>> Support provided by a partner to New Jersey's manufacturing industry focused on productivity, performance, and strategic development.

♪ >> This is "NJ Business Beat" with Raven Santana.

Raven: Hello, I am Raven Santana.

Thank you for joining me.

New Jersey's health care industry is one of the most important in our state providing critical care while innovating in the field for researches initiatives.

There are nearly 23,000 health care establishments in New Jersey, many of which are hospitals.

Those contributed 29 billion dollars to New Jersey's economy in 2020 according to the most recent data.

They served 14 million patients and have at least 154,000 four and part-time employees who make $10 billion in salaries and wages annually.

Some of those hospitals are safety net hospitals meaning they have a mission to serve the poorest, underserved communities.

Oftentimes, those run as nonprofits with a similar commitment to community health over investor profits.

I spoke to the president and CEO of care point help which runs safety net hospitals and recently transitioned to a nonprofit model.

Tell me about care point health's mission to serve Hudson County.

>> These hospitals have been serving this population which have been seeing this mix of people for the last 150 years of existence.

These are the only hospitals that have remained where they are in the communities where they first started.

Hoboken and Christ are called safety net hospitals.

Initially, Christ and Hoboken was never established to serve the wealthy.

It was set up to serve the poor and the needy.

We continue to do so.

We have not moved it to another area which is a better location, we have kept it where they are.

Probably they are the only continuing hospitals serving the poor and needy for a century.

That has gone on now and we are committed as a system to do so, provided we also get a lot of support from the state and other agencies as well as philanthropic as we become a nonprofit.

Raven: How are you able to do that while still driving innovation?

>> You do innovation with what you have got.

You cannot go into high experienced innovation.

It has to be low expense innovations.

We are turning a lot of our care models that include continuing care but also taking care of patients at home using new technologies which are low-cost.

We are doing pregnancy follow-up using remote cam monitoring.

We partner with Saint Peter's that also sees a lot of disproportionate care.

Raven: Tell me about the just help foundation.

>> Previously, we had a foundation that supported us but was not born out of CarePoint Health.

It existed before we came.

Just health is something I thought of walking up the stairs thinking we need to focus just on health.

It has to be fair so it is just.

It has to be just in time so we provide care just in time.

I said, let us create a foundation because philanthropy is very important in such hospitals.

People do give philanthropic, charitable grants to hospitals but our story has to be out.

People realize these community hospitals need more charity than bigger centers in big cities because they already have enough .

We have to have decent revenue for decent charity.

Raven: People want to know where their money is going.

>> Correct.

We said let's create the Just Health foundation to create just care for the most needy people.

Just Health has been created to take care of the 50,000 uninsured people and a large number of underinsured people.

Insurance does not really cover cost of care.

That is what we have created.

Just Health will allow us, we have also been given an opportunity, you see the school of medicine and other major industries as well as individual donors, they just donated to one of the Barnabas hospitals, our community hospitals have done the same amount of work if not more during the pandemic.

The litmus test is if you are there when crisis strikes.

We were there.

Hoboken Hospital rank number four in safety net in the country.

Christ Hospital was rated number one.

They are the most impartial observer of health care.

Christ Hospital rank number one in the United States for equitable care.

That means we take care of all people equally irrespective of race, ethnicity, income levels, any other factors.

We are number one in the country.

That happened around the pandemic.

We have been doing a lot of good work.

People need to support us charitably through the Just Health foundation.

Raven: We know it is not just your patients that you care for.

It is also your employees.

Tell me about CarePoint Cares.

>> If we do not take care of the people providing care, it does not translate willingly or happily into good care.

We started creating nursing lounges, creating programs for them.

There is a nursing lounges set up in Hoboken.

We plan to do the same at the other two hospitals.

We have created expanded physician and resident lounges.

In the nursing lounges, you can have other staff.

We provide food, counseling.

In the physician lounge, we allow physicians to interact with each other.

