Welcome to the Becker's Healthcare podcast. I'm Chris Sosa, the copy chief here at Becker's. I am thrilled to be joined by Dan Larson, principal and chief strategy and marketing officer at HealthBridge Children's Hospital. Dan, thank you for joining us today. Thank you, Chris, for having me on. Wonderful. Dan, for our audience members who are not familiar with you and your work, could you please introduce yourself and tell us a bit about your background? Sure. So my name is Dan Larson. I've been in health care since, 1989, as as a principal owner of three different businesses. The the one that the HealthBridge Children's Hospital is a current business. Initially developed a partnership with my sister who's a speech pathologist in 1989, and we founded a company called South Coast Rehab Services, which contracted with skilled nursing facilities throughout the country. We we drew that to about 17 states and 240 some contracts, and then we end up selling it to one of our, actually, one of our clients. And we became their in house, rehab company once, the the Sniff business and Medicare business went to prospective pay. So that was in 1997. And as as part of that, we were involved in in another takeout of SunHealth from from Regency. And when we were managing, that rehab department, we had a little group in there called Meridian NeuroCare, which was really a kind of residential based spinal cord and and traumatic brain injury rehab business. We we liked it a lot. And so when, Sun went to purchase that deal, we asked, Rick Matros and and, yeah, if we could go in and buy it. He said, absolutely. So he, along with Bruce Broussard, former Humana guy, he was our CFO at the time. We purchased Little Meridian NeuroCare, renamed it Care Meridian, and grew that to a multisite operation to 32 sites, and then we we we exited that business as well. In in the mean so most of my career has been kind of in this post acute rehab space. I did do a short stint here in St. Louis, where I was the CEO of Premier Care Orthopedics, which is a kind of a roll up strategy for practice management roll up strategy for orthopedic surgeons. And then we also founded a group called Signature Health Services, which was a large which now got large MSO. So, again, most most of my space has been in the in the in the rehab post acute side of it. And, really, the the pediatric hospital is very similar to that. We have four levels of care. We have, we have both, acute beds and subacute beds. We have LTAC. We have acute rehab. We have subacute, and we also have outpatient services. So I I never say never, but I think, after thirty five years, this will probably be the last company I start. Well, clearly, you've had a lot of experience in any number of areas in in health care, Dan. So what exactly about investing in starting Helpbridge Children's, appeal to you in particular? So I'm a I'm a huge proponent. So take a step back. Most of the stuff I've been involved in, deals with especially the the care meridian phase of it dealt with really complex injuries that required really long long recoveries, multisite kind of, you know, kind of care model. And so understanding that the family is going through this recovery process and there's gonna be multiple providers involved, I was a huge advocate for, you know, having a coordinated care model. So we had actually, at Care Meridian, with, Santa Clara Valley, hospital, we developed a program called NeuroNet, which was really a collection of four different, companies that provided that full level of care with a common, nurse navigator as the case manager, from the onset of the injury all the way to home. And so that coordinated care model was a huge deal to to us. We we saw, the outcomes were much better. The client satisfaction was much better. And so we as we looked at this segment of of pediatric care, most of these kids are, you know, very fragile, medically complex kids. It's the same it's the same problem, same business problem. And so we are, you know, working hard to build out that full continuum on the post acute side, and then and then working and coordinating that with our with our for hospitals, in the in our markets that like the CHOC hospitals of the world. So it's it's really, you know, again, taking these kids that are medically complex and have these long recoveries and and building, both efficiency into it and predictability for families. I understand. I mean, clearly, there's a lot of work involved with that, Dan. Given all that that you've just laid out for us, what are your top priorities today? So we are, we're working with several different hospitals to, you know, to, put process to that coordinated care model, that nurse navigation. Again, think we think that is is real key. We also are looking at at ways where the ED boarding problem, what especially with these kids that need, acute beds where we can accept these these children directly out of the EDs. That's a that's a big push of ours. And then, you know, again, these kids most of these kids are going home with some level of permanent disability and and ongoing medically complex issues. So there's a, you know, high risk for these kids to bounce back. And so we're implementing a program called safe at home, which is a, you know, post discharge predictive risk scoring framework so that we can, look at the the the the things that basically impact that child's life that could end up causing, you know, a negative event like a seizure or something else that would require rehospitalization. So