Helping People Help Other People: The Role of a Rural Hospital Leader with Benjamin Anderson, episode 10

Benjamin Anderson and Wyatt Beckman

Join us for the latest episode of Health on the Plains – a Kansas Health Institute podcast focused on rural health challenges and opportunities in Kansas. Meet the leaders and doers working to make communities healthier, more vibrant places to call home.


On Health on the Plains, episode 10, Host Wyatt Beckman takes listeners to Hutchinson, Kansas, to visit with Benjamin Anderson, President and CEO of Hutchinson Regional Medical Center. He emphasizes the need to develop leadership in rural health care. He addresses meeting the health care needs of the community while keeping work-life balance in focus and highlights innovations to improve population health through unique partnerships. He also discusses access to care and why he thought it was important to advocate for Medicaid expansion.

Episode Highlights: 

  • 3:33-6:42: Wyatt and Benjamin reflect on Benjamin’s early career, his family’s decision to move back to Kansas, and the importance of rural community health, emphasizing the need to transform fragmented health care delivery systems to better meet community needs. 
  • 6:42-11:58: Benjamin discusses the importance of involving family and community, specifically mothers and caregivers, in health care decision-making processes. 
  • 11:59-18:47: Benjamin explains how health systems reflect the communities they serve, addressing provider recruitment and training challenges and opportunities, and how sustaining communities economically relies on strong hospital and health care systems. 
  • 18:47-27:21: Benjamin compares and contrasts the health administration training program ladder versus those for medical providers, what it means to be a health care administration leader, and the work needed to ensure the next generation of rural health care leaders. 
  • 27:22-35:06: Benjamin highlights the pressing challenging health outcomes in rural Kansas, how health care leaders are addressing these issues, and introduces an innovative approach to tackling loneliness among older adults in Hutchinson, Kansas. 
  • 35:07-39:23: Benjamin discusses the desperation often driving innovation in rural Kansas, rural hospital closures, and how to reframe health as a public asset. 
  • 39:24-55:25: Wyatt and Benjamin discuss Medicaid Expansion in Kansas, why Benjamin felt compelled to advocate for it, and the challenges of balancing the many roles of a hospital and community leader and family.

Voice over 0:00
This is Health on the Plains, a podcast about rural communities, rural life and the many factors influencing the health and well-being of rural Kansans. Health on the Plains is a podcast from the Kansas Health Institute, a nonprofit, nonpartisan educational organization, committed to informing policy and improving health in Kansas, through honest nuanced conversations with leaders and doers from a variety of backgrounds. The Health on the Plains podcast offers unique insights into rural health challenges in Kansas and shines a light on the people and organizations working to make their communities healthier, more vibrant places to call home.

Wyatt Beckman 0:41
Welcome back to another episode of Health on the Plains. I’m your host Wyatt Beckman. Today we’re in Hutchinson, Kansas, with our guest, Benjamin Anderson, who is President and CEO for Hutchinson Regional Healthcare System, a position you started just this year in January. Hutchinson Regional Healthcare System serves Reno County and the surrounding areas through the Hutchinson Regional Medical Center, Hutchinson Regional Medical Foundation, Hospice and Home Care of Reno County Health Equip and Horizons Mental Health Center. Before coming to Hutchinson, Benjamin served as vice president for Rural Health and Hospitals at the Colorado Hospital Association for nearly four years. He has also served as a clinical instructor in the Department of Family Medicine at the University of Colorado. And before his time in Colorado, he served here in Kansas at Kearney County Hospital, in Lakin, in the southwest part of the state. He earned an MBA from Drury University, and a Master of Healthcare Delivery Science from Dartmouth. Benjamin is a known innovator and leader and health care executive and speaker. And we are just thrilled to have you here on the podcast. Thanks for having us.

Benjamin Anderson 2:41
Excited to spend this time with you. Thank you for the warm introduction.

Wyatt Beckman 2:43
Well, there’s so many places we could start our conversation, so much experience you have to draw on. But I want to start with where you’re at now. And on your LinkedIn bio, you describe yourself first as husband and father that comes before all the the other things that I mentioned, all the other positions. And you recently made the decision, as I mentioned, to come back to Kansas, with your wife and your family to move back to Kansas. And you chose to make rural Kansas home again. Beyond this opportunity, which was part of what brought you back, you know, what was part of what went into that decision? What brought you back to Kansas?

