Hillsdale Hospital News

Episode 78: Making Infusion Centers Possible in Rural America

Specialty outpatient services like infusion can be a risky business for rural hospitals. Such a service requires drugs that come at a very high cost and a challenging reimbursement process that can leave hospitals holding the bag and unable to sustain infusion care for their communities. So, how do rural hospitals find a way to provide specialty services like this without facing financial woes?

On today’s episode, hosts JJ and Rachel talk with Jacob Dozier from Community Infusion Solutions about how partners can make specialty services possible for rural hospitals.


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Audio Engineering & Original Music by Kenji Ulmer




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Rachel: JJ. We talk about health policy constantly on Rural Health Rising and how important it is for rural hospitals and health care providers to have a seat at the table.

JJ: That’s right, Rachel. There are many ways to have an impact on health policy, but for our listeners who really want to gain experience in policymaking at the federal level, we have a great opportunity. Opportunity to share.

Rachel: The Robert Wood Johnson Foundation Health Policy Fellows program seeks out midcareer professionals who are interested in federal health policy to learn how to improve the health of our nation and ensure everyone has a fair and just opportunity for health and wellbeing.

JJ: The program starts in September and runs for one year. Applications are open now and close on November 7, but you’ll need at least a few weeks to get your materials together, so don’t wait.

Rachel: If you’re interested in learning more or applying to this prestigious program, visit healthpolicyfellows.org. That’s healthpolicyfellows.org. Specialty outpatient services like infusion can be a risky business for rural hospitals. Such a service requires drugs that come at a very high cost and a challenging reimbursement process that can leave hospitals holding the bag and unable to sustain infusion care for their communities. So how do rural hospitals find a way to provide specialty services like this without facing financial woes, with attention to.

JJ: Detail, carefully laid out processes, and Rachel the right partner.

Rachel: I’m Rachel Lott.

JJ: And I’m JJ Hodshire.

Rachel: And this is Rural Health rising.

JJ: Welcome to episode 78 of Rural Health Rising. I’m JJ Hodshire, president and chief executive officer of Hillsdale Hospital.

Rachel: And I’m Rachel Lott, Director of Marketing and Development.

JJ: All right, Rachel. We have been excited here at Hillsdale Hospital to have recently brought our infusion services back to Hillsdale Community area with the launch of our center for Infusion Care just last month. And it is a new twist on what we’ve had in the past, but with a focused approach on giving the best care and services to our community and surrounding communities as it relates to infusion care. So today we’re going to talk about why such a service would have closed in the first place here and what made it possible to bring these services back.

Rachel: That’s right. We are talking with someone who we’ve gotten to know very well over the past several months as we work to launch our center for Infusion Care, and he’s been our partner and guide through it all.

JJ: Our guest today is Jacob Dozer, chief operating officer for Community infusion Solutions. Welcome to Rural Health rising Jacob.

Jacob Dozier: Thank you so much for having me, JJ. It’s a pleasure and an honor.

Rachel: So, Jacob, to start, why don’t you tell us a little bit about yourself, your background and your work at Community infusion Solutions.

Jacob Dozier: Absolutely. So, coming from a small rural town in East Texas, born and raised in a town called Texarkana, ultimately really gave me an opportunity to dig into sense of purpose, sense of community sense of belonging and honestly coming out of high school and coming out of college. That drive really pursued throughout my college education and ultimately led me into indirect patient care. Not being a clinician or formally trained to administer services, I found myself enrolled in a program that would help me care coordinate patient care in my rural community, which honestly was the turning point in my passion. I’m a graduate of Texas A and M. Proud graduate, proud aggie.

Rachel: I’m a graduate of Baylor University, so I just have to give that disclaimer.

JJ: Oh boy.

Rachel: I did not know that he was an Aggie before I scheduled this podcast recording.

JJ: Well, it was nice knowing you, Jacob.

Rachel: But we have all the same favorite Mexican restaurants in Dallas, so we’ll give it a pass.

JJ: Okay.

Jacob Dozier: Giga Maggie my education through Am was just a wonderful experience and once I began to really step more closely into the healthcare industry, I really identified a strong passion for patient services. Access to care was something that I developed a very quick passion for and that’s really been the pursuit of my passions throughout my career at this point. And it’s a really valuable service that I’m proud and honored to be able to participate in.

