Transcript
Delaney Crowe (00:01) hey, how’s it going? Good? How are you? I’m good.
Kern Haynes (00:09) Good.
Delaney Crowe (00:12) Does it feel like the end of the quarter?
Taylor Ryan (00:15) No, I mean, I don’t have anything out. I pushed my like only, I mean, I pushed everything out to later quarters a couple weeks ago. So, I’m just, you know, business as usual. You’re in the receipts proof timelines channel, right? Yes. No, oh, my God. It’s all like bravo people. Okay? I need to add you to it.
Delaney Crowe (00:41) Wait, what is this because of summer house? Yeah… receipts proof timelines?
Taylor Ryan (00:51) I’m adding you. I just added you to it.
Taylor Ryan (01:00) Dude.
Delaney Crowe (01:03) is Noah joining? No?
Taylor Ryan (01:06) He’s not going to join. Oh, okay. He was like, I could just use the time back.
Delaney Crowe (01:09) Okay, cool. Kern’s here. So, I’ll okay, perfect. Yeah.
Delaney Crowe (01:20) Hello? Hi, kern.
Kern Haynes (01:25) Hello? Good afternoon.
Delaney Crowe (01:27) How are you doing?
Kern Haynes (01:29) Well, how are you doing?
Delaney Crowe (01:30) Well, thanks for asking. Thanks for joining. I looped in my colleague Taylor. She’s yeah, she can kind of go into more on, you know, medallion. And so I’ll let her introduce herself but thought she could kick it off.
Taylor Ryan (01:44) Yeah, sounds good. Nice to meet you kern. Thanks for joining. Where are you based?
Kern Haynes (01:48) I am in Philadelphia.
Taylor Ryan (01:50) Nice in the city. How about you? I’m in the Los Angeles area, but I grew up on the east coast. I actually went to the university of Delaware, so, I spent a lot of time in and around the Philly area. So, yeah.
Kern Haynes (02:03) Nice. One of my good friends went to university of Delaware and I was just in Los Angeles last week came back on Saturday, one of my friends that’s from the east coast, moved out to San Diego and got married in San Diego, but I flew into la because I got a bunch of friends in la. I wanted to hang out with them the day before the wedding. Nice. So, yeah, love la, love everything about it. Love California, just the west coast in general.
Delaney Crowe (02:31) Yeah, I’m from San Diego, actually.
Kern Haynes (02:34) Oh, nice. Nice.
Delaney Crowe (02:35) Where were you in San Diego?
Kern Haynes (02:38) The wedding was in the garden. Let me get the exact name of the garden, botanical garden.
Delaney Crowe (02:48) Quail botanical gardens. Maybe, yes, yes.
Taylor Ryan (02:51) Okay. Is.
Delaney Crowe (02:52) that in encinitas. Right?
Taylor Ryan (02:56) I’m sorry in.
Delaney Crowe (02:57) Encinitas?
Kern Haynes (03:00) Yes, I guess it’s an oceanside. Oh,
Delaney Crowe (03:06) oceanside. Okay. Well, I’m sure. It was beautiful. My family’s all in San Diego right now, and I feel like the weather’s been amazing. The.
Kern Haynes (03:13) Weather was absolutely phenomenal and, you know, just perfect temperature, nice, cool breeze. It was, fantastic weather for a wedding. The event space was beautiful. I had no complaints. It was a fairytale wedding and they both thoroughly enjoyed themselves.
Taylor Ryan (03:33) Oh,
Delaney Crowe (03:33) that’s very nice.
Taylor Ryan (03:35) Love it. I love when you can, kind of do they live in San Diego or do they live on the west coast?
Kern Haynes (03:44) No. So they both live in Austin, Texas. Oh, okay. Nice. But the bride grew up, her family is in San Diego. So with the father paying for everything he said, listen, if I’m paying for everything, I’m going to get married in San Diego. So he made everyone come out there, which is fine. If I was in his shoes, I’d do the exact same thing.
Taylor Ryan (04:09) Totally nice. Well, awesome. It sounds like you had a great time. I did next time you’re out west, let us know. We’ll we.
Kern Haynes (04:17) could have had this meeting in person and I know.
Taylor Ryan (04:20) That you guys were all.
Kern Haynes (04:21) On the west coast? Yeah.
Taylor Ryan (04:23) Medallion’s a fully remote company. So we’ve got folks everywhere.