Benjamin Anderson 3:33
Yeah, great question. I asked my wife when we first got married, “where in the world do you want to live?” And she said, “frankly, the rectangular state in the middle,” that’s the center of her universe. And she’s from a fifth-generation family farm in northeast Kansas. And at the time, she didn’t really designate where in Kansas, just anywhere in Kansas would meet those needs. And so we spent our first 11 years out in southwest Kansas, in Ashland and then in Lakin, Kansas, and I feel like I didn’t grow up there as a child, but I grew up there professionally, went there in my 20s and cut my teeth as a scrappy hospital administrator and those two communities, I mean, we’ll be going to weddings and funerals there for the rest of our lives. We are permanently connected. My cell phone number is still in Ashland, Kansas. Cell phone number. And will be indefinitely, and so we moved to Denver with a son with some special needs, we needed to access the Children’s Hospital, a special school for him. And we were there during those crucial developmental years. And it came time where you know, our kids are now 11, 11, 9 and 9. And we’re in, we’re coming up on the back half of the of the parenting years for our children, and we wanted them to be near family. And my heart is in rural community health, and I enjoyed that work, and we probably if not for the needs of our son we’d probably still be living in western Kansas. But we needed to be near closer to resources. And so when I began having conversations about coming back here I had a conversation with with Senator Jerry Moran, who’s been a longtime friend. And then he’d shared with me some of what was going on here, and the opportunities for this place and what this health system means for the state of Kansas and for the region. And the importance that this place operates at its best, and that led to conversations that led us here and I would say the reason why we live here now I mean, I love the work but my favorite part of living here is seeing my wife look out the back window of our house and look at a sunset and realize that this has happened to her like I came home yesterday and playing basketball in the driveway with our son as the sun was setting. Family evenings in a place on the edge of town is Kayla’s lifelong dream. And so it’s really fun to see that come to reality for her and the work’s great. So it works well.

Wyatt Beckman 6:07
What a beautiful image. And I’m sure beautiful memory to have that. And I’m so happy that that that worked out. And I know when it was announced that you were coming back to Kansas with your family, I saw lots of excitement to see you come back. So I’m sure the folks here in the hospital and the health system are really excited to have you back as well. And what that means. I’m sure we’ll talk about some of the work you’re doing now and some of the specifics. But I want to sort of take us back a couple of steps first because as you said, you sort of professionally grew up in southwest Kansas, and I think your expression, a” scrappy rural hospital executive,” and you you really did a lot of wonderful and impressive things there that gained some national acclaim. You expanded primary care and you secured thousands of dollars in grant funding and increased financial stability of the hospital and you expanded obstetric services and showed a lot of innovation. There’s lots of successes. But since that time, as you know, over four plus years ago, we’ve seen new challenges, we had COVID-19 pandemic, we’ve seen hospital closures continue to be a challenge. When you think about this opportunity you have now and those challenges you faced back back then, what lessons do you think you are pulling in or experiences are you drawing from that time in southwest Kansas that you’re bringing to the work now?

Benjamin Anderson 8:01
Yeah, I think about that, and I think about change and resistance to change the reality and the necessity of change now. Because every year that we continue, as we’re currently going, our health system can become more anemic and more vulnerable. And therefore our community, I mean our health system is a reflection of our community because we’re vulnerable, that says there’s this need to transform our health care delivery system to better meet the needs of a community and yet, even in Hutchinson, it’s a relatively fragmented health care delivery system. It’s not a secret. I mean, we’ve known that for a decade, when I was living in western Kansas, there’s a multi- specialty clinic and there’s a hospital and there’s an ambulatory surgery center, and there’s a federally qualified health center. And historically, they haven’t necessarily been rowing in the same directions. And I think insofar as we can get them to row, we can we can come together and row the same directions the community wins. And each time that comes up, and we share an opportunity at a rotary or a chamber meeting or somewhere in the community where, you know, for example, we’re hiring an OBGYN here, recruiting him and his family with 10 children into our community to bring the obstetrics community together. And he will literally and sacrificially practice in three different locations to pull that OB community together. Each time that’s mentionedm there’s audible applause, because the community’s starving for that kind of working together. But I think we have to transition from a mentality of how do we maximize market share, to what problem are we trying to solve? Let’s solve a problem together. And the money will come. But let’s begin by solving the problem, and we first have to do that by asking the right questions of the people who the people’s health that we’re affecting, they’re the ones that that need to have the voice at the table. Thery’re the ones that need to be handed the mic. So we’re starting with moms here. And so I think a lesson I learned in western Kansas, especially in Kearny County Hospital, we would say in Spanish, “las madres tienen la llaves del reino,” which means the mothers hold the keys to the kingdom. And women ages 18 to 44 years old, navigate the health care delivery system for three different, four different generations. Those moms in the sandwich generation that are raising children and caring for aging parents, and in-laws, if we engage them, if we build trust with them mountains can move. And so I think that’s a big part of what we’re focusing on here now. And the recruitment of that OBGYN is to say, “we heard you, you need this service, you need us to work together, this matters.” And so we’ll begin there. But I think we have to, to solve any of these complex problems, we have to start with the people that are most affected. They have the answers, if we’re willing to listen to them.

Wyatt Beckman 10:59
What a great insight into, I had never thought about that challenge and opportunity of that age of caregivers, caregiving down and navigating children and navigating up and how much insight they could bring into the work you’re doing.

Benjamin Anderson 11:18
There’s one person in the whole world that can convince me to get a colonoscopy, and I’m married to her. And she’s sure that she’s not going to be a widow for that reason. So I’m going to get in there, and I’m going to do it, and even as a health care administrator, I’m not crazy about going in to have the procedure done. But I have a history of colon cancer in my family. And so she says, “No, you’re gonna get in there.” And so, you know, by the time I was in my 20s, I was already, I was I was being screened. And it was because she was really stewarding the health of our family. And she saw that and saw the importance of it. And I don’t think I’m alone in that. I think I think moms have that kind of influence.