JJ: Talk to us a little bit about your company. So, you’re with Community Solutions and can you talk to us a little bit about infusion services? Excuse me? Can you talk to me a little bit about the company? I know that you have a partnership there. Can you explain a little bit about what you do?

Jacob Dozier: Absolutely. So, our organization really focuses on rural communities. That is the really primary focus point of our own passion. And realistically, we work with those community hospitals to develop and implement outpatient infusion programs. That does take a couple of different forms. Some of our partners, we are developing these programs from scratch. Other partners, we are taking ownership of their existing programs and expanding them, improving them, making them more than what the facility has established prior to our arrangement. And our focus is to identify communities with about 3000 people. Ultimately, we do found and support all of our partnerships in data. It’s a data driven approach to be able to make sure that there’s enough of a market capture opportunity for our relationship to even be viable. We want to develop regional Centers of excellence in these communities. Regional Centers of Excellence are things that you commonly see attributed to major service providers like the Mayo Clinic or some of the large oncology cancer programs out in Houston, MD Anderson comes to name. Ultimately, we want to develop that same notoriety along with these partnerships in our rural communities, which does have some measures of success attributed to being a regional center of excellence. On average, adherence rates for patients on infusion therapies is about 55% across the country, which is markedly low. Our program is designed and specifically adapted to promote higher patient adherence. On average, our community population, our community programs generally hit about 90% patient adherence rates.

Rachel: Wow.

Jacob Dozier: She’s a fantastic thing.

JJ: And one of the reasons we partnered with them.

Jacob Dozier: Oh, yes. So, pursuing that Regional Center of Excellence also does pull from a percent of that market capture. We want to try to establish about a capture rate from those outside referring specialists. These are the specialists that the facility in our rural communities generally, they don’t exist. So, we work to establish those relationships to drive those patients back to the program. In the rural community, whenever we’re focusing on the patient adherence, that has a lot of tentacles that help improve the quality of our service. Not only does it help to improve the patient’s own experience in managing their disease state, but it does generate higher volumes and higher revenue opportunities. Inherently. Instead of a patient being maintaining poor adherence and only being serviced four times in a calendar year, our processes maintain that adherence rate, which may equate to ten or twelve services per calendar year just by the simple fact that we are managing those patients and keeping them on track.

JJ: Great program. And so, Jacob, now that we’ve established who you are, who your company is, what you do, the benefits of your adherence rate and the benefit to the communities, let’s start with the why. And we do this on every episode so we get to know our guests just a little bit better. And so, I want to know, and so to our listeners, what is your why? What motivates you? What gets you up out of bed in the morning?

Jacob Dozier: We want to bring a valuable service to these rural communities. What gets me out of bed every morning is knowing that I am contributing to the overall improvement and ongoing success for these rural hospitals. The plight of the rural hospital in today’s healthcare industry is not a secret. And every time you open up Becker’s Health Care, you read these woes, you read these financial straits that these hospitals across the country are facing. You read of these examples where hospitals are going to bankruptcy, going into foreclosure, and what happens when that rural community loses its hospital, that patient population? It’s almost like a death sentence. That access to care is immediately cut off in an already struggling community that gets me out of bed every day. We want to do our part as a third-party service provider to help keep hospitals viable and help keep patient care local.

JJ: What a calling. So, Jacob, let’s lay the foundation for our discussion today. So, let’s talk a little bit about the specifics many might question what do all of these infusion services entail and encompass? So, I’d like for you to answer that. I mean, what does it entail? And why are they so tough to bring to small rural communities like Hillsdale? I mean, what makes it so difficult?

