Jeff Standridge:
Hey guys, welcome to another episode of the Innovation Junkies Podcast. I’m Jeff Standridge.
Jeff Amerine:
This is Jeff Amerine. Glad to be with you this morning, Jeff.
Jeff Standridge:
Yeah, looking forward to it, man. Listen, we’ve got a great guest. I’ve known this guy for a few years. He’s really made some significant changes in a fairly large health system in our market. Matt Troup, good to have you with us today.
Matt Troup:
Great to be with you guys. Thanks for having me.
Jeff Standridge:
Yeah. Despite the fact that he wanted to play his walk on music this morning, we, uh, we were able to, uh, we were able to kind of set that aside. Um, kind of the, uh, what did the Aggies fight song? Was that what that was? Or it’s not technically there.
Matt Troup:
Yes, yes. And for those, you know, just tuning in here, it was our devotional. I’m going to call it a devotional here right before we got started. For some reason, the camera angle has cut off my spinning head here. I think my Texas Aggie helmet here.
Jeff Standridge:
Yeah. Well, if, even if it hadn’t cut it off, we would, we would actually pop it out when it went to production. So we’re all, we’re all good there. Oh, me. So, so Matt, um, what, you know, I’ve had the privilege of getting to know you, uh, more and more over the course of the last few years. And I know that, um, you know, obviously you lead a, a, uh, a fairly significant health system in Arkansas relative to your size. So tell us a little bit about the health system, the size of the health system, give us kind of, our listeners kind of a little bit of the scope and then a little bit about you and your background just briefly and your role on a day-to-day basis.
Matt Troup:
Sure. I serve as CEO of Conway Regional, and we are a technically three-hospital system. We have Conway Regional, which has 180 beds, and Dardennell Regional, which is a critical access hospital. Critical access hospitals are a special designation within the hospital industry. They refer to rural hospitals that get additional funding from the government because of their location and sort of environment they have to operate in. And then we have a rehab hospital across the street over by Laurel Park that is a joint venture with our physicians. It was created, gosh, probably close to 25 or 30 years ago and has been a great partnership with our doctors. We also like a lot of health systems employ a number of providers. So we have over 90 providers in our network, primary care, orthopedic surgery, general surgery, cardiology, a very broad range of specialties. And then recently, I know a topic near and dear to your heart, Jeff, from an education standpoint, we launched a residency program. So for family medicine and internal medicine physicians. So we have close to, I think it’s 30 now, residents in house that are training up in Dardanelle. They’re training here at Conway Regional as well. And it’s been a great program for us.
Jeff Standridge:
Let’s talk a little bit, but so topic we’re going to have today is going to be around strategy and growth. So to set that topic up, talk a little bit about the growth that the health system has experienced and, and we’ll use that to kind of weave our way into your, your perspective on growth.
Matt Troup:
I think it’s a fascinating story. And what I love to tell, I’ve been at Conway Regional now for about eight and a half years. And prior to this, I was in Little Rock working for CHI St. Vincent and had a role where I had responsibilities in multiple campuses. And my boss at that time, who still is my CHI boss, Chad Adentle, would tell me about Conway and tell me about, at that time, a lot of the turmoil really that was occurring within Conway. We had another hospital coming to town. It was the first time in the then 90-plus year history of Conway Regional that another hospital was actually gonna be built. And so there was a lot of concern about that. So much that we really came into this, and I say we bring, CHI St. Vincent came into this thinking that this was a contraction situation, a situation where we were going to, need to right size our chassis, if you will, because we were going to lose volume, lose clinicians, doctors, other staff to a competitor. And as I sit here today, we’re over two times as large today as we were back then. And we really saw the opportunity to tell a better story and frankly, partnering with not just doctors, but other community members on Conway. Conway is, I know you both know, a very proud community. People love Conway. They move here and they don’t want to leave. It’s a city of colleges. It’s got a young, vibrant sort of feel to it. And when I got here, that’s really what I noticed first and foremost. And if you have that kind of engagement, you have that kind of willingness to work hard and to do what it takes, you can do a lot of great things. And so we turned a situation that initially was a turnaround and kind of shrinking to a size that we thought was going to be our new normal to one where we’ve been able to double our volume, launching a new service lines, new communities that were underserved and position ourselves for the future. So it’s really been a great story.
