CHC Outlook 2026: Aaron Wilson & John Browne, CHAS Health
In this episode of the “Achieving Health” podcast, host Chad Mulvany is joined by Jeff Allen, partner and leader of the community health center (CHC) consulting practice at Forvis Mazars. Their discussion features special guests from CHAS Health, a nonprofit FQHC in Spokane, Washington: CEO Aaron Wilson and Chief Operating and Strategy Officer John Browne.
Jeff, Aaron, and John explore the outlook for CHCs in 2026, including:
- Revenue cycle challenges and improvement opportunities
- Effects of changes in the 340B Drug Pricing Program
- Medicaid patient volume in the wake of the One Big Beautiful Bill Act
Transcript
CHAD MULVANY
On today’s episode of “Achieving Health,” I’ll be joined by my colleague Jeff Allen and special guests Aaron Wilson and John Browne from CHAS Health. They’ll explore the outlook for CHCs and FQs in 2026. Stay tuned.
ANNOUNCER
This is “Achieving Health,” a podcast from Forvis Mazars, where we delve into the topics that matter most to healthcare organizations across the continuum of care. Our goal is to help you navigate the dynamic healthcare landscape and achieve health at your organization. Here’s your host, Chad Mulvany.
CHAD MULVANY
Welcome to “Achieving Health.” I’m Chad Mulvany, director in the Healthcare Practice at Forvis Mazars. Thank you for joining me. Today’s episode continues our recent series exploring the 2026 outlook for organizations across the care continuum. We’ve had some great conversations with leaders of health systems, long-term care, and rural healthcare providers. And today, we’ll turn our focus to community health centers.
I’d like to welcome my colleague Jeff Allen, partner and leader of the CHC consulting practice at Forvis Mazars. I’d also like to welcome our special guests, Aaron Wilson, CEO, and John Browne, Chief Operating and Strategy Officer, of CHAS Health, a nonprofit federally qualified health center based in Spokane, Washington. Aaron and John, thank you for joining. And, Jeff, thank you for guiding this conversation. I’ll turn it over you to get started.
JEFF ALLEN
Thank you, Chad, I really appreciate it. And I’m really excited to have Aaron and John here today. Aaron and John both have done a great job with their clinic out there in Spokane, Washington. We’re excited to have them and hear their industry insights. And so, I just like to start, if you don’t mind, Aaron and John just give us a little feel of how you got involved in community health centers. You know, how did you get started?
AARON WILSON
So, I’ve been with CHAS now since 2002, and obviously the community health center has changed pretty dramatically from those early days in 2002. But, you know, I ended up in Spokane to go to Gonzaga for law school. And that was in the sort of mid-90s. And, you know, I went to work for the firm I interned for and had been with them for about three years.
And then my paralegal left and ended up going to work for the founding CEO of CHAS, Peg Hopkins. And they were looking for somebody to come do corporate compliance work and grants management work. And so, my former paralegal reached out and said, hey, would you be interested in having a conversation about the job? And, you know, I was at that point in life where I was wondering whether billable hours were going to be my, you know, next 25 to 30 years or whether there was a different way to do it.
So, I figured, what the heck, I might as well go and work inside a business and learn the business. And that was sort of my initial pathway in. So, I started off doing corporate compliance reports. I wrote my first 330 grant application, which was no small thing back in the pre-digital day. And then, you know, as was common back then, if you were competent at things, more things just kept coming in your direction.
So, I worked my way from there up to the chief operating officer and eventually took over here at CHAS as the CEO in 2015. So, it’s been a journey and I actually really appreciate the non-sort of traditional approach to getting to where I’m at. There’s just a different perspective and there’s a lot of things that I think really help when you’re running a large health center organization to bring to the table.
JEFF ALLEN
Excellent. That’s interesting, your path there. John, what about you?