Jacob Dozier: So, our services are quite comprehensive the services that we target vary in acuity. These may be patients that are just acutely ill, and they’ve been ill the night before. Now they need a little bit of hydration and just to keep them out of the Er. Get them back on their feet. And that range extends all the way to patients that have these very complex disease states that require these very costly but also complex medications on a given regimen. Ultimately, where our service currently kind of has a line in the sand is chemotherapy. Chemotherapy and development of oncology medications is what we refer to as another ball of wax, where ultimately there’s a lot more specificity and a lot more development that’s required in our partners that do provide chemotherapy. But on average, the majority of our patients that are being serviced have targeted disease states. These are patients with some known diagnoses that drive our data review, such as ulcerative colitis, rheumatoid arthritis, multiple sclerosis, osteoporosis, even certain forms of allergic asthma. All require, at a certain point, the administration of these complex medications that require a certain degree of training in order to be able to administer and to even manage appropriately. One of the common challenges that we face as a third-party service provider and in partnership with our partners is healthcare reform. Insurance companies have some very tight processes in place to maintain control of the costs associated with these complex medications, which can result in some difficulties in getting those approvals. For our partners, the difficulty in obtaining those authorizations is, realistically, one of the most common balls being dropped across the programs that we either inherit or develop, whereas our services specifically cater to those authorization requirements. It’s an ever-changing landscape that is dealing with our commercial and even our lovely federal payers just to maintain status quo and be able to promote these services.

Rachel: So, JJ. Let me ask you about this, too, because as we kind of indicated in the beginning, Hillsdale Hospital did have infusion services at one time, but we had to shut down that service line in 2020. So, what led you to that decision at the time and also what made it so challenging for us to keep it open?

JJ: Well, Rachel, there were two distinct barriers. Number one, I want to preface by saying that the services in a community like ours are much needed and for the reasons that we’ve discussed previously on this program, which is in part because we are in a very poor community and transportation is here not present for public. And so, we have a challenge of getting patients out of Hillsdale. So as many services as possible that we can provide here, we want to. But the problem that we started to experience and there were two major barriers. Number one, to Jacob’s point, we didn’t have an ultra-focus on the process for authorizations. And so, when that happens and your person who is doing the pre office is actually the person who’s rooming a patient in, making the appointment and then getting supplies for the office. It’s not a focused approach. And so, things get missed. And as a result of that, you can sustain quite a bit of loss in a program like ours. And we did that for several years, significant losses. But the second component that was very challenging for us was the cost of drugs, right? And we didn’t manage that the best because, again, there were challenges that we couldn’t staff it fully. We didn’t have the wherewithal to do that. When you talk about small rural hospitals like ours, we’re not overwhelmed with a high number of staff. We have, many of us, like you wear a hat and then you wear five other hats. You may have your main responsibilities, but you’re picking up four or five other tasks. And the same way functions and happens in the clinics is because they’re doing a number of jobs. So, what happens is if those drugs, for whatever reason, were ordered and are not needed, Jacob can tell you in an oncology drug, we’re talking 30, $40,000. You only have to get hit once or twice for that and it will turn your program upside down. And so, we experienced some of those challenges. The payers began to change. We begin to see that for some of those costs for the drugs begin to increase. We’re not getting the full reimbursement and then just the pre authorization for those very challenging. It’s a very delicate service line. And so, for us, we knew that we needed an expert. Rachel, we couldn’t do it alone. When we started buying practice, we didn’t know about practices. We started running specialty care. We didn’t know about specialty care. I mean, we’re on the hospital side of medicine and so we can handle or we can handle Er, but when it comes to looking at a performance and understanding the full scope of how the processes work in a clinic is a little different. And so, we had to accept that reality. We also could not operate more than two years in a deficit, and so we had to eliminate the program. So, calling on experts like Jacob and his company allow us really to have someone who’s ultra-focused in this area, who have the expertise in authorizations, drug utilizations, negotiating those prices and all of those factors, whereas we’re not just expecting one or two people in the office to do it. And that’s the success now of the program much different than where we were four years ago.

Rachel: So, Jacob, with that said, get into a little bit more of the specifics of how do you at community infusion solutions overcome those challenges for rural hospitals? What are you able to do that your partners like Hillsdale Hospital can’t do on their own? And also, might I mention, in a way that is more financially sustainable than if we tried to recreate our own program from the ground up?

