Rural Health Transformation, Mobile Healthcare, & Expanding Access with Mission Mobile Medical

Speaker A: Name is Chase Marable with the CHC podcast and I am m so happy to be joined by our friend Travis. Travis, thanks for joining us today.

Speaker B: Yeah, thanks for having me Chase. Appreciate you and uh, your team, all you guys are doing.

Speaker A: Yeah, well thank you so much and uh, this is going to be a great conversation. We're going to talk about rural health transformation, we're going to talk about access to healthcare and I just can't wait. And we visited almost a year and a half ago. So if you want to learn more about the story of how Travis Scott going and his incredible organization, then tune into that as well. But Travis, for the viewers or listeners that are listening in right now, could you just give us a quick overview of you of um, Mission Mobile and all the great things you're doing?

Speaker B: Yeah, yeah, for, for sure. Thanks for uh, for the intro. So you know Travis LaFever, I'm CEO, founder here at Mission Mobile Medical Group in North Carolina. And I uh, lead our team of about 150 folks scattered out all over the country. We're in 42 states and day in and day out we are helping health systems, health centers and health plans really access all of their catchment areas or their patient populations. So we are a uh, full stack mobile healthcare company. That means that we are everything from turnkey access solutions out in uh, a uh community running a community health program all the way back here at the ranch. We are vertically integrated and so we design uh, build and deliver our own mobile global clinics.

Speaker A: That's incredible. And the work you're doing is impacting those patients and those health centers that are going out and serving all the patients in those communities and breaking down the barriers to healthcare.

Speaker B: Yeah, it is. I mean one of the things I'm most proud of is that a lot of organizations say hey, we'll come do it for you or we'll give you the tools to do it. But our organization as you sort of climb the ladder of uh, solutions and is really, we're happy to do it with you at whatever level of intensity that you need. Somebody to sort of shoulder to shoulder, stand in the gap with you, walk beside of you. So we have an implementation team, we have a compliance team, we have a field services and staffing team. We just, you know, we're B Corp Chase and you know, while uh, margin's important, it's not. I think Zig Ziglar is the one who said, you know, money's not the most important thing in life, but it's right up there next to oxygen and uh, we believe, believe it's right up there next to purpose. And you know, uh, our, our vision is to see healthcare delivered through this model in all 3,143 counties and parishes in the country. We believe a more efficient, effective distribution of our healthcare resources would really unlock a ton of value for the country and Americans. And so we just, we, we just want to see the work done and we'll help in any way. I mean, I'll, I've, I've, you know, I'll move chairs, mop the floor, right? Like, uh, make calls. Like, we just, uh, we just want to help people do this work. We believe in this model. Yeah.

Speaker A: That's incredible. And so when, when you have that community health center that you're working with and they have that opportunity to work with your team and put in a, uh, mobile unit, put in those resources in order for them to go impact more patients, you know, what, what outcomes do you see? How do you see the barriers break down? How do you see the patient's health outcomes? What do you see with that?

Speaker B: Yeah, great question. So I always like to try to start at the top and break it down. Like, super simple. You know, my mentor John, he always says, put the cookies on the bottom shelf, right? And paint a picture so people can just not, you know, see it in their head and they don't misunderstand. So, so I, I think there's, uh, these boxes, right? This revenue box and this cost of delivery box and this quality box and this impact box. And if you put those in an equation, that net benefit of the organization is revenue minus cost of delivery, plus or minus quality, bonuses, penalties, and then there's impact. Mobile health serves three of those boxes, so revenue for sure. I believe that patients don't have access barriers. I think providers have access barriers to the patients that need them. You know, if you think about, you know, fuel companies and food companies, if you don't have a grocery store, you don't say you have a barrier to access the food. It's really the food or the grocery store that did not set up an access point in that space. And same thing if there's no gas station in your county, you don't have barriers to fuel. The fuel company has a problem because they can't get there, you know, cost effectively. So, so revenue. We think that, you know, mobile encounters are what we call origination event and that, uh, there's a cascade of revenue for health centers that follow a mobile health encounter. For example, one of the use cases is medical, right. Primary Preventative care and screenings. But we think that once a patient becomes engaged with the health center, that the cascade effect drives dental, it drives vision, it drives prescriptions. And especially for health centers with 340B, that cascade is far more valuable than the, than the encounter necessarily. So revenue is a big one. Then on the quality side, we think there's a quality aspect too, that if they have issues or have some quality bonuses at stake, that accessing more of their patient population, really reducing the distance between where those patients are and where the, uh, brick and mortars are sending the provider out to the patient improves access, is proven to improve quality and lower cost, uh, overall. And then impact, of course, you know, there is obviously with the, uh, health centers, you know, we're big believers in the movement and study not, not just believe in or heard about, but study what Dr. Geiger, what John Hatch did, and try to replicate in our community health programs and our implementation processes, this idea of that we have to develop trust in the community, that these programs are designed to deliver what they, they need, not just what you think they, they need what they want in a lot of times, and, and to build trust. And a lot of our processes are around that. And I think that community health centers who access their full market, their full service area, that's the only way they reach their full potential is, is trying to engage and embrace and attract everyone who needs them, um, in their service area.