JOHN BROWNE
Yeah. So, mine was very untraditional as well. Somewhat like Aaron’s, but a little different. I was, actually I grew up on a farm in central Washington, and I was getting ready to graduate undergrad and felt like I needed some sort of business-related experience, something beyond just farming.
And so, I was graduating in finance in econ at the time, zero intent or interest in going into healthcare, didn’t even really know what a health center was, even though my dad was the CEO of one for almost 30 years. My mom was a nurse there for the same health center for about 35, but I still had no idea what a community health center was. And so, I asked my dad if he had any ideas.
I was going to school here in Spokane, and he called Peg up. He was good friends with the founding CEO as well. And asked her if she had something available for me, just for an internship, just for my last couple quarters at Eastern Washington University. So, I got into the finance department here at CHAS as an intern and was getting ready to graduate undergrad and Aaron offered me a job at an opening in their accounts payable department, which was one person who was in an accounts payable specialist role.
I was actually on a road trip up to Alaska with my dad when I got that call. So, anyways, yeah. I ended up, it was 2006, so, you know, things were starting to turn a little bit, you know, just with the economical environment, and I was like, yeah, that sounds good. I’ll take a full-time job rather than, you know, looking for one, which was my plan. And I was planning on getting my MBA or thought about it, and, you know, just doing the internship. I knew CHAS was a really great employer that, you know, cared about their employees and was super flexible and things like that.
So, I thought I would stick around for a couple years while I went to graduate school. And then again had zero intent on hanging out long-term. But one thing kind of led to another and I just have enjoyed CHAS all these years. I’ve been here for over 20 years now and went over into operations for a little bit and became the CFO about 13 years ago and then just recently moved over to the chief operating and strategy officer role. So, just kind of one thing led to another.
JEFF ALLEN
That’s interesting. You guys both had interesting roles. I bet your dad is proud that you went in, you know, because he, you know, you said he was the CEO of a health center for many years. He probably loved the fact that you’re, like, going to work for a health center, which is awesome.
JOHN BROWNE
Or he thought I was crazy. Because he retired, like, two years after I started.
JEFF ALLEN
That’s awesome. You know, let’s just start with the patients. I mean, you know, it’s interesting to listen to everyone talk about the challenges that are out there, but I would love to hear from both of you. I mean, what are some of the challenges that CHAS patients are facing right now? And, you know, and what are your thoughts on that?
AARON WILSON
Well, I can jump in really quick. I mean, I don’t think these are like surprising. I think these are pretty, you know, commonly known challenges. But, you know, obviously the cost of healthcare, I mean, it’s hitting the patients like everything else. Affordability is really an issue. Those are the hard decisions, you know, patients have to make when they’re looking at the cost of a prescription.
And you know, what are the other household expenses they’ve got to cover? You know, it’s an increased burden on them just from, you know, anxiety and managing household expenses and all those things. I would say access continues to be a challenge for folks. So, we do a really good job about trying to be creative from a primary care perspective about how we can support our patients from an access perspective.
But, if a referral is needed, or you know, or a prior auth is needed, getting patients into other systems that offer specialty services that we don’t really have the ability to provide can really be a challenge for them to continue to sort of follow their primary care provider’s directions. You know, and we’re still suffering from workforce issues.
I think less on the shortage. You know, it seems like we recovered a little bit on the shortage for some roles and positions. Obviously, we still have key shortages for, I would say, medical providers mostly. And that’s just, the reality is the residencies aren’t pushing out enough physicians in our part of the country. And, you know, that continues to be a challenge.
And just, I would say, the level of stress folks have been feeling over, you know, the last 5 to 6 years, it hasn’t really let up. I mean, it’s ebbed a little bit, but that’s something that a lot of our professionals are dealing with on a real-time basis. And then I think from, you know, our patients, we serve a pretty broad area here, you know, around Spokane.
So, our geographic territory is not just an urban setting. There’s a lot of folks that are in rural settings and trying to figure out ways that we can engage with those individuals around how they can get access to care, and whether that’s trying to come up with transportation or getting them to a library so they’ve got good wi-fi for telemedicine, you know, all those types of things.