Jeff Standridge:
So clearly some lessons to be learned there in when the environment is such that many organizations might hunker down as you talked about right-sizing. You guys took a bold step forward in growth and expansion. So talk a little bit about that and what drove that.
Matt Troup:
You know, it’s interesting in health care. We tend to be very nice when it comes to competition. And we are, as a nonprofit, we have a mission that really supersedes competition. But as I said before, I think really what resonated was that we were not going to take this lying down. We weren’t going to sit back. Um, and so tapping into that really tapping into that sense of pride. Um, um, Jeff, I think you’ve, you’ve heard a gentleman speak, um, by the name of, oh gosh, and his name just jumped out of my head, but, uh, we, we had a, we had a consultant come talk to our hospital, um, uh, Tom Atchison. Yeah. Yeah. And he has a phrase that if, if you, um, shoot for happiness, you know, you, you might, you might get a happy staff and that’s, that’s good, you want your staff to be happy. But if you aim for pride, you get happiness kind of thrown in and job satisfaction. And so we’ve really emphasized this sense of pride that we’re going to be one team. You’ve you’ve heard in our community that we’re one promise. We want that word promise is very intentional to combine and congeal us around a central message and a central theme. And that promise is to be bold, exceptional and called three components that really resonated with our community. So we’re bold for our community. We’re bold for our roundabouts, our goofy, idiocentric little things that we have here at Conway, and bold about how we’re different. We’re gonna be exceptional. Healthcare is a continuously, continuously improving field. And I don’t mean just how we run hospitals. I mean, medicine itself is just iteratively bettering itself, improving itself upon research, upon further, you know, review, which oftentimes changes. And so we’re always about providing exceptional health care. And then we’re a call. None of this really Matt Troup:ers if we don’t have some core sense of calling. Health care is too hard. It’s too difficult. I can’t pay people enough to put up with what they have to put up with in a healthcare environment. It’s very, very challenging and exhausting. So we really emphasize those three components in our communication and our strategy. We talk about it at every town hall that we do. And it’s really important that we all are unified on that theme. And I can’t tell you how many times I get that repeated back to me from our staff. And I know it’s something we can measure and monitor and it really resonates.
Jeff Amerine:
It sounds like you’ve got to, you obviously are the keeper of the culture and you’ve developed a strong culture. How does that inform hiring? If you have to let somebody go, is that always a component of the talent side of what you do?
Matt Troup:
Yeah, and you used the word I. I don’t ever feel comfortable saying it’s it’s a that I’m keeping a culture. I really feel like we have a great team here and anything that I have. You know, been able to quote thus far as an accomplishment really has been a team effort, and I think if I’ve been successful in anything, it’s it’s really just engaging people where their heart and their passions are and helping them to be successful. But yeah, so we use a couple of different tools.
We partnered with a company called Talent Plus on our interview process. This has been something that hasn’t been without its fair share of debate, but it’s a tool that when people apply for a position, it gives us feedback on their tendencies, their interests, and where we can help them be successful. And so when we onboard folks, we kind of have a good assessment of their skills and their strengths and their tendencies. And that certainly helped. Also, we, like a lot of companies, have an onboarding process. The leadership development process is something that we’ve invested a lot in over the last several years to really invest in our leaders, because our leaders, our day-to-day leaders, are the ones that really have to carry the torch on this. And then we structure. So…I could describe to you an operating way of being that really tries to hardwire those softer things into how we operate day to day. All three components are really important.
