In this episode, Jon Besler, CEO of BESLER, reflects on our first one hundred podcasts. Topics include past guests, top states for listeners, and key topics of the past and future.
Mike Passanante: Hi! This is Mike Passanante. And welcome back to the Hospital Finance Podcast and our 100th episode. Today, I’m joined by Jon Besler who is the CEO here at BESLER. And we thought we’d just take a few minutes to reflect on where we’re at and where we’re going with the podcast, engage with you, our audience, and take a few minutes to thank you for coming back each and every week and paying us the honor of being with us and inviting us into your space. So, thank you.
And Jon, welcome to the show.
Jon Besler: Absolutely, Mike. Thank you very much for having me on. This is a significant milestone for us, our 100th recording of the Hospital Finance Podcast. I’m delighted to be on again. This is I think the third time that I’ll be on over the past year. I really appreciate the opportunity to speak to our audience.
And a very special thank you to all of our audience members who have, like Mike had said, participated over the course of the last year. I hope we’ve brought timely and relevant content to all of our listeners.
Mike: Yeah, and we launched the Hospital Finance Podcast on February 18th 2016. And we’re already just about two years in here. It seems kind of crazy.
Let’s talk about why we decided to do this in the first place and why we keep doing it.
Jon: Sure, Mike. Thank you. And we understand that we need to meet our audience where they are. What we try to do is provide relevant and timely content not only to our clients, but to our listeners, to the folks that dial in to our website and look for answers to their questions that they have from a hospital finance perspective.
We certainly understand that not everyone will want to digest a white paper on a weekly basis or a monthly basis or maybe even on an annual basis. We understand all the pressures that our clients are up against. And certainly to add one more thing on to their list isn’t always the easiest thing to do. And certainly, via the podcast, we can create the content and boil it down into 10- or 15- or 20-minute clips that our listeners can listen to at their leisure. On their way in to work in the car, if they take the train, they can dial in through iTunes or SoundCloud or any of the other platforms that we offer. And again, we can meet them where they are to get the information that we think they valuably need.
Mike: Now, we’ll talk about that more in a minute too. But just for fun, I think we’ve pulled some interesting stats, and we’ll share that with the audience. We’ve had over 60,000 downloads of the podcast already. Did you ever think it was going to be that large?
Jon: You know, I’m not a betting man, but had you given me a bet two years ago when we started this thing and said that we would have over 60,000 downloads and listeners, I would’ve given you odds on that bet, and I would have felt very comfortable that I would have won that.
Now, when I look back, our first 10 podcasts were all internal information that we set out and we wanted to share with our audience. And candidly, I thought, “Well, if it’s just us talking, will our audience continue to dial in?” Not that we don’t talk about relevant things all the time, but after a while, we all start to hate the sound of our own voice.
And so, certainly, by allowing our team the space to do it, but then as we started to get out into the marketplace and talk to some of our clients about being participants in the podcast and all the relevant industry team members, I really think that, at that point, it started to take off and people really understood the momentum behind this, that it’s not just BESLER talking about this, it’s our clients, it’s our industry, it’s physicians.
There’s a whole series of topics just around healthcare reform. And I think that as some of those topics really took hold, the listenership got out there. And you know how it works with word-of-mouth. And certainly within our client base, if the CFO is listening to it or the director of finance, and they find value in it, odds are they’re going to recommend it to one of their team members to dial in as well.
So, really, to get back to your question about did I ever think we would have that level of listenership, we certainly hoped to when we set out. Did I think we would get there this quickly? I would have to say no. But I’m very appreciative that we have.
Mike: Yeah, certainly. We’ve been privileged to have people really all over the country share the podcast. And we’ve seen that, and we’ve heard from them. And again, it’s just a real privilege to have that.
Touching on some of the topics we’ve gone over—and there have been many because, really, there are no lack of topics in the healthcare space these days—our first episode was about bundled payments. And we’ve covered that extensively throughout the show’s history (and I expect that we still will). What do you have to say on that, Jon?
Jon: Absolutely! I think that bundle payments and the emerging payment model, CJR, everything that CMS and the Center for Innovation have really put out there, when you think about it, it makes logical sense.
We’re trying to bend the cost curve. We know that healthcare can’t continue to rise at the level that they traditionally have. And for emerging payment models, it really makes sense. And to boil it down to even a more basic term, EPMs and bundled payments seem to be the next wave of DRGs. It’s just another grouping of how to get funding to a hospital in the most efficient way and have that taken care of in the most efficient way.