And then, you know, trying to get everybody up to speed on what those telehealth opportunities and what is, you know, what are the sort of new digital interventions that we can leverage for healthcare access? Whether it’s, you know, some aspect that includes AI or other things, but just making sure folks feel confident as they, you know, look at some of these alternative options on reaching us.
And, as we look at our, you know, everybody’s looking at the same factors around age of our population. And so, you know, trying to get ahead of what we can do for our geriatric population and trying to engage with those folks before they hit that, you know, age 65 so we’re not seeing these formerly uninsured folks show up with just a conglomerate of issues.
The clock’s going the wrong direction for us on that one. Folks are aging in to Medicare quicker than we can spin services up. So, that’s something both from the patient perspective and us, we’re just trying to engage with folks locally.
JOHN BROWNE
I think the only couple things I would add, I mean, that was a pretty comprehensive list, but, you know, speaking of access, I think just to build on that a little bit, our patients definitely have issues with access even to services that we offer. But, just with the complexity of our patients and the acuity of what they’re coming in for and the huge amount of, you know, just comorbidities and diagnoses and then everything our patients deal with, it is really, really challenging them. And really challenging for us to get them into the appropriate services they need outside of CHAS as well.
And so, when we look at our specialty referrals in the community and we look at referrals to other, you know, whether it’s housing or transportation as Aaron mentioned, or, you know, even just with our community partners, it’s really hard when we’re serving, you know, half of our patients are on Medicaid and 10% of them are uninsured, and a good chunk of them are on Medicare.
There’s just a lot of providers that are feeling the squeeze all over the community. And so, you know, we see it on the hospital discharges, you know, we end up kind of being the primary provider in the community for all the hospitals when they’re discharging patients that don’t have a primary care provider in the community, or are complex.
And, you know, they don’t have room to take them on their own panels. So, I think access in general across the entire healthcare spectrum around here, and I know this is true everywhere, is a real challenge for our specific patients. It’s a lot easier for folks on commercial that, you know, are relatively simple as far as their needs for healthcare to get access.
But for our patients, it’s a whole other challenge. And the other thing I would add to that is behavioral health, mental health, and substance use services. And so, we have specifically invested a lot in building up those services internally. We have two community behavioral health clinics, one in Idaho and one in Washington. So, we’ve even gone kind of to that next level of, you know, providing a little bit more complex behavioral health services.
But, that’s a huge challenge and something that, as a community right now, we’re dealing with and we’re trying to figure out how to build up those resources and how to structure ourselves a little differently than we have in the past, so the patients can get what they need.
JEFF ALLEN
I was just recently looking at some data and since the start of 2024, the average operating margin of the health center is actually in the negative. So, I mean, you’re in a period where you’re stretching resources, right? I mean, you’re trying to make things where, you just listed off many things that your patients are struggling with. They’re trying to figure these things out. And, all of a sudden, we’ve got a little bit less resources to stretch around.
But what are you all doing at CHAS to try to meet all these needs and stretching these resources that you have to make sure that you can meet all those healthcare needs that that you all mentioned?
JOHN BROWNE
So, I think, first and foremost, what we started to do, and this started well over 12 months ago, closer to 18 months ago, is just take a look at, you know, from an efficiency lens, our own administrative resources and what, you know, what we can do. We tend to, you know, focus on the clinics and productivity and what we can squeeze out of the general, you know, operating system.
And I think we, you know, we took a hard look at what we are spending internally on administrative staff, technology, software, all kinds of resources. And so over the last 12 to 18 months, we have really, really been focused on that initiative. We’ve whittled down our overall administrative costs in a number of different ways. We’ve not been backfilling positions for the better part of 15 months, in some departments even longer, on the administrative side.
And, we’ve been whittling down our overall software tools, trying to consolidate and condense those and, you know, look for favorable contracts with our vendors. And so, we have gotten to the point where, yeah, we’ve shaved off millions of dollars a year in administrative costs. And so, that was one of the things we did right from the get-go.