Jeff Standridge:
So I want to go back and revisit the growth just a little bit. So you step into this health system that’s in a bit of a crisis. First time in 90 years, a new competitor has come down the highway, so to speak, and has with very clear intentions of taking volume away, taking customers, quote-unquote, I’m using air quotes here, taking customers away. How did you make the decision?
And then how did you execute on that decision to say, we’re no, we’re not going to hunker down. We’re going to step forward. We’re going to grow. What, how did you make that decision? And then, and then what did you put in place to kind of execute on that decision?
Matt Troup:
So there’s a great book called The First 90 Days by Michael Watkins. I’m a huge believer in that book, but he talks about really assessing your environment. As a new leader, when you get put into a position, take time to assess your environment. Don’t come in guns a blazing with some brand new vision that nobody understands and nobody has a relationship to. So I was very intentional coming in just to get to know people, which really underscores really, I think, the answer to your question. And that is by building trust, by building trust with the medical staff, with key leaders here, both formal and informal, and really listening, not trying to unleash some master vision. I’ve been in health care since 96, I can’t add this morning, it’s too early, but I think that’s 27, 28 years. And I’ve been in a lot of different environments and I could do a cocktail napkin, here’s 12 things you need to do day one. But instead, I really spent time listening. We created what I would call a kitchen cabinet of physician leaders, both formal and informal physician leaders.
We started meeting monthly when I first got here and just talking about the environment, really unstructured time, just talking about what was going on in the market, where each of us saw things heading and ultimately created something that we call our ACM, which stands for Accountable Clinical Management, which is our partnership with doctors. And that was really what launched a lot of great conversations around growth, a lot of great conversations around culture, equality, service, et cetera, that helped enable us to achieve great things. That’s a long-winded way of answering your question, Jeff, but I think trust is probably the simplest answer I can give you. It’s just building trust on day one was so critically important, particularly with this team. It accelerated growth. Great.
Jeff Standridge:
And so on the business side of healthcare, talk about some of the decisions that you made that were, you know, probably decisions that a lot of organizations wouldn’t make in a, in an environment where intense competition has come into the marketplace and, and how kind of the outcome of some of those decisions.
Matt Troup:
Boy, my head goes to COVID and a lot of things that came around as a result of COVID, whether it’s masking protocols, vaccination requirements that came about, ultimately, we’ve got to take a step back and really focus on what’s best for our community and engaging, you know, stakeholders along the way, knowing that some are going to be upset about that and some are going to be very supportive. But ultimately, at the end of the day, you know, as a leader, you have to get to make some difficult decisions. You know, there were there were other things when it came to recruitment. You know, we have specialties here that when we go out and recruit another provider to the market, creates competition, just within Conway Regional. And how we do that really matters. There is a long legacy here prior to my arrival where an administrator would talk to a surgeon and the surgeon would say, yeah, I want to come to Conway. And they would work it all out. And the surgeons at Conway, who had served for a long, long time, had no idea that that guy even existed. We don’t do business that way. We are very upfront about it. And I’ve had a couple of occasions like that where we’ve really had to talk it out and work with the medical staff on those kinds of issues. Dardanelle is a great example. As I’m talking here, I’m coming up with better answers to your question. But when we brought on Dardanelle, Dardanelle was literally circling the drain. In 2019, it was very close to closure and we came in after a for-profit had operated that for about seven or eight years. And at the time, you know, there were a lot of questions at the board level, the medical staff level of what the heck are you doing? And as I sit here today, it is breaking even. It supports a lot of growth, frankly, a lot of referrals back to Conway for cases and things that they can’t do.
Matt Troup:
So the community’s won because they’ve retained their hospital. We’ve won because we’ve better their overall financial performance. And clinicians were a part of that ultimate success. So sometimes you have to make difficult decisions. You gotta try to focus on doing it the right way. And that’s worked out well for us so far.
Jeff Amerine:
What do you see as some of the challenges to growth going forward? I mean, it doesn’t seem like the healthcare environment ever gets any less challenging. So I’d really be interested in your perspectives on that.
