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- [00:02]
Athenahealth Representative
@ 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.
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Laura Dearda
This is Laura Dearda with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Timothy Collins, Chief Executive Officer at UCR Health. Timothy, it's a pleasure to have you on the podcast today.
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Timothy Collins
Thanks for having me. I'm excited to be here.
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Laura Dearda
Absolutely. Now I'm looking forward to learning more about some of the cool things you're doing at UCR Health. I know it's such a unique time in healthcare right now and certainly a lot of growth and innovation happening, but you know, challenging times as well. So I'm looking forward to talking through more of this with you. But before we dive in, could you introduce yourself and just tell us a little bit more about UCR Health?
- [01:18]
Timothy Collins
Sure, I'd be happy to. My name is Tim Collins. As you had said, I'm the Chief Executive Officer of UC Riverside Health. We are the clinical arm of the UCR School of Medicine. So it's where the physicians practice, where we train the future physicians. We have residency and essentially it's where patient care is provided and the educational experience is provided as well to these future physicians. I spent nearly three decades in healthcare. I started and, you know, just had a passion for healthcare. I realized early on in my career that I didn't want to make or produce things. I wanted to have an impact on people and that each day when I went home from work, I always wanted to make sure that I left the world a better place. And I hope that that continues. And plus or minus, good or bad, I think I've had an impact over my close to three decades. So I've spent a lot of my experience in health systems. I recently worked for an organization in San Diego and then about two years ago I came to UCR and really my main focus here is to expand the clinical enterprise, the network, the clinics, the integrated offerings that we have for patients in this marketplace because this market is under resourced and we're looking at about a 20 to 21% growth rate to 2049. And right now our primary care ratio to population is the lowest in the state of California, and our specialist rate is the lowest in the state of California. And our hospital beds is lower than the average in the state of California. And with the population growth that I had mentioned before, that will decline. So we really have to come up with some solutions for the future to create more physicians, to attract more physicians to this marketplace, to provide more care and care opportunities at the lowest cost possible. And so that's why I came here, is to be able to build the clinical network, to be able to expand the number of residencies that we have, the number of medical school students we have in the school of medicine, and to really be proactive in addressing the needs for this future that we have in the Inland Empire.
- [03:45]
Laura Dearda
Absolutely, that makes a lot of sense. And it really is a helpful lay of the land for the market that you're currently serving. And you know, from your perspective, what's the biggest winter success story you've had from this last year or so?
- [03:58]
Timothy Collins
I think that we're at the heart of something that's absolutely critical, as I mentioned before, addressing the future needs of the population. And unfortunately there's no magic or silver bullet that will solve this problem that we have. It'll take a lot of organizations working together and a lot of collaboration. And this year we announced in June a decision from the University of California that we will make an investment in the Inland Empire, we call it the Inland Empire, which is Riverside and San Bernardino counties, to create a health sciences campus in Riverside. And it will be a multi phase project that will, that will expand our clinic locations from 3 to 10. It will have what we call a specialized ambulatory center on this 20 acre campus. And it will also, it's already entitled for a 280 bed hospital for the future. So we're really excited about that as part of this solution. And right now we're continuing to build the clinical network because as a lot of your listeners will understand, marketplaces that have been impacted by the entry of some of the private equity firms has created tremendous fragmentation for providers. They've lost access to contracts, they've lost access to their patients that they've held for years. And as a result, there's opportunities, opportunity to create an integrated network in the Inland Empire. And so that's also what we're trying to do at the same time is to create this integrated clinical network among providers that really props them up for the future, gives them access to contracts, ensures that that patient physician relationship stays in place, and also addresses the care gaps that we have for our future. So we're really focused on laying the groundwork for, for a sustainable long term clinical and academic model in the Inland Empire.
- [05:55]
Laura Dearda
Absolutely. I love that. I think that makes a lot of sense and certainly a lot to think about. But providing that type of access to care is no easy task. And so seeing those opportunities continue to grow is critical. Now, from your perspective, what are the top two to three issues that you focus on right now? What are top of mind for you and your leadership team as you're thinking through the decisions that need to be made?
