Zachary Yoder on Expanding Rural Care, Financial Sustainability and Health System Growth

In this episode, Zachary Yoder, MHA, RN, NEA-BC, FACHE, President, St. Mary Medical Center, Holy Family Medical Center and St. Luke Medical Center, OSF HealthCare, discusses expanding access to care in rural communities, investing in robotics and outpatient services, and preparing for Medicaid and reimbursement pressures. He also shares his approach to culture, patient experience and building OSF HealthCare into a regional destination for specialized care.

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- This is Laura Dierda with the Becker's Healthcare

- podcast.

- I'm thrilled today to be joined by Zachary

- Yoder, president of Saint Mary Medical Center, Holy

- Family Medical Center, and Saint Luke Medical Center,

- all part of OSF Health Care. Zachary, it's

- a pleasure to have you on the podcast

- today. It's a pleasure to be here. I

- appreciate the opportunity.

- Absolutely. Now I'm excited for our conversation. I

- know we're gonna talk a lot about how

- things are going today, some of the cool

- things that you're doing at the hospitals, as

- well as how you're looking at the future.

- But before we dive in, can you tell

- us a little bit more about yourself and

- your background?

- Yeah. So, I've been at OSF for a

- little over a year and a half now.

- I started my career at Orange Jewish Hospital,

- almost twenty years ago now, as a patient

- care tech, was in nursing school and went

- to nursing school and and got out in,

- about four or five years into my, staff

- nurse position. So started some,

- charge nurse leadership positions and supervisor positions and

- then just kind of

- took off from there and and got more

- involved into,

- leadership across the hospital and then into executive

- leadership,

- as a chief nursing officer.

- And then from there,

- got into more operations as a COO, and

- I've been a president now for,

- almost two years. So

- Wow. That's amazing. And, you know, what a

- a great career journey in terms of being

- able to,

- you know, start in health care and and

- experience so many different aspects of it before

- becoming a a top leader at the hospitals

- today. And and, you know, when you think

- about that position, what is the state of

- the union for you?

- Could you tell us how things are going

- right now and what you're focused on for

- the rest of 2026?

- Yeah. So this this year's really been about,

- building momentum,

- and investing in our communities and our people.

- We've really continued to grow,

- a lot when it comes to

- our capacity,

- both on the outpatient and the inpatient side.

- We've grown in robotics this year, so Saint

- Mary Medical Center, here in Galesburg, Illinois, which

- is about about two hours south of Chicago,

- in between Peoria, Illinois and, Iowa, the Quad

- Cities area. We've we've done robotic surgeries here.

- So we have a da Vinci, and we

- just got our ion bronchoscopy

- robot this year as well, which we've kind

- of exceeded expectations so far on that too.

- So,

- we've really grown in the robotic space, which

- I think is

- not necessarily rare in rural medicine, but it's,

- you know, it's not exactly common either to

- have

- multiple robots in a rural space and so

- keeping that care local, close to home is

- really important for us.

- We've also invested in our capacity through the

- ED.

- We've expanded,

- six more beds here at Saint Mary, which

- they were full the day we got them,

- because we are just overran with, patients in

- the area. We we take care of, between

- these three hospitals, roughly a 100,000 patients,

- with a little over a 100 bed capacity.

- So, you know, that that's quite a bit

- of,

- of geography and and patients to take care

- of, and our our ED is frequently overran.

- And so we're always looking for ways to

- kinda take the steam off the ED and

- make sure we're getting our patients through,

- the continuum of care appropriately.

- But we've done a lot around expansion, a

- lot around, you know, just building momentum, growth.

- Our biggest thing is keeping care local.

- If it can be done as close to

- home as possible, we want to do that

- and then as we get, you know, a

- little higher complexity in our patients, we will

- get them to the next level of care,

- typically to our flagship hospital, Saint Francis in

- Peoria,

- which is our, tertiary quaternary center.