Taylor Ryan (04:27) Okay. Yeah. But yeah, anyway, thanks for taking the time. Yeah. So like Delaney said, you know, the two of us kind of work together handling, you know, she’ll, kind of help handle scheduling meetings with folks that have potential interest in medallion. I am the account executive aligned to greater Philadelphia health action. So, the point of our conversation today is really just to understand if there is a potential fit like what you guys are doing and for us to get a better understanding of, you know, your day to day and if there are any challenges that medallion could potentially help with. So, in my mind, you know, success out of today’s, meeting would be either, yes, it’s worth continuing discussions or even no, there’s not a ton of alignment. So I’d love to just get to know a bit more about what you do, your role and what’s all going on at greater Philadelphia health action. And then I can obviously go through a bit of an overview of medallion just to give you a bit of a picture of how we sit in the market and, you know, how we see the credentialing and enrollment world. But yeah, if you wouldn’t mind, you know, jumping into your role a little bit that’d be great. Yeah.
Kern Haynes (05:41) I’ll give you a quick elevator fill of gpha and then a little bit more about myself. So, gpha, a 58 year old organization. We’ve been around a while, 13 locations throughout the greater Philadelphia area. The largest fqhc in the Delaware valley. We see 1,100 patients a day, between 80 to 90,000 patients annually, that tied to visits. We see about three, we saw about 300,000 visits last year, 110,000,000 dollar organization. We hit that milestone in 20 25. Very excited about that. We have about 750 employees. And we see throughout our 13 locations, we have medical, dental, behavioral health, pharmacy. We also have some specialties, rheumatology, podiatry, endocrinology, infectious disease. I’m missing a couple but we add specialties as we see the need and demand for it. And so that in a nutshell is greater Philadelphia health action and who we are, what we do, we have up to 750 employees, about 150 to 200 of those are providers and, you know, need or require to be credentialed on an ongoing basis. More about me, I’ve been with gpha for 19 years, essentially my entire career. I started just out of undergrad as a medical case manager, working with our providers to do continuity of care for patients and get them into their appointments and ensure that we remove all the barriers to care. And so I held that role for a number of years, went back to business school, got my mba, and then worked my way up the proverbial corporate ladder, held about five or six different positions in between case management and what I am now which is the chief financial officer. I got promoted into that role March 11 of 20 20 right before the pandemic, and then it was trial by fire. Worked. It seemed like night and day relentlessly went from getting promoted that Friday and being all excited to coming back on Monday and having a shelter in place and went from seeing 1,100 patients a day to about 400 patients coming in on that Monday.
Kern Haynes (08:09) And, you know, the subsequent weeks before we got telehealth, and all the measures in place to assist with delivering care. So, very, brutal times. But luckily enough for me, you know, I was able to maneuver and get through it. And here we are today. So, yeah, I said a lot and so I’ll pause and see what questions you have.
Taylor Ryan (08:32) Yeah. No, I really appreciate all that background. I mean, what a career you’ve had and I can imagine like you said, March eleventh, you got promoted. Yeah, talk about timing. Yeah, I’m sure that was a really tough time but obviously like, very important work. I’m sure that it was a big learning lesson but also difficult. So, no, and congrats on all the growth, you know, that the company has seen. I, you know, I think when we were initially starting to reach out to you, we were looking at some of our fqhcs you know, within our book of business. And I think that you guys really stood out just because of the size. Obviously like Philadelphia is in itself like being a major city. I’m sure that you have lots of different specialties that you have to be able to provide for. And so just, I think we’ve been focusing on, you know, trying to understand how the new, like the new bill that passed and the funding associated with it is playing into some of the… I guess initiatives across the fqhcs that we work with. And so that was our initial interest. But then once we looked under the hood and saw like how complex the organization was and just how big you guys are and just the size of the community that you serve, it was clear that there’s a large operation under the hood there. So, yeah, no, it’s great to understand your background. And I’m sure that you know, the organization inside and out having been there, you know, almost two decades now. So, yeah, I mean, yeah.
Kern Haynes (10:15) Sorry. No, sorry. Go ahead. I was just.
Taylor Ryan (10:18) going to say, so I mean we can kind of take this, you know, I can certainly start to just ask questions but maybe as a jumping off point because, I did, you know, talk to Delaney and it sounds like the initial thing that piqued your interest was the potential of getting delegated agreements in place. Not sure if that’s where you want to kind of start the conversation or, you know, if you would prefer, we can just kind of take a step back and just get a better understanding of like what credentialing looks like, you know, what, how you’re managing that obviously like there are probably quite a few different needs. You’ve got multiple facilities, different specialties, you know, I’m sure lots of different provider types, you know, lots of growth. I’m sure that there are a lot of different things going on. So maybe I’d ask you like, is delegated agreements and delegated enrollment credentialing, like something super top of mind for you or, you know, what piqued your interest and what would be a good use of time for us to talk about today in your mind? Yeah.