Matt Troup:
You know, I just attended the American College of Healthcare Executives annual Congress. It’s the first time I’ve been in about five years. And I was really struck by the complexity. And everybody says that every year about how complex healthcare is. And it’s just like the acuity of patients. People keep saying patients get sicker and sicker. It’s almost amazing that we admit anybody alive anymore. They’re so sick. But you know, the complexity and you know, there are a lot of health systems now getting into direct to employer contracting. So we’re working out the middleman, the managed care plan and contracting directly with employers. We’ve got to have a lot of data. We’ve got a lot of have a lot of experts that know about, you know, actuarial tables, utilization trends and patterns. How do we manage that, you know, as well as just the population health, community health, keeping patients out of the hospital. So that takes infrastructure and data that health systems aren’t, societies just don’t typically have. There’s a lot of promise with AI. And frankly, as more and more health systems do this, it gets more and more scalable. So, but that is an interesting, you know, aspect of growth that we’re starting to get into, but have a lot to learn for sure.
Jeff Standridge:
I know quarterly you take your leadership team and your expanded leadership team, which is about a hundred or so, 90 or so directors and managers and what have you offsite to do some leadership development. We talked about that and we’ve had the opportunity to run some innovation sprints with your teams over the course of the last few years. Talk about some of the innovations that you guys have brought into the health system over the course of the last eight years, seven and a half, eight years.
Matt Troup:
Well, you know all those innovation sprints start with trust falls so we do trust falls by the masses because. Right, right.
Jeff Amerine:
They teach you that at A&M, right? But they forget the part about there’s gotta be somebody there to catch you, right?
Jeff Standridge:
Yes. I think, yeah, I’m thinking, you mentioned trust falls in A&M and I’m thinking of the video of the guy who’s, they’re telling him, okay, you got to just trust people and they’re all standing behind him and he falls forward.
Matt Troup:
Yeah.
Jeff Amerine:
I’m sorry.
Matt Troup:
Yeah. Well, yeah, you know, that’s that’s a story, you know, with our innovation sprints that I love telling as well. We had this innovation, this idea, I guess, probably 17 or 18. I think it was 2018 where we brought our leaders together in partnership with with you, Jeff and others. We we we taught people how about innovation and have you come up with an idea? How do you put a business plan around it? Things to consider. And we segmented those 110, 120 or so people into groups. They selected projects, they presented to us as an ELT. And executive leadership team and three teams were ultimately selected out of that group with a presentation to our board at our fall advance. Advance is another word for retreat, we don’t retreat, we advance, so that’s the play on words there. Nonetheless, yeah. So that was a great project, a lot of great learning going on with those leaders who had to put that plan together, present it. And the one that was selected in 2018 was this concept of a call and referral center that could help navigate patient care. So you go to see your primary care doc, you’ve got an orthopedic, let’s say issue that you wanna have looked at, it can be very challenging and time-consuming to make that handoff from the primary care doctor’s office to the specialist. And so we created this infrastructure, the business proposal to the innovation sprint was to create an infrastructure that can help make that handoff, it can also help manage chronic diseases. So as folks develop congestive heart failure or other chronic conditions help manage their journey through our health system. Well, just as we were getting that started, COVID hit and that team quickly pivoted to become a COVID call center, helping to schedule testing, when vaccines were available, scheduling to get vaccines.
As you all know, we had to be very flexible and nimble in the COVID pandemic. We had a drive-through for about 18 months, COVID drive-through for about 18 months of staffing that, making sure that the tests were getting processed, providers were being, and patients were being communicated with, was a huge effort. But that muscle that we built in that innovation sprint really got applied in a completely different way.
And now today, as we’ve kind of come out of COVID, that team is really refocused. We’ve invested additional resources into that. And to your point, Jeff, this was a this is now a revenue source. This is now a source of growth because as we’ve been able to improve quality, reduce readmissions, that’s additional revenue to our health system. And it’s it’s sort of odd for a hospital administrator to say this, but we want to keep people out of the hospital.