- [06:18]
Timothy Collins
I think one of them is what I had just mentioned, which is provider and care access. And I had mentioned that the population has grown rapidly and it will continue to grow rapidly. We've got certain dynamics that are going on in this marketplace that are causing the constraints. One is businesses are moving to the Inland Empire because of the lower cost of housing. And I think most people have probably heard about the high cost of housing in California in general. So people, young families are seeking out lower housing opportunities. So we're seeing just this boom right now with housing, but again, not enough providers. So we're trying to create the opportunities to keep more of our School of Medicine graduates local and we've developed a medical group and a physician network to do that. So we're very focused on creating the access that this community needs and as I had mentioned, the fragmentation that exists as well. So we need to make commitments to patients about the service that they'll receive. I believe that unfortunately patients have become a commodity and that's far from what I believe. I believe we need to have a patient centric model that listens, understands their needs and then is unique to what they're looking for. If it's online scheduling, if it's online communication, for really busy parents who have to fit in scheduled appointments when they can, if it's offering urgent care, if it's offering locations that are different for them, it's really dealing with the care access and recruiting and retaining physicians. And we're also working with our sister UC organizations. So that's also the beautiful model for UCR as we expand. This has been a UC Regents initiative and a priority for the state to make the investment in this marketplace. And the other UC medical centers have made commitments to support our growth. So we're not going it alone. And we'll have the support from providers, you know, other organizations bringing physicians into this marketplace addressing care gaps in the short term so that in the long term we can do it ourselves. So really, those areas right there, provider and care access, we need to improve that. The second one, I think, is operational readiness. And I think I won't belabor the OBBBA implications, but I think everybody's reeling right now on how is that going to impact each one of our communities and each one of our patients. It will be unique. Between eligibility constraints, reimbursement delays, red tape, all these other things, and then future reimbursement levels, the cost of care that keeps going up, as we've seen, you know, cost and utilization keep going up in this marketplace, which is driving up overall costs. And without the reimbursement to support that, it's going to be an unfortunate situation for a lot of people who are going to lose insurance. So we're doing a lot of preparation for that. The third one is defining our brand promise. And I had mentioned the ideas about access, but we put into place some strong metrics around, and we've met with folks with patients and developed some focus groups to identify ways in which they see value being created and how they want their care provider and how they want to work and contact their provider. And we've also started to use more nurse practitioners in our model as well. So it's looking at those things, like when you call us, we want to get you in for an appointment within 10 days. When you call us, we want to make sure we find out your referral and your authorization so you have control over your future. When you email us with a medication request, we get right back to you within 24 hours of your email. So we're tracking all of those things. And we want to make a really strong brand promise to our patients in the marketplace. So I think overall, it's addressing some of the current issues we have with care access. And I had mentioned before about building the network for the future. So we're in the planning stages for that, looking at how do we prepare ourselves for the changes that have occurred with reimbursement and some constraints on eligibility. And then the third one is defining a patient centric model that really allows us to monitor our performance and gain input and understand and listen to what the patients want so we can create a better performance framework for the future.
- [10:55]
Laura Dearda
That makes a lot of sense. And I really appreciate you digging into some of these topics because I know it's so important to have the type of care model that's transformative, that is nimble, and that can respond to Some of the big challenges that you mentioned in terms of access to care and how things are changing at the state and federal level too, for some folks, and then being able to pivot and address that in a meaningful way. I think too, when you look at, you know, that patient centric care model, the ability to keep that patient front and center and anything that's happening and need changes, you know, I know that's so important, so critical for hospitals and health systems. So, you know, when you think about your current transformation and how things are going, how do you work with the clinicians and really keep their perspectives top of mind within the leadership of the organization. Organization, so that you're able to make the right adjustments as time goes on.
- [11:53]
Timothy Collins
I think the main priority for us lately has been making sure we're engaging and engaged. And so we've got our chairs and our physician leaders who. What I found is if they understand what and why and how, they can help us with implementation and they can help us with the how. Sometimes the best ideas that we have aren't the best ideas in reality, because, you know, it takes different perspectives to make sure that we're addressing the critical. I think some of these challenging problems, they continue to persist because we don't think holistically enough. We don't engage people. So that's really the main area lately is to engage, understand, and to listen and then to make adaptations and adjustments to what we thought rather than railroading our plan. It might take a little bit longer, but in the long run, you have champions for the change. You have people who understand how to change. And I come from, from a philosophy, Laura, that when I, when I look at physician leaders, I've always felt that the more you share, the better they understand and the better partners they are. So I, I am a big fan of communicating frequently and holistically. So financially, clinically, operationally, so they understand. So when they go out and try to support change or change themselves, they can articulate the why. And the why is so important in healthcare nowadays because some of the changes that are being made sometimes don't make sense, to be honest with you. But at the face level, you need to get these individuals so that they're engaged as leaders and they understand. So we've been doing a lot of communication, a lot of sharing, a lot of, you know, iterative discussions back and forth around the priorities. And what we found is when we do all of those things, they're highly engaged, they're supportive, and they begin to communicate our vision and our mission for Us and they become, you know, participants rather than renters, if you are, they're owners of the solution rather than renters. And that's really where we want them to be as partners, seats at the table, understanding and support, supporting our, the change as leaders.