- Got it. That you know, it it's helpful

- to understand, and I think the success that

- you mentioned in terms of making sure you've

- got the right capacity and,

- moving patients through quickly is is certainly

- so important. I know many hospitals and and

- organizations,

- struggle with that and and we're trying to

- find ways to optimize

- the way their patient journey through the hospital

- and those kinds of things. And so, you

- know, what has led to the success that

- you have? How do you really

- structure the teams in in data and information

- and technology to all work together to achieve

- these results?

- So OSF in general is really big on

- technology and innovation.

- You know, we've we've done a a lot

- around our on call center with our telehealth

- components and,

- sharing resources with our system as far as

- referrals, and, we have a care hub that,

- we funnel patients through so that way, we

- can make sure that they're getting to the

- right

- resources in a in a timely manner. But

- I think more importantly in our area, we've

- really focused on

- optimizing what we have,

- and working on our culture of our team

- to to continue taking care of patients locally.

- And so we have, increased our leadership

- across all three hospitals,

- to be shared.

- And so I think that's a big thing,

- where our leaders and staff are are being

- shared across all three hospitals, and so that's

- providing some continuity.

- We've set the three hospitals up in kind

- of a hub and spoke pattern over here

- in the West Central,

- region. And so our hub being Saint Mary,

- but a lot of our patients don't necessarily

- need the

- complexity that comes with the larger hospital, and

- so we can send them to our critical

- access hospitals to receive the appropriate care there,

- which takes the steam off of the larger

- hospital that's

- frequently at capacity for beds. And so, we've

- also put our surgeries in some of those

- locations.

- We've increased,

- some of our abilities to to do radiology

- and scans, and and we've put, specialty providers

- in each location more frequently so

- our patients can seek this care closer to

- home and not have to come to one

- location.

- And we've really just focused on trying to

- push and pull our resources that we have

- to the appropriate

- spot.

- And I think that really has set us

- up for a much better year this year.

- And we're really excited for what 2027 is

- gonna bring as well because we have,

- you know, more outpatient services coming.

- We're continuing to grow in robotics.

- We'll be growing in cancer care as well.

- And then across the market, you know, our

- focus is really,

- to continue to bring those access points as

- needed, to to where the patients are.

- That's fascinating to hear. Thank you so much

- for digging a bit deeper and sharing the

- strategy behind how you're looking at the different

- hospitals and the ways that they can truly

- work together in order to benefit community and

- provide care close to home.

- Now in looking at the future too, I

- wanted to ask,

- about some of the headwinds. What are some

- of the big things that you've got your

- eye on and that you're preparing for for

- the next year or so?

- So I think, you know, very similar to

- what others are dealing with with Medicaid and

- reimbursement pressure. I mean, that that's definitely a

- big one. I think when I think about

- our our biggest external headwind,

- especially in the state of Illinois, it comes

- in two categories. I think in one, it's

- it's the,

- the Medicaid and reimbursement pressures, like I mentioned,

- but then another is the,

- the trial lawyers and the and the things

- that come with that.

- There's a lot of, liability and litigation that

- happens in the state too, which is very

- costly and very expensive,

- for everybody involved. And I think that, you

- know, that that can be a major issue

- when it comes to cost of care.

- It it's harder to recruit physicians to those

- areas as well because of the known liability

- cost associated with it. And so when we

- look at a couple of those different things,

- they're they're two or three buckets, but they're

- very, very expensive buckets.

- And, you know, OSF, we take care of

- the majority of the Medicaid patients, in the

- state of Illinois. So when you look at

- outpatient and inpatient combined,

- Medicaid patients,

- seek OSF at a higher rate. And so,

- you know, this this headwind specifically is going

- to impact us

- disproportionately,

- and I think that that's something that we

- really need to,

- to continue to pursue.

- Another piece is specialty recruitment. You know, most

- of our hospitals are in rural markets or

- in, you know, smaller cities.

- And so specialty recruitment and keeping

- those physicians there is is difficult,

- especially when we have specialists that are traveling

- to multiple sites.