Kern Haynes (11:14) Great question. And this call or engagement is right on time because with us, we are struggling to, with just the entire credentialing process altogether. We historically had an internal credentialing department which fell apart, I’d say around the end of 2018, 2019 Ish. And then we pivoted to using cvos to do our credentialing. And we, you know, that worked well for a bit and continues to work well on the medical and behavioral health side. But on our dental side, it’s proven to be a little bit more challenging because dental is unique in a sense where it requires a little bit more attention to detail. And so we originally had that part all together outsourced to one cvo and they struggled just with the number of providers that we had and the workload. And so we decided to bring on a different cvo just to carve out dental and place them as a way to divvy up the work and have more have it more a dental have dental being paid more attention to and that cvo that we carved out to struggle. So then we decided to bring an in house. And we are, from my standpoint, you know, I’m just trying to figure out how to make the process just in general more efficient. And delegated credentialing is something we’ve explored in the past. It was one of my initiatives coming on board as a CFO before covid pandemic took me in a different direction. But now that I’m revisiting it, we had a consultant on previously and they were unsuccessful with coordinating with the state to get us delegated credentialing. And so now that you know, that was mentioned in my conversation with Delaney, I wanted to see how possible… it was to get it done. Was it just that consultant that was unable to, you know, maneuver and get it done? Or is it something that as an organization or as you know, yes, an organization, the state and the payers just isn’t ready for, which is why, you know, I asked a lot of questions just around your experience and your ability to get other entities, other fqhcs and similar size organization because I know that plays a role in it delegated credentialing and so that’s of interest but just improving the overall credentialing process. What value can you add to gpha in order to make us more efficient? Totally? No. And that.
Taylor Ryan (14:08) Makes a lot of sense. And I guess quick question on that. Do you have any insight into maybe like what the challenge was or why the delegation process was unsuccessful with that consultant?
Kern Haynes (14:22) Yeah, no, it was. I can, so from an entity standpoint, you know, our… HR department, I feel like it’s very well at or does very well at onboarding providers. And just all of the paperwork and the things that go in into onboarding provider. We’ve I think we’ve done a phenomenal job at that. And the processes that we have in place is excellent matter of fact, we’ve been audited by the plans and a lot of different entities. And we’ve given was recognized as like best practice, best in class, all that good stuff. And so we tried to use that to say, hey plans, you know, we’re essentially duplicating efforts here and you can come in and see what we do and give us the thumbs up, and you know, that’ll help expedite and create this delegated credentialing. But from my understanding, the plans were like, well, you’re just not big enough in order to receive delegated credentialing, you have to be at a certain size in order to qualify. And then, so we try to take this to the state level and have what is, our pca, our association of community health centers come together and use the power of all the fqhcs to get delegated credentialing but not all fqhcs are alive, right? They say if you see one fqhc, you’ve seen one and not all of them have the same onboarding HR processes in place. So that fell apart. So that was the rationale behind it. Okay?
Taylor Ryan (15:59) That’s super helpful. And from like, I know one of the things that, and it’s specific to each plan with like what their requirements are for, to get a delegated agreement in place.
Taylor Ryan (16:10) But on average, like we see… they require like 100 providers to start those conversations. So, I guess I know you said you have like 150 to 200 providers. I guess what portion of those providers are dent like dentistry versus medical, behavioral health? Yeah, great.
Kern Haynes (16:31) Question we have, and I can get the exact number for you. If it’s closer to 150. Now, we probably on the dental that’s the easiest, we have about 20 dentists and hygienists on the behavioral health side, I would say about 50 behavioral health providers between counselors and psychiatrists, and psychologists. And then the remainder would be on the medical side.