Raven: when we think about the demand when it comes to community hospitals, I cannot help but think about the urgent care centers and walk-in clinics.

They are everywhere.

How is that impacting community hospitals like this one?

>> The sickest people who need care will still come into the hospital.

We have to do a hybrid method.

That is part of innovation.

We will do a hybrid method in which we will increase the quality of care inside hospitals but also set up some urgent cares.

Raven: Rather than go against it, you are joining.

>> We have to do it.

That is the future of care.

If we move from urgent care and outpatient locations to home, the future of health is being treated at your place of residence.

There is an act that was passed.

There are other acts in which caregivers will be compensated for taking care of their family.

That will be the eventual model 20 or 30 years from now where most of the care will be given at home.

That is the future.

Community hospitals will be needed.

Hospitals are a safety net.

I was telling people in a recent keynote address.

I was talking to an audience and I told them these hospitals have been through three pandemics.

The plague, Spanish Flu, and CoVid.

Who knows what is next?

Unless we find other methods, right now, safety nets are very important.

People should realize these hospitals have to remain.

Raven: Typically when you need to go to the doctor for a sick visit, you will go to your primary care physician's office.

According to the Association, New Jersey ranks 19 when it comes to active primary care physicians.

This week, we have learned many PCPs are battling a new trend in health care, competing with urgent care centers.

Many primary care offices are overwhelmed with demand, leading to fewer available appointments and more patients heading to urgent care.

I sat down with the epidemiologist and professor at Montclair State about the research she has done into the growing competition.

When people are sick, they should be battling the sickness, not insurance companies.

We know that is the case not just for Americans but especially New Jersey.

When we think about affordable insurance and look ahead to flu season, COVID vaccines are in demand, are you concerned at all?

>> About the overall affordability?

Absolutely, especially for people at the margins and people who have health insurance that is not really affordable health insurance.

We have a lot of people in this country considered underinsured.

We talk a lot about uninsured but there are a number of people who have health insurance policies where the premiums are too high, the coinsurance, the co-pay, then when you add on having to take off time from work to see a physician and get flu shots, it can become incredibly expensive quickly.

That keeps people out of the health care system.

Raven: We know that during the pandemic, those urgent care walk-ins were on demand.

It seems like they are here to stay.

I wonder if this in any way is the future of health care.

How are these urgent care walk-in clinics impacting the likelihood of private practices?

>> We have been seeing an increase of about 7% of new walk-in clinics per year over the last three or four years.

There is a lot of money in private equity firms investing in this.

This is really part of the future of medicine.

Some of this predates the pandemic.

It was driven by a push to keep people out of emergency rooms and a combination of people who had access to health insurance through the Affordable Care Act.

There was this push to have urgent cares affiliated with hospitals.

Now we are seeing the next iteration of that.

The good news is it does create opportunities that are far more convenient.

They have longer hours, weekend hours, for people working to get health care.

But we are seeing a decline in physicians in private practice.

We have been seeing that decline probably since about 2007.

What is really fascinating to me is when you look at the demographics of that, for example, women doctors are less likely to be owners.

It is not happening evenly across the sector.

Raven: Do you think people are choosing walk-ins now over private practices?

>> We are seeing that people are increasingly choosing that.

Utilization at walk-in clinics is up by about safety percent since 2019.

A lot of it was -- 60% since 2019.

A lot of it was driven by the rapid tests to travel.

I don't see it going away.

Convenience is cost.

Even if you are paying the same amount in terms of health insurance, if I can get into see that physician quickly on the same day, people are tending to choose that.

Raven: When we look at the larger picture, how are those clinics impacting community hospitals?

>> I think what we are seeing is people are less likely to go directly to an emergency room for what our urgent care issues that could be dealt with in a physician setting.

But we are seeing a shift of physicians working at hospitals or affiliated with hospitals and starting to choose to work for these clinics.

The other issue is there is a lack of continuity of care.

Just because you see one physician today, if you go back in three months, you will not see them.

They are not intended to be used for management of long-term chronic conditions and yet people seem to be relying on them for that as well.