and we're, you know, we'll overlay that with AI tools to be able to look at these trends and hopefully get to a point where we can start predicting, okay, if these things are happening, the risk for this is is as acts. And so what we wanna be able to do is support those caregivers at home to be able to give them a little bit of a heads up as we start seeing trends that are developing that could, you know, potentially end in some negative event that would require a rehospitalization. Dan, I'm glad you mentioned trends. With respect to those, whether it's the safe at home program, which sounds like a terrific, if not a very complicated and challenging endeavor that you have going on. How do you think your role is going to change, and how is the role of your team going to change? Well, I don't know necessarily if my role will change that much. I I, you know, as as an owner too, I have my hands as you can imagine in finance and everything else. My my primary focus though every day is is really the the the strategy and the payer side of the market. So I don't really anticipate much change to my role, but a lot of our clinical people are are required in in these, development meetings. And so they've never, you know, they've never been in them before. So it's all kind of new territory for them, participating in more business process than, you know, being on the floor clinical. But we have great experts, and and, these different models are predicated on the fact that, you know, again, we can we have the clinical goods to deliver. So I need them involved in that in that development process. Lastly, Dan, I have a two part question for you. Sure. Here's how it goes. So I would like to know what exactly is making you nervous about health care in general right now, whether it's pediatrics related or not, and what are you excited about? Well, on on the pediatric side, obviously, unless you've been living in an alternate universe, you know, we we see, you know, the the headlines every day about the prospective Medicaid cuts, coming down. And so, you know, it it depends on how that, you know, how those end up happening and how that would affect us. Most of the kids that we take care of, tend to be Medicaid at some point. And in California, if you're if if you have a catastrophic injury or illness and it goes more forty five days, you get put in at the into the CCS process. So, it's a covered it's a covered actually, a a covered level of care within the state of California, which is unique. And so not knowing fully how that plays out, you know, we're we're we're watching it. We're we're a little bit nervous. We're we're anticipating that, given the space that we're in and and we're in such a cost savings, level of care, we should be okay. But, you know, it all depends. And and from our perspective, since it's pediatrics, we're not worried about, you know, the the work requirement, or any of that. So we're just kind of a niche player in that. So we're watching it carefully, but it definitely is something that, you know, it had has us concerned. On the on the, you know, what makes us excited, you know, this level of care, is unique. And the the reason why it's unique is if you look at Medicare, Medicare cut cuts across all 50 states. Right? So you have the same you have a well worn path to these adult continuous of care, short stay, LTAC, acute rehab, SNF, assisted living, home health. Those are all licensed, levels of care with reimbursement. When you look at our level of care, it's predominantly Medicaid, so it's a state by state effort. So there's no way really where you can just go this business model is gonna work in every state because there might not be the reimbursement for it. However, we as we see the trends, California has gone to a % managed Medicaid. We're seeing more and more managed products, that growing. That gives us the ability to negotiate deals directly with the insurance companies and not state itself to get the right rate structure. So we're we we, you know, we feel like we're in the in the early minutes of the first quarter of the game, and there's no 800 pound gorilla yet. And there's a lot of organic opportunity out there. And so and and we we know that this business is, was founded in February. I tried to buy it when I was at Care Marine, and I couldn't get it done, but we eventually did, personally. But this this this proof time and time again to be able to create, you know, outstanding outcomes at a lower cost price. And a lot of these kids would would formally just live in the children's hospital. That's an inappropriate level of care. So we think estates are looking to reduce cost spend, as the insurance companies are looking to, you know, find alternatives to higher cost, you know, types of settings, I think, you know, this level of care is is is perfect. We see it you know, health systems are gonna, you know, want it. Insurance companies are gonna want it. So we we just I think this is the one true thing where you kinda you always see those business slides with the hockey stick. I think this is as these states become more managed and as we start to see this roll out, I think you're gonna see, you know, big growth, if, you know, three to five years out. That's when it's gonna take off. So, we just wanna be we wanna be on the front end of it. Dan, thank you so much for all your time and your insights today. You've been very generous, and we can't wait to share them with our audience soon. I appreciate it, Chris. Thanks so much.