Wyatt Beckman 11:59
Absolutely. You earlier mentioned the idea that health systems are a reflection of the community they serve. And when we talk about rural health and rural health care, we talk about some of the challenges and some of the losses that come from hospital closures or even a reduction in services. And a lot of times that focuses on the services, and that’s a big piece of what rural hospitals do is provide health care, provide access to health care. But it sounds like you see the role of a rural hospital in a community as more than that. What do you think rural hospitals mean to rural communities? And does it extend past providing access to care?

Benjamin Anderson 12:55
I think the first question I have to answer is access to what? Right? We provide access to what we’re paid to provide access to, which isn’t necessarily what the community needs or is asking for. And so we have to analyze first what, from a care delivery standpoint and access standpoint, to what are we providing access. When I was out in western Kansas and Lakin, we engaged some some students from Baylor University from the honors college to come up and facilitate a survey, community engagement survey in partnership with KU’s Department of Preventive Medicine, Public Health, in Wichita. It was a household survey and through community-based participatory research methods, we hit 85% of the households in our two cities of Lakin and Deerfield. And it was $10 in a local chamber bucks, you know, incentive and we were able to get that the word out and get the feedback back from them. We essentially asked them, we asked them how they defined their health and wellness. And then who was responsible. We get the demographics stuff out of the way but really what we asked the, the bulk of it was in the major sectors of society, health care, public health, early childhood development, research and extension, faith, community, employers, community as a whole. In each of these sectors, there was a list of services. And you would check what are you aware of the that your health system is providing, or that’s being provided in the community or in each of these sectors? And then what would you want to see more of. And took 10 minutes to complete it. And the data was really gold, and so for example, with health care, to answer your question, in every single category, when we divided the answers by race, by White folks and Hispanic folks, in every single category, White people were more aware of services than were Hispanic people. And in all but three categories, Hispanic people desired more services than White folks and the exceptions were mental health support for caregivers and end-of-life care. And there were cultural implications of why those three were exceptions when we did more qualitative research with that, but it refocused us on what people were asking for. They’re asking for mental health services, they’re asking for substance use stuff. They’re asking for support for caregivers, they’re asking for after-hours non-emergency care. They’re asking for the things that, for the most part, we don’t really have reimbursement mechanisms to pay for. And so we are what we are reimbursed to do. And we think from the care delivery, simply that we’ve got to provide those relevant services. But beyond that, hospitals, as is a frequent talking point in the Medicaid expansion discussion, are the largest employers in our communities. And when that goes down, we lose the school. When the school goes down, we lose the community. And it’s so important that we recognize the economic drivers. In Hutchinson, for example, we are sending tens of millions of dollars in wages out of our community and into northwest Wichita, every year, just in the form of physician salaries. We are at the base of a movement towards recruiting 50 new physician families back into Hutchinson in the next five years to fill existing roles, ER doctors, hospitals, others, because we are such an economic driver in just the ER alone, just to recruit the ER staff to live in Hutchinson would be like the Chamber bringing in a business with $5 million in salaries, to buy groceries at Dillons and to put kids in school. And it’s all of that economic activity. And we have an opportunity in every one of our rural communities that the where there’s a hospital to make sure that we continue to sustain our communities economically.

Wyatt Beckman 16:47
So it’s something I would hear in, in in your your thinking and some of the conversation as far as when you’re when we’re thinking about what a rural hospital is, and can be something that you’ve made a point to do is ask questions, you’re trying to listen to what what are the needs and and find ways to directly hear from your community about what they’re receiving what they would like, and and where that gap is. And that that sounds a lot like leadership. Is that part of how you approach and think about what it means to lead a team, lead the health system is is thinking about what questions aren’t being asked and how to get that information to inform the decisions you need to make as a teacher

Benjamin Anderson 17:42
in college, challenged me one time her name is Elizabeth Teisberg. She has moved schools now she’s now at the University of Texas. But it’s a time when I was in college with her in New Hampshire. She said so often we ask a patient when they leave the hospital if the sheets were soft, and if the bed was comfortable. And if the nurses were nice and if the food was warm, and it was delivered on time. And essentially, we’re asking about hotel services. We’re asking a patient leaving the hospital how did we do? And she challenged me and she said, What should we be as asking a patient when they leave the hospital? And she’s really teed it up. The obvious answer is well, how are you? Yeah. Did your chest still hurt? Is your blood pressure still high? Are you taking your meds? Did you get your meds filled? Do you have a ride to the pharmacy? Do you have prescription drug insurance? Are you choosing between food and drugs? Because if you’re choosing between food and drugs, you choose food and you don’t get the drugs you go back to the ER we’re not asking the right questions and I think it’s so important that we ask those questions and I’ve I’ve been taught there’s a doctor in in Wichita named Todd Stevens that when I was a rookie CEO, he was a faculty member at the family medicine residency and at Via Christi and I’m like a Via Christi Family Medicine Residency wannabe to be that will never graduate. I just love that training program. And then KU School Medicine Wichita does such a good job of residencies here in Kansas. And so Todd is a hero to me. And so Todd’s challenge to me even back then he said as a hospital CEO, as a healthcare leader, administrative leader, your job is to help doctors help other people. If you’re not doing that, you can question what value you’re bringing to the healthcare delivery system and into a community. And I think as leaders Our job is to, as the Kansas Leadership Center says, influence others for the common good. But really, we do that by helping people help other people by lifting them up. And I think we can do that by by asking what do you need? What do you need to be successful?

