Blog, The Hospital Finance Podcast®

Our Financially Broken Healthcare Delivery – How Can We Fix It [PODCAST]

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In this episode, we’re pleased to welcome Jason Povio, President and Chief Operating Officer for Eagle Telemedicine, to discuss our financially broken healthcare delivery and how we can fix it.

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Highlights of this episode include:

  • About Eagle Telemedicine
  • Current method of healthcare delivery
  • Who is being adversely affected?
  • What can be done to fix broken system?
  • Where the strongest demand for telemedicine is

Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Jason Povio, who serves as president and chief operating officer for Eagle Telemedicine. In this role, Jason has oversight over all aspects of the business, including operations, program implementation, post-implementation support, credentialing, as well as marketing and business development. He has a diverse background in systems engineering, along with broad experience in healthcare, working in large, integrated healthcare systems in a number of operational excellence and executive positions. Jason received his Bachelor of Science in Industrial Engineering and a Master of Science in Engineering Management from the University of South Florida, along with several graduate certificates in quality and change management. He also holds a Lean Healthcare Certification and is a Lean Six Sigma Black Belt from the University of Michigan. In this episode, we’re discussing our financially broken healthcare delivery and how we can fix it. Thank you for joining us today, Jason.

Jason Povio: Thank you for having me. That was quite the introduction. [laughter] I appreciate the time and look forward to the conversation.

Kelly: Great. Well, let’s jump in. So, Jason, let’s start with you telling us a little bit about Eagle Telemedicine. What are your priorities as president and COO? What is Eagle Telemedicine’s mission?

Jason: Sure. So, to start with, Eagle Telemedicine is a professionally managed full-service telemedicine organization. We’ve been driving virtual clinical service innovations for nearly 15 years now. We started many years ago with hospital medicine, and have expanded over the years into 17 additional specialties by focusing on strong collaborative partnerships, really centered on creating patient-centric service models. As I said, we do offer 17 medical subspecialties now nationwide, and we do this by developing highly tailored clinical models with very low capital investments required by our clients. There’s really no IT or information security interfacing or integration that’s really required. We offer a tech flex model. We do partner directly with our hospital and health system IT departments to securely access host systems where the care really takes place. We truly believe in one patient and one chart.

As far as my priorities go, I’m really centered and focused on fulfilling our mission. I work to foster a dynamic culture and develop talent that’s really going to help drive Eagle forward into the next frontier of telemedicine. Really trying to maintain a position as an industry leader. I’m responsible kind of on a day-to-day basis for guiding the organization and seeking new and innovative care settings to continue to drive access to care. Our mission can really be understood by boiling it down into three simple words: lead, collaborate, and serve, something we created last year, and I’m really excited about. But we really aim to lead our industry in building strong collaborative partnerships and creating access to care by serving the underserved. So I could continue and go on and on, but I know that we’ve got other [laughter] questions that I’d love to get to.

Kelly: Awesome. That sounds very impressive. You’ve said our current method of healthcare delivery in the US is financially broken. What is breaking it?

Jason: [laughter] Enormous costs. The maldistribution of access to care. Inappropriate utilization. Fraud, waste, abuse. It’s kind of hard to distill it into one single thing. But I believe a fundamental restructuring of payment policies with the introduction of new and innovative delivery systems is really required to get us back on the right track. Of course, if we don’t solve for or find some solutions or pathways for what I’ve continued to say is the inescapable math problem of physician and nursing shortages, none of that may matter. In my personal opinion, it really is the lack of alignment between the three stakeholders and healthcare. Healthcare really boils down to these three stakeholders. It’s the patient who’s seeking care. It’s the caregivers who provide the care, and caregivers can be individual physicians, systems, hospitals, and the like. And the insurers who pay for the care. Each of these stakeholders kind of really have a different goal or aim in this equation with the caregiver and the patient probably being the most aligned for most of the time.

However, there can be some substantial goal divergence at times. We could spend an entire hour discussing these concerns, especially as it relates to health insurance companies, but we can probably save that for another time. Telemedicine is, in the overall history of medicine–medicine dates back, what…2,400 years or so. Telemedicine’s relatively new. But it’s been around for quite a time. Quite some time. It’s evolved, and the technology is really driving advancements. Its impact can be felt in many measurable ways, purely by driving down cost and creating access to specialty care not previously available to many, especially in rural America. But it can also play an important role in volume management or utilization for the number of care settings. So, I think it really plays an important part of how we’re going to drive things kind of forward.

