Building Sustainable Home-Based Care Models with Dr. Gregory Goodman Medical Director at Maribel Health

[00:00:02] Hey everybody, welcome back to the Outcomes Rocket. I'm so excited to have an amazing friend and an

[00:00:10] excellent healthcare leader, Dr. Gregory Goodman on the podcast. He is a medical director at Maribel

[00:00:18] Health, an associate physician at Brigham and Women's Home Hospital Program and instructor in

[00:00:25] medicine at Harvard Medical School. He's a recognized physician leader in hospital at home

[00:00:31] and has performed hundreds of home hospitalizations. Dr. Goodman was awarded the 2022

[00:00:38] hospital at home physician of the year by the hospital at home users group. His clinical focus

[00:00:44] is on building innovative home based care models, and I'm so pumped to have him here on the

[00:00:49] podcast. Greg, welcome to the Outcomes Rocket. Dr. Gregory Goodman So absolute pleasure, thrilled

[00:00:54] and honored to be on your show and thank you so much for having me. Dr. Gregory Goodman

[00:00:58] It's my pleasure and I just got to say for the listeners and to you Greg, kudos because back

[00:01:05] in the early 2000s when I was deciding to kick off the podcast, I went to your website and for

[00:01:12] those that don't know, Dr. Goodman has a podcast as well and I was just like, man,

[00:01:17] who is this Dr. Goodman? Like you had all these awesome people on there and I actually

[00:01:22] aspired to be like Greg and his podcast. So you were an early inspiration for me and I'm excited

[00:01:30] that we're here chatting about the very amazing work at Maribel. So Greg, before we start, just

[00:01:34] tell us about what got you into the business of healthcare and we want to know more about that.

[00:01:39] Dr. Gregory Goodman So thank you so much. Since I was pretty young, I think in elementary

[00:01:44] school I wanted to be a doctor. So in high school I was shadowing a neurosurgeon during the

[00:01:49] summers. I do anything but neurosurgery now. I'm a general internist, but it was the early

[00:01:56] exposures to healthcare, serving people, seeing the value of being able to be a part

[00:02:03] of somebody's life in a really unique way. And right after med school, I had the opportunity

[00:02:08] to join a venture-backed startup called Remedy Partners thinking about new payment models with

[00:02:13] bundle payments. I then went back and finished my training at kind of a small community site

[00:02:20] and then joined academics. So very different path in terms of my journey and felt really

[00:02:26] fortunate as I was thinking about what I wanted to do with my life. I had read David Levine's

[00:02:31] first randomized control study, sharing the incredible work with the first 20 patients

[00:02:38] in terms of hospital at home and was just incredibly inspired by the impact he was having.

[00:02:44] And for the last six and a half years have practiced at Mass General Brigham.

[00:02:48] I was the first full-time home hospital doc, so all in, and then joined Maribel,

[00:02:55] which I'll share more about where our mission is to make home as the center of the healthcare

[00:03:00] system. And so personally, it's really meaningful. My grandfather was a house call

[00:03:05] doctor in South Africa and actually tragically passed away making a house call at 34. And so

[00:03:12] to me, I get to share his legacy every day. I make a house call every day. I help the health

[00:03:17] system build care in the home. It's honoring him and it's really incredible work. And he

[00:03:22] was doing this 60 or 70 years ago. So we're getting back to the basics of just providing

[00:03:27] excellent care to patients and supporting big healthcare systems to do that.

[00:03:32] I love it, Greg. And when you first shared that story about your grandfather with me,

[00:03:36] we were in Boston together a couple of months ago. I was like, it really touched my heart to

[00:03:42] hear that you're doing what you're doing in honor of him and getting back to the basics.

[00:03:47] And I think it really connects well with what you guys are up to at Maribel Health. So

[00:03:51] why don't you talk to us about what you're doing there and how you're adding value to

[00:03:55] the healthcare ecosystem? Yeah, thank you. So Maribel Health was started by Dr. Adam

[00:04:01] Graf and Ron Paulus. So physician-led, and I was the first hire. And what I thought was unique

[00:04:07] about Maribel was that Adam has a very deep home-based background, was the former

[00:04:15] chief medical officer of Biota. Ron is a former CEO of a large healthcare system mission.

[00:04:22] And so what I thought was really unique about Maribel, where our mission is to make the home

[00:04:27] the center of the healthcare system, is that deep expertise across the continuum,

[00:04:32] all the way from the very acute facility-based care into the home and into the community.

[00:04:39] And so our goal is to provide expertise and tools to large healthcare organizations.