Jacob Dozier: Absolutely. I really can’t stress enough how everything that I’m about to say results around process and bandwidth. Our process, as we’ve navigated these waters for more than a decade, have become more and increasingly and increasingly refined. We understand the potential pitfalls that go along with providing this service. We understand the potential pitfalls that go along with the insurance company’s expectations of providing these services. And as a result, we’ve been able to very efficiently identify those requirements and support that efficiency adherence with our staffing components. We of course, acknowledge that hospitals are inundated with need. Staffing is definitely a challenge across almost every hospital in the country, and identifying where those opportunities exist in third parties also opens you up to that extension of your labor. We integrate with the hospital’s existing labor pool, which lessens that load, but also gives them a resource, a much-needed resource to help fill gaps that maybe don’t have to be done by a nurse or an already strained business office representative. The way that we integrate with the payers is very unique. We actually promote and foster relationships amongst the payers that in many cases do not exist in the hospital’s Day Today management of their hustle and bustle. And when you consider volumes, we have very keenly adjusted volume productivity measures for our staff members that allow us to maintain an adequate headcount with minimal turnover and really focus on that subject matter excellence so that our team members become highly proficient at navigating these complex referrals. Establishing those relationships with the payers is one of the fundamental building blocks of our organization. But also, something that would benefit hospitals for all service lines that they are incurring a heavy cost on. Where there’s a great high risk but high return for understanding that red tape and then establishing the processes to safely work within the confines of that red tape is exactly what community infusion solutions brings to the table. Every case that we process goes through a very intensive review, and this happens very timely. As our processes have become much, much more refined over time. We’re able to generate a great amount of productivity that would require someone without that subject matter excellence and expertise to, you know, pull out a ruler, put out a highlighter and really dig into those cases. Whereas our organization really focuses on efficiency and promoting that excellence in our product. I think also our ability to really dig into reimbursements. As JJ noted in the conversation, some of these drugs carry a significantly heavy price tag. And similarly, if you are going to go on the line and purchase that medication, you’d better take a look at what you would expect to get paid, assuming that you have accounted for all of those checks and balances. That’s another benefit that our organization brings to that table. Throughout the implementation process of our arrangement, we really push the hospital contacts that we partner with to work with us to identify those expectations. That allows us to complete that due diligence in a timely manner whenever the actual referral is received. Another really important aspect that we bring to the table is identifying barriers for the patients. When you think of social workers and discharge planners in the hospital setting, they’re looking for resources and connecting those resources for those patients as they’re preparing to discharge from the hospital. When you think of other outpatient service offerings, it’s extremely unusual that there are team members that are performing the same level of care for those patient populations. Our team brings that to this program. We engage with the patients and identify barriers for cost. If there is a barrier, we look for alternatives. Are there alternative medications that are lower cost? Are there programs that will help pay the patient’s costs? Or what variables are available that are worth consideration to improve and eliminate that barrier? We do that for all of our patients to help promote their willingness and their interest to maintain their services within the program impacts adherence and definitely is a financial success for our partner.

JJ: You know, Rachel, on the patient side of things, we have what are called nurse navigators, right? And they help a patient navigate the.

Rachel: Health system, which is just so complex. It’s so sad that that’s necessary, but.

JJ: It is, it is. Now, on the opposite side of that, really, this company functions like a nurse navigator does to a patient, as this company does to me, an administrator. What they do is they identify gaps, weaknesses. If we come to them and say, we’re having a payer mix issue, this is going on. They’re aggressively addressing it. Now. They’re not bringing the staff. That’s not their job. Their job isn’t to bring me the tables and the equipment. Their job is to look at the totality of this program to identify how do you get the best out of this program. And they have been successful in that. Now, Jacob, my question to you do you find yourself more in rural communities or would you say what percentage of your services would be in the rural community? Just a guesstimate.

Jacob Dozier: Near 100%?

JJ: Near 100%.

Rachel: I was going to say almost exclusively.

Jacob Dozier: We are exclusively. Not exclusively, but we are committed to that rural population. And that really is our target focus, as those rural communities often are the ones that are most disparate in today’s healthcare industry that receive the less attention, that receive, the less access, that have the greater incidences of barriers that get the short end of the healthcare stick. And we are committed to we are committed to improving patients in rural communities’ lives, improving their health outcomes, and helping do our part to ensure the viability of our partner hospitals. And we are passionate about that.

JJ: You are. And that passion shines through. And our implementation meetings and our initial discussions, and even when you are on campus and it looks like even today, you’re not even at your home base, you’re somewhere traveling, probably setting up a center somewhere, correct? Yeah. And that’s a lot of your responsibilities. And I guess why don’t you explain to our listener, let’s say that there is a rural hospital listening to this. Talk a little bit about your experiences in coming into those rural communities and watching this service line and then what has been their response?

