'ASCs are the future:' How MemorialCare Medical Foundation’s new CEO wants to change healthcare

David Kim, MD, was recently appointed CEO of MemorialCare Medical Foundation, a Fountain Valley, Calif.-based medical group encompassing MemorialCare Medical Group, Greater Newport Physicians and more than 200 outpatient care centers.

He will also serve as chief executive of the MemorialCare Heart & Vascular Institute and the MemorialCare Cancer Institute and as the lead physician executive of the MemorialCare Clinically Integrated Network. Dr. Kim first worked with MemorialCare from 2009 to 2015, where he served as a medical director before advancing into leadership roles, including regional medical director. 

Becker's connected with Dr. Kim to discuss his plans for his new role, his healthcare philosophy and more.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What inspired you to take this role and what are your plans for success?

Dr. David Kim: I grew up at MemorialCare professionally; it was the first evolution of my first job as a doctor and then my first foray into administration and leadership.  I first experienced what nonclinical healthcare administration was like at MemorialCare, and so it felt a bit like coming back home.

From a personal and professional standpoint, what MemorialCare offers is the opportunity to be big and small at the same time. It's big enough that we can take advantage of the scale to provide world-class care in terms of resources, talent, service lines and clinical expertise, but it's small enough that we're still able to meet patients in a more intimate and personal way.

From a leadership perspective, it allows us to be more agile in decision-making and strategic directions. If all of a sudden we want to move in a different direction, it doesn't take an exorbitant number of meetings — because we're small enough where we can get leaders in a room to say, "Okay, here's the new direction, here's how we're going to do it together." 

MemorialCare also has the ability to be in an organization that can materially and tangibly improve the care of a community. I can go home and tell my kids what I did today to help make healthcare better for the communities we serve, and then articulate exactly what it is that we did: We made it easier for a patient to make an appointment. We made it easier for patients to follow up with their physician. We made it easier for patients to make a phone call to talk to somebody; that is worth getting up in the morning to go to work for. What are my plans for success? First, I'm hoping and planning to succeed. So that's important. My general approach is thinking about how to deliver on the quadruple aim:  experience, quality, caregiver and physician experience. So how do we deliver on that in a way that engages physicians as partners, caregivers and employees as active contributing members of a team, but also so each of them goes home and says the same thing to their family: "I made healthcare better today."

Through driving the principles of value-based care, we can think more about how to take resources to care for a population versus, "How do I care for our population so I can get more resources?" Those are very different approaches. And I think the future of healthcare relies on figuring out how to do value-based care successfully. And when you look at some of the investments that Memorial has made over the years, like our ASCs, and our many other joint ventures, we're ahead of the game, in terms of thinking about how to care for our population in a value-based care way. So how do we execute on value-based care? How do we engage physicians as partners? How do we engage our employees and caregivers as active, contributing members of the team? And then how do we make care accessible?

One of the things we talk a lot about is quality measures. So, what's your mammogram screening rate and how are we screening for colon cancer and diabetes, but none of that matters if patients can't access care. So we're really thinking about access through a quality lens. If we're building a health system and working with physicians that we believe give world-class care, it's our obligation to figure out how to make that accessible to the people who need it. And that is not easy. Hiring is harder than ever. We don't have enough primary care physicians in America to serve the aging population — 10,000 people turn 65 a day in America — it's not an easy thing to fix. So, we are working to make healthcare better for the community. 

Q: Where do you think that outpatient care is headed in five years, and where are the opportunities for growth?

DK: I think COVID-19 taught physicians how care can be taken to an ASC without sacrificing quality or experience. I have a lot of orthopedic friends that for three or four months couldn't do any surgeries because the hospitals were closed down in 2020, and they figured it out. They said, "I'm not going to be put in a position again where I have to rely solely on a hospital for me to be able to provide and care for my patients." What they discovered is that it's a pretty great experience for the physicians. And it's a pretty great experience for the patient. 

Ambulatory surgery is not only here to stay, with CMS redefining its inpatient-only list and physicians gaining an understanding of what success at ASCs looks like from a clinical operational financial standpoint. With the healthcare dollar being stretched thinner and thinner, we're going to see more and more patients and physicians choosing to do their surgeries in ambulatory settings. And I think as technology gets more sophisticated, as payers increasingly start suggesting and directing patients to lower cost of care, ASCs are the future for routine procedures.  Then the really sick, really fragile, really complicated patients and surgeries will be done in a hospital, which is the right thing.

We will always need world-class hospitals.  The very sick, fragile complicated patients and intricate complicated surgeries, will be done in hospitals, where highly skilled specialists have access to operating rooms that allow for the most advanced equipment, multidisciplinary surgical teams and the ability to have specially trained nurses and support staff to care for the patient as long as is necessary. 

I'm very excited about the future of ASCs. We have a partnership with SCA, with more than a few surgery centers in the market. The other part that I think is interesting is that physicians can have equity in ASCs. So, there’s a portion of them wanting to optimize the business and optimize the care’, it’s a very compelling value proposition for the physician community.

MemorialCare is uniquely positioned. We can be a catalyst for change in healthcare nationally. Do I really think we can be that catalyst? It will be hard — but yes, we can do it.

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