Health:Further

In this episode, Vic and Marcus sit down with David Dill, CEO of LifePoint Health, to discuss LifePoint’s approach to healthcare in smaller communities, emphasizing partnerships and local impact. David shares insights on LifePoint’s transition from a public to private company under Apollo, which enabled long-term investments in areas like rehabilitation, behavioral health, and data management. The conversation covers LifePoint’s national quality program, partnerships with Duke, and the import...

Show Notes

David Dill is chairman and chief executive officer of Lifepoint Health. In this role, he is responsible for the development and oversight of Lifepoint’s strategic priorities and organizational growth, advancing the company’s mission and strengthening its culture enterprise-wide. He joined Lifepoint in 2007 as executive vice president and chief financial officer before serving in his most recent role as president and chief operating officer from 2009 to 2018.

Before joining Lifepoint, David was executive vice president of Fresenius Medical Care North America and chief executive officer in the East Division of Fresenius Medical Care Services, a wholly owned subsidiary of Fresenius Medical Care AG & Co. KGaA.

David is a former chairman of the board for the Federation of American Hospitals (FAH) and currently serves as a member of the FAH’s board and Executive Committee. He also serves on the American Hospital Association’s Health Systems Committee. He is immediate past chair of the board of directors for the Nashville Health Care Council and remains an active board member. Additionally, he serves as a director on the boards of R1 RCM and the American Heart Association's Greater Southeast Affiliate and is a member of the board of trustees for the Murray State University Foundation.

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What is Health:Further?

Every week, healthcare VCs and Jumpstart Health Investors co-founders Vic Gatto and Marcus Whitney review and unpack the happenings in US Healthcare, finance, technology and policy. With a firm belief that our healthcare system is doomed without entrepreneurship, they work through the mud to find the jewels, highlight headwinds and tailwinds, and bring on the smartest guests to fill in the gaps.

If you enjoy this content, please take a moment to rate and review it.

Your feedback will greatly impact our ability to reach more people.

Thank you.

All right.

We are recording the health further podcast live from Nashville health care sessions hosted at the country music hall of fame by the Nashville health care council.

And, uh, I just got off stage doing a panel with, um, Anna Hagooey and Adam Bowler.

We were talking about all things in the investing world and fresh into the podcast box with, as always Vic Ghetto, but also, uh, my very, very, very, very dear friend, uh, and one of the most influential, powerful people in, uh, healthcare in the United States of America.

He may, he may not like that, but I think modern healthcare.

So I, I probably can point to them for the source.

Uh, David Dill, who's the CEO of LifePoint Health, David.

Great.

It is great to be with you.

I'm, uh, we're sitting here and I'm looking at so many.

Friendly faces, and it's good to see everybody all back together again.

If I get distracted during some of this, it's because somebody's making a funny face at me.

Outside of one of these windows here.

But I'll try to, I'll try to maintain focus.

Yeah,

we're in this fishbowl, uh, where everyone can see us, but they can't hear what we're saying, which is kind of cool and kind of distracting.

Let's talk about them.

Yeah.

David, um, Well, first of all, just, just really quickly.

I mean, your, your reaction to Nashville health care sessions this year, you, you've, you've been involved on the board of the health care council for years now.

You've been in this industry here in this city, uh, almost two decades, right?

I mean, you know, how does it feel to this city start to actually convene one of the most important convenings for healthcare in the, in the country annually now.

Um, and just the response and the electricity out there is fantastic.

Well, this is a, as you mentioned, this is year two of this event.

Uh, it's something at the healthcare council and our board have been talking about for several years.

Uh, it's one thing to, uh, you know, bring in donations and contributions and membership fees and dues.

from member companies, uh, and we deploy those resources by convening groups together.

Well, as the as the community continue to grow, literally, we were building up reserves that we had to question ourselves.

What do we do?

As a as a as a membership company, we had two options.

One dividend the money back out to the members, or if there's value in this, let's put the money to good use.

and make some investments in the city.

And we felt Nashville was getting to the place, uh, with with infrastructure, with hotels, with, uh, you know, flights coming in and out from all over that the time was right.