Jacob Dozier: Absolutely. So ultimately when we come on to the scene in a particular market, we realistically want to dig into the hospital’s opportunities. We always start without migration. Any service provider who comes to your hospital to promote a potential service offering, please take a very hard look at that out migration data. That leakage is just critically important to even enter into an arrangement with the third-party providers such as us that out migration on average that we see across the country. And we have analyzed hundreds, if not thousands of health care facilities. On average, there is a minimum of about $450,000 in non-chemotherapy out migration that we see pretty much across the board. That outmigration has to be that initial foundation of is this market viable? What we do in our communities is not smoke and mirrors. There’s a little bit of trust and a little bit of expectation. But our initial review of every program that we partner with is founded in that migration leakage to determine what’s going were. Is there enough of that here that if we impacted this community positively that that would be successful? I just really can’t speak enough about how critically important making sure that a provider or an entity that’s bringing you a service to sell produces that out migration study is just critically important. Outside of that, we generally operate underneath the guise of the hospital itself. What I find is that oftentimes our relations are most greatly impacted by the hospital’s relations within their own community. Sometimes for better or for worse, right? That’s always a moving target. But we brand this program and this product as the hospitals program and product. So that gives us a lot of value add in terms of that brand recognition in the community, but it also opens the door to previous bad taste experiences that people in the community may have against the hospital. But that really is something that I think is very important in the overall reception of the service, is that we operate as the hospital. While we’re supported and in partnership with community infusion solutions, it is the hospital’s program that we really work with them and push them to promote that advertisement to get that visibility out at every square corner. We’re working with our marketing teams to make sure that their social is covered, their print is covered. We do direct mail engagement, we do direct to consumer engagement independently at the hospital, but under their name’s sake. And that’s really important to maintain that face value and that recognition in the communities from the moment that we identify a potential opportunity based on their out migration to the moment we’re up and running after a contract is signed, that implementation process is pretty tightly confined to about eight weeks. So, from contract initiation to servicing, your first patient can honestly be as little as eight to ten weeks. And for a service line that brings this much revenue opportunity, that’s unheard of. If you’ve implemented other service lines, not only is that cost of development considerably higher than what we incur, that that timeline would never happen in as little as eight to ten weeks. And I think that our project management of implementation is another benefit added to our partnership because our hospital partners are already busy, their staff are already inundated, they’re already overwhelmed. So, to have us come in and project manage that implementation, it’s like a win win from that contract execution, because we make sure that the timelines are met. We know what needs to happen, we know how that implementation needs to be done, what has to be accounted for, in what order, even should they be accounted for, to make sure we maintain a timely launch. And so, the facilities that we work with generally have a great experience through that implementation process because we handle so much of that lift.

Rachel: And what about the patients and the communities? You talked about the out migration. What do you see in that? What kind of numbers are you typically seeing of getting those patients back to getting that service locally, whether it was never there or it was there and then it was gone and now it’s back? What kind of numbers are you seeing when the centers are launched and then those patients start coming in to that local infusion center?

Jacob Dozier: That’s an easy 190 percent of the time. What we do is so keenly specific to those patient targets and the data analysis that honestly, by the time we launch, we already have a road map. And so, we have encountered our fair share of facilities that either market share was too high or community presence was too poor that we could ever overcome. And there are certain things that we cannot overcome, but on average, 90% of our programs are successful within the first 30 days of their operation. And I don’t know how many service providers could really vouch for the same because we do so much work and so much due diligence and that preparation that by the time we go live, within about eight weeks, we’ve already run press releases, we’ve already gotten word out in the community. I mean, there’s a lot that happens and build up to that go live opportunity.

JJ: And let me talk a little bit about that though, Jacob, if I could, because I think that’s an important aspect as we have listeners, Rachel, because we’re small and we look at the responsibility you have. If you look at the heavy lifting that Jacob did with their company. Could you imagine you having to do that?

Rachel: Oh my God, for me, no. And the way that they did such a good job of pushing us to stay on target and to get everything done that we needed to get right, all of that stuff. I mean, I was sitting here thinking, can community infusion solutions run our infusion center and also like my entire life keep me on track? Because you guys, you will be such.

