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CEO Roundtable: Health Systems

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For this CEO Roundtable podcast, leaders from local health systems sit down with Springfield Business Journal Executive Editor Christine Temple. This month’s guests are Max Buetow, president and CEO of CoxHealth; Michael Calhoun, CEO of Citizens Memorial Hospital; John Myers, president of Mercy Springfield Communities; and Dr. Matt Stinson, Jordan Valley Community Health center president and CEO.

An excerpt from the podcast follows.

Christine Temple: There was a national survey that was conducted late last year amongst the largest health care leaders in the country. They’re saying that business confidence in the industry was up about 8 percentage points from a year ago. How would you all characterize your confidence of the health care industry?
Dr. Matt Stinson: I think it’s a complicated question. It’s such a big industry, but when you boil it down, the health care of the region occurs because the health care organizations work together. I have confidence in the people that I work with and the health care organizations I work with. At the state level and at the federal level – that creates a whole lot more noise and it’s more nebulous, but I think working with the organizations locally, I think we can do things to affect the health care of the region very effectively.
John Myers: I couldn’t agree more. If you look at not only Springfield but the southwest Missouri footprint, we’re seeing growth in lives, people moving here, and I think a large part of that is due to the health care infrastructure we have. I know we say this a lot, but Springfield is really a medical hub for southwest Missouri.
Max Buetow: I think if you look to the macro picture of health care, though, it’s an industry born out of necessity because there’s a need for people to have received care to remain healthy, and I think it’s an industry that has survived many ups and downs over the course of time. So you build a certain level of resiliency and muscle to be able to pivot in critical times. We saw that during the pandemic. We’re seeing that now with economic and workforce and other challenges that other industries are facing, but maybe the difference is we’ve done it more than a time or two, and so there’s a need which creates a mission which creates resiliency, and I think we’re willing to step up to that.
Michael Calhoun: There’s a lot of uncertainty at the big-picture level, especially just with the rising costs in health care and we’ve all seen the numbers related to health outcomes. But locally and just how I feel about health care right now is more optimistic, and I do feel like we’ve become more resilient in recent years and I’m very hopeful that we’ll be able to continue to grow what we provide our communities and do it better.
Temple: As we’re sitting here now, we’re just a few days out from the inauguration, and of course we have a new administration with President Trump and last week Gov. Kehoe was sworn in. Some of the questions around the Trump administration policies, maybe around rollbacks of some Affordable Care Act subsidies or perhaps Medicaid cutbacks. There might be expanded rules about pricing transparency, reform to the pharmacy benefit manager systems. Lots of kind of question marks. What regulation improvements are you advocating for or perhaps against? What are some implications that you’re concerned about right now?
Myers: There’s a lot of noise out there, but I’m not sure how much we’ve actually heard from President Trump outside of Make America Healthy Again. When I think about this, there’s a couple things – the waivers that are expiring for telehealth and hospital at home, I think renewing those would be helpful for CMS because that allows us to bring care to the patient where they want to receive the care. There’s a lot of noise within the big pharma for 340B. That program is a federal program that’s really important; it’s where hospitals and other covered entities get a discount on drug prices and then we are able to pass along those discounts into savings to create community health programs, charitable care. Obviously, if those were to expire, I think that would put all of us in the community in a difficult situation.
Stinson: I’d say 340B is one of those areas for us that’s important, too. We’re also looking at some other areas, say in the state level, so I know there’s some movement around the foster care system. We take care of a lot of foster care kids at Jordan Valley, and so how Children’s Division functions as well as maybe how the medical side of care is delivered to those kids who are in foster care would be one of those areas I think we would advocate for meaningful change. Right now, it’s cumbersome to make some changes, especially in the behavioral health side on medications for kids who are in foster care and you need to go through a set of approvals to change a medication, and it creates challenges both for the kid as well as for the family who’s in crisis.
Calhoun: The 340B program was mentioned; that’s obviously important to all of us and something that we’re focused on – medication access to our communities and being able to pass along discounts. The other thing is just improve relationship with payers and fair atmosphere related to prior authorizations, and being able to get access to care for patients is really important. It seems like at the state level there’s a lot of support for making changes to that to make sure that we’re all advocating for the benefit of the patient, and that really is what we’re focused on right now and something that I’m interested to see how that goes upcoming from a federal perspective.
Buetow: I think we have so many wonderful things that are happening at the state level right now. The Kehoe administration, he’s building an incredible team around him. We see a lot of faces that have deep, rich health care experience. Several members of his team have come from the Missouri Hospital Association, people that have been in and around health care, so I think he’s put experts around him to advise him in great positions, but we have elected officials from this community that have always been swinging big bats for us and will continue to do so. Lincoln Hough has been one of the biggest game-changers I think for this region, in at least at the time I’ve ever been here. Our superstar health care champion that sits on the rep side is Melanie Stinnett, and she’s proposing some of that legislature to Michael’s point that’s going to help us create some of that reduction in bureaucracy that health care so much needs in order to meet the demand of making sure things continue to be affordable for our customers and our patients.
Temple: We’ve talked through many challenges that you’re facing at your health care systems. What are the things coming down the road that you’re planning for? What would be some of the big challenges in the next five, 10 years?
Buetow: It’s an interesting statistic, but health care is now the No. 1 target for cyberattacks, the health care industry. And it’s vaulted to the top of that and probably has a pretty wide margin on No. 2. As a community, that’s one of the things that we’re looking forward to having conversation around. Because, as an example, if we were to have a cyberattack at CoxHealth, that would impact every single one of us sitting at the table today. So, we don’t need to be developing plans in isolation of what happens. We need to have collaborative conversations about what happens if one of our health care partners in this community falls victim to a cyberattack. As much of our effort that we’re putting into that, every single one of us is vulnerable. I do think that’s going to spill over into a broader community collaborative conversation.
Temple: It seems like the more maybe AI applications that you adopt, the more entry points may be opened.
Buetow: It’s interesting because the advancements in technology help us to better secure ourselves, but also give opportunity for people to break through that security. There’s almost nothing that’s safe anymore. And so it’s more about even let’s do our best to keep people out, but what do we do in that situation to make sure we’re back on our feet, we’re taking care of patients and we’re not significantly disrupted if something were to happen.
Myers: And there are technologies now where five, seven years ago, they may have been standalone, but now everything’s integrated into your system. So, there are things that have technology in them that you would never guess need to be vetted before you can integrate that in.
Calhoun: People may be surprised the amount of time we spent worrying about this and creating plans to help protect ourselves from attacks, knowing that the best we can do, we’re still vulnerable. I think that’s a welcome discussion, how we can all do this better together.

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