Kelly: No, makes a lot of sense. Who is being adversely affected the most by our current system?

Jason: Patients. I mean, a one-word answer, but patients. It’s really the lack of access to care, timely care, the right specialty of care, and then the burden of the debt. Our system is really affecting patients greatly in their ability to get the appropriate care where they are, when they need it, how they need it, and in a cost-effective manner that can continue to really propel them forward on the path of getting themselves in a better place. Especially with chronic disease conditions like diabetes, for example, and proper management of that so that they can stay healthy, stay out of the acute care setting, and kind of reduce the burden on the system at large.

Kelly: Completely agree. And I actually knew the answer to that question. I was like, yes, I got it. [laughter]

Jason: It’s funny. Even those of us that are in healthcare, I mean, we’re patients. We have experienced frustrations. We have gotten a bill. [laughter] We have seen services denied, and if any of us live in certain areas, have tried to seek specialists, you know that that can be difficult, and you can wait a long time to get in to see the physician. So, it’s– [laughter]

Kelly: It’s frustrating. Yes.

Jason: Yes.

Kelly: Yeah. Yes. What can we do to fix this broken system? I assume telemedicine can help.

Jason: It can. If I had the ultimate answer, though, I would be on an island somewhere, I think. [laughter] My own personal island. But continue to innovate. We really need to foster innovation and driving new care delivery models. We’ve always said– and when I say, “we,” I mean Eagle. We’ve always said that telemedicine is the great equalizer in healthcare really disrupting the status quo. It helps to redistribute care and significantly reduce costs across the industry. Now, telemedicine or telehealth, I mean, it’s a very broad category. And Eagle, we play in a few different domains within that. But there’s just so much opportunity to drive care through remote technologies.

Kelly: Most definitely. Do you have any examples to share of how telemedicine is making a difference in the status quo?

Jason: Certainly. I mean, a couple come to mind. I think the first of which is probably more for our financially minded audience members. But a hospital system that we’ve worked with was really struggling to staff their nights across multiple locations. They really struggled to recruit and retain talent. I mean, at the end of the day, we’re all humans, and working nights is not the most pleasurable experience, right? They had, on average, I think roughly a base expense rate of somewhere around 23, 24 hundred dollars a night per hospital to try to staff with physicians. And they did so with disparate resources, the utilization of Locums, overburdening employed staff. I mean, we all kind of heard that story. And they really struggled to kind of manage standards of care with too many transfers of patients. It’s really easy at night either with a Locums or with an overburdened physician to just want to transfer that patient to a different level of care rather than take them in house. And a nighttime telemedicine solution was designed and implemented that really helped to standardize care across those locations and certainly stabilize staffing with a small pod of physicians. We developed what we called stay/go criteria, as an example, which really helped to identify when a patient can stay and when they truly needed to go. So, patients were able to get their care close to home.

At the end, transfers were reduced by– it was somewhere between 30 to 40 percent, and so it really increased the patient census there. The patients received that care close to home. Loved ones didn’t have to travel to see mom or dad. Standards of care were monitored and managed, patient satisfaction scores improved. And again, for those CFOs that may be listening or other financially minded individuals, the expense base really reduced materially. It was just over $800 a night roughly on average for those same shifts that were costing 23, 24 hundred. So average savings of, what is that? Yeah, about 1,500 per night, and 365 nights a year, you got to be close to $550,000 per hospital. So that is a material cost savings for the hospital so that they can reinvest in other resources and continue to provide care to their communities. So that’s more maybe a financially focused example, certainly with some quality elements and aspects to it.

But another one that came to mind was working with a safety net hospital and if anybody knows about safety net hospitals, I mean, they kind of care for everybody that can’t seek care elsewhere. And they manage a lot of care for the underinsured and non-insured patients who struggle to receive that care. We help to develop a model for being able to dialyze patients when they showed up to the emergency department. And eliminate the unnecessary transfers of those patients to other facilities. We’re currently working with them to try to take that farther upstream and develop a viable outpatient community-based solution to really create access to dialysis to avoid the emergency department visit altogether. That’s obviously a struggle because there are finances involved in that, and have to understand where those come from and be stewards of those precious resources, but it’s exciting to be involved in organizations like that that are trying to drive an improvement of care within their community. So, I mean, these are real impactful outcomes simply by leveraging the capabilities of what we can offer through telemedicine.