Speaker A: Absolutely. And if I'm a community health center, I've been hearing a lot about the funding coming in for rural health transformation. I think a lot of our listeners are really interested in maybe taking that next step to say, where do we go now? How do we access and how do we, as you mentioned, bring the provider to population? So maybe talk about what's going on with rural health transformation and the grant funding there. And what are you seeing?

Speaker B: Yeah, so nationally, I think it's a bit of a Gordian knot. And what I mean by that is that it's, uh, it's messy and every time you pull on one end, the knot looks like it gets tighter. So as, as you know, these are block grants to, uh, individual states that come with a lot of strings and some risk of clawback. And what we've, you know, here across the country, because we are competing in every state and engaging with state health departments, with our community partners, academic medical centers, everybody. And we hear 50 different stories about their approach, about their concerns, about their opportunities. Mobile Health was written into as. I don't know if you have heard this Stat or not, but 40. On which article you read between 44 and 48. But a significant number of states wrote in something about mobile health. And, and so there is opportunity and appetite for this delivery model. At the same time there's, it really depends on the state's priorities whether an application for a uh, mobile health program is going to be seen as sustainable or not. Because that is the common thread through all 50 states is that do not bring us a project that will not stand on its own two feet, that these projects are not. This, this money is not designed to fund a short term project. It's designed to bridge and help create a sustainable care model. And uh, we're seeing, you know, tremendous success there too. So. And I would say that it's a spectrum from individual projects and health centers, clinics, health system saying, hey, we want to dip our toe in and can you help us with a mobile health program in our community? All the way up to a state saying, hey, we're going to build a network of uh, mobile health programs and we're going to collaborate between providers and payers in the state and we are going to change the provider network in our rural communities. We are going to backfill all these physicians who are aging out, retiring, looking to hand off their panel, but finding no one to hand it to. And that's a lonely uh, feeling not only for the providers but also for the patients that they've been a part of their lives for the past 20, 30, 40 years. So we're seeing significant interest in mobile health as a network adequacy solution and access solution for, like I said, health systems and health centers who really want to reach their full potential in their market.

Speaker A: Absolutely. And so depending on that specific state guideline or strategy, you're seeing so many different ways on how mobile health programs are being utilized. So if I'm a community health center and I may not know what that looks like in my state today, where could I go to get a resource to help understand how could we plug into those mobile health programs?

Speaker B: Yeah, great lead into I think a plug for the National Rural Health Association. Uh, they're tracking tremendous amount of this, of initiatives in each state. Obviously each state is going to have its plan. The Office of Rural Health is going to know exactly, you know, uh, what the opportunities are, the information's not private necessarily. And then you know, they could always reach out to us and we could say yeah, we have this opportunity. We don't. We have grant writers who are helping, you know, I don't even want to count up the number of hours and weekends that they have been working because it is a tsunami. Right. Of opportunity. You can imagine like 50 states and, and you know, 44 initiatives and with all the different requirements and partners and you know, we have multiple partners per state. I mean we're just putting in, helping folks write application after application after application and using, you know, standardized, you know, budget standardized, you know, program descriptions and then allowing or at least helping them craft what it means for that program locally. Because really the power of mobile health is that it's flexible and that that's this type of solution that community health demands. You, you can't sit in one state and know the. I mean it would be sheer arrogance to believe that I could know what a, uh, county in Wyoming needs or a county in Missouri or a county in Florida. Like there's no way. We have to have that local partner who first of all wants to do this work, second of all has some resources and third is willing to say yes, come, come help. We the, some of the most risky programs we see are the folks who say we, we got this right, we know how to do it and, and they are going to be approved for an application, they're going to get some equipment and they're going to spend quite a bit of time trying to figure it out versus just following the, the playbook.

Speaker A: Absolutely. And for your team to help on the grant writing and for so many resources on rural health and to help understand what the state strategy is. What I'm hearing is that there's a lot of resources that our health centers can tap into to really understand what is it that our state strategy is on mobile health programs. And then how can we work with partners to apply that to our practice?

Speaker B: Yeah. And connecting and collaborating uh, with other partners. There are for example academic medical centers who want to do research but not necessarily provide clinical services. There's health systems who don't have primary care as a clinical service line and they're looking for how do we unload our emergency department run transition of care programs to prevent readmissions. But we need a community health partner to do that. And uh, it's not just send all of our uninsured to the health center. Like that feels like a, uh, pattern that I see repeated quite a bit. But the attitudes are maturing. Chase and folks are beginning to recognize the value of the health centers that they've always produced high quality, cost, cost effective, you know, efficient care with great outcomes and, and that they're not just for, for seeing their shuffle shuffling their uninsured folks over there anymore.

Speaker A: Absolutely. And uh, we have some incredible teams and partners that provide high quality care to people that, that really need it. Right. Um, something I'm really, I love to see about your organization is the partnerships that you have in place. And for our listeners, if you haven't followed the organization on social media or the website, please do it. One thing that you guys have is the executive and residence program. And I think you learn so much from what's going on in the industry and federally and legislatively in the operation and you have such great partnerships. Can you maybe talk about that? I think uh, there was a saying in the past that we're stronger together than we are singularly. Uh. Right. So maybe talk about your experience with partnerships from rural health to mobile health programs and just kind of what that means for you and your organization.