Raven: could we see a decline of doctors opening private practices and going to work at urgent care centers instead?

>> We have already started to see a shift away from private practice and physicians affiliated with health care systems.

Part of that has to do with the billing structure and ability to negotiate better prices from payers.

With the increase in the number of these walk-in clinics, and that includes places like CVS, the physicians no longer have to deal with the administrative tasks because there is a corporate structure to address that.

We are seeing fewer physicians in private practice.

Raven: We know obesity has been a major health issue in the U.S. for years.

It seems obesity and weight loss has been a hot topic recently due to the demand of diabetes drugs that in turn cause weight loss.

Let's talk about what kind of impact that has when you think about the future of how we treat obesity and the demand for diabetes drugs.

>> The challenge is that because there has been such a demand and significant amount of off label use of the drugs, it has made it harder for people who need it to control their blood sugar to access the Ozempic.

There have been a run on these drugs.

It is creating a challenge in the market.

Raven: In some ways, do you feel it is discriminatory?

I feel like those who suffer with obesity are usually those in communities who are in disadvantaged communities or do not have the resources to help them with weight loss.

>> I think the structural inequalities we have seen around a multitude of health outcomes, die B.C., -- diabetes, obesity, tend to be in communities of color who also may not have affordable health insurance coverage for these types of drugs.

In the United States, these cost more than they do in other countries.

There are cases where people who have the means can go to other countries and get the drugs or go to medical spas and pay full price and make an end run around insurance.

That is dangerous because there are significant potential side effects white pancreatitis with these drugs -- like pancreatitis with these drugs.

You do need to be seen by a physician and monitored.

The reality is when something goes viral, people find a way to get it.

Raven: I don't think that drug is going away either.

>> It is not.

Raven: Thank you so much for joining me.

>> My pleasure.

Raven: New Jersey's hospitals are at the forefront on medical innovation.

From new medicines to artificial intelligence and robotics, our medical centers are turning groundbreaking research into lifesaving technology.

At Hackensack Meridian health, new cancer research will blossom into a full-fledged spinoff company that will use new technology to achieve earlier than ever detection of tumors and other diseases.

We spoke about the new company and the discovery that led to its creation.

Tell me about how this company came about.

>> It is super exciting.

Hackensack Meridian health has the center for discovery and innovation where we have labs, close to 28 right now, 175 scientists.

It came out of a discovery from one of the labs.

It is focused on identifying biomarkers for cancer in particular.

In this particular situation, we are looking for lung cancer biomarkers.

They found a really good way to do that.

Not only find it but find it in a failed breath which is unheard of, -- in exhaled breath which is unheard of, so we are super excited about it.

Raven: Will it replace other diagnostic methods or is this an optional service?

>> It is an interesting opportunity for us to meet and unmet clinical need.

To diagnose lung cancer today, the easiest way to do that is sadly by accident.

It is when you are going in for an x-ray and you find there is something on the x-ray for example, a lung nodule, and they cannot figure out what it is.

Many times, you don't have symptoms for lung cancer so it is late or far along.

It will enable us to get an exhaled breath sample and identify whether the nodule is cancerous for something else.

Maybe it is just inflammation or infection.

For us, trying to identify those cases that are lung cancer very early on can make the difference between life and death for many of these patients.

If you catch it very early, treatments are much more effective.

The mortality rate is much lower for those patients who have early-stage lung cancer who are found and can go into therapy.

Raven: What will the cost be for consumers?

>> It is interesting.

We are not quite to a point where we are getting it the consumer market yet.

We are expecting it will be sub $150.

The standard of care right now is you have to go in for what is called a low-dose C.T.

scan.

You get exposure to radiation basically.

That is about a $500 test for most patients.

If we can get that down but also do it in an easier way so people do not have to go to an imaging center and go through that process, we are hoping we can see patients take us up on being able to screened much earlier for the potential for lung cancer.

Raven: Tell me about it.

First of all, love the name.