- Sometimes you only need one or two of

- a specialty provider, which comes with an increased

- call burden and other kinds of things. And

- so, you know, that's very difficult model to

- recruit to as well. And so we have

- a handful of specialty,

- positions right now we've been recruiting for for

- a while, and it's a very difficult space

- to be in, I think, when it comes

- to those,

- specifically around, like, GI, urology, and some cardiology

- services that we're focused on.

- And then I think the other real big

- one is kind of the cost pressure.

- I think when we talk about what are

- we doing for cost of not only labor

- but supplies and everything else, you know,

- A really large portion of our cost obviously

- goes to to our labor force,

- which, you know,

- it continues to go up every year. And

- as we,

- focus on retention efforts and things like that

- to keep our

- employees happy,

- and keep them here at our locations, it

- it does become increasingly more difficult as,

- staff are pushed and pulled to different,

- areas and seeking higher reimbursement and things like

- that too. So there's a lot of different

- areas, but I think a lot of it

- stems around the financial viability of the organizations

- and the ability to get,

- reimbursement dollars for the work that we're doing.

- Absolutely. That makes a ton of sense. And

- I think, you know, when you talk about

- that financial viability, being able

- to find a sustainable strategy going forward knowing

- some of the Medicaid cuts and reimbursement,

- policies that are upcoming

- and taking effect next year.

- So when you look at that, how are

- you

- really

- what are the conversations like, I guess, with

- your executive team about what you need to

- do in order to keep that financial viability

- and and, plan for,

- the next couple of years knowing that those

- cups cuts are coming? Are there other places

- that you're looking to bring in additional revenue,

- or how do you think about that?

- Yeah. So our growth in our our certain

- areas around, you know, surgery,

- cancer care,

- outpatient services, we have a lot of initiative

- to to continue to bring more outpatient services

- when it comes to,

- scans and different testing in the area. We

- have, you know, low dose CTU testing and

- rapid diagnostic clinics. We have, a new CTA

- coming, which is gonna help us with some

- of our,

- patients that are,

- needing, scans when it comes to their cardiac

- issues or,

- potential stroke diagnoses.

- There's a lot of things we can be

- doing in that space, which we're going to

- continue to push,

- but then a lot of it comes with

- the pieces that we can control,

- making sure we're controlling our,

- efficiencies when it comes to the cost of

- our

- teams, what it costs to do business every

- day,

- making sure that we're being good stewards of

- our resources. We're growing in the right areas,

- that our that our community needs.

- You know, we're not an organization that's going

- to to chase the almighty dollar. We're we're

- going to really focus on our mission, and

- our mission is to take care of of

- those that are that are vulnerable in the

- communities that we're in. And so, you know,

- that comes with a high cost. And so

- we have to be very careful with how

- we structure things to make sure that it's

- a service we can continue into the future.

- But I think the biggest thing that we're

- focused on over the next ten years is

- what we're calling destination OSF.

- And destination OSF is an opportunity for us

- to

- to grow,

- across our,

- markets. It's an umbrella opportunity, essentially.

- We're identifying those services where we can truly

- be differentiated.

- We're investing in our physicians, technology, our infrastructure,

- and then we're making OSF a destination for

- those services.

- And so when you look at our services

- across our markets that we

- are focused on, we have a wonderful children's

- hospital in Peoria that's,

- doing amazing things,

- and we have a cancer care institute, a

- neurological

- institute,

- a cardiovascular

- institute. And so when you look at all

- of these things that we have in our

- market,

- we really can be a destination center for

- those folks in the Central Illinois region,

- and we're hoping to continue to provide those

- services for years to come. But we want

- to be the destination center that people come

- to, and so, you know, offering those services

- and making sure we're the very best quality

- safe care, and provide the best experiences where

- is where we're heading.

- That's great to hear. And I think when

- you talk about having that destination OS, bringing

- patients in and, focusing on that patient experience,

- what have you noticed about how things have

- changed over the last few years? I know

- technology obviously makes a lot more,

- possible within the health care space when you

- think about the patient experience. But how are

- you seeing, you know, some of those trends

- evolve, and and,

- what do patients expect when they're coming in

- these days?