And we could kind of see the writing on the wall with the way things were going and the One Big Beautiful Bill being passed and just things looking like they were going to get tougher for health centers and margins were going to get slimmer as you mentioned. The other thing that we did operationally is we have service lines, you know, it’s, I mean, a lot of folks look at their different departments in this way. We call them service lines.
But we’ve got like primary care, dental, behavioral health, pharmacy and so on. And we took a really hard look at each of those service lines from just an overall financial sustainability lens. And the finance department worked really diligently with each of the service lines to create what we call kind of a sustainability road map.
And it’s very different by service line, but the point of it was to not only look at, you know, any sort of revenue cycle improvements that we could identify, which we did identify a lot of those, particularly in dental and behavioral health and looking at, you know, billable encounters and billable providers, but just looking at the overall opportunities we had within those service lines and how we could utilize staff and resources better.
And so, in the primary care setting that ultimately led us to rolling out kind of a new team-based care initiative that we’re doing right now, which really, at the end of the day, is about maximizing the scope of each of the care team members and making sure that they’re all working to the top of their scope and that we’re being efficient with patients. Ensuring that, you know, they’re getting what they need but seeing the right clinical person at the right time.
And, in some of them, like dental, some of the service lines like dental and behavioral health, we really did focus on access and productivity and using our staff a little bit differently. And so, in dental as an example, we had issues with billable encounters, and we actually had a pretty high percentage of our encounters that were not billable or that were getting denied.
And it was sometimes as simple as we just were bringing patients back too early for their cleaning follow up and not waiting until, you know, a day after that six months to bring the patient back in for a cleaning. And so, those encounters were getting denied.
AARON WILSON
You know, just to add, as far as looking at our existing footprint, you know, for the last probably, you know, five to eight years, a lot of our growth has really been driven by new access points and new locations. And so, our current expansion plans are really focused on how we can build out our existing sites, like how can we expand hours.
So, for example, we’ve got, you know, one of our dental clinics is now open on Sundays and looking at, you know, extending hours and evenings, how can we infill with our existing infrastructure, one of our, you know, training and development locations that had, basically a dental sim lab, you know, opening that up to the population. So, we’ve got one dentist running three chairs out of that.
We’re also working on our training. But, you know, we’re using the space so, we have, a lot more efficiently, and really focused on if there’s growth, it’s going to be within an existing site. We’re not pursuing new bricks and mortar opportunities, really.
JEFF ALLEN
You know, John, you hit on something interesting there. You mentioned and said about, you know, billing and, you know, sending in claims and getting them denied and have all those things like that. I’ve been hearing as you know, as I, you know, you probably know I’m here at the national conference here in D.C. and there’s a lot of, you know, listening just to people talk what their concerns are. And rev cycle seems to come up a lot, right? I mean, what do we need to do there? So,
Aaron, John, what are your thoughts? I mean, what are you all doing at CHAS is to make sure that your rev cycle is optimized as much as possible?
JOHN BROWNE
Yeah. Well, I think I mean, first and foremost, I kind of alluded to it earlier by just having the finance department revenue cycle team directly engaged with our service lines and ensuring that we’re doing what we need to, to maximize those billable encounters. I mean, the worst thing you can do is, you know, provide services and do all the work and spend all the money but not get reimbursement that you’re owed for it.
And so, we’ve been looking at a lot of things within our service lines, pretty much across the board, to maximize revenue and ensure that, you know, even if it takes an extra click or an extra step but it produces a billable encounter versus something that normally would not have been billable or been denied. We’re doing that work.
Within each of the service lines, we have, actually, finance representatives. A lot of them are revenue cycle-specific, but some of them are, you know, financial analyst representatives amongst those service lines. And that’s part of their goal and objective is to maximize revenue within the service line and not necessarily to cause a bunch of additional work on the operational side, but really to understand what we’re doing and where we can, you know, potentially be a little more efficient or maximize revenue or add an additional step, like I said, to make an encounter billable.
