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Becker’s Healthcare Podcast
Transformation, AI, and Community Health at Ballad Health with Tony Keck
00:15:35
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- [00:02]
A
Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year, those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies, and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit Beckershospitalview.com and click on the events tab in the upper right.
- [00:38]
B
Hello, everyone, and welcome to the Becker's Healthcare Podcast. I'm Scott King, thrilled today to be joined by a very special guest, Tony Keck, chief transformation officer with Ballot Health. Tony, how are you? Thanks so much for joining us.
- [00:50]
C
I'm doing well. I really appreciate the invitation to talk.
- [00:54]
B
Of course, you know we're going to need your expertise on a lot of topics here. Always a lot going on in health care, but especially now. But before you do that, Tony, I was wondering if you'd please just tell us a little bit about yourself and your journey in healthcare.
- [01:06]
C
Sure. You mentioned my Chief Transformation Officer title. That's just a couple weeks old. I now have responsibility for strategy and analytics and IT and digital services and operational excellence and project management and our research department. That's a big change from just a few weeks ago when I was our chief population Health officer had our growth group also had behavioral health. But every few years in Ballard Health, we switch around executive responsibilities. It's a succession planning exercise which gets us exposed to the entire organization, but it also brings new blood, new ideas into different parts of the system. Been with Ballot Health since its inception was with one of its predecessor groups, Mountain State's Health alliance for three or four years. Before that, Prior to that was in government for about seven years working for Bobby Jindal and Nikki Haley. So I've been really honored to be able to work with communities for a long time.
- [02:10]
B
You don't really hear about a lot of providers or health systems doing that. Is that right? Like, just like switching up the executive responsibilities every now and then?
- [02:19]
C
Yeah, we, we put a lot of time into succession planning because we, we know it's a tough business that increasingly you need to have a lot of specialization, but at the same time, you have to have a broad view of what's, what's going on in the world. And so if you're looking at the trends that affect health systems, you got to be able to understand and work in the government space, the payer relations space. You have to understand strategy Increasingly, you really have to be able to operate in the IT space as a leader. So unless you're getting exposure to all of those, we just don't think it's possible to develop a leadership team over time that's sustainable. Not just for five or 10 years, but for 30, 40, 50 years.
- [03:09]
B
Yeah, I just think it's so interesting and so great that everyone, when they switch, kind of understands or gets a sense for what everyone else has been doing and what it takes to keep the system going. So I think that's wonderful. And now let me ask you about trends in healthcare. Which ones are you paying attention to right now? Tony?
- [03:25]
C
Well, I hate to start out with probably the answer of the day, but certainly AI and cyber security, I think they probably go hand in hand. We want to be able to focus on AI as a tool to improve our clinical outcomes and patient experience. But I think we will be just as busy as fending off the bad actor threats that AI is increasingly making possible. You know, separately from that, we have to be able to keep up with the payer's use of AI that goes beyond what we think is reasonable to control fraud, waste and abuse. In that sense, we're really in many cases also the patient's advocate because, you know, many of these payer decisions increasingly being made with AI impact patient health and what they ultimately pay. I think more broadly affordability. You know, I've been around long enough to seeing several major shifts in payment and practice starting with DRGs. That's how I got my start in healthcare. And we're in the middle of, I think, one of these big shifts right now. But no matter how much technology and how many payment incentives and how many legislative programs we've seen to throw at healthcare, it's still outgrowing the ability of many families to pay for it. And it sort of feels like a big Jenga tower right now. And it's a, you know, and the problem is it's a zero sum game. We try to save money in one sector by shifting it to another sector and, and that just doesn't work or it hasn't worked. It doesn't reduce cost, the consumer ultimately and maybe we just need to, to start, start over.
- [05:21]
B
What are you most focused on and excited about right now in healthcare?