So about three years ago, we began planning what we now know is healthcare sessions.

And as I look at even the name out there, it plays off of and we may talk about this a little bit more as the, uh, as the The discussion goes on.

It plays off of this collaboration and music industry that really built Nashville into what it is.

And Marcus, you and I have talked about this.

I think collaboration is one of the things that makes Nashville pretty unique.

And I give the musicians a lot of credit.

for that.

And as health care continues to grow and evolve, we want to make sure that collaboration continues to happen.

It's the only way that we're going to be successful to really create something that's lasting and meaningful.

So Sessions is a play on that.

Uh, and last year to, to, to watch it all come together.

And now this is year two and we'll continue to build off of this.

So it's really exciting to see investments that we've made along with the city to to bring a couple of thousand people together, uh, in a place that people want to come to anyway.

It's not that hard of a sell, uh, versus flying all the way out to the West Coast or up to New York City or Boston up in the Northeast, uh, come to Nashville and you can see a lot of different things.

That was one and two.

Um, Nashville is really evolving in the healthcare community from a provider centric, uh, largely a provider centric, uh, you know, piece of the economy and, and part of the sector to now with technology and you guys are great examples of that and there's so many more and now we have Oracle and we have Amazon and so Nashville is changing and we need to evolve and change with it and that was really what led us to this investment and to watch it come to life and sit here and see all these people, uh, walking back and forth, it, it's really exciting.

Well, we're thrilled to be here and to be able to record this podcast, uh, live with all the energy going on around us, but just to segue off of your last point about how Nashville has changed in terms of our healthcare industry.

It really has evolved rapidly over the last decade, right?

From this heavy, heavy provider centric industry into, you know, a pretty diverse industry.

Obviously you had all of the.

folks that were surround, you know, consultants and things like that.

There were sort of staffing that were surrounding, but really over the last 10 years, we've seen data technology, make a really big move into this city.

And also even, you know, at least offshoots of the pair ecosystem are starting to be here as well, right?

Can you talk about how that is reflected in the partnerships that are now possible to happen right over the course of the last 25 years, technology has pretty radically changed the way that health care is delivered paid for, um, you know, and and even the access that patients have to their own health care information.

Technology has been a massive, uh, Advancing force in that it also is changing the way that organizations can work together from the perspective of someone who has worked on the health system side for for quite some time.

How have you seen technology change the way that partnerships can be structured are structured and how does it make them better?

Yeah, well, there's a lot that's in there and, uh, Maybe we break it down into what I'll call economic partnerships, uh, where you have kind of shared interest, shared ownership, and some non economic partnerships.

Uh, and we have examples of both.

I'm sure both of you have some great examples of both as well, but, but you're right.

If you go back, you know, 15 years ago or so, um, I think about the makeup even of our board at the Health Care Council and the membership of the Health Care Council.

It looks a lot different.

It looked a lot different than it looks today.

And I just finished a meeting a few hours ago upstairs and when I look around that table, we would not have had all those voices around that table 15 years ago.

And it is really a result of.

The recognition that health care is evolving and health care is changing and technology plays a big role in that.

And so, uh, we have adopted that at our company, uh, getting better control and having better control of our data to share, to make better decisions, to have more viable partnerships with others that we can all be successful.

So that has really been at the crux of, of, uh, investments and decisions that we've made as a company, uh, to invest, whether it's in, you know, just public health.

block and tackle electronic health records, which was the first phase of this.

We have a big partnership with an organization that's helping to kind of sit over the top of all of our different pieces of technology to bring real decision making, um, capabilities to our people on the front line.

Not just a fancy dashboard for David to look at or for our CFO to look at, but for our operators at the unit level.

to look at on a day to day basis, a minute to minute basis to make better clinical decisions.

And we're just really scratching the surface of it.

The balance of it is there's just, it's, there's an insatiable, uh, amount of technology that's out there and we can only adopt and pay for a certain amount of it.

So picking our, and choosing our spots is probably the biggest challenge that we have.

It's not because we've run out of opportunities, I can assure you that.