The other thing we’ve been doing is, and this really goes back to the other question before this too, around efficiency, is just looking at our AI and software capabilities and our technology tools. And so, we did, about a year and a half ago, we started to implement a tool called Arintra, which is an AI revenue cycle tool, and that has been fully implemented now.
It took longer than we initially expected to get it fully ramped up. But, it is really doing a lot of the work that our billers were doing previously. And so, it’s allowed us to not have to ramp up our billing staff, even though we’ve seen pretty significant growth in our overall encounter volumes. And it’s extremely accurate.
And we’re seeing days in AR drop continually because of this tool. And, it’s, yeah, it’s actually catching things that humans would not catch. So, that’s been huge for us on the revenue cycle side. It again has just been, you know, maximizing reimbursement for work that we’re already doing.
AARON WILSON
We’ve been trying to create some capacity. So, we have folks going back and double checking our contracts and then going back and reconciling those contracts against payments. And again, it’s one of those things when you’re a really busy health center and finance department, having the ability to allocate that resource to go back and validate that those payments are actually what the contract states.
We’ve definitely found some opportunities there. And they have been, you know, not insignificant. So, again, just having the ability to say one person is going to go back and really go back to the contract and make sure those are adding up. And it’s a fair amount of work once you start going across all the service lines, but I guarantee there’s opportunities for folks there too.
JEFF ALLEN
Yeah, absolutely. You know, the other thing everybody’s talking about, you know, here at this conference is 340B, I mean, it seems that people are worried about it. What’s going to happen to it? How is it going to affect us? Well, I’d love for the two of you, if you wouldn’t mind, to take a few minutes and comment about, you know, all these changes in 340B and how it’s affecting CHAS?
AARON WILSON
Well, it’s definitely a multi-level threat, right? Because, you know, we’re dealing with not just the Inflation Reduction Act impacts, but we’re dealing with, you know, the rebate model, you know, what’s that look like? And then we have threats in our state right now that are, you know, as cataclysmic as anything else. So, right now in the state of Washington, for example, pharmacy is carved into the, you know, managed care benefit.
But when state budgets start getting tight, they start looking to where, you know, those non-mandatory Medicaid programs that they don’t have to cover. And pharmacy seems to stick out every year. So, it’s a lot of defense right now and a lot of education with, I would say, our legislators around health policy and why it makes sense to keep, you know, the 340B program, you know, embedded within the managed care products.
But also really, it is the one discretionary sort of revenue source that we have that, you know, as we prepare for changes and are able to sort of sustain some of the volatility in the marketplace, the 340B program has really, you know, allowed us to prepare for that. But, as those margins keep slipping away and we’re looking at just the initial you know, results for January as it relates to, you know, new medications that are excluded because of the Inflation Reduction Act.
Those are real hits. And, you know, it’s, the trend is not going in the right direction, I think, as far as, you know, the sort of shield the 340B provided for a lot of the changes in the marketplace. You know, it allowed us to take time and respond to things thoughtfully.
But yeah, those margins just continue to be ground down. And I don’t see that trend going the other direction unfortunately.
JOHN BROWNE
Yeah, I would add, I mean, absolutely hundred percent it’s impacting us in huge ways. And I was just actually talking to a couple health centers in the last couple days, from the Forvis Mazars best practice group that we have. And, they’re, you know, we’re just now starting to see the impact of, you know, the Medicare for pricing and, and also some of the folks falling off of ACA plans because of the subsidies going away.
And so, a couple of the other CFOs across country are reporting, you know, upwards of 30 plus percent margin drops in their pharmacy program. And, you know, just based on, you know, some initial, more anecdotal information, it looks like we might be about there as well. And so, it’s significant. And that’s already on top of the drops we’ve seen over the last several years, whether it’s because of contract pharmacy going largely away or some of the Inflation Reduction Act drugs, you know, being reduced in prior years.
