Announcer: You're listening to the Intermountain Podcast with Dr. Mark Briesacher.

Mark Briesacher: Hi, I'm Mark Briesacher. I'm the Chief Physician Executive at Intermountain Healthcare, and I am here today with some very good friends, old friends and new friends, so Rebekah Couper-Noles, who's our Associate Chief Nursing Officer for Community Based Care, Jeff McNally, who is the Medical Director for Homecare, and Joel Macey, who's the new Executive Director of Operations for Homecare.

But that's not where Joel and I first crossed paths in our lives. So, we met each other way back in 1996 at Bryner Clinic, and I was a fortunate pediatric chief resident who got to come join your team, Joel.

Joel Macey: And that was a great day.

Mark Briesacher: For both of us.

Joel Macey: Yeah.

Mark Briesacher: For both of us, and of course, Joel, you've been in operations in the medical group for, boy, the last 20 plus years, and so this is what I'm thinking, this is the old introduction. I'm actually going to have Rebekah do the new introduction.

Rebekah C.: Well, we're thrilled to welcome Joel Macey to the role of the Executive Director for Operations for Homecare. Joel expressed interest in this position a long time ago, and we had the privilege to interview him and really hear about his passion for doing operations work but in a different domain than what his many years of experience has been in, particularly in the medical group. And we were very excited after lots of thought and lots of interviews with incredibly qualified people to select Joel for the position because not only is he a proven dedicated leader, but he has incredible Intermountain experience and community experience that makes him the perfect fit for this role.

Mark Briesacher: I can tell every caregiver at Homecare that they're getting an amazing leader and someone who, like I said in the beginning, is I consider being one of my very good friends. Joel, you have always given so much thought to the nurses and the front desk team and the medical records team. I'm laughing as I'm thinking about that old medical records room down in the basement, which my office was right next to, being in pediatrics of course, and of course the physicians and advanced practice clinicians that were at the clinic, and then more broadly across the medical group. So, if you're listening from Homecare, I just want you to know that you're very lucky to have Joel as your executive director, and we're going to see some amazing things.

So what do you have to say about that, Joel?

Joel Macey: Well, I appreciate those kind remarks, and this is ... I'm very, very excited to be a part of this team, and I can't think of anything more special. I mean, it's a special opportunity to be able to provide care for patients in a hospital setting or in a clinic setting, but going into a home and delivering care in a person's home is really a sacred experience, and I've heard so many positive things about the caregivers that we have at Homecare and Hospice and just remarkable stories about impacting people's lives and not only in their final days, but just helping them to get back on an independent path.

And that's really what has attracted me to this group of people is the fact that they're out there day by day working in people's homes trying to make their lives better, and in the short time that I've had to interact with many of the leaders there, I've just been really impressed with how committed people are to make this a very successful part of Intermountain Healthcare, and I think we're in a unique place here to be able to have this service available with the other things that we offer, and being able to have that integration is really, I think, a very unique thing in healthcare.

So, I'm thrilled to be a part of the team and excited to get in there and make a contribution and work as a team of people because this is really, it's a team sport, and it's just not going to be accomplished by one individual person but with a group of all the caregivers that are actively engaged there at our Homecare operations.

Jeff McNally: I'll say, Joel, I haven't told you yet, but since the word has been getting out the past week, I've had at least five or six phone calls a day from different people at Homecare that have worked with you over the past years that are just so excited to have you on the team, so-

Joel Macey: Yeah, thank you.

Jeff McNally: ... we're happy to have you.

Joel Macey: Yeah, thank you very much.

Mark Briesacher: So, you all have had at least a week or so to think about where Homecare is headed, and I am so optimistic about the people there and the care they provide, and so I'm wondering if the three of you could just sort of freeform a little bit here and talk about what's on your mind and where you're thinking about Homecare heading.

Rebekah C.: Yeah. I think one thing I would say is that we have a pretty incredible foundation of services that Homecare is already providing, and one of the things that we're really excited to keep working on is just how do we make those services even better than they are today, and how do we make sure that our caregivers have all the training and the support that they need to be incredibly successful in the home and that they're getting the structure and the supplies even, day-to-day supplies, that they need to do this work, and we're really excited to look forward into how we can grow the existing services based on the incredible work that we know is already happening every day.

Jeff McNally: I'll add. So, I've been in this role for about two and a half years, and we started out right off the bat adding two new service lines to Homecare with palliative care and this post acute care team, which started getting us more connected to the system than we have been historically as a homecare company, but what I find really exciting right now is just in the new structure. With Homecare being under Community Based Care, there are some new teams and councils being put together, and I think of the Community Based Care Ops Council that meets regularly where we have, in the same room, the senior leadership from Medical Group and LiVe Well and Population Health and Homecare talking about how we can line up our services to take care of patients in our system the best way, and that's the biggest change in direction I see right now, and it's really going to be nice to have somebody in this operations role because we're at a critical point right now to really drive home that collaboration in the rest of the system.