Speaker B: I'll tell you, the Executives in Resident uh program is one of the best ideas not only that I've ever like been a part of, but that I've ever found and, and Chase, I'm a reader and I'm a student of leadership and, and just you know, I've, I've never seen sort of this explained necessarily. I've seen it in action one other place but surrounding my, me and our executive team with, with past CEOs of health centers and health systems health plans and, and, and, and folks from cms, folks from HRSA who had unbelievable careers, right. Like federal government employee of the year, you know, Dr. McGann for example, he and his team, just unbelievable insight and input and mentoring. Not just in the technical side of kind of healthcare and their particular domain expertise, but just mentoring and, and, and, and what I can expect. It's almost, I don't know if you like river rafting, but it's like having six or eight guides. You can imagine what kind of a trip you might have and how smooth it might be if you had six or eight guys who have been doing this for you know, 30, 40, 50 years and kind of coaching you uh, down the river. So just just fortunate to be able to have those folks on our team and um, and then unbelievable, you know, provider partners. So some of our health center partners are so generous with their time, their talent, their advice. You know, we follow uh, pacing strategy. So the idea is that we're collecting exemplar and, and we try to platform them so other folks who are just getting started can see what's possible. You know, because a lot of I think I can comes from, I am like, am I good enough, strong enough, do I have enough resources? Is it safe to try this new thing? And when a health center who's just getting started looks over at a health center who has 10 mobile clinics, they go, well, what one can do, anyone can do. And, and, and, and they begin to believe, not that this is not just for, you know, that health center, but it's for all health centers. And it's not just for that community to benefit, it's for their community to benefit. And, and so just, uh, unbelievable partners. You know, I really believe it's who power. Uh, I think that we grow up, you know, in school and we are coached and commanded to do your own work and don't look at anybody else's paper and don't ask anyone else for answers. And when we get out of high school, we think we're still in it. Because humans, we're professionals, I found, are loathe to ask for help. But when reality, instead of when faced with an obstacle asking what should I do? And your brain goes, I don't know, we've never done this before, right? And you're in your little bubble, like arguing with yourself. If you switched it to who do I know that can help me with this? All of a sudden a world of possibilities and abundance opens up to you as, as a person, as a professional, as a leader. So rather than saying, what should I do? Or how am I going to do this? To who do? Uh, I know is a way to tap into that. And we are living proof that if you put enough good people together, they are going to figure some stuff out.

Speaker A: That's incredible. And I think about earlier in the conversation, tying it to those three pillars, I think about impact and with tying those partnerships into your organization and other health centers and systems across the country, that allows you to then make such a great impact on the partners you serve every day. And it's a, incredible to see.

Speaker B: So, so that's a great point to, to talk about. What you're describing is, and there's the book called the Seven Powers. Right? And seven powers, one of them is network power. And if you think about Facebook, every individual who joined Facebook made it more valuable to the people who are already on there. And so the, the network, every time we add a health center or a health system that we do another program and we're up to about 300 now delivered. And every time we add one, we add to our blanket of best practices. And so number 301, 302, 305 and 310 get the benefit of all of that learning and sharing and togetherness and community that we've been able to build here. And so it's just an incredible group of clients and partners and uh, professionals just passionate about solving this problem.

Speaker A: That's incredible. Well, as we tie a bone the conversation today, we've talked about the importance on mobile health and what we can do to get the provider to the patients right. And we've talked about the impact and the quality and the encounters within the communities they're serving. We've talked about the huge rural health transformation with mobile health programs, state level, individual community health center level, the resources that they can go back and connect. And then we've talked about just the importance of leadership and partnerships to go out again, serve the community health centers within, ultimately serving the patients that are looking for that care. So as we tie it up today, what else do you. If I'm a community health center listening, what else should I know about mobile health? How can I get plugged in in order to learn more or if I'm wanting to write a grant, take that next step? What should I do?

Speaker B: Yeah, I'll just leave you with, with our, our motto, right, which is let's go. As you know, we, we have a, an ethos here of servant leadership. We value all people and, and it is our, we feel an obligation to serve all people. And when the people you need to serve are over there, the servant leader feels an obligation and, and is compelled by character to have the courage to go. And, and so that's what we say and we wrap all that up and let's go. And, and I would say the same to any health center who is considering this or maybe has tried it in the past and it didn't quite work out and I wasn't optimized before is that you don't have to be alone, you don't have to do this alone. There's, there's some folks who would, would, would just wake up every morning wanting to help and you serve your community better. You guys are heroes. And, and we're here for you. And let's go.

Speaker A: Let's go. All the listeners, thank you so much for listening in. I'll include links into the description, so links to connect with Travis's team and then also please recommend checking out the Mission Mobile Medical Group and seeing all of the incredible stories of other community health centers. So Travis, thank you so much for joining.

Speaker B: Thank you, Chase. We appreciate your partnership.