And so, it’s hitting us in a number of different ways. And, I will say one of the advantages that we have at CHAS is just volume. And so, you know, our margins are getting smaller, but we are seeing volumes continue to go up on our pharmacy program. We have a huge focus, and we always have, on our in-house fill rate for scripts.
And so, we, I would say, at least from the health centers that we’ve talked to, we have one of the better in-house fill rates, and it’s upwards of 75 plus percent of the scripts that are written from our providers we fill in-house and we’re very focused on, and very intentional on the specific scripts that we fill too, as far as targeting ones that we know have margin that we know is better for the patient to fill in-house from just an overall patient quality and outcome perspective.
And so, those chronic condition meds and things like that, behavioral health, anti-psychotic meds are ones that we really focus on filling in-house. And I would say the other area that we’ve been focusing on is just outside of the traditional retail pharmacy world. So, we have more recently delved into specialty pharmacy. We have dual accreditation for that.
And we have our own in-house specialty pharmacy now; we are working on implementing an infusion center in which a lot of health centers have done recently as well. And so, just looking at ways to capture other pharmacy and/or 340B savings that are, you know, outside of contract and retail pharmacy.
JEFF ALLEN
You know, a follow-up to that. You know, you’re talking about volumes and you mentioned volumes and trying to get that, have you guys seen a reduction in the Medicaid volume? I know the redetermination has been a big deal with Medicaid. Have you all seen Medicaid patient reductions in that or are your percentages dropping in that area?
JOHN BROWNE
We have. I mean, yeah, if you’re referring back to COVID years, when, you know, they kind of went away with recertifications and folks were able just to stay on forever through those years, yes. We did see an initial dip and it was sizable. And in certain programs it was bigger than others like our dental program saw a pretty significant decline.
We have not seen those rates go back up. And it’s something that we’re highly focused on. But yes, we have seen those go down since COVID years. More recently, we’ve actually seen a little bit of an uptick in our overall Medicaid volumes over the last several months. And once they went down, they went down fairly quick.
And then just, I would say stabilized, you know, over the last couple of years. So, they were fairly flat. But we have definitely had some major internal focus on overall Medicaid volumes and specifically knowing what’s coming down the pipe in 2027, we’ve been focused on the pediatric population and more of your traditional Medicaid population.
You know, the TANF patients. And so, that’s an area that we’ve been working on and have a pretty major internal initiative to try and mitigate some of the risks coming in 2027.
JEFF ALLEN
Awesome. Yeah, I know, you know, it’s been a challenge. A lot of, you know, Washington’s an expansion state, I know it affects some states differently than others, but I know there’s a lot of, you know, angst out there about, you know, what these long-term effects might be.
You know, other than the One Big Beautiful Bill you talked about, other than, you know, 340B changes, are there any other things out there that you, you know, Aaron, you and John are looking at or like, there’s a threat here on the horizon or we’re worried about this or anything like you want to share with our listeners?
AARON WILSON
Yeah. I think, you know, we just have been taking a step back a little bit strategically and looking at where the, you know, what the pressure points are on it. It really does wrap around sort of our core 330 services. And you know, 340B is part of that. And so, trying to assess, you know, what are those other sorts of non-330 opportunities that, you know, we can continue to focus on as growth areas that we haven’t historically been engaged with.
And so, again, we’re thinking these aren’t projects or programs that we’re going to be able to open the doors tomorrow. But I think there’s definitely some opportunities out there for folks to consider. You know, we’ve continued to grow our specialty pharmacy.
And that has been a good opportunity as well as looking at, you know, how can we best address some of our patient access issues for infusion services? We know that’s a real issue for our patients, whether there’s not opportunity to build out services around that. And then looking at programs that we haven’t traditionally looked at. And, you know, the PACE program is a great example of, as we look at a growing geriatric population, there’s some opportunities potentially.
