This article is sponsored by Synchrony Health Services. In this Voices Interview, Skilled Nursing News sits down with Randall J. Bufford, Founder & Chairman of Trilogy Health Services, and President & CEO of Synchrony Health Services, to learn about Synchrony’s progressive approach to integrated solutions and the benefits of utilizing a sole vendor partner. He also discusses his vision for future offerings to build upon Synchrony’s integrated solutions approach.

Skilled Nursing News: What career experiences do you most draw from in your role today?

Randall J. Bufford: Given that I’m 63 years old and I’ve been doing seniors housing and long-term care for 40 years, so there are a large number of lessons I can call on. When you think about seniors housing, long-term care and other related businesses, the No.1 challenge is our workforce. The thing that I spend the most time on, and that I’ve always been passionate about, is serving our employees and culture.

I think the experience of building a very unique culture of servant leadership inside the Trilogy organization has translated well into what we’re doing here at Synchrony. If we have a great employee experience, we know we’re going to have a great customer experience. For us as an organization, that’s an area of focus as we put our businesses together under the Synchrony brand.

When starting a new company, you have to build culture. I think my years of experience with Synchrony, Trilogy and other organizations I have led have helped us do that.

Synchrony’s approach to integrated solutions is innovative. Can you explain how your vision for this approach became a reality?

I think a lot of new ideas and visions are the result of external macro forces. In this case, we had a significant event with the pandemic. If we go back in time, we had two operating businesses: one was called PCA Pharmacy, Trilogy’s pharmacy, which we founded in 2002. We started our therapy operation, which was branded differently as Paragon Rehabilitation, in 2006. The idea of bringing these businesses together came out of my providing support to these businesses.

First and foremost, as the founder and CEO of Trilogy, I worked on succession planning in 2019 and passed the leadership to an awesome leader, Leigh Ann Barney, who is our current CEO. She was our chief operating officer at the time, and the two businesses reported to her. As part of our succession planning, I had this idea that maybe I’d take these two businesses and keep them going while Leigh Ann took on the CEO job.

Trilogy was around 115 communities at that time, and initially, I saw these businesses going either back to the new COO who would be hired to replace Leigh Ann or perhaps would fall directly under Leigh Ann. Then in March 2020, the pandemic happened. All those plans changed in different ways, and I realized our two businesses over here didn’t really cooperate or collaborate.

They operated in silos, missing the natural advantage to having clinical collaboration. There just wasn’t a synergy, or cultural alignment. We decided that for branding purposes, we would put them together under an umbrella. It was important to signal we’re one company and one voice trying to serve our customers and our employees.

Soon after, I saw the opportunity to serve and differentiate ourselves to not just our Trilogy customers (because about two-thirds of our business is outside of our Trilogy customer base). We saw the pharmacy wasn’t adding value to the therapy teams and vice versa, and we started to consider how to collaborate and bring real value besides just the obvious brand recognition.

Talk about how providers benefit by having pharmacy, rehab, labs and other services through just one vendor partner. What economies of scale do they realize?

There are three broad areas. The first and foremost is clinical collaboration. If you’re using three different organizations, it’s not easy for them to collaborate. They don’t have all the clinical data in the same place. We control the data flow around our lab, our pharmacy business and our rehab business, and we can put all of that together. We are uniquely positioned