[00:04:46] They could be healthcare systems, they could be home care agencies,

[00:04:50] and supporting them on that journey, providing a partner both knowledge and tools and

[00:04:56] technology to help them deliver home and community care. We've spent a lot of time

[00:05:02] in the acute care space, supporting large organizations like Mercy to build

[00:05:07] the first hospital home in St. Louis, but are also working with Biota, which is one of our

[00:05:12] investor partners, in thinking about how do we design care for the community with a focus

[00:05:17] on palliative care? And so I think what's unique about Maribel is we are deep in terms

[00:05:24] of being operators, being clinicians, being technologists, and we uniquely partner.

[00:05:29] So it's not a one-size-solution fits all, but really figuring out how do we add value?

[00:05:35] Where are you in that advanced care journey? And how do we support you

[00:05:38] and your community to get care at home? I think that's great. And there's a lot of

[00:05:43] clamor around this topic and how do we make it happen? And the entrance of

[00:05:49] large consumer companies making a play at also doing this type of work. How is what you guys

[00:05:56] do at Maribel different or unique compared to what's out there? Yeah, I think what's most

[00:06:01] unique is the way in which we form our partnerships. So because we have deep

[00:06:06] experience in large health systems, because we have experience in home-based care

[00:06:11] organizations, most of our team or many of our team are clinicians. So I think we're rooted

[00:06:18] in that unique perspective of actually knowing how to deliver the care. And it's really hard,

[00:06:24] right? It's not let's set up a program and let's get going. It's designing a model,

[00:06:30] understanding your population, understanding your community, doing that deep analysis,

[00:06:36] and figuring out what is the best strategy to get going. And I think that's what we're

[00:06:40] different about. We're not just a purely venture-backed tech company that's trying

[00:06:45] that has a single RPM solution. We really think about how do we connect expert knowledge

[00:06:52] and tools to appropriately build capacity for your hospital as well as serve your community?

[00:06:59] And so I think we partner with our health systems and home care agencies in a way

[00:07:05] that's sustainable over time. We want to build many year and potentially decade relationships.

[00:07:11] And so it's really thoughtful and intentional with how we partner in the effort that we put in

[00:07:17] on the ground and to make sure that it's a success for the health system, for the home care

[00:07:22] agency, and for the patient most importantly, right? Providing an absolutely exceptional

[00:07:28] experience and thinking outside the box to do that. I love that, Greg. And what does

[00:07:32] a win look like? You get one of these programs into place. Is it uniform? Does every

[00:07:38] organization think about this differently? Share more about that. Yeah, so maybe I'll give you an

[00:07:44] example of a program I've been intimately involved with. So Mercy is a large healthcare

[00:07:49] organization with their headquarters based in St. Louis. At the mid, there are kind of corporate

[00:07:54] layers called a ministry. At their ministry layer, they made a bold move in terms of their

[00:07:59] 2025 strategy to say home is the default side of care, which is incredibly bold, right? From

[00:08:06] a senior leadership perspective. And so then we worked backwards and said, okay,

[00:08:12] how can we support you on that journey? Hospital at home from a capacity perspective,

[00:08:18] their hospitals are overfilled, the EDs are congested. So that seemed to be a significant

[00:08:23] problem that we could support them on. And so we spent time about nine months designing

[00:08:30] the program hand in hand, right? So our kind of executive team with their team

[00:08:36] in the trenches thinking about how do we design a model that's sustainable, scalable,

[00:08:41] that serves their community, not only in the St. Louis market, but also throughout their

[00:08:46] ministry. And so we launched our first hospital at home program in late September of last year.

[00:08:53] We spent a lot of time, right? It's a whole new model of care, educating, providing

[00:08:57] knowledge transfer, building systems, helping to build the capabilities to do this.

[00:09:03] We're very excited with where we are. We're already in the top 2% of hospitals in terms of

[00:09:10] volume, in terms of hospital at home, and we're expanding to sites. And so I think our keys

[00:09:14] to success are partnering and understanding the organization, building those relationships.

[00:09:21] It's back to the basics and then making sure that we ensure that the care is absolutely

[00:09:25] exceptional for the patients and supporting the clinicians on this new journey. Being a

[00:09:31] home hospitalist is very different, right? It's not something that you're trained to do

[00:09:36] during your traditional internal medicine training. And so how do you gain those skills

[00:09:41] to support this new model of care as a leader in the space?

[00:09:45] That's fascinating. Appreciate that example really brought it home for me and I know

[00:09:49] probably for the audience too, Dr. Goodman. So as people are thinking about doing this,

[00:09:54] health system leaders are considering it or maybe they tried and got burned. What's one of those

[00:09:59] biggest setbacks that you see out there? And maybe give us a framework that we could think about

[00:10:05] it in. I think the hardest thing is that for a lot of health systems, they have a number of

[00:10:10] priorities, right? Because they're thinking about their system in general, the focus has

[00:10:15] mainly been on bricks and mortar and facility care. And so I think as a lot of healthcare

[00:10:21] system leaders think about it, a partner is a great option, right? Because our team wakes up,

[00:10:27] sleeps, breathes and thinks about how do we advance care in the home, which is very unique

[00:10:33] and different. How do you mobilize a workforce? How do you support the current technologies?