You have to tell me how you came up with the name.

This is a game changer.

Let's talk about it.

>> Let me take a step back and tell you how we named it.

It is kind of like a Shark Tank kind of opportunity where people come in that are team members and maybe outside companies.

They are looking to pitch their story and idea to us.

We could not take Shark Tank because it was already used.

It is so funny.

I hate to say this but this was a men's thing.

They wanted to get something aggressive so they went after grizzly bears.

If we like it, we will give you a bear hug.

They called it the bear sts den after that.

People are getting comfortable with it.

People can work on projects and ideas and begin to develop them into new and innovative solutions for our patients.

Raven: Your passion continues to shine.

As we are doing this interview, I can see how excited and committed you are to doing this.

What is behind all of this?

>> One of the things that is ingrained in me and I think I can give it to my father, give credit to my father, he was always very curious about things.

He always liked to solve problems.

As a result, I think I grew up with that natural curiosity.

I wanted to go to med school.

I had gone through school and I had to work and make some money.

I started going into health care from a different perspective.

I found out I was really good at bridging science and business in a very different way.

It fits nicely with innovation where you can focus in on solving problems, unmet clinical needs or problems at the med side.

How do we do that in a way that facilitates care and delivery of care in the future?

That is what super excites me.

We know we can do better and different.

Let's figure out if there are options to test and experiment and figure out how to do it differently for the future.

Raven: As we look ahead, what is one goal you want to tackle, that you want to solve?

>> One of the goals I have is about creating more access.

Making testing and capability of monitoring your own body and help very different for the future.

How can we empower people to take care of themselves differently?

Give them the right tools.

It is not a technology issue.

It is about how we get the technology where it can connect and help people take care.

It is almost like your check engine light.

How can we create a check engine light for a person so they know when to take care of themselves or go to the doctor and find out what is going on with them?

Raven: Preventative.

>> Absolutely.

Getting things much earlier helps us as a society to continue to produce and provide for our families.

That is what we would love to be able to do, focus in on how we can drive the capability and tools to the individual level in a way that makes a difference.

Raven: You are doing that.

>> Thank you.

Raven: You are a true leader in health I.T.

and transforming health care.

Thank you for sitting down with me in discussing this.

Before we leave you, here is a look at this week's top business headlines.

The drugstore chain his filing for bankruptcy and will close some stores in New Jersey.

They filed for Chapter 11 protection this week in New Jersey citing years of decline in sales and growing debt from opioid lawsuits.

They will provide 3.5 billion dollars in refinancing as it goes through a restructuring plan that will include closing six stores in the Garden State.

Right aid has faced a number of lawsuits based on the addictive painkillers.

Shovels are finally going in the ground after decades of planning for the gateway tunnel project preconstruction on the first phase will start in the next few weeks according to transportation officials.

The CEO of the gateway development commission revealed early construction will kickoff in North Bergen.

The work is part of a roughly $16 billion project to construct two new Hudson River rail tunnels between New York and New Jersey.

It will also rehabilitate existing tunnels in use.

It has been broken into nine parts allowing early work to begin while going through a process to qualify for federal grants.

Jersey City filed a federal lawsuit to prevent police officers from using legal weed not on the job.

City leaders argued the adult used marijuana industry goes against current laws which say a person cannot legally own a gun if you use a schedule one drug.

Marijuana is a schedule one drug.

They are suing to clarify that federal law supersedes state cannabis laws and officers should not be allowed to consume cannabis off-duty.

The city has assumed -- approved 40 centers.

Two officers successfully sued and won reinstatement.

The city is appealing the decision.

That does it for us this week.

Remember to subscribe to our YouTube channel to get alerted when we post new episodes.

Next week, we look at the health of the commercial real estate industry with some companies choosing to stay out of the office while others bring workers back in person.

I am Raven Santana.

Thanks for watching.

We will see you next weekend.

>> Support provided by NJMEP, focused on productivity, performance, and strategic development.

♪ ♪