But it is, there's only so many things that we can get done.

Yeah, I mean, what I wanted to touch on is there's an opportunity, I think, to empower your caregivers at all different licensure levels.

to deliver better care, be more efficient, and also get better fulfillment, enjoy their job more.

And so maybe, is that one of the metrics that you're looking at as you think about where should we spend time and energy in technology?

Yeah.

Is can we empower our people?

Yeah.

Because really, the people at Life

Yeah, so, so Vic, we, we, uh, developed, uh, with Duke.

So, if I rewind 15 years ago for us, we, uh, developed a partnership with Duke University, and it was really designed to go out and acquire hospitals in and around North Carolina.

Uh, but it was this notion that if we combine a disciplined operator of community hospitals with a brand and a reputation of Duke.

Could we build something that one plus one was more than two.

And as we developed that partnership and we started being invited to go to communities all through North Carolina, it was incredible the reception that was there.

Uh, the understanding of we can get a Duke brand.

But somebody that knows how to operate community hospitals, and we're proving out this thesis of one plus one could equal more than two.

And while we were doing that, and we were very successful and acquired about probably 10 or 12 hospitals, uh, over maybe a 7 or 8 year period, uh, all the way up through probably 16, 17, uh, was the last year.

hospital that the partnership, uh, uh, purchased and, and partnered with, uh, we developed a national quality program and we developed a national quality program with Duke that we could spread out to all of our hospitals.

My fear was as the operator of the company that we would have this separate track of quality if you were a Duke related hospital or affiliated hospital, but our other 50 hospitals over time could get left behind.

And what I was looking for was I need a program that served as the railroad ties that bound the track together.

So no matter where healthcare moved, whether you were in North Carolina or in the other states that we operate in, that we were going to have the identical program and that national quality program where the railroad ties that ensured they stayed parallel.

Well, the vision

that you brought to it is to take that.

Really thought leadership, incredible combination in North Carolina and then bring it to the rest of the company that you lift everybody up, you lift

everybody up.

And where I was going with the main tenants, the three main tenants that we set around board tables and talked about for a national quality program was about.

empowering leadership.

Uh, this isn't, you know, quality is not just the C.

's job or the chief medical officer's job.

We expect in our company, every one of our CEOs to stand up in front of a room and explain what's going on with their clinical outcomes, clinical results and what they're doing to drive them forward.

So empowering leadership.

In setting expectations is number one.

Number two is proven methods of performance improvement.

So I was in here, uh, around the hall here earlier today, talking, uh, to some representatives from one of the partners that we work with about the research that they've done.

And how do we take their research that's proven?

That's documented.

And then we're the only ones that can go adopt it.

And then we adopted so proven methods of continuous improvement as much as I would like to say we can implement this.

We hit the switch.

It's in.

We're done.

It's this journey that we're that we're all on.

And then finally, creating an enterprise wide company wide, but also a system wide in a hospital wide, uh, commitment to safety in the community.

So so a culture of safety, community.

Proven methods of performance improvement, but it all starts with leadership and empowering leadership at every level to, uh, to drive us forward.

And, and that's been exciting to watch.

It's been very exciting to watch our CEOs of our hospitals.

Some naturally are pretty gifted at being able to get in front of a crowd and talk about their quality results.

Some Aren't very good at all.

And to watch how that whole curve has shifted as the expectations were set and we get them in an uncomfortable spot, force them to own it.

And now we have a group of leaders.

They're not all like

positive peer pressure where they, they pull it.

There is.

Yeah.

And, and I can tell you 15 years ago, if we were at a meeting and we say, we're going to talk about quality, the CEO would have, uh, stood up just like a good leader and said, Hey, Uh, we're going to talk about strategy and then quality when we get to it, I'm going to introduce you to my CNO and let him or her do that.

Now our CEO has to do that, and I think that's been a big cultural shift.

And that partnership with Duke, uh, part of that was kind of a non economic partnership.

We developed that with Duke, uh, but it really started out of that economic partnership with Duke to go out and make a difference in the state of North Carolina.