So, logically, it makes sense. What is a struggle for us—and I think on the provider side as well—the struggle for us is to really think about what is this administration going to do with bundled payments. Yes, they might make sense. But if they never get implemented, how do we really live in that one foot in, one foot out kind of world.
So, I think it will be a continued area of emphasis not only for us to continue to talk about and for our clients to continue to participate in and be aware of. The fact that the administration has taken away a lot of the mandatory components of it, I think has somewhat delayed the inevitable. I think whether it’s this administration or the next or the one beyond, we are going to continue to look at ways to deliver care in a much more efficient care setting. And bundling payments in that method just makes logical sense.
Mike: And certainly, you’ve kind of spoken to it from the sense of a government program, which obviously Medicare being the largest of the payers (it really drives the train in a lot of ways). But as we’ve seen and talked to some guests on our podcast, there’s no lack of bundles in the private space either.
Jon: That’s right, exactly. And obviously, what we see the government doing, we see the private insurers following suit—so when we go back and we had a podcast (or a few podcasts) on readmissions and that impact, and we’ve seen the private insurers latch on to that concept and say, “Well, now we want a readmissions clause in our commercial contract,” and providers have had to either adapt or negotiate with that as well.
And very similarly with the EPM and CJR, we see the private insurers latching on to that and saying, “Well, if it can save us money, if it can save the program money, it’s just a different program. It’s the commercial program versus the governmental program.
And certainly, if it makes business sense on the insurance side, obviously, they have a lot more leeway when it comes to administering what they want to as opposed to the federal government which, as you know and as some of our guests have talked about, there’s a lot of red tape to get an idea, not only off the ground, but then implemented and following suit with all the constituents.
Mike: Right! And you’ve touched before on the range of guests that we’ve had on. And they’ve gone from elected officials to healthcare policy experts, providers, payers, even other vendors, really a cross-section of participants in the healthcare landscape. Why don’t we take a few minutes and just revisit some of those.
Jon: Sure, sure. Absolutely! And to get back to your question earlier about did I really ever think that we would have not only the amount of listenership, but the volume and quality of listenership and participation that we’ve had, I think our guests have, like I said, ranged in not only level but what their experience and expertise is and positions within healthcare finance.
And to have a US representative that we had on from New Jersey 7th congressional district, Republican Leonard Lance, great insight as to what is happening from a state level. And obviously, his input on the federal side.
We’ve had Mark McClellan who’s a former senior fellow at the Brookings Institute in Washington DC, former commissioner of the FDA under Bush, and administrator of CMS.
And these are very topical and timely. These are the folks that are creating the policies that, yes, we might get to vote on and massage, but it’s their votes and their ideas that are really taking hold. We like to think that we might play a small part in that as they dial in to what we publish, not only through the podcast, but also through some of the white papers and articles that we’ve released, and they participate in it from that perspective.
And if we’re able to share our views and our participants are able to share their views as well and they’re dialing in, you hope that it creates this sort of snowball effect of what we’re talking about and what we’re ultimately massaging into federal policy that not only might but will impact all of us at some point of our lives.
Mike: And we’ve been honored to have providers on as well. And some of them, we’re lucky enough to call customers.
Jon: Absolutely! And that’s an important part of what I really view as our podcast. It’s really the community of participants that we have. It’s not just a BESLER idea. It’s not just an outside counselor or outside advisor. It’s our customers that are participating—not only dialing in, but actively participating and sharing their view of the world because no real better outlet for some people to talk about the issues that impact them.
And some of these things might be state-specific. Some of them might be hospital-specific or systems-specific. However, when I look at the healthcare community, these issues are being batted around across the country, whether it’s the S10, whether it’s CJR, whether it’s identifying areas for opportunity with patient access and collections like Barbara Tapscott from Geisinger had dialed in and spoken about—more areas to look out for financial health professionals in general.
These are all issues that not only our clients are dealing with and then want to come on the program and talk about, but if it gives not only them a voice, but the listener on the other end to feel that this isn’t just my hospital’s issue, that other hospitals and very reputable hospitals across the country are dealing with and grappling with, I think there’s not only a lot of strength in numbers, but there’s a lot of community that we can talk about these issues, raise them to the level of they are concerns, and then hopefully come up with solutions and ideas that we can then take back and incubate and talk about and really get the word out of.
These are issues that we need to address. And this is how we can make the healthcare world more efficient, safer, a better outcome for not only the patients, but the entire community.