Rebekah C.: I think that's a great point, Jeff. One of the parts that brought me here to Intermountain myself was this new way of looking at how do we provide care to our communities and the grouping of Community Based Care and taking services that traditionally haven't worked together at all; we've been pretty siloed in the past, and many organizations are still very siloed. That was one of the most innovative and exciting things that Intermountain is doing and is really leading the way, cutting a path for the entire nation and how we can think about care for our communities differently, and that's one of the most exciting things about being part of Community Based Care. Bringing those groups together to talk about connections and integration and care, frankly, that goes all the way across the continuum.

Joel Macey: I might add that the idea of where things need to go in the future of healthcare to be more economical, to be more affordable, it's moving services upstream, it's getting into people's homes, it's providing opportunities to deliver care in the lowest cost setting where it's most appropriate. So, this is really, I think this idea of bringing these Community Based Care services together is an opportunity to be more innovative, to be more out of the box thinking, and to be able to have a significant impact on just the delivery, the cost of delivering care. This is where I believe where it's going to really have the most impact.

Mark Briesacher: I'm curious when you describe this idea of Community Based Care to colleagues from across the country who work in other health systems or work in a multi-specialty clinic or another homecare agency, what do they say?

Jeff McNally: So, I just got the phone call yesterday with our Linc collaborative, which is a learning innovative network collaborative of home health companies that are a part of a nonprofit integrated healthcare delivery system, and we were talking about how we run our homecare agency and how we integrate with the system, and I was reviewing our new structure, and it's interesting because I feel like where most of these companies are now, we were two years ago. We were just banging down the doors and the walls trying to figure out how do we integrate, communicate, collaborate better with the other parts of our system, and this new structure just really allows us to do that in a way we've never been able to do before, and so I feel like we're leading out in a way with Intermountain, that other companies are going to learn a lot from us.

Rebekah C.: I agree with you, Jeff. What I've heard from colleagues when they learned about what my new job was, they were almost a little bit confused. "Like what do you mean? What does that ... How did they put all that together? And they just have one group that's kind of putting it all ... " Yep, that's what it is. They've restructured the entire organization to think about healthcare and a new paradigm, and that is kind of mind blowing when you've been in a system or in an integrated health system that's done things in a very different way for many, many years. So, what's happening here is really innovative and almost revolutionary.

Mark Briesacher: I can tell you that the most common responses are somewhere between, "Wow, you're doing that?" to something like, "Holy cow, how are you doing that?" So, they quickly are thinking, "Gosh, how do we do it?" And there's that twinkle of envy that I pick up as well. So, how exciting, again, for the caregivers at Homecare to know that they're part of something really special that's happening here? And of course we're doing it because we want to always be better at taking care of people.

I certainly have felt more connected. I think it's due to us coming over to hear from your team about the amazing things that are happening when we do our step back reviews, and I can tell you the day that Kim Henrichsen, our Chief Nursing Executive, and I spent with a Homecare nurse and went to a patient's home. Joel, you said it, right. Those are sacred moments, and the connection, the trust, the ... Oh, I mean, they're so happy to see them. Right? And so it's really, really cool.

So, Joel, this is the first hundred days question. So, what are you going to be doing between now and Martin Luther King Day?

Joel Macey: Well, first off, I'm going to be an excellent listener. I'm going to try to absorb as much as I can, and I want to get out and meet as many people as I possibly can. We have a big span. We span the entire system, and I know we have people out in rural areas and in other urban areas who may feel like they're working out there without any attention or feeling maybe that they are not a part of something that's bigger and really great, and so I want to get out and meet with those people and understand at the very front lines the work that people are doing so that I can make good decisions and good recommendations to advance the cause of Homecare. So, a good listener and getting a lot of advice from those folks in the field and at other levels in the Homecare service.

Rebekah C.: I love that, Joel, because every person that works at Homecare is caring for our patients, and every single caregiver has something valuable that they can share with us about the work they're doing.

Mark Briesacher: I'm super excited, Joel. I'm excited for everybody at Homecare and Hospice, the new teams, the wheelchair teams, the infusion teams. I mean, most people don't even know all the amazing things that happen out there at Homecare. So, I need to say thank you to the teams at Intermountain Homecare because my mother-in-law passed away 10 months ago, and the transition from the hospital to our home, it was amazing. Everybody from the palliative care team that met with her in the hospital and then supported us throughout the next couple of days to the people who were delivering equipment and a bed, and I mean, the medicines came at 10:30 at night in the middle of a snow storm, to have Dr. Smith available to answer my questions because I didn't want to be making any decisions, even to the day where the medical equipment team came back to pick everything up.

That was when I realized that the work that happens there and the care that's delivered is just unbelievably amazing, and to serve a family in that time of life and to do it the way that everyone did is ... It means a lot, so thank you to everybody at Homecare because you're number one in my book.

Joel Macey: Thanks.

Jeff McNally: Thank you.

Rebekah C.: Thank you.

Mark Briesacher: Thank you very much.