And while we're on North Carolina, I, I think it'd be, uh, it would, it doesn't feel right for me to, uh, to not mention everything that's going on in Western North Carolina.

And we may not get another chance to talk about that, but I'll be over there later on this week.

Uh, just the devastation.

So, thoughts and prayers are with the people in Western North Carolina.

It is a, it is sad.

It's tough.

The pictures are hard.

The reality is hard.

Uh, but when you watch team members come together, come in your greatest time of need, sometimes you see the greatness and it's been so inspiring for me over the last six or seven days to watch team members taking care of team members.

And then we do what little we can do to help bring additional resources into the community.

So a shout out to, uh, to that, uh, to that part of the country.

And now we have another storm barreling down in Florida.

Uh, these are tough times, but this is what we do in healthcare.

Yeah, absolutely.

My, my prayer is that for.

These, uh, these parts of our country that have been devastated is that they have the kind of triumphant return that we had in Nashville.

You know, I never wanted to live through the 2010 flood, but I do believe that this city took, you know, a turn after that because we saw how we could all come together and take care of each other.

Right.

And so that's my, that's my prayer is that, uh, you know, uh, in these very, very dark times, these communities just see, see just how strong they are.

Yeah.

And it's, uh, it's just amazing when you, uh, some of the pictures and the stories that I've heard from our team and leading into the storm, we positioned some resources and support.

In a certain place where we thought they were going to be needed the most only to find out, uh, by, by Friday afternoon that we had the right resources.

They just weren't in the right place.

And then to relocate those resources became a problem because roads and bridges.

And so, uh, the patients that our teams on the ground had as we went through this, but whether it's fuel trucks or water trucks are partnering with second harvest food bank, we've sent it.

Trucks over a food.

All those little things really proved to me why partnerships are just so important.

You cannot do this on your own.

You have to have people that can come alongside and like points blessed to have a lot of those partners.

Uh, that's a great segue because you just talked about a non economic partnership that you ended up leveraging into national level improvements across your entire network.

Um, but then we just.

We just zoomed right back into something that was happening locally, right?

You have the benefit of being this really, really strong national network where you can get the peer pressure and you can get the, you know, the standards and all that kind of stuff.

Operating leverage.

That's great.

Um, but at the end of the day, each one of these hospitals.

Inside of their community, um, is seen as something important to that community.

Hospitals are, are, are these kind of weird things where they serve a purpose, but the members of the community see them as something more than just a place where you go get health care, right?

Oftentimes they end up sponsoring.

You know, little league teams or they end up being important philanthropic, you know, providers in those communities, et cetera, et cetera.

I think people look at their hospitals as important cornerstones of their community.

They employ a lot of people in the communities.

And so I think many times as people who are trying to focus on innovation in healthcare, we see a lot of things around the development of, uh, the, uh, determinants of health and things like that and health systems get charged with, uh, Improving the overall wellbeing of their communities far beyond what their standard remit would really be far beyond, Hey, this is a service I provide.

This is reimbursable.

Um, and what you just talked about showing up in a moment like this in partnership with, you know, different, uh, you know, second harvest and things of that nature.

Can you talk about those local partnerships, um, and maybe how LifePoint is able to provide an infrastructure that can standardize them, but still the local teams have to.

partner with organizations in that community and they will be different than the next community um, that a life point hospital resides in.

And, and how do those, how are those partnerships structured such that life point can do its best to deliver on that, that, that promise that the community sort of believes is, is important.

is there.

Yeah.

Uh, there's a lot of thoughts that go through my head when you, when you, when you were speaking.

And if I reflect back on, uh, sometimes I wonder why am I at LifePoint doing what I'm doing?

I'm an accountant by training.

Uh, I got into healthcare 30 years ago, came to LifePoint, uh, 17 years ago.

Uh, and, uh, what drew me to LifePoint Uh, was this notion of providing care and communities that don't have the resources that a city like we're sitting in right now has.

And I grew up in a small town in western Kentucky.

Uh, my favorite place in the world, I've traveled all over the world, is to go home and be with my mom.