JJ: Am just going to tell you it’s true, within a week, you’re going to be identified. Well, what Jacob brought to the table was a focused approach and I was very skeptical, trust me. When I first was pitched this opportunity, something, I’ve been here, done it, I knew that this was something that the hospital had not been very successful in the past. And I thought, well, give me your best shot. And then the presentation came and I was alright, still a little lukewarm. And then Jacob arrived and it’s kind of like you heard the angels, because all of a sudden, he sat at the head of the table in the boardroom where normally I said, and just throwing it out there, Jacob, next time that you’re at a small hospital. But so, all of a sudden, he’s at the top talking about the process and he’s got an algorithm, he’s got worksheets, and he’s going through it methodically. I thought this is exactly what we needed. And then he would say stuff instead of like, will you do that? And you do this. He’d be like, I’ve got that. No, I’m going to meet with you, I’m going to do this. That is the benefit for those small rural hospitals listening today. That’s the heavy lifting that Jacob and his team can do. And I can’t speak enough to that process of how rural hospitals alone cannot implement a service line like this, let alone in a short time frame. Rachel, you know what I’ve worked on in the past by myself to try to implement, two years later, I’m getting a service line because it is just this isn’t what we do every day, right? And we’re busy with 20 other tasks. His focused approach has been on one service line. So, I would encourage our listeners today, if you’re considering a partnership, I would encourage you to reach out to Jacob and his team, really to look at the services in your community. Don’t be a naysayer. Even as I was thinking, no, this would never work in our community because the community over next to us has one and this community has one. Don’t listen to that because this is hugely successful as a result of the attention to detail that Jacob and his team has given us. So, I’m just impressed with that.

Rachel: Rachel well, and JJ, what happened when we launched our infusion center in September.

JJ: It was so overwhelmingly received by the community and providers. That within three weeks, I had to move it because the volume was over.

Rachel: And within three days, we knew we were going to be moving within the first week, two and a half weeks to get yes. I mean, that to me was really impressive because with any new service line, you just don’t necessarily know until it gets started how it’s going to go and how the community is going to respond to it. But it was like gangbusters. I mean, it’s been unbelievable. And part of that is it tells you how significant the need is when you see that even your estimates are being blown out of the water of the uptake that you expect to see from patients of like, whoa, this is way more than we even anticipated. It speaks to the importance of having services like this available locally. And also, I have to tell a story about Jacob because that day you were talking about where he was sitting at the head of the table.

JJ: Yes.

Rachel: What was impressive to me about this is, like Jacob said, his why and part of his passion is patients having access to these services in their communities. And I can tell you he cares about the patients because we’re sitting in the boardroom, and this is our implementation kickoff meeting, and we are waiting for Jacob, and it’s like five or 10 minutes after the time our meeting was supposed to start. And we’ve got, you know, probably most of our senior leadership team and a couple of folks from some other departments there. And we’re all kind of looking around like, okay, where is this guy? And come to find out, he comes in several minutes later after Randy Holland, who has been on this podcast before, infection Control Officer and Director of Ancillary Services. He calls Jacob and figures out, oh, he’s across the way at the hospital because our building that we’re in is across the parking lot. And he comes back in. Well, turns out he was helping a patient in the parking lot who was, like, lost or trying to return a piece of equipment or something. I don’t even remember exactly what it was, but what I remember is the time that he was spending not at our meeting at that moment was because he was helping one of our patients, and he hadn’t even met any of us here face to face yet. And that really impressed me. That spoke volumes.

JJ: Absolutely. It resonates. And then when we look at the team approach that Jacob has behind him, he is bringing to the table years of experience and expertise, but also, they know rural communities. Rachel, that’s the human touch. What you just did, that was a human touch. Now, in most of our vendors, when they walk in, it’s not necessarily in tune to the patient.

Rachel: Right.

JJ: And it’s more they’ve got a task, they have a quota to meet, whatever. Not the case with our partners. Here.

Rachel: So once the centers are launched and you’ve seen your good numbers, within 30 days, within two to three years, let’s say, how are you seeing those infusion centers impact the hospitals that they’re in? How is that benefiting them? What are you seeing two in three years down the road?