Mike: Jon, I pulled a few stats I thought might be fun to share. First is the top states for our listenership. I wonder if you think there’s any surprises there. But let’s go down a couple in order. Top state, California.
Jon: Interestingly enough, as a New Jersey-based firm, I would have thought that we would have more listenership here in the northeast. Many of our clients are in that northeast corridor. Certainly, population-wise, absolutely in California. That would make a lot of sense as a single state. But I am a little bit surprised that some of our listeners on the West Coast are dialing in more consistently.
Mike: And if you go down the list, you have New York (which is obviously northeast, in our backyard), Texas, Illinois—big states. New Jersey comes after them. So our New Jersey fan base needs to pick up the ball.
Jon: Well, there’s only so many of us. We’re population dense…
Mike: We’re dense.
Jon: But not necessarily population voluminous.
Mike: Right! Okay, I’ll give you that. Florida, Pennsylvania, Virginia, and then Massachusetts to sort of round out the top ten. All interesting states, and a lot going on in each of them.
Jon: That’s absolutely right. So when we look at—we talked about some of the state-specific issues. When I look at California, not only the state budget crises that they tend to face from an ongoing perspective, they’ve had a significant issue with the S10, for example. And so I wouldn’t be surprised if a lot of listeners from California specifically dialed into that.
We’ve been very active with some representatives from California talking about the impact of implementing the Medicare Cost Report Schedule S10 and what financial detriment that would have for the state of California.
So, I don’t know if that particularly correlates within the stats. But as we talk about some of these state-specific issues, absolutely.
When we look at Florida—you mentioned Florida and Virginia—those are two states that did not expand Medicaid under the ACA. So understanding that they would have some very state-specific issues from a Medicaid perspective as well as a DSH standpoint and just other funding issues.
So, if you look at those federal DSH dollars that did not make their way through Medicaid expansion to those two states, I’m certainly not surprised that those states in particular would want to dial into a program like this and learn about ways that, aside from what happens from a legislative standpoint that they might not have control over, what are some of the interesting things that they can do and learn from our membership on creative ways to help bolster their finances.
Mike: Yeah. And one of the things that it’s always interesting to look at and find out is how your listeners engage. With a show like this, you can do it right on your desktop, you can listen to it on your phone or your iPad.
And for us, really, it’s those that we would call iOS devices (iPhones, iPads, folks coming in from iTunes). And they’re not in the office, right? They’re out probably at the gym or relaxing or shopping or doing some other things out and away from their daily routine.
Jon: Right! Well, again, to get back to that, one of our goals was to meet our clients and meet our listeners where they are—and participants. And understanding that when you dial into the office every day, your task list might be somewhat left over from yesterday and last week, and is only going to accumulate over the next eight, nine, ten hours, however long you might spend behind your desk, that we needed an opportunity to not only have our listeners be able to participate at their desktop if, for example, they decided to eat lunch and dial if they had an extra 10 or 15 minutes that day or, again, on their commute, or at the gym.
I think the interesting thing about our community is that I consistently hear that people want to make a difference. People want to be productive and they want to effect change in some way. And so the workday doesn’t just last 9 to 5 anymore.
And I think specifically with this community, we need to look and work “outside” of those traditional office time hours. And the fact that technology is there to allow our members to do that, that’s wonderful.
If someone wants to, again, dial in in their car as they’re driving in to work and listen to two or three podcasts if they have a half hour commute or so, well, that’s a great opportunity for them to kick off their day.
And hopefully, we give them some things to not only think about, but maybe potentially implement and have some more productive conversations when they get into the office because they’ve already cued up their day.
Their work list, their task list might be as it is. But if we can help expedite and jumpstart their day and again think of creative things or give them some new things to talk about and be even more productive, I think that’s a great goal for us and a great attribute for our listeners.
Mike: Well, Jon, it’s been an honor to host one hundred Hospital Finance Podcast episodes. I’m certainly looking forward to the next hundred. And I hope our audience is as well.
Jon: Absolutely, Mike! And I really appreciate what you have certainly done for the Hospital Finance Podcast. I know that to host a hundred episodes, when I look down through the stats, I think we’ve had some participants that have spoken three, four or five times, but you’ve been here for all 100 of them. So congratulations. I’m glad to hear that your voice certainly hasn’t tired. And I look forward to not only the next hundred, but the next hundred beyond that as well.
Mike: Thanks, Jon.