- [05:26]
C
Well, you know, going forward I'm really am excited about what, what AI is going to be able to bring, bring to the, to the table. And so, you know, in my previous population health role, we were focused on one of our North Star goals, which is to reduce the years of potential life lost in our community. And, you know, that's a statistic that's tracked worldwide and in the United States county by county. And it basically is a measure of early death. And not surprisingly, in the Appalachian highlands, we have more early death than in most of the rest of the country. And so we've got a goal to reduce 100,000 years of early life lost over the next decade. So to do that, we've been really doubling down on the things that we do well and then trying to do more of that. And so a good example is screenings. We do a pretty good job of screenings right now, but if we can go the extra mile and, you know, increase our screening rates by 5, 10, 15%, we know that we're going to save lives. We made a heavy investment in smoking cessation. You know, copd, pulmonary disease, lung disease. It's a big deal in this region, one, because we have really high smoking rates, two, because of black lung from the coal mining industry. And so we've been putting a lot of investment into catching lung disease early, helping prevent it, and we're really seeing that gain a lot of traction. So I'm excited about what AI is going to continue to bring to the table to be able to better do all that. It's not just AI, it's really some of the new biotechnologies that are coming out and so on. We're really at, I think, a pivotal point where we finally have the technology to do a better job, a more personalized job, getting down to the genetic level in improving people's health. And so that's a, you know, that's a huge sea change. And I think you're starting to see some of it with GLP1s. That's, you know, most of our admissions are due to heart disease or some aspect of it. And, you know, you trace that back to obesity and diabetes and so on. And by fundamentally changing that through GLP1s from a population health perspective, it could be as big of an intervention as we've ever made in public health. So that's, I think, pretty exciting. You know, something I'm proud of that we've done in this organization is we've really improved our balance sheet over the years and our operational efficiency. But at the same time, we've been making these really heavy investments in, and not only access, which lots of people are doing, you see, you know, cranes in the sky in almost every major city around the country. We don't have major cities, we have small cities. But we're still investing in access. We just built a brand new addition onto our children's hospital. Our NICU programs expanded and modernized. We're expanding our ED at our level one trauma center. We just added new beds to one of our hospitals that was, you know, full to the top. That's all great, but we're also investing in sort of going beyond beds and thinking about being a true community health improvement organization. And so the major investments we've made in behavioral health, moving from a hospital based program to a community based program has been, I think, really impactful. We've invested lots of money in our nurses and you know, our turnover is now the lowest that it's ever been. We're reaching out to people who are most vulnerable and enrolling them in care programs that have shown three to four times return on investment in terms of the money that we spend on uninsured folks who frequently visit the ED. And we've gotten 91% of them connected with primary care on a regular basis. So it's a win win for everybody. So those are some of the things that we've really been working on and we're just going to build on them in the future going forward.
- [10:15]
B
What are some of the things that, that helped yield that kind of growth, Tony, where you can help? There's so much expansion and, and so many more patients can be helped now.
- [10:24]
C
Well, I think that the, the merger between Wellmount and Mountain States was a big contributor to that. We had a lot of unnecessary duplication in the region. We had hospitals that were 2 to 3 miles apart that were 20 to 30% full, losing tens of millions of dollars a year that just went out the door and didn't benefit patients at all. And by eliminating that wasteful duplication, we were able to take those dollars and reinvest them in these programs. By the time we get through the first 10 years of our merger, will have invested well over 300 million of incremental dollars in these new programs that again, go beyond putting heads in beds. I think we've also done a lot of work just generally becoming more efficient. We are a Medicare break even organization. A lot of organizations around the country set that as a goal many years ago, but very, very few have actually been able to attain it. And we have, we have to be because we're reimbursed less than almost every region in the, in the country from Medicare and other payers. And so we have to be incredibly efficient. And, and we are. And so again, when, when you're able to, to build on that efficiency, you're able to potentially invest some of it in, in some of these, these new ideas and new, new services.
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B
Absolutely. And Tony, the last question I have for you. How have you evolved as a leader and what advice would you give to, to leaders that are evolving now?
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C
Well, I always look at myself, you know, 10 years in the past and think, man, you just did not know what you thought, you know, back then, right? So it's, it never, it never, it never stops. And I, I just took an AI course with my, my son at the University of Michigan. Both of us took it together because he's at the beginning of his career and I said, you know what, AI might be threatening your career path as a, you know, a sort of a young professional and, and me as a, you know, an older professional, I need to keep up with what's going on. So we both took that course and I think being lifelong learner and making it fun is really critical. I work with a lot of students from the University of Michigan and the East Tennessee State University School of Public Health and mentor quite a few of them. And one of the things that I am always, I'm full of all sorts of advice, but one of the things that I'm always strongly suggesting is that they get experience actually laying hands on people. You know, there's plenty of times as a management student or administrative student in health management, public health to get experience going to meetings and doing spreadsheets and all that stuff. But, but working as a cna, a transporter, community health worker, emt, even in volunteer roles is really an incredible, is incredibly important to understanding the constant stress and uncertainty that's present not only in our patients lives, but our team members lives. And so I say that for that group, but it extends, it extends to all of us as professionals, regardless of when we're in our career. We're putting a lot of effort internally into management, rounding into starting every meeting with a mission moment and system. Wide tiered safety huddles where they start on the units early in the morning and by 9 o' clock in the morning it reaches the executive level about what's going on in every single unit in the system that potentially is a safety issue. So those are all things that keep us really close to the work. And I think it's easy as a manager with everything that's going on, being constantly attacked, you know, under payment changes from the federal government, from the payers, cyber threats, I mean all the things, it's easy to get distracted from what's really happening on the ground with the people that are are basically generating all the outcomes for you. And so that's probably one of the most important pieces of advice I can give is just to be consistent about that.
- [15:19]
B
Absolutely. And Luke, that's fantastic advice. Really appreciate you sharing that with evolving leaders. And thanks for sharing all your insight with us on the podcast. It was a great conversation. I look forward to working with you again soon.
- [15:30]
C
Thanks for the time.