Jacob Dozier: We’re seeing continued growth; we’re seeing continued increases in revenue. On average, our hospitals, year over year, once they have a fully mature program, you’ll still expect to see a 510, some cases on a very dramatic scale, 15% annual market increases. And, you know, one of the amazing things is that we get to maintain that partnership to promote that expansion, promote and support that growth. And because for us, we have it very well mapped out, x amount of volume equals Y number of staff. And so, it’s something that has been a really beautiful thing to see in our more long-term partners. Some of our partners have been on service with us for seven, eight years. And so, to see that continuous, ongoing growth from what I implemented many, many years prior is just a marvelous thing. And that’s one of the really amazing things about this type of service offering, is that it’s sustainable, it’s viable, it’s successful only when run and managed appropriately. And that’s just something that I cannot speak highly enough about, is the importance of making sure that you or someone around your inner circle, if you’re providing these services, you really look within and make that determination, because if you’re not, you are very well at risk of the financial viability that’s type of service.

JJ: Well, Jacob, believe it or not, our time has come and gone and we could spend another hour talking about the services that you and your company offer, but obviously all good things come to an end. But for those listeners today who are interested in services like this, it doesn’t need to come to an end because you certainly are available to work with them and their communities to provide local care right in their own hospital, in their backyard. So, I want to once again, thank you for joining us today. It’s been a wonderful opportunity to learn about your company, to learn about your services, and most importantly, how you’re impacting patients each and every day by changing their lives through this type of medicine much needed in our rural community. So, Jacob, thank you for joining us today.

Jacob Dozier: Thank you so much.

JJ: Before we close, we like to do a fun segment with each of our guests. So, we want to know, Jacob, what is your most unique rural experience or one of your favorite memories that is unique to rural life?

Jacob Dozier: I think the most unique opportunity that I faced in the rural communities has really been I’m walking down the floor; I’m pounding the pavement at a hospital. We just recently launched this operation. And over here that there’s this case manager who’s struggling with this patient. He needs this long term. I’ve been a dietic, he’s just had his arm cut off and all this really horrendous stuff, but they can’t reach the patient. They’ve been trying and trying to try, and so, lo and behold, I engage with that discharge planner and I get the patient’s information. I drive through the river, over the woods, through the hills to this patient’s house and connect with them. And they are in the very bottom of Appalachia southern Ohio Kentucky region. And the patient just was almost at a loss. He just was in a daze. I’ve sat on a bucket and conversation with him and his brother, who is his caregiver for about 15 or 20 minutes, and established a relationship and showed him that I cared, that he got better three times a day, eight weeks. That gentleman was committed to the service and he drove to his rural hospital and got his infusions 100% adherence without failure, successful outcome. And we still remain in contact to this day. It’s my most special and most revered memory in all of my travels across the country. That one stands out and has been something I’ve gotten to hold on to and cherish.

JJ: That’s fantastic. Wow. What a remarkable story. Jacob, once again, thanks for joining us today.

Jacob Dozier: Thank you guys so much. Des wishes. Have a great day.

JJ: Next time on Rule Health Rising we’ve another great conversation with another great guest, so be sure to tune in.

Rachel: And with that, don’t forget to subscribe wherever you get your podcast. And if you like what you hear, leave us a five-star review on Apple podcasts and tell others why they should listen to your feedback helps more listeners find rural health Rising.

JJ: And you can now find us on Twitter. I’m at hillsdaleCEOJJ Rachel is at ruralhealthrach. And you can also follow the podcast at rural health pod. Until next time, stay safe, stay healthy, and stay strong.

Rachel: Rural Health Rising is a production of Hillsdale Hospital in Hillsdale, Michigan and a proud member of the Health Podcast Network, hosted by JJ Hodshire and Rachel Lott. Audio engineering and original music by Kenji Olmer. For more episodes, interviews and more information, visit ruralhealthrising.com JJ. We talk about health policy constantly on Rural Health Rising and how important it is for rural hospitals and health care providers to have a seat at the table.

JJ: That’s right, Rachel. There are many ways to have an impact on health policy, but for our listeners who really want to gain experience in policymaking at the federal level, we have a great opportunity to share.

Rachel: The Robert Wood Johnson Foundation Health Policy Fellows Program seeks out midcareer professionals who are interested in federal health policy to learn how to improve the health of our nation and ensure everyone has a fair and just opportunity for health and wellbeing.

JJ: The program starts in September and runs for one year. Applications are open now and close on November 7, but you’ll need at least a few weeks to get your materials together, so don’t wait.

Rachel: If you’re interested in learning more or applying to this prestigious program, visit healthpolicyfellows.org. That’s healthpolicyfellows.org.