brilliant people coming together to do really great things. But in all honesty, it is becoming harder and harder to keep those micro societies together as the external world comes into our walls. I often joke with my teachers that I have all these titles, but my self appointed title is that I'm the mayor of Franklin Town, that I've got a small town of 3,000, very diverse, very motivated and highly skilled people. And my main job is to keep that society together and focused on our mission and our values and providing excellent patient care. And I think as the temperature continues to rise outside of our walls, focusing my team and my leaders and my associates on sort of what's important and how to continue to, yes, we don't ignore what's happening in the outside world, but we channel those anxieties into how well we care for our patients. I think that's a daily. It's the thing that I think about the most in my day as I park my car and start to make the walk in is how, you know, how, what am I going to do today to make sure that I'm giving my team everything they need to make them feel the best about walking through these doors with me. And you know, one of my biggest anxieties and I think every healthcare leader, if you ask what is the one thing that keeps you up at night, it's not how we're going to pay for service, it's not inflation, it's not, you know, labor shortage issues. Those are all important. But the biggest issue is security, right people? The fear of workplace violence, the fear of campus security, that's all consuming. If we don't feel that we can be safe on our campuses, it's impossible to take care of our patients. I'm so proud at MedStar that we have invested so heavily in our security posture, in having world class human resources and then lots of technology enablers including deployment of evolved weapons detection system and many other items just to make sure that our physical security is there, then working with our teams to make sure we have behavioral health response teams and all of those items that we need to keep safe. So the hardest thing that I have to do is also because I've interviewed a lot in my life, so I'm going to turn the negative into a positive on you is also the biggest blessing that I have as a hospital CEO in this era is that I get to do that hard work every day and it's paying off. My associate engagement scores are the best they've ever been at this organization and patient experience scores are on the rise and that had been an area of challenge for us. Our recruitment rates are spectacular. We have the best retention that we've had with turnover rates which you hear other systems have real struggle. I've got one of the lowest nursing turnover rates below 2% that we've ever had in the history of the organization. So I feel that it's working. It's never, you're never, it's never job done in these types of positions, but it's, it's just a privilege to get to tackle those kinds of problems every day.
- [25:30]
B
Yeah, I think so. So, so, well said, Dr. Levine, a real pleasure kind of hearing about your leadership points, how you work with your teams and some of the fantastic work at MedStar. On that note, I know that you're coming up with your meeting with your hospital presence soon, so I know we're coming right up on time here. So last, last question before I let you go. I'd love to hear, maybe just looking ahead two, three years, MedStar Health biggest opportunities, focus areas for growth for the organization. We've talked about a couple already, but any other areas you'd love to highlight before we wrap?
- [25:59]
C
Yeah, sure. I think, you know, for MedStar Health, overall service lines, a ton of ambulatory expansion. So we have dramatically increased our ambulatory network. We're the largest urgent care provider in this region. We have multiple ambulatory specialty centers, sort of hospitals without bed, type of multi specialty units, you know, imaging centers. So we are accelerating that build out across our region, you know, focusing in sort of filling in our map where we, we historically haven't had connect points between our hospitals and our major centers. So from a system perspective, enormous build out of our ambulatory chassis. And I will be personally involved in one of those. We're developing an ambulatory surgical center about nine miles north of my hospital campus in collaboration with a number of service lines across the organization. So that is a planned opening about, also about 18 months from now. So that's a major priority for Franklin Square. I mentioned some of our strategic service lines. I talked to you about what we're doing in neuroscience. We have a very large integrated surgical service program here with expected growth in bariatric surgical oncology. Our GI chassis is just popping. We just hired another advanced endoscopist and demand in this area for those services is very high. Our orthopedics growth will largely be predicated on sort of migration into those ambulatory surgical centers. And we also recently opened and expanded our ambulatory cardiovascular service. And just a few years ago we were doing about 250 cardiac caths a year. And we're annualizing now. This year we think we'll do close to 2000. So significant expansion of those services. And so I think, you know, again, it's sort of the theme that I started with. You know, this is what systemness allows you to do. It allows you to focus, you know system wide strategic service lines and then concentrate those services in the high growth areas in your system. And as I tell my teams during leadership meetings and town halls, we're a large community hospital, but what I describe is we're a tertiary care medical center on a community hospital basis. And so while we're going to continue to grow those things, I'm probably going to. We're hiring a few new OB GYNs and we'll probably do two to 300 additional deliveries over the next year. On top of the 2,000 that we did last year. We have a level three NICU. We've got inpatient behavioral health. So I know you asked me to say one thing and I did the typical CEO thing and said no, we've got 50 priorities, but it's all really one priority and it's focusing on what are the needs of our community and what do they want to receive locally versus traveling. And then how can we wrap all those services around so that we leverage all of the talents and benefits of being in a big system right close to home where patients are. And that's what I'm going to be working on this year and next year and hopefully for a few years after that.
- [29:05]
B
Fantastic. I think sounds like you've got your hands full. But a lot of exciting areas, growth opportunities in the pipeline. Dr. Vian, so greatly appreciate you the work that you and your team do. So greatly appreciate you taking the time out of your, your very busy schedule to have a chat with us. Allow us to pick your brains a little bit. And I really look forward to seeing you in person at the Becker's annual meeting here in Chicago in April. So thank you so much.
- [29:27]
C
Well, you're welcome. It's a pleasure talking to you. Appreciate the opportunity and I'll see you in a few months.