And not only is that a good thing to do, the right thing to do, morally, ethically right thing to do, it’s also a good business. And that really is sort of the transformative aspect of healthcare that keeps a lot of guys like us awake. How do we pivot our thinking from how do I get patients in a bed to spend the night with me in a hospital to how do I keep them out of the hospital? How do we more effectively, cost effectively provide that care and then how do we help employers save money because frankly, the cost of healthcare for employers has increased 55 % in the last 10 years and that’s just not sustainable either. So it’s a challenge but I think a really, a fun one really gets you back to the core of why you got in healthcare in the first place which is to help people be better.
Jeff Amerine:
Quick follow-up on that one. It seems like, with the Affordable Care Act and different things, there began to be some pretty significant disincentives for readmissions and things like that. Do you think, so that’s kind of the stick side of the sort of federal incentives for doing right by the patients, but do you think that some of those incentives are going to change towards wellness, towards hospital systems being very intentional about making sure they get good outcomes on wellness and whether or not someone’s ever admitted. How do you see that changing?
Matt Troup:
It’s really interesting. There’s a book I read several years ago that compared and contrasted the American health care spend versus other countries. And we’ve all heard this before. We spend way too much in the United States on health care. And our outcomes aren’t great. Our community wellness isn’t great.
And really where we differ, if you look at this on two different aspects, if you look at healthcare spend and then community wellness, so things like access to mental health services, access to childcare, access to affordable housing, food, good quality food. When you look at those two things, you add those together, the United States is actually on par with a lot of countries in the world. We spend way too much on healthcare and not enough on some of these other programs. That could be a politically sensitive topic, but the data backs this up. So where healthcare is shifting is really more on how do we provide those social services, if you will, maybe in a way for our community. We’re not gonna be a childcare provider to the entire city of Conway, of course, but we can certainly follow up with patients. We can ask questions about their resources. Do they have money for food, good quality food? Can we get them connected to a homeless shelter or to other community resources that kind of fill in the gaps and how do we partner with those organizations to do that? So that’s really the shift, you know, and where I see a lot of incentives moving because effectively we’re going to spend this pool of funds in one aspect or the other. How could we do that more efficiently?
Jeff Amerine:
It seems like the mindset is going towards the causation versus the symptom. You know, social determinants of health, being preemptive, that makes a lot of sense.
Matt Troup:
Yeah, that’s very true. The challenge we have, again, in this country is just the, it’s so heterogeneous. We have a rural community that goes without a lot of basic primary care services. And we have a community here in Conway that’s more affluent and that thinks that every neck pain or any injury on their body is some life-threatening illness. So you have the really super worried well, and then you have this other population that is so sick they have no idea. And so how do you pivot and serve both communities well is a challenge for sure.
Jeff Standridge:
So what keeps you awake at night? You know, CEO of a large health system and lots of things going on, 2X growth over the course of the last five to seven years. So you have a fairly large footprint as an organization. What keeps you awake at night? What do you worry about?
Matt Troup:
You know, I think the the coherence of keeping a team on the same page and focused. We can have so much going on that a lot of times you can feel like you’re spinning your wheels and not getting there. So making sure that the team is is all rolling in the same direction that we’re of one accord. A lot of times doctors, hospital administrators and community members and staff can all kind of be on different pages, have different priorities and so.
Keeping that same sort of sense of team and commitment and family intact as we grow is something that keeps me up at night. You can get really distracted on politics and people’s wants and needs and things that kind of distract you. So those are the kinds of things. But I will say that when it comes to my job, if I ever lose sleep, it’s generally because I love it so much and I’m trying to find ways to do it even better. I really feel passionate about healthcare and great work that we do and the people that I get to be around. These are some of the best people in our community, frankly, who sacrifice so much of themselves and their personal life to serve. It’s a great story to be a part of.