- Yeah. I think expectations themselves always change and

- get get,

- a little more difficult, I think, to attain

- sometimes when, you know, health care can be

- clunky and it can take time to do

- things, whereas people are used to instantaneous

- gratification,

- with their phones and and being on social

- media and things like that. And so, you

- know, we're always,

- you know, a little behind the eight ball

- when it comes to to that in health

- care.

- And so I think what we can really

- focus on is providing a good experience for

- people, providing the right culture at our organization

- where our patients feel valued and respected when

- they come in.

- We often say this on our team, but

- if we we need to treat every single

- patient as if it is our loved one.

- Is it you know, if it's your child

- or your mother or your husband or wife

- or whoever you you really,

- find to be the most important person to

- you,

- treat that patient in front of you like

- that person. If everybody is doing that all

- of the time and is here for the

- right reason, mission focused,

- we unite under the same values,

- that will be a great experience for all

- of our patients.

- You know, nobody wants to seek health care

- services. Nobody wants to come to the hospital,

- right? It's something that you're in a vulnerable

- position. You're,

- might be having the worst day of your

- life, right? And so you're met with people

- at the organization,

- that are going to treat you,

- with the dignity that you deserve. And so

- I think that ultimately

- having that experience,

- communicating with people, involving their families,

- having our providers, you know, sit on the

- edge of the bed and talk to people

- to take a moment to really treat them,

- like the person they deserve to be treated,

- that's really important. And then as leaders, we

- have to be treating our employees the same

- way. Right? So we have to be coming

- to work,

- to to be the best version of ourselves

- for our teams. And so when we model

- that behavior and our teams model that behavior,

- then our patients feel that. And so, you

- know, I I think we make it a

- little difficult at times when we chase patient

- experience scores and we talk about all of

- these things. Because at the end of the

- day, people want to feel special. They wanna

- feel heard. They wanna be communicated to, and

- they wanna feel safe. And I think at

- the end of the day, that's really what

- it is, is what would you want if

- you were in that situation?

- What would you want for your loved ones?

- And so that is our culture that we

- have been,

- creating, and we're gonna continue to create until

- probably forever. Right? It's a constant refinement.

- Absolutely. That you know, thinking about culture, thinking

- about the ways that, you know, you can

- really make a difference, for folks coming into

- the health system and that human to human

- connection is so critical within the health care

- space. I I really appreciate that. Now before

- we wrap up here, I wanted to ask

- you about leadership as well. Who's a leader

- that you really admire from any industry and

- why?

- That's a good question. I've been, you know,

- I've been coming to Becker's for,

- five or six years now to the conferences,

- and

- I like them

- because I I really enjoy spending time, like,

- finding some of those leaders

- to listen to,

- and kind of listen to every year and

- hear their story and progression

- And one of the one of the guys

- I've really come to like,

- through my time at Becker's has been John

- Koras.

- He's the CEO at Tampa General.

- I I really like how he puts culture

- with execution

- and also with the health system transformation that

- he's been undergoing over the last few years

- because I find that the way that he

- approaches his work with not only be being

- transformative,

- but the way he really focuses on people

- and creating the culture

- and then and then getting everybody to a

- point of ownership where they can execute,

- and breaking down those barriers for people.

- He said a lot of really great things

- that I've come to admire over the years.

- And so, you know, that's one individual I

- think that I've I've really come to respect,

- and somebody that I've I've really learned a

- lot from just listening to, over the years

- of coming to Becker's.

- I 100%

- agree. It's just fascinating and inspiring to hear

- what John has to say every year and,

- you know, thinking through what it takes to

- have that type of transformation.

- So I appreciate having your thoughts there, and,

- you know, I'll be excited to see you

- as well at our CEO CFO round table.

- I know you'll be speaking on a panel

- and I'm sure inspiring many folks who are

- in the audience as well.

- Absolutely. I'm always honored to to be involved

- in that. I think,

- any opportunity I can to to share,

- my thoughts and insights and also just, learn

- and be around other folks that are lifelong

- learners is always a wonderful opportunity. So thank

- you.