Taylor Ryan (17:01) Okay. That’s super helpful. I mean, if obviously, we can dive deeper there, but it sounds like at least on the medical behavioral side, you should be at the number at a number that, you know, you could start to have those conversations. And I’m thinking it might be a good time for me to just give you an overview of medallion and like explain where, we kind of fit because obviously, you know, there, there’s a lot of pieces to the puzzle here. So let me just, I’ve just got a couple slides here that I’m going to run through that kind of help just give you a visual as I’m talking through our story. All right. Can you see my screen? Yes, I can. Okay, perfect. All right. Really quick. So high level, you know, medallion is a healthcare technology company right here. You’re kind of looking at an overview of some of our, you know, our customers, our investors. And the story here is really just all of these folks up on the screen, see the problem that we do and are kind of aligned on. There is a challenge across the industry associated with the lag between you hire a provider, and then when can a provider actually see patients and bill and generate revenue? And there’s a lot that has to happen in between as you’re very well aware. And so I think for a lot of organizations, this is a really slow costly, you know, error prone, lots of friction process. It sounds like your HR team has the onboarding process really locked down. But as I’m sure, you know, like credentialing can mean lots and lots of different things. There’s lots of pieces to the puzzle here. And I think the story with medallion is we cut out up to 90 percent of the manual work in the process. So whether it’s you know, automating things like primary source verifications, or even talking about the payer enrollment side of the house as I’m sure you’re aware, you know, that there’s a lot of time where people are spent sitting on the phone on hold with payers there’s a lot of manual work that goes into it. We’re also an ncqa accredited cvo. So as you’re familiar, I know you guys have tried the in house approach as well as outsourcing, you know, to other cvos. We kind of sit in a unique spot. So I’d say we’re careful to not say that we are a complete outsourced solution. And the reason is because I think with a lot of outsourced solutions, what comes with that is a black box. Like you don’t have any sort of platform or any sort of visibility into the progress whether it’s you know, getting providers credentialed or getting them enrolled with health plans, or even let’s say that you went down the path of getting delegated agreements in place and you want to track how the process is going. But we also, you know, have the expertise, you have a full team behind you of subject matter experts at medallion that are here to, you know, advise you and help guide you in terms of best practices, but are also doing all of that manual work for you. So it does, you know, to some degree augment the amount of people that you’ve got in house, you know, sitting there and doing all that work. So hopefully they can go spend time on higher value tasks. And so, you know, when we’re thinking about the impact that we have on our customers’ organizations. Usually, we see the goal being to fit into one or all of these three buckets accelerate revenue, reduce operational costs, remove provider abrasion, right? Like it’s really hard as, you know, to hire and then retain… talent. It’s a very competitive market that’s obviously, very important. But as the CFO accelerating revenue, reducing operational costs, I’m sure that that’s where a lot of your time is spent looking at the numbers. And so these are the three value adds that I’d say are most common for our customers. And then from like a product perspective, like how do we achieve those things? This is sort of an overview of the medallion platform. And if we decide to continue conversations, we can get a bit more into the tech, show you what it would look like, the look and feel of the platform, what exactly we would be handling, what your team would be handling, and how we would work in practice. But thinking about all the things that have to happen in the provider data management lifecycle and to reduce the time from hiring to seeing patients, maybe some of these things are relevant for you. Maybe all of these things are relevant for you and an organization of your size, odds are you’re going to have, you know, more of these things be relevant than less. So whether it’s you know, we’re just talking about payer enrollments, delegated payer enrollments, direct payer enrollments, cbo, credentialing, hospital privileging, ongoing monitoring, making sure that your providers are in good status licensing, you know, some of our organizations will take on licensing for their providers. So there’s a lot that we handle. The goal is to number one, make your lives easier, take the headache out. Of the day to day and take the manual labor off of it. Number two, create a lot of visibility for you. So at any point, you can see how things are tracking. And then the third thing is we provide best in class turnaround time. So when you’re thinking about the organization and how you guys are operating, it matters on both a provider experience level, right? Like if a provider’s hired, but it’s months and months before they can start, you know, doing work, there’s frustration there. But also to the business, how many people days is it taking you to actually, you know, get a provider seeing patients and is that causing revenue leakage or delays on the finance end? And so a lot of our time is also just spent understanding what are your turnaround times and how can we improve those? I’ll stop there. Any questions? Is this resonating absolutely?
Kern Haynes (23:17) Absolutely. And so with medallion, is it now required for us to have… to be doing credentialing internally, right? So, would you connect with just the dental piece or if you’re eligible to work with cvos? How does that play a role in this? Yeah? So we.
Taylor Ryan (23:37) are a cvo. So if you wanted to use us in that capacity, and I totally hear what you’re saying, I don’t mean to just brush over the dental piece because we also understand dental is a very different animal than behavior, behavioral health, medical. It’s very different that we do have, we have customers of ours that operate similar to you guys, where you’ve got, you know, an arm of your business that is just dental. We also have organizations that we work with that are purely dental. So that’s an area that we’ve started to, you know, sort of build expertise in. And we, while we, you know, there are some things that have to be treated differently than medical or behavioral just because of the requirements and just the logistics that go into those, you know, different sorts of provider… types we can, you know, we can handle both sides of it. So I.