And so again, reaching out to our, you know, other health center friends across the country to get, you know, ideas of things that they’re doing that are a little bit outside of the line of fire right now and try to diversify our revenue streams a little bit. So, when there are big pressures on 340B or 330 grant programs, we’ve got a couple other directions that we can look to sort of sustain ourselves and get us, get us through. It’s what the current crisis is providing the opportunity and just how can we get ready for some of this a little bit differently. And some of the solutions align with some of the challenges that we identified previously too.
JOHN BROWNE
Yeah. No, I would agree. I think, you know, it feels like health centers, I mean, nobody will say this outright, but it does feel like health centers and our traditional funding is just under attack on a regular basis. And although there seems to be, on the surface, a lot of support for health centers and what we do and what services we provide, it feels like everybody thinks we can do this work with significantly less revenue.
And so, the funding is not there. Not feeling super great the funding is going to be there. And definitely what the last few years, I think, have taught us is that just that we shouldn’t count on it. And so, looking at other non FQHC revenue streams has been something that we’ve been doing very diligently for a while.
I think it’s always been a strategy to, you know, diversify to some degree, but I think we’re seeing it as a bigger risk now than ever. And, so, yeah, as Aaron mentioned, we’re underway with infusion. We’re actually going to get those services up and going hopefully early next year, early first quarter, maybe second quarter 2027. But that work is underway right now.
And then the PACE program is something that we’ve been looking at for a while now. And it always was viewed as a major risk and something that maybe wasn’t super smart for health centers to go into. But, now at the number of health centers that have done it and been successful at it, it feels like there’s a much better road map towards being successful in a PACE program if you do it right.
And obviously you need the infrastructure and you need the resources, and you do need to ensure that you’re not putting your core services at risk for that, but it feels like there’s enough of them that have popped up and health centers seem to be kind of the most common sense type of system to invest in a PACE program.
And Aaron mentioned we’re just seeing an ever-growing geriatric population. The other systems, the health systems in our area want less Medicare patients, not more. And so, they’re looking to us to continue to grow our services and access for the Medicare population. And so, knowing that a lot of these are very complex and knowing we’re in a good spot to be able to potentially save the system, in totality, money.
I think that the PACE program is absolutely a no-brainer for us. And so, we’re just starting down that road right now. We’ll probably look at, as far as actually having a program up and operational, it’d be 2028 at the earliest. But I mean, as you know, these things take time, they take huge amounts of investment, but I feel like it’s kind of the next step for us to continue to, you know, diversify ourselves away from the FQHC revenue.
JEFF ALLEN
Great insights. Really appreciate that. My last question I have for both of you and, Aaron, I’m going to start with you on this one. I want to hear both of your insights on this, but CHAS Health has had an amazing history. And if you think back to what you have, but you’ve had two CEOs in the entire, you know, history, unless I’m not aware of one. But, you know, two CEOs in your history.
And so, Aaron, here you are. You had to replace the founding CEO who’d been there for a quite a long time and step into some big shoes. And I just, you know, you’ve now had 10-plus years at the helm, CHAS continues to do well, continues to grow, continues to thrive even despite some of the, you know, some of the challenges that we’ve talked about that you’re facing.
So, I would love to hear advice. I mean, there’s a lot of, I talked a lot of people in the last couple days that are brand new. They’re younger, they’re just getting into executive type roles at health centers. I mean, Aaron, what is your advice for these young up-and-coming, you know, executives that are just stepping into a role as a CEO and they’re trying to make sure, you know, they want the health center to succeed so badly. And, they really want to see, you know, have success. But what would you tell them? What would your advice be to them?
AARON WILSON
Well, I think something I learned early on and this was through observation. But, you can go a long way if you don’t surprise people. And so, whether that’s your staff, or your board, or your, you know, community partners. And so, that just, you know, it forces you to get out in front of situations and have conversations.