- [14:10]
Laura Dearda
Got it. That makes a lot of sense and is, you know, a really smart way to approach it. I love that kind of philosophy of it. You know, looking at it might take just one bit longer. But having those physician champions can make a big difference. And fully understanding the why leads to a stronger how to get it done. So I love that. And speaking of the future, when you look at the next few years or so, where do you see some of the biggest opportunities for growth in the next few years?
- [14:36]
Timothy Collins
I think there's a couple different areas that we're focusing on. One is I mentioned before, expanding our clinical footprint, improving clinical access. We also need to be adaptive to what patients want. We've seen a tremendous uptick in our telehealth and what we have seen is that if we can make it convenient for patients, they will use that option most of the time as a preference. And it's interesting because, you know, we pride ourselves on having an amazing psychiatry network and now we're at about, I think about 90% of our visits are online or telehealth. And that's. I don't know if there's a, you know, a best practice out there, but I'd probably say that's pretty close to it. And it's really convenient for patients. It's convenient for the clinical teams too because they can go from patient to patient to patient without having to worry about being on site, etc. So we're able to line them up that way. So it's really looking at both our physical footprint and our virtual footprint. The second one is I mentioned that the challenges of expanding the workforce and we have to address the workforce pipeline and it has to be driven by, you know, increasing number of slots that we have overall. Right now our medical school has capacity for 500 medical school students. The unfortunate thing for us right now is that we don't have a network that's sufficient to support those 500. We can only support about 325. So we know we can recruit or, you know, attract more medical school students to address this problem. And we also need to retain them in the marketplace. So we need to expand our residencies with partnerships and things like that for our future. And just a little note, we're a community based medical school so we rely on our providers in the marketplace to support these clinical rotations. And we don't have a hospital right now, but that's, as I mentioned before, part of our plan. So it's also tied to only going to solve this problem by collaboration as well. And so we need to have collaborative care models and partnerships with hospitals for residents, addressing the gaps in care collaboratively and being able to recruit and retain physicians for this marketplace and create a sustainable model for them to stay in this market. The debt structure that most medical school students have as they come out, it's unbelievable. So we're able to offer some scholarships through the state and through some very gracious donors that allows physicians, if they practice in the marketplace for five years, their debt is covered. And so as a result, that helps these physicians really become critical members of the community. So I think expanding our footprint using our every means that we have around, expanding our workforce force and our pipeline around providers, and we're only going to be able to do this through collaboration with organizations in the marketplace. We have to think differently around our partnerships. It can't be a, you know, a win lose equation. We need to create win win equations that, you know, one organization can't win everything. It has to be done that, you know, with a broad understanding that there's a give back to the community for the future. And we need to make investments together. And that's the way that we're going to solve the problem. Not by one silver bullet or one solution. It's going to be really a gumbo, if you will, of a lot of ingredients that need to go into the solution that's going to craft an outcome for us.
- [18:24]
Laura Dearda
Absolutely. I love that analogy. And especially given a little spice to, to that gumbo and you're in really good shape there. So that's awesome. And I love the way you kind of talked about the bringing the physicians in, getting them to stay in the community and doing what you can in order to support them as they're starting off. I know that it's a really critical time, especially after they've been in school for so long in training as well, and then looking at, you know, giving back to the community and making those partnerships a win win in as many ways as possible. You know, I think that's so important because it's easy to lose sight of that necessity to support partners in that same way and have a mutually beneficial connection. Especially, you know, in times when there's a lot of stress within the healthcare space.
- [19:12]
Timothy Collins
It is. And I, you know, the challenge that exists or I'll say the opportunity is that when you have a place where physicians call home and want to be here and have a passion to be here, they will do whatever they can to have an impact for their community. We have focused on recruiting medical school students who are from this community and will stay in this community. They might have to leave for a rotation here or there, but we want them to be a part of this community and a part of the solution. So that, you know, we talk about the. How we need to understand better some of these physicians that are in this marketplace right now understand what their patients need. So that is more of the holistic view. And that's what's going to help us with population health. That's going to help us address some of those care gaps, that's going to help us address some of those things where we talk about social determinants of health and gaps in care and things where these physicians will know how to connect their patients more effectively. Because they grew up in this marketplace, they understand the market and they know the physicians. They're pure physicians that they can refer to and they can work on behalf of the patients who really need them to move the needle on some of these population health issues around diabetes, you know, behavioral health issues, you know, hypertension, a lot of these things that, you know, pediatric asthma, all these things that we're really trying to change. You're not going to do it with just documentation and tools within an electronic medical record. I firmly believe that it's also the social component and the networking, the understanding of what's, what's in the market. Maybe some of these individuals face the very same challenges that patients are facing right now. So it's also being able to have those honest, truthful conversations that will change people's futures.