Kelly: Those are great examples. Are you seeing a higher adoption rate of telemedicine in hospitals the last few years, particularly in rural hospitals?

Jason: So yes, we sort of went through a period, obviously, through COVID where there was an extreme increase in utilization, particularly for infectious disease and critical care services. And so those were obviously directly correlated or linked to the virus itself. But coming out of COVID, we’ve seen a bit of an explosion. I wouldn’t say that it– necessarily adoption. Adoption has increased, but I wouldn’t say that that’s what was the catalyst. It was, I think, COVID showed everybody that this could be done with good quality, and there started to be this thought process about, where else can it be applied? And the needs are coming from all over. Certainly, rural hospitals, but even major metropolitan hospitals.

An example is an inability to manage non-malignant hematology patients. These are patients that certainly have a blood disorder or something going on. It’s not malignant, and so they’re less of a priority than their malignant counterparts. And oncology practices are overburdened at the moment. And so as an example, we’ve seen a tremendous increase in requests for managing and servicing hematology clinics across the country. I think rural hospitals are starting to think about how this can be applied in the community more from an outpatient setting perspective. And so there’s been a lot of interest and a lot of movement towards multi-specialty outpatient clinics where a rural hospital can maybe take advantage of resources invested in a brick-and-mortar location, leverage staff in a way, and manage capacity to actually offer access to a variety of specialties throughout the week to its community. So, it’s been exciting. It’s been fast-paced. For the first time in Eagle’s history, we have actually had to formalize kind of a recruiting effort and strategy for physicians. We’re very successful at it, but given the increased adoption, it’s been a wonderful roller coaster ride for us.

Kelly: It does sound like it’s been very exciting. Specialty coverage is a big part of the growth in telemedicine, and you mentioned earlier that Eagle offers 17 specialty coverage areas. Everything from tele-cardiology to tele-rheumatology. Where are you seeing the strongest demand for telemedicine right now? And is there any reason for that?

Jason: Yes. [laughter] So the specialties that are seeing the biggest demand are the specialties that have a higher prevalence of chronic disease. I think one of the unfortunate outcomes or undesirable outcomes from the pandemic was the lack of care for patients that had chronic diseases. And so these patients went for long periods of time without seeking care or getting management, new onsets weren’t diagnosed timely. And so I think we just have a situation where you have a ton of people in the country who really need to get that care to get their chronic disease under control. And so a few of the specialties that have really elevated have been rheumatology, for example, and helping to manage patients not only in the clinic, but in infusion centers. Hematology, which I mentioned. Cardiology and endocrinology and diabetes management, for example, have been some big ones. And for us at Eagle, I mean, again, very mission-driven organization. The intrinsic value of being able to develop and design cost-effective solutions for communities across the country to help create that access. And to do so in very collaborative ways where we’re partnering with local physicians in addition to being the sole provider in many cases has been really exciting for us as we’re continuing to grow.

Kelly: Yeah, I bet it is exciting times for you all. Thank you so much for joining us today, Jason, and for sharing all these great insights on a very important topic.

Jason: Oh, you’re welcome. I love being able to talk about Eagle, talk about what we do, and then how we’re impacting care across the country. So, I really appreciate the time today.

Kelly: Yeah. And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that?

Jason: The best way would be to navigate to our website, www.eagletelemedicine.com. There’s a ton of information to be consumed from case studies to all of the different solutions that we offer. And then there’s easy ways to get in touch with us to discuss any of the needs that you may have.

Kelly: Great. Thank you for sharing that with us. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…

[music] This concludes today’s episode of the Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.com/podcasts. The Hospital Finance Podcast is a production of BESLER | SMART ABOUT REVENUE, TENACIOUS ABOUT RESULTS.

 

If you have a topic that you’d like us to discuss on the Hospital Finance podcast or if you’d like to be a guest, drop us a line at update@besler.com.

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