Jeff Amerine:
So the Aggie football coach situation doesn’t keep you up at night.
Matt Troup:
You know, I have been so frustrated for so long that, you know, but in an odd way, and this is kind of it’s germane to your podcast here. You know, with Texas entering the SEC, we’re going to restore a rivalry that really that kind of tells A&M’s existence. You know, why we exist goes back to the very core of our hatred for the University of Texas. So.
Jeff Amerine:
Yeah.
Matt Troup:
I have a feeling we’re gonna have a whole new spirit and things are gonna be great next year. I drink the Kool-Aid every year, even though I get very disappointed, but you know.
Jeff Amerine:
You have to, you know, if you’re, if you’re an Aggie football fan, a Razorback football fan or a Navy football fan, it’s an exercise in patience and resilience every year. There’s not a lot of celebrating involved in recent times for any of us, but anyhow.
Matt Troup:
Yes.
Jeff Standridge:
For sure. For sure.
Matt Troup:
You just have this tendency to set expectations way, way, way too high. And yeah.
Jeff Amerine:
Exactly.
Jeff Standridge:
This year will be the turning point. This year will be the turning point. We’ll be perennial national champions for the next decade. So.
Jeff Amerine:
That’s right. This is our year.
Matt Troup:
Yeah, yeah, my family makes me sit out. We have a TV outside and make makes me go outside during the 8 in football games because I just I have to yell and scream and my house backs up to the Tucker Creek Trail. So I’m sure people out on their Saturday evening walk are really concerned about the guy who’s completely losing his mind. You know.
Jeff Amerine:
Yeah. That’s always a good time to take off any of your biometrics too. Cause it’d be like, Oh, not to have a fib and cardiac arrest or a stroke. I need to take this off.
Matt Troup:
Yeah.
Matt Troup:
Yeah, yeah, you just completed a workout.
Jeff Standridge:
Your family, your family’s begging you to go back inside. Your neighbors are calling your wife, begging her to get you back inside. So, um, so if we were to just, just, uh, landing the plane here forecast forward three years, you know, um, from today, you know, what’s, what’s one accomplishment that you, you hope the health system makes, uh, or, or, or maybe a, uh, a milestone you hope to see the health system accomplish in the next three years.
Matt Troup:
Hahaha! You know, um…
I would say we are the partner of choice. In Arkansas, we have a lot of small independent hospitals that are under a lot of financial strain and are reluctant to join a large system for fear of losing their autonomy. Their ability to serve their community is the way they have perhaps for decades. I would like for us to be known as the partner of choice for those hospitals. And I’d also like for us to be known as a partner choice for our doctors, for our community. You know, we’re a central Arkansas-based health system. Our focus is central Arkansas and we exist because of partnerships. Doctors, others believe in us and are working together can create some synergy. So, you know, very high level. It’s that sense of, hey, they are the partner choice and if we’ve got to be a part of the health system in order to survive, then we want to be a good partner with Conway Regional. I would also like for us to have the best darn family medicine residency and internal medicine residency program in the state. I really am proud of the work that we’ve done there. I think, you know, when I retire someday and looking back on things that I’ve been a part of, I think that’s going to be one that is really going to make me proud that I can say that I was part of the team that did that. That’s really helping to solve a lot of the problems that we talked about before with community health. Primary care is the route to do that, to keep people out of the cardiologist’s office, to keep them off the cath lab table or the OR table is good primary care. And so I want to see us grow to be a real regional presence in primary care, serving particularly that vulnerable community in rural areas.
Jeff Standridge:
Very good. We’re talking with Matt Troup, CEO of Conway Regional Health System. Matt, we really appreciate you being with us today.
Matt Troup:
Hey, you bet I enjoyed it. Giggum Aggies.
Jeff Amerine:
Thanks for coming on. That’s great, Matt.
Matt Troup:
You bet.
Jeff Standridge:
This has been another episode of the Innovation Junkies Podcast. We’ll see you next time.