- [21:21]
Laura Dearda
Absolutely. I love that. In a really, really strong point, when you think about how you can build a community alongside of the organization. Before we wrap up here, I wanted to get your sense in a few words on leadership. What do you think it will take to lead a thriving hospital and system over the next five years or so, especially given some of the things we've talked about today, how healthcare delivery models are evolving with technology and resources and more.
- [21:48]
Timothy Collins
I think that we unfortunately have in some cases evolved into a me too approach on our strategy? I think that organization needs to understand its brand and its commitment to its marketplace. What are you really going to do? What are you really going to do? Well, and it allows organizations to focus on those things. I've seen organizations where they start to acquire assets because they think, wow, this is a growth opportunity for us, and they end up wasting a lot of money because it's not tied to their core mission. So I think that's the part that's probably at the forefront of me. What's our mission? What's our vision? How do we deliver on that and how do we also adapt and innovate based on that? So we can't. You know, if something needs to change, it still needs to tie back to your mission and your core values of the organization. That's why people come to your organization and remain at your organization is because of the mission and because of the culture. It's what you do. It's how you do it. So I think as we move forward, we need to be very quickly adaptable to changes in the marketplace and then use some of the innovation that's available to us to be more efficient, but never lose sight of our mission and our vision and our values that we live with. So when we make decisions, those need to be forefront. I think also that from a leadership perspective, we need to be very strategic listeners and we need to understand better. When you understand what people need, you're better at delivering the care and the outcomes and the solutions. It's when you don't listen and you just hardwire it and it isn't what the community needs that you'll continue to fail and struggle. And that's also that connection back to your mission. The third thing I'd probably say is as a leader, it's resilience. And I can't tell you how many times I've been disappointed with a result that, you know, it. You know, it didn't get where I wanted it to get to at the beginning. But as a leader, to be honest with you, that's also part of creating the best solution. And it's the patience that you need to have and the resilience you need to have around coming up with new opportunities, but most importantly, being inclusive with others and getting different perspectives and viewpoints along the way. I'm a big fan of being inclusive, understanding diverse perspectives. And I think we make better decisions and our outcomes are much higher quality when we bring in different perspectives and we ask questions that are humble, humble inquiry that, you know, maybe we think we know the answer, but the humility that we as leaders need to have as we move forward needs to be even greater because these problems continue to be problems because the solutions we came up with are not working. So we have to understand at a deeper level why they Keep happening and understand how we can engage people who are on the front lines, ask the right questions, empower and engage. And some of the best opportunities that I've ever come across, to be honest with you, are when I'm rounding and I ask people, what do you think? What do you think we should do? And I'll get even down to the folks who are the environmental service workers who I think are heroes, actually, that during COVID they continued to come to work, continued to place themselves in the role of, in a way, caregivers for patients, providing, you know, they were, they were ensuring that the rooms and the hallways were clean. They, they have better eyes than I do. They have better eyes than most people because they see everything. And I love to tap into those individuals in particular because I can get so much from them and I can engage them. And when you make it their idea, it's amazing what you can do. It's a multiplier. When you engage them, you find out what they think, how would they go about it? Because they have such. They're so intuitive around identifying solutions to problems that we usually can't solve. So all these things relate to how we need to solve problems in the future and how I am one individual trying to create a culture of engagement, resilience, empowerment, leadership. So each individual should be a leader and they should understand the what and the why we're trying to do it so we can live out the mission.
- [26:16]
Laura Dearda
I love that. Tim, thank you so much for joining us on the podcast today. This has been such a fascinating and inspiring discussion and I look forward to seeing you at our CEO CFO Roundtable in November. Just a great opportunity to continue this discussion and learn from each other.
- [26:31]
Timothy Collins
Thanks for having me and I look forward to being there in November.
- [26:36]
Athenahealth Representative
At 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 lines. Practicing medicine is complex, but running a practice can be that much simpler. With Athenahealth, see how simpler is healthier@athenahealth.com.