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The Year of Flexibility — Issue #9

The only constant in 2021 was the need to be ready for change

Greetings and happy New Year to everyone.

I have been excited to do a Year in Review newsletter for some time because 2021 was a year of tremendous growth for Core Clinical Partners, and I am very hopeful for what lies ahead. At the same time, I have struggled to know what to say about this past year in healthcare, because it was different for everyone.

The one constant is that it was bad in some way for nearly everyone at different times in different places. Between the COVID surges, the nursing shortage, general burnout of healthcare workers, scarce resources, and a patient population demanding specific treatments of hospital staff, it has been a year of frustration and trial for many in healthcare. 

Thinking back on last year, the only other constant was a need to be nimble no matter what came next. As a company that is spread across different regions, from Ohio to Louisiana to Oklahoma to Arizona, our clinicians and operational leaders experienced different challenges at different times as waves of the Delta variant reached different locations. I am extremely proud of how the Core team handled all of these challenges with our characteristic flexibility and commitment to partnership. 

But honestly, like many people, I started 2021 expecting a very different year than the one we got. I started out trying to plan for a return to normal, or at least trying to predict what a new normal would look like.

What we planned for in 2021

In January last year, I remember we were hopeful. The winter surge was on the downswing and we were trying to figure out what the rest of the year would look like from a staffing and volume perspective. We were doing as many emergency medicine and hospital physician services groups do: trying to predict volumes, establishing metric goals and action plans.

Here at Core, we were planning to get back to some kind of business as usual. COVID had disrupted or altered some of the process improvement work that we normally bring to our partners. So instead of thinking about the normal processes for ED flow, patient satisfaction, and geographic rounding on the hospitalist side, we were thinking: clean waiting room vs. dirty waiting room, how do we separate COVID from non-COVID?

Now, COVID isn’t over and we are still trying to predict volume surges, but one thing that has remained constant is hospitals and health systems need to provide higher quality care at a lower cost. In other words, now more than ever, they need partners who can provide value.

Thankfully, I believe we’ve built a company better able to deliver that than most, and a lot of that in 2021 came down to being nimble.

Different waves at different times

Probably nothing exemplifies that more than what happened at our partner site in Louisiana. In May, Core announced that we would manage ED physician services at St. Francis Medical Center, a hospital in Monroe, a small city in the north part of the state. Less than two months later, the Delta surge threatened to overwhelm the hospital.

Our Vice President of Clinical Operations, Mark Canada, traveled from his home in St. Louis to be on site. What he and the team were able to accomplish is really a feat of operational excellence, flexibility on the ground, and extraordinary teamwork by everyone involved. We wrote an entire newsletter about Mark’s experience, but the short of it is that, far from being overwhelmed, St. Francis Medical Center became a crucial center of care for COVID patients, the hospital’s reputation in the community immeasurably improved because of its ability to care for patients safely and quickly, and deliver life-saving monoclonal antibodies to those who needed them. Even as patient volume surged, quality metrics actually improved, and patient satisfaction soared.

Meanwhile, Core continued to grow. Between myself and COO Jessica Long, we hired throughout the year in expectation of future growth. Then, in the Fall, that growth came in the form of new contracts in Oklahoma and Arizona. And then Delta hit those regions as well.

As a company, we didn’t just experience one wave. We experienced several waves at different times in different places. Through everything, our team pivoted as needed to serve our partners and the communities.

There is no doubt that thousands of care teams around the country have acted heroically over the past year during these extremely trying circumstances. But I believe Core was especially helped by two things.

First, nearly everyone on our team was hired to start their own department of the company. When Kelsey Wood started as Director of Revenue Cycle, she knew she was the department. When Kevin Yerovsek started as Director of Recruiting, he knew he was the department. When we hired for those roles, we hired people with an entrepreneurial mindset, people who were able to wear many different hats while helping us build infrastructure. This became a major strength in an environment like we have had for the past two years. Kevin and Kelsey and others on our team came to build out their departments, and with that comes the ability to pivot and change as circumstances require.

Second, I think we’re able to be more nimble because we can make final company decisions at the operational level. There is no private equity board here overseeing our decision-making. There is nobody who is not in the company who thinks of themselves as responsible for the company, so we can do what we think is best operationally, and we can make those decisions fast. I truly think this is a huge advantage.

There is no one-size-fits-all

This brings me back to the very first newsletter I wrote this year. In it, I wrote about one of the most important lessons I’ve taken in my career: there is no one size fits all way to do partnership.

Our flexibility as a company has allowed us to adapt to local conditions in different places throughout the country. And the RFPs that we have responded to and won show that any group, no matter how big or well-financed can always be replaced by someone willing to put in the work and deliver value.

My challenge in 2022, as Core continues to grow, is both to preserve our flexibility and nimbleness as a company and also to use that nimbleness on the ground to deliver quality and value wherever we go. (One change I’m going to make as of now is to scale back the frequency of these newsletters, from monthly to quarterly).

No one knows what will happen this year with COVID. Just like I was wrong about things getting back to normal in 2021, there is no way I can tell you what the future will hold when it comes to variants, volumes, or healthcare in general. But I can predict at least one thing: whatever comes, we will need to stay nimble.

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