Wyatt Beckman 19:46
So we’ve talked about recruiting rural executives, rural physicians, rural hospital leadership, and you recently highlighted a story I’m from Colorado, about a rural Colorado hospital hiring a 24 year old CEO Aidian Hettler, Aidian Hettler, and you, you shared some comments about the hire. And you, you’re encouraging. You noted he has a bright future. And he’s had some early success. But you also said that, that, despite his success, that might not be the norm for a lot of our rural hospitals. And you said something that stood out to me, you said, rural health care, does not have an adequate farm team to ensure its future vitality. Yeah, tell me more about that.

Benjamin Anderson 20:39
I only we have a bench, we have really good people who have been in these roles for 30 and 40 years that have been running health care delivery systems, faithfully serving in these roles, and we don’t really have people that are coming up to replace them comparatively we have in medicine, we have a well oiled machine through a rural training track and, and that we would identify kids that are strong in the sciences and their sophomore year in high school. And we would usher them into undergraduate programs that are pre med programs that they can learn and prepare for medical school, and they’re in state schools and private schools, but we, we usher them in and then they go through shadowing opportunities and stay part of of clubs and networks through undergraduate training to to prepare them to be admitted to medical school, and then we offer them a a medical school scholarship that if they come back and practice in these rural areas, you know, we’ll cover your medical school or, or if you take out loans, then we’ll we’ll reimburse those, those loans if you come out and work in these areas, and then we have residencies that are rural focused residencies is even unopposed, which are family medicine residencies that don’t have another residency they’re competing against, so that we ensure that the family physicians that go out in these areas have all the training they need to go out of these areas. And then, and then even sometimes their obstetrics fellowships, or procedural fellowships or international fellowships that can better prepare them, and then when they come back into a community, we’re ready to receive them, and we pay off their loans, and we help them get settled. And, and we think through, we think through all of those details for a doctor.

We do comparatively nothing. For the person who’s signing their paychecks, we can take the maintenance guy who’s been there the longest, you’ll do. It’s not that a maintenance worker can’t be trained into being an effective CEO. But is that really comparable, when we think about what we’re doing to train somebody into the complexity, it could be a department head or an ancillary department head, we, you sort of come up through the ranks in this on the job training, we would never do that for medicine. We’ve never taken on the job trained clinician and have them performing procedures. And yet the delivery of health care is no less complex than the clinical medicine. And we are not taking responsibility for the training of those, the next generation leaders, at least locally, I would tell you that there is a really good example it’s coming for the last five years at the National Rural Health Association has a rural hospital CEO certification program, it’s a year long program, I think it’s $10- $12,000 to be involved in up and coming leaders that would be identified as maybe the next car going through this virtual program. And they develop relationships with their cohort of their class and they come out far better prepared, Bill Auzier. Dr. Bill Auzier runs that with NRHA. And I know some Kansans have been through it. And, and so there are some opportunities to train but comparatively nothing with physicians. You know, when we think of what we do for doctors, that we’ve got to make a similar investment in their administrative partners, if we want to see the healthcare delivery systems thrive and prevent the burnout of the doctors that we’re spending a million dollars training.

Wyatt Beckman 23:55
It sounds like there’s a there’s a gap between the importance that our rural hospital executives have in making sure that hospitals are thriving and delivering that care and addressing that complexity you talk about. There’s a gap between that the value that they bring, and how much we’ve paid attention to it, to say it very directly. What do you think is behind that gap? Why is there that gap between how important it is and how much we’ve invested in?

Benjamin Anderson 24:29
With administration? I think, so medicine began with doctors. And somewhere around 100 years ago or a little less than that the Mayo Clinic had this epiphany. And they weren’t the only ones but they were leading the way, had this epiphany that you know, medicine is becoming complex enough that we really need people that specialize in ensuring that when I hold out my right hand, there’s a scalpel, right, that sterilized equipment exists or supplies exist when I need them, because we want people practicing at the top of their license. And so having people that specialize in the billing or the collections or the finance of health care delivery, or the supplies, or the operations, and the throughput, as it’s become more complex. There’s value in that. But I think there still is a nagging perception that administrators are just in the way. And I mentioned Dr. Todd Stevens earlier, another lesson he taught me is that, you know, physicians and administrators don’t have to be at odds with each other. They can work together. In fact, they can be very effective in the delivery health care when when they agree to work together. And I think that’s a focus here at Hutch Regional. We’re identifying people that are exceptionally gifted leaders, you defined leadership earlier, they just get it. They understand how to be in that space and be present with people and encourage others, and people want to follow them, whether or not they’re in the current position of executive leadership, people just want to follow them. And I got a call recently from Dartmouth College, I attended there 10 years ago, and the recruiter for their new Master of Health care Administration program called saying, “Hey, we are looking for two specific leaders to go through our MHA program and to fill out our class, and there may be some scholarship money that can can make this education very affordable for them. If you can find us somebody that’s really strong in hospital operations, somebody strong in medical practice operations and management, we can make a way for them to attend an Ivy League college, if we can find these specific roles, but we want to make sure that they’re from a rural and frontier background, because we want to represent the United States. So two of our leaders have just been accepted into the Tuck School of Business at Dartmouth College, and we’re gonna send them there. There are three more that are gonna go through another, a similar program at Dartmouth. So we’re sending a cohort through three different programs at Dartmouth this fall, to build up and develop them. So that we can send six more through next year, and six more through the following year. So we can have a cohort that learns the same change language, and can lead those efforts together. I think the best investment we can possibly make is in the building the capacities of clinical, administrative and governance leaders in our health care delivery systems. We do that so many other problems solve themselves, because they’ll intuitively do it.

Wyatt Beckman 27:22
So you recently shared a story about a physician friend of yours, who was not able to write a prescription for what she saw the patient really needing. And what she saw was that those things that influence our health and the things that the patient needed, a lot of them were things that happened outside the doctor’s office, outside of the hospital, things like human connection and meaningful relationships and having a sense of purpose in life. Those things that we can call that the human conditions of life. What role can rural hospitals play in addressing those human conditions? Those things that happen outside of hospitals walls.

Benjamin Anderson 28:15
Very, very good question. And that is the question moving forward when we think about the population, the United States and of our society. Every year, when we were out in western Kansas, we would put up an outcomes pyramid on the wall. First of all, we’d get the schools, the sheriff’s department, the hospital together, the faith community together in a room, oversized partially cooked pieces of red meat, because that’s how we connect to talk about health in western Kansas, is big steaks, right? So we get to get people together with that. And we put up this outcomes pyramid in every corner of the room, and each of our respective groups would get together, and at the top of that pyramid, we would have them write “outcomes that matter most to the people that we’re serving” in our own context, so health care might be a diabetes or heart disease or, you know, the ultimate health outcomes related to depression or anxiety. And then underneath that, we have the decisions that people make that lead to various health outcomes. And in corrections, it would be decisions that lead to those outcomes, or education, it’d be graduation rates, and that kind of thing. So all the outcomes would be different based on our own disciplines or backgrounds. The decisions in the middle that lead to those outcomes would be different decisions depending on the area of the community that we were talking about. And at the bottom of that pyramid, we would all individually write out the factors that would lead to those decisions that lead to health outcomes. That’s the human condition, the social determinants of health, the stuff behind the stuff that leads to ultimately the outcome. But the interesting exercise that when we would line up all these pyramids next to each other, the outcomes will be different at the top, and the decisions that people would make would be different, but the human condition was almost always the same. And so we would agree as a community, the sheriff’s department and the hospital, and the school system and the faith community, what one thing are we going to put any of our disposable energy toward, to address this year. And the most recent one, before we moved to Colorado, it was it was hungry kids. We’re an agricultural community, in the middle of middle America, and we have hungry children, especially in the summer times when when schools shut down. We saw that become more acute when when school’s out during COVID. And all of a sudden, we’ve got a real food issue with with families that have come to rely on on breakfast and lunch at school for their kids. And so we’ve been hungry kids, we’d agree that there was just, it was never acceptable to have a hungry child in our community. So we we put together efforts, you know, got some grants and put together efforts to prepare meals, essentially extending the Meals on Wheels program for seniors, to children, to make sure that children had what they needed, especially over the summer. That was our one way of, so here, I think something that we’re focusing on at Hutch Regional is loneliness. So researchers for now over a decade have been describing what will be the 2030 problem, which is when the last of the baby boomers turn 65. And, and there’s been a decade of research that shows that, that thousands per beneficiary are spent more per year on a Medicare beneficiary that’s lonely versus one that’s not. And that thousands it’s been spent on on health care services, 911 calls and emergency department visits, those types of things, that when people are lonely, they call 911, you know, they have anxiety, they have heart, you know. They have chest pain, whatever that is, they end up in there. And that’s not the place that they most need to be. And so what we’re coming to a conclusion of is that loneliness is very expensive. And it’s an epidemic in the United States. And so, the story of Hutchinson is the story of America. Like we have many of the things that exist that ail America, they exist here. And much of the innovation that can exist in United States to solve problems can be done here. And if we can solve it here, it can be solved elsewhere. And so there’s a place in town called The Clayworks, which is run by an organization called Disability Supports, and it essentially trains people with intellectual disabilities in the fine arts, and that organization then markets their work for a fair wage, or for a fair rate, and it’s used to support those artists in life in steps toward independence. And so there’s a place called Scuttlebutts, it’s a coffee house we rent space from there. And it’s a place where anyone can go , and the owner, Joe Young is known for knowing people’s names and know what they’re drinking by the second time you go in there. You don’t even have to ask, he offers the drink you ordered last time and you just have a place there, you got a place you gotta be and that’s it. And so we are partnering with Horizons Mental Health Center, with our physician team in the community with Scuttlebutts with The Clayworks and with the United Way to give about a dozen seniors by next month, we’re going to identify a dozen people that have no friends. And they’re going to be given an opportunity for a bottomless account at Scuttlebutts Coffee House, and weekly art sessions led by an artist with a disability and accompanied by a therapist from Scuttblutts, I’m sorry, from Horizons, to facilitate these sessions to essentially facilitate friendship, but the way they’re going to be identified is a family doctor in town, and an ER physician in our ER and a therapist at Horizons are each being given a prescription pad, essentially, it’s a prescription for friendship, that they’re going to write them a prescription and they get to take that in and that’s their ticket in. And through that we’re going to begin to track the health outcomes of how they change based on the introduction of one meaningful friend. And we’re gonna facilitate, not that we’ve got the trademark or the patent on friendship, heaven sakes, no, but to begin to make that right thing a little bit easier, in hopes that other people will see it in the community and replicate, “hey, that really isn’t that expensive to do.” It’s pretty low cost. It’s just kind of common sense. So that’s something we’re focusing on, it’s really fun within the community. And we’ll begin to address the loneliness issue in the community.

Wyatt Beckman 34:24
What a really neat collaboration and neat innovation. Loneliness, the Surgeon General identified it as an epidemic and something that increasingly, getting more and more attention and rightly so. It sounds, I’m excited to hear more about how that progresses. It also strikes me, even though you you framed as it’s not not too complex, it’s kind of innovative. And that’s not an obvious thing that a health care organization would be doing to serve their patients. When you think about being innovative, what role does innovation play in being a rural hospital or a rural health care system?

Benjamin Anderson 35:18
Desperation drives innovation. And we’ve got some of that in rural health care delivery in Kansas. We’ve got a dozen closures in the last decade here, just here in Kansas alone. Ten closures, something like that, rural hospital closures, and each time it’s devastating for rural community. And if we don’t innovate, were dead. Our days are short, and they’re numbered. And so we have a responsibility to recreate what we’re doing to ensure that we remain viable moving forward. And I think we can do that, we can innovate because the best ideas, the best innovations come from the people that are closest to the issues by simply asking people that are on the front lines or asking people that we’re serving, “what do you need? How can we do what you need?”

Wyatt Beckman 36:08
When you think about some of the the shifts we’ve seen in rural hospitals, you mentioned the closures, talked about desperation and innovation, I know you’re working specifically to build a fantastic health system here in Hutchinson. But you think about broadly, the landscape of rural hospitals in rural health care, where do you think we’re going and what are some of those challenges that we’re seeing now that are going to continue to be on the horizon for rural hospitals?

Benjamin Anderson 36:46
It comes down to and this is talked about frequently in Kansas, we have 150 to 180,000 Kansans that can’t get access to primary care services. The common west Kansas phrase I’d use to describe that in just plain speak that ain’t right. That ain’t right at all, that we would be turning people away from health care, because of their inability to pay for it. Dr. Martin Luther King said of all the injustices in the world, health care, injustice in health care is the most inhumane. That we would be turning people away based on that. And that is not an America that we want to describe to our children. It’s not okay. And so, I think about just beginning there. The next generation of clinicians, of leaders, of health care workers don’t want to have to think about how a person pays for care. Health is a public asset. Disease does not discriminate. Whether health care is a right or a privilege isn’t actually, I think, the right question. Health is a public asset and healthy people are able to work. And I believe work is good for the human soul. It’s good for the human body, and the human soul to go to work. And we can go to work insofar as we’re healthy enough to go to work. And so I think we’ve got to be able to address that access issue to ensure that people can get to the care they need, because as they don’t, they access care in the most expensive and ineffective ways, through the emergency department with unnecessary tests and sometimes invasive and dangerous tests that wouldn’t be necessary if they can go through the emergency room. If we can get people into the areas and access to the care, paying for what they can pay for, but by getting people access to the right kind of care that we don’t have to up the prices, increase the prices on those who are still paying to cover the gap for the 10% of our patients, that can’t pay. We’ve got to address that. And we can address it. We can do it here in Kansas. We don’t have to lead the nation. And the state that gave back the most federal dollars and sent that on to California, Colorado and in Massachusetts, we actually can lead an effort that ensures that we have access to care for everyone.

Wyatt Beckman 37:37
And I know the topic of of expansion, Medicaid expansion is one that you mentioned earlier and is part of this conversation. KHI every year does work to provide data and neutral testimony when we have that opportunity to inform policymakers with information to think about this issue. You have also made an effort recently to share your perspective on the importance of expansion and how you see it impacting rural hospitals. That, when I think about the role of a hospital administrator and executive, you’ve got a lot of things on your plate. And, but you’re taking the time to do some of that work and go outside of your building walls and outside of city limits and and have those conversations. Why are you making such an effort to do some of that? And do you think that’s an important thing for rural administrators to be engaged in those conversations at the state level?

Benjamin Anderson 40:33
People die if we don’t. I can’t live with that. People are dying because we haven’t. People have died because we didn’t. Can’t live with that. So, I mean, I’m a conservative Republican by birthright, born into conservative family, as I said earlier, I believe work’s good for the human soul. I don’t like paying taxes, especially if I’m hearing or learning that tax dollars aren’t being stewarded properly. And I think there is waste in government, and I identify with rural Kansas values. I’m comfortable in a red state, in a red county with red-leaning people. I mean, I identify with a lot of their values. I think this one is in its own category. That if we want people to be productive and lean into their communities, they have to be healthy enough to do so. And this specific issue is in its own category. And we cannot, we can’t ignore it anymore, because it has become so pervasive. An uninsured child infects the insured child in school. In rural areas, we can’t segregate ourselves from the need. Not that we should in urban areas, but we’re far less able to do so in rural areas. And so we must care for our fellow neighbor. If we want our communities to be where, what they could be. I think it comes down to, you know, we’re coming up into the summer, into the Fourth of July. Do we hold these truths to be self evident or not? Are all people equal? Or aren’t they? And if they are, then we have to reckon with or we have to grapple with why a rural American is more than 50% more likely to die due to unintended injury than an urban American. Those are undeniable facts. And why a Black woman in the southeast part of the United States dies three or four times more often than a White woman in Denver during childbirth. Do we hold these truths to be self eviden or not, because if we do, we can’t live with that. We can’t stand for that. That is inconsistent with the creed of this country. And so we must hack that. We must figure it out, we must address it. And we have a responsibility as health system CEOs to step into that gap, even if it means taking a few darts locally. And I’m taking a few, I’ve never been so public politically as I have during this legislative session, because so much is at stake. I’d prefer stay out of the fray, do my own thing. There’s so much at stake here.

Wyatt Beckman 43:28
There’s a lot that I imagine you, over the course of your career, and recently as you you just said that you’ve taken some darts, you’re stepping into the fray because of the importance of having these conversations and the importance of sharing what it can mean and trying to inform those decisions. And I think about those other hospital executives or health care system executives, and the similar weight that they carry, and all the many things on their plate, trying to be the best they can for their people that they work with, for their families. You recently shared something that you did, thinking about how you are balancing all the work you’re doing and thinking about the values that you hold, and you shared, you bought a a lockbox for a cell phone. And so when you get home, there’s a specific time every night where cell phone goes in the lockbox, it’s locked and you are fully present with your family. And that’s something that you identified that is a value and a way that you want to show up for your family and still balance what you care about, and your commitments to to the workplace, and it makes me think about how our executives and leaders balance so much. So, I wonder, when you think about what you’ve learned in your career, what advice would you give to that rural health care administrator, executive leader that’s starting their career and has the weight of their family, their community, the weight of trying to maybe feel like there’s a need to save a hospital that’s really challenging? What would what advice would you give them in balancing all of that?

Benjamin Anderson 45:47
The lesson I’m learning present tense the hard way, gosh, this is such a hard thing for me to comment on. Because, you know, for example, the cellphone jail is under construction, or under renovation right now, because our kids stuck something metal in the lock, like just trying to play with it and get it open, and so now it doesn’t open and shut right. So now the version of the cell phone jail is sticking my phone in my wife’s back pocket, say, alright, that’s jail for now, until we can get the lock fixed on the cell phone jail. And so it really remains a relevant thing for us right now. But even before jail, it’s home, like, am I am I at home to even put it in jail, you know, and in three nights a week, I’m in some meeting or recruitment event or whatever. And we expect that the first 90-120 days here, but we’re still trying to develop that. That priority, I think some other boundaries we set in place is that every Monday morning, I take a different kid to breakfast. And they know, they track the calendar, they know when it’s their week, and who’s in order, and who’s been recently, and surprisingly, where they want to come with me is, they want to come to work. They want to go through our hospital cafeteria, and they want to sit in my office and they would have breakfast with me and they pretend they’re at work with their dad. And they’re at work with their dad. And so that’s a Monday morning thing. On Saturday mornings, it’s golf lessons. And I’m a pitiful golfer, but it’s golf lessons. My son and I are both left handed. And so we’re learning how to golf together, and I don’t have the, you know, the capacity to take on a hobby that doesn’t involve kids right now, because time is so scarce. So, I think finding things that are fun with our families is important. And I think I’m learning that just, present tense, in the process. I think backing up a little bit further, I think a hard lesson that I’ve had to learn, as a person of faith, is not all good work is God’s work for me. And just because the need is there, doesn’t mean I’m the one to meet the need. And there’s even some pride in me that’s being exposed. I think about why would I think that I have to do that? But the because if my cup is full, if I’m at capacity, anything else I put in there, something else has to go, something else has to come out. And often by default, what goes is my kids and our marriage and the health of our marriage. And so I think there’s this grappling with the reality that I’m nobody’s savior. And not all good work’s God’s work for me. And in some work, is in so I can just focus on those things that are and let others step into the gap. And right now, for example, that you can’t go into a community meeting in our community, where child care and housing are at the end of the meeting, like it’s child care and housing, and child care and housing and childcare and housing. And child care and housing are crucial needs in this community to determine health outcomes. It’s a justice issue. It’s an equity issue. And it’s not where I’m called to lead right now. We can support, come behind, reinforce, can’t lead the child care charge right now. And I can’t leave the housing charge. And those are two of the most important charges to lead in Reno County right now. That’s somebody else’s lead. And we got it, we got to step in behind them and reinforce them. But I can’t solve that stuff. And I think there’s just a realization that we can’t fix everything, and that’s okay. And then probably better for our children, for our marriage. And I’m a better leader in the health system when I can recognize that there are a few things I can do to try to do that as well.

Wyatt Beckman 49:22
And when we when think about, that’s a great visual image of the cup that’s full and trying to add more, and it can’t hold any more, and something has to overflow. And we think about rural communities. My analogy is the idea of wearing many hats and lots of folks that are exercising leadership in rural communities, whether they’re hospital executives or they’re the local pastor or they’re the local coach, they take on a lot and do so because they really care about their community, but the long-term sustainability of their contributions to their community can be sacrificed if they take on too much. And I think that’s a great insight that you have. But I imagine that it’s easier said than done, I would imagine.

Benjamin Anderson 49:22
Yeah, I have been in the last two weeks, six or seven community leaders saying, “what’s the hospital’s position on child care, what’s the hospital going to do for child care?” And there’s history there that I can’t appreciate that predates me, and just having to set that boundary saying, “you know, let’s get a board resolution on what we can do in that specific space, because we can’t do everything.” So how can we engage this in a healthy way, and just boundaries are so important, and boundaries are, unfortunately, less common than they could be in rural areas. Boundaries are hard.

Wyatt Beckman 50:54
We talked earlier about hospitals and rural health care extending their focus and finding ways to meet the needs of their community outside of their walls. And it sounds like there’s a tension there between all that a hospital or health care system could in theory do and all the needs that are there, and that point where it’s too far, how do you think through that balance between identifying those gaps and coming back to what is the core role for a health care system or for a hospital?

Benjamin Anderson 51:38
I think that’s the core question of strategy. And that’s why strategy is so important. And good outcomes require good strategy. And so Hutch Regional, over the last 90 days, we’ve been on a data collection blitz, that really are in several major categories. And the first is the landscape, what’s going on outside of the hospital and public health outcomes in the community and what’s our service area and the legislative environment. And the second one is operations. And that’s what’s going on within the hospital or the health system, with regard to quality, and IT and facilities. And that kind of thing. And then the third is workforce, and what’s the shape of the people, what shape are the people that we’re working in, and we’ve collected information around that. I could share further. But then fourth is the the voice of the consumer and then collecting that. And then on May 16th, we’re going to place, a museum called The Cosmosphere, which is one of the world’s most renowned space museums, located right here in Hutchinson, and we’re renting out a room in there. And we’re going to have this data condensed or synthesized into 20-minute TED Talks. And we’re inviting community leaders around this around the city to come in and hear that information, then help us inform the strategy moving forward. Then we’ll get together for a mission, vision and values talk early in the afternoon, where all of our affiliate boards will get together and agree on a common mission, vision and set of values. And then after that, our health system board and senior leaders will identify three to four, maybe five priorities, and then we’ll build the strategy around them by June. And we’ll approve the strategy and the budget that goes with that. So that by July 1, we’re off to the races, and we’re running it, and then we stay narrowly, within those four to five areas. And we focus on those things, doing those things well, because what it does is it gives credibility to the strategy. And when we get back into the strategy, folks know gosh, whatever ends up in here really happens, 80 – 90% of it’s accomplished, if we’ve effectively done this strategic plan, right. And we just keep that in front of us, and keep that in front of us, and keep that in front of us. And then we’ll do it, and then we revise it, we revise it and keep going forward. I think that’s how we do it. But we have to have measurable outcomes. Because if we don’t measure it, it doesn’t matter. And no commitment to measurement is no commitment at all. For example, like saying we provide great care because we know our patients by name. What that says is we know our patients names, it doesn’t say that we actually provide great care, we have to have outcomes to back it up. And so when we think about the strategic work that we do, we’ve got to make sure we have outcomes in each of those areas.

Wyatt Beckman 54:04
We started our conversation, talking about your family and what brought you back, and the life that you and your wife and your children get to have here in Kansas. And we’ve talked a lot about your work and what you’re building here and the challenges you’re addressing. When you think about all that you do, there’s strategic planning, there’s leadership, there’s looking at data, there’s presenting, there’s all sorts of things that you could, all sorts of ways you could describe what you do. When you when you tell your kids and you describe what you do here and what your work is here, how do you describe your work as a rural health care executive?

Benjamin Anderson 54:59
I help people help other people. Yeah, if they’re tempted to say, “Well, you’re the boss, and you’re this your that.” No, that’s not how it works. My job is to help people help other people. I’m a helper. And sometimes that involves making hard decisions. Sometimes that involves changing things. And sometimes that involves encouraging people, writing notes, and visiting with patients. But at the core of it, any decision that they make, I hope is received, is a desire to help encourage and build up other people. And I’m sure that I have room in that to do that more effectively and be more present with folks. And I hope that our children see their dad doing that in an honorable way. And I hope that’s the example that we’re setting for them as parents is intentional, thoughtful service. In our family, we’d call it washing the feet of the community, or washing the feet of others. And I guess that’s what I say, washing the feet of the staff is my role. And I’m on a journey to learn to do that better.

Wyatt Beckman 56:26
Well, we really appreciate you taking the time to share some of your lessons learned, some of your wisdom about that journey that you’ve been on, and really excited to see what that looks like moving forward. And thanks so much for sharing with us how you help others help people help others.

Benjamin Anderson 56:46
Thank you for the interview. Obviously, really appreciate your approach to this. You’re so prepared and so thoughtful and you prepare all these questions. Really have done homework that made the conversation really meaningful. So thank you for the way you did it.

Wyatt Beckman 57:00
Thank you.

Voice over 57:01
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Health on the Plains Production Team

Wyatt J. Beckman, M.P.H., C.H.E.S., Host

Theresa Freed, M.A., Producer, Editor

Emma Uridge, C.H.E.S., Field Producer, Coordinator

Stewart Cole, Editor, Graphic Designer

About Kansas Health Institute

The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.

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