And, you know, they’re just sort of essential change management things, really. But, if you can not surprise your board of directors, that is a great way to be around for a long time, right? And so, you know, we take the time to really start talking about ideas when they first start hitting us, right?
Like, we want to bring them along as we think about what the strategy could be so we’re not, you know, just showing up with a fully baked proposal, asking for approval in one meeting, right? They’ve been part of that sort of discovery and part of that process. So, it’s one of those things.
I remember taking over and just being very focused on, okay, I’m not going to surprise people with information or decision making. I’m going to spend the time on the front end so they’ve got the right information and they feel like they’ve been empowered to support the decision-making process and engage. And even if they’re not in full agreement, they still have that ownership being part of the process early on.
So, that was one thing I focused on. And I think if, you know, the other thing is, you know, as health centers, we have great missions and frequently are, you know, our core values can be a really good focal point directionally for how we lead and how we engage with our staff and how we engage with patients.
And so, just being true to those, that’s something else that I think has helped me along the way is, you know, if I’m having second thoughts or doubts, sort of going back to just those core values and trying to align, you know, what my options are and filtering them through those values has been, you know, helpful. And then, if they’re the right ones and you’ve spent the time identifying and designing them, you know, they are a great guide when things are a little bit challenging.
JEFF ALLEN
Excellent. John, what are your thoughts?
JOHN BROWNE
Yeah. I certainly agree with everything here and said I would add that I think somebody coming into an executive role in a health center needs to, first and foremost, be willing to embrace change. You know, just knowing that there is, every day there’s change in this industry and in health centers specifically, we’re, you know, always kind of living on a thread, you know, as far as, you know, things seem good one day and we lived through some pretty decent years, through COVID, and then, all of a sudden, the rug gets pulled out from underneath you and you’ve got to think quickly. You’ve got to act quickly.
And so, I think change is just the one constant in our industry and in the business of community health centers and just embracing that from the get-go and learning to be nimble, learning to be flexible and ensuring that you’re surrounding yourself with staff that all have those same traits.
And so, I think that, you know, our leadership team right now, that’s one of many really awesome pieces about our team is just that we’re all willing to jump in and help out where needed, but we also expect there to be change and know that we’re going to need to kind of make decisions on the fly sometimes and go different directions.
And we’ve worked through it and our board is the same way. I’d also say, I mean, just around that cultural piece that Aaron was talking about, I think just having a really good understanding and finger on the pulse of the culture in your organization and ensuring that, you know, one of our core values is fun. And I think just, to me, what that also means is just keeping things lighthearted when it doesn’t need to be overly serious.
And, you know, we sometimes tend to overcomplicate things or make things harder than they need to be. And this environment right now, certainly, but healthcare in general is already very challenging and hard enough. And when you make it harder and, you know, you tend to not take the wins when they come and maybe not be as lighthearted as when, you know, during certain times that you can be it just that can have an impact on morale long-term. And so, you know, I think just adding that fun in there when you can and making sure to celebrate your successes and your wins when you can is really important.
JEFF ALLEN
Well, that’s great insight. I really appreciate you, Aaron, John, both. Thank you very much for being willing to do this today. And you know, lots of great pearls of wisdom for those that listen to the podcast. And so, we really appreciate you taking the time out today and sharing your wisdom with us. So, thank you, and great to have you on the podcast. And, certainly, we wish nothing but the best for CHAS Health going forward.
AARON WILSON
Great. Thanks, Jeff. Appreciate it.
CHAD MULVANY
I’d like to thank Aaron, John, and Jeff again for today’s episode. I also want to thank our listeners for tuning in and following “Achieving Health” wherever you listen to podcasts. If you want to learn more about the topics we discuss here, be sure to check out the show notes for related content and information about how to get in touch with me and the team at Forvis Mazars.
I’d also encourage you to go back and listen to some of our recent conversations with other industry leaders, if you haven’t already. I’ll be back next Wednesday, March 18th with the next round of “Washington Watch” updates. Until then, here’s wishing you good health for you and the communities you serve.
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