Uh, that's home for me and it's really what reminds me of our company each and every day.

And so the, the mission of our company has been, uh, for, uh, Almost all of our company's history, which we've been around since 1999.

So a little over a quarter of a century at this point, uh, has been making communities healthier.

And I like that mission statement, first of all, because it's short and it's easy to remember and write out, but it's infinitely complicated because making communities healthier is not just taking care of people when they come to the emergency department or to the clinic or wherever it is that they need to be kind of caught and taken care of and then move to the right setting of care.

But it means that we're an economic engine in these communities.

We are more than just a healthcare company.

We're making communities healthier.

We're the largest employer.

We're recruiting the most high paid talent that comes into these communities with oncologists and orthopedic surgeons and cardiologists.

We're a big taxpayer as a, as an investor owned company.

So we are an economic engine of these communities.

And so what that means is, uh, when Toms of need.

Uh, to much is given, much is expected, right?

And so we have to lean in and be there.

And there are some things that we can do at a national level, but those local partnerships, whether it's with EMS, uh, whether it's with local food banks, whether it's with the local community college from a recruiting standpoint, uh, all those little local partnerships are vitally important.

We choose at LifePoint at the national level to only get involved in a couple of things reflect the mission of who we are.

And our two big partners here are Second Harvest Food Bank and Special Olympics.

Those are two big national partners.

To some extent, those partnerships really don't matter in Price, Utah, when a crisis happens.

What matters is, is they have a relationship and a partnership.

So I think about it as we're basically just modeling up here.

What's important for them to develop on their own.

So in their greatest time of need.

Yes Second Harvest can help us and we can have a lot of resources go but the resources that are available in the community It's important that that partnership has that hospital has those partnerships intact and our hospitals do a great job of that because to your point These are the biggest businesses in the community.

Everybody understands how important the hospital is.

Are we perfect every day?

No But most of our communities understand what we stand for.

And that is to make every one of our hospitals, the best and most that they can be.

You talked about being investor owned when I, when I met you, LifePoint was publicly traded company.

Um, and then, you know, Bill Carpenter, uh, retired and, and you stepped into the role of CEO and kind of almost right as that was happening.

Um, Apollo, uh, Purchased LifePoint and the company was no longer a publicly held company.

And so, you know, I, I remember sometimes we'd have breakfast and you talk, sort of talk about what it was like to be a public company, uh, you know, manager, uh, and, and, and officer.

Um, but, but since then, it seems like you've just had a lot of, um, Just a lot of joy in doing your job.

You know, you haven't mentioned kind of, you know, board meetings or investor calls or anything like that.

You never kind of talk about that at all.

Right.

And I was just sort of wondering where we're investors at a much smaller scale, but I know the relationships we have with the founders we invest in and the management teams we support.

And when we sit on those boards, um, it's real, you know, it, we, we are shoulder to shoulder with them.

We're rolling up our sleeves.

Sometimes it's great.

And sometimes it's some of the hardest things these people will ever have to do.

And, um, I think a lot of people just think about investors as writing checks and that's kind of it.

And they're just kind of, you know, money grabbing people or whatever.

But if you, if you really want things to work out, well, there is an importance of the culture in the relationship between investors and management teams.

Can you talk a little bit about.

You know, sort of maybe just a, a very small amount about the change from being publicly traded to, to privately held.

Um, and then what's, what's it been like, you know, working with Apollo, one of, you know, sort of America's great investment firms.

Yeah.

So, uh, LifePoint's been around for 25 years.

I've been lucky enough to be part of the company for the last 17 of those years.

I've seen the company from the seat of the CFO of the company and the chief operating officer of the company, now the CEO of the company.

And I've only ever worked in healthcare.

In a for profit environment and a public company environment until November of 2018, when we took this company profit up until then my previous, whatever that is, uh, 18 years.

Plus, uh, was all around, um, actually more than that.

22 years, uh, was all around, uh, being a public company.

So all the pomp and circumstance that comes with that, the investor meetings and the roadshows and the raising of equity and board meetings and annual meetings.

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What is Health:Further?