[00:10:39] How do you engineer those solutions to support each of those kind of components? And so I think

[00:10:46] our approach is to do an assessment, more of the strategic advisory services to understand

[00:10:52] where are you today? What's the current state? Where do you want to go? And then how do we

[00:10:57] fill in those gaps, right? And that's our approach with each of these organizations.

[00:11:02] Everybody's got different goals. Our goal is to partner with organizations to support them on

[00:11:08] building a sustainable solution for them in their system. So we want to be a long-term partner.

[00:11:14] I really can't stress that's like a huge differentiator. I fly out to St. Louis

[00:11:19] probably twice a month and train and coach our physicians and providers.

[00:11:24] It's a full commitment. We're all in on supporting them. It's not provide strategic

[00:11:29] guidance, support them on implementation and good luck with the customer success.

[00:11:34] We are all in, in terms of that framework. Well, that expertise is key. You guys have it.

[00:11:40] The partnership is critical. What about technology? What role does technology have here

[00:11:45] in making all of this happen? Yeah, I think technology is absolutely critical.

[00:11:50] The way I like to think about our company is we're a team of experts and consultants with a

[00:11:55] world-class engineering team. And so the way we're thinking about technology is how do we

[00:12:01] fill in the gaps for what exists today? So a lot of systems use Epic. So how do we

[00:12:06] leverage Epic to its greatest capabilities? How do we build the framework within Epic to support

[00:12:12] clinical documentation? Epic was built as an EMR for a lot of facilities, right? Not a mobile

[00:12:19] workforce platform. And so I think what we're thinking about is how do we make clinicians

[00:12:26] more efficient and optimize workflows and hard wire technology? And so our technology platform

[00:12:33] over time is going to be modular. So plug and play, maybe you have an RPM solution that you want

[00:12:38] to use. You have an EMR. What are those gaps? Right? It could be logistics. It could be

[00:12:43] workforce management. It could be visit planning. So our platform is designed to support you

[00:12:49] and help you in terms of thinking geographically, right? Because you have a nurse here,

[00:12:54] you have a paramedic here, you have a doctor here. How do we deliver the right care at the

[00:12:58] right time at the right location, utilizing those resources in a way that's most efficient?

[00:13:05] And so we've been really intentional with not just coming out with a platform. We're

[00:13:10] co-building and co-designing our platform with Mercy as well as thinking about how do we

[00:13:16] support many of our partners in terms of using tech to scale these models.

[00:13:21] That's great, Greg. And we all know we don't need another point solution.

[00:13:26] So I think it's great to hear about the intentionality that you guys are taking

[00:13:30] with the technology piece. So very excited to hear about the model, the way you guys work.

[00:13:36] For everybody listening, thinking about a program like this or just wanting to learn

[00:13:41] more and getting ahead of the game, what closing thought would you leave us with?

[00:13:45] And what's the best place that the listeners could get in touch with you and the Maribel

[00:13:49] team? So in terms of closing thoughts, go big and go home. We need both of you.

[00:13:55] We need bold healthcare leaders that want to make a difference. From a patient perspective,

[00:14:00] it's incredibly meaningful to sit on their couch, meet their pets, do a kitchen walkthrough.

[00:14:06] That's the secret sauce to this model, whether it's on the acute care side or providing

[00:14:11] longitudinal care to patients and families. It's that deep bonding connection. It's what

[00:14:16] is most meaningful, I think, in the reason why I continue to do what I do and I'm so

[00:14:21] proud of it. It's incredible, right? Once you've made a house call and had that

[00:14:25] honor of being a guest in somebody's home, there's just so much we can do.

[00:14:30] In terms of connecting, would be thrilled and happy to have conversations with healthcare

[00:14:34] leaders about where they are in the journey and how Maribel can support. You can reach

[00:14:39] out on LinkedIn or directly through the website or via email and Sol, super honored to be

[00:14:46] a guest on your show. I look up to you and what you've built over the years and it's

[00:14:51] just fun to watch. The work that you're doing is incredible to support healthcare,

[00:14:56] to advance and make sure that others get to hear about what's out there so they can make

[00:15:01] great decisions and support patients. It's really exciting.

[00:15:04] Yeah. Thank you, Greg. Really appreciate that. Kudos to you and the work that the

[00:15:08] Maribel team are up to. I can't thank you enough for being with us. Folks,

[00:15:13] in the show notes, you're going to find all the ways to get in touch with Dr. Goodman

[00:15:17] and the Maribel team. So don't shy away from that. Go big and go home. I love that call

[00:15:23] to action that Greg left us with. And with that, just a big thanks to you,

[00:15:27] Dr. Goodman for being with us. Thanks all.