Kern Haynes (24:34) think, you know.
Taylor Ryan (24:35) We’d love if it makes sense like we’d love to get a better understanding of how you’re set up, maybe how you’re doing, how you’re separating things today. I think you said initially you tried to outsource everything to one cvo that wasn’t working. So then you tried two cvos, and then I think you said that you eventually brought the dental back in house. That’s correct? We’re really that’s correct? Okay, great. We’re really flexible like we are… you can use as much of us as you want or, you know, piecemeal kind of a la carte. So if you guys feel really good about the dental side being kept in house and you’d rather keep it that way and then take, you know, take a look at the other side and maybe just focus on delegated agreements. There’s lots of different ways that we could take it and it’s really up to you about like what you see is maybe some of the lowest hanging fruit that you feel like you could take, you know, maybe fix in the near future or if you want to, you know, eat the elephant all at once and just kind of take a look at everything and then figure out where we play. That’s also an option. But all of these things, you know, when you look at dental versus the medical behavioral side of things, all of it is relevant to both sides and we can handle both. Does that make sense?
Kern Haynes (25:55) Yeah, that makes sense. So till let’s take a step back… all along, tell me more about medallion, give me history how long you’ve been around fqhcs that you’ve partnered with any in Pennsylvania specifically? Because as you know, each state varies right? With just credentialing and provider enrollment. So, do you have footprints in Pennsylvania? And if so, any fqhcs that you can specifically point to that you’ve worked with?
Taylor Ryan (26:26) Yeah, certainly. So, tansy. Your first question… no question about how long we’ve been around. So our founder, we actually kind of came out of covid. So we started as a licensing company. Our founder, you know, had a friend who was in the healthcare space and was explaining to him just how difficult it is to get providers licensed across state lines. And obviously, as I’m sure you experienced with covid, telehealth became, you know, what everybody was looking to do for obvious reasons and that’s that really exacerbated the problem. So we started in 20 20 as a licensing company and then built our entire suite from there. So once, we kind of tackled licensing, we realized that there is a huge market here, a huge problem across the industry and a lot of the folks, you know, a lot of the companies, that are approaching it have been around for a really long time and maybe there was room for disruption from a, you know, automation perspective and just looking at things from a little differently. So that was our Genesis in terms of fqhcs. Let me do some research on fqhcs that are relevant to you. All I know that we have, you know, we’ve got 400 plus customers and I know that we have had a lot of success working with fqhcs but I want to make sure that I call on ones that are relevant to the size and just the scope of how big you guys are. And then let me do some research on any Pennsylvania specific fqhcs. But I can tell you that, we definitely have had success, in that space. And, you know, should we get down the line, and if you ever wanted, to meet a customer reference, we’re always happy to set up conversations as well so you can kind of pick our customers brains in terms of their experience with medallion.
Kern Haynes (28:24) That’s exactly what I was thinking and where I was going next. And I’m sorry, I got a hard stop at two 30 or shortly thereafter because I need to get to the office by three 30 and I’m about an hour away so… that’ll be extremely helpful just so that, you know, we know that you have experience in this space because for us gpha, that has been the indicator on whether or not folks really understand our fqhc space because it tends to be a niche, you know, that you need not specialized in, but you need a certain level of understanding in order to be successful.
Kern Haynes (29:03) And then I’ll be communicating with our chief human resource officer because he’s my partner in this credentialing processes. And, you know, figuring out if this is a direction that we want to move forward in. If you could send me the slide with all the information that’ll be helpful. It’ll kind of help me, you know, review and get him caught up to speed on medallion, who you are, what you do. And then the next step would be to set up a call with us three. So chief human resource officer myself and then you guys. Perfect.
Taylor Ryan (29:39) Yeah, that sounds great. Let me do some homework on some good customer references for you. So you can, you know, get a look at those I’ll send over the slide deck like you mentioned. And then, yeah, if all looks good and you want to continue conversations, let’s find time for a follow up call.
Taylor Ryan (29:56) And I’ll also bring on my technical resource who can get a little bit more into the weeds. And I know he’s also helped with a lot more. He’s helped with a couple fqhc deals I’m six months in and he’s got a couple years experience working directly with customers. So that sounds like a plan. Awesome. Well, thank you so much for your time. Curran. Appreciate it. Nice meeting.
Kern Haynes (30:20) You Taylor. Nice meeting you, Delaney. I’ll.
Taylor Ryan (30:22) let you go. All right.
Kern Haynes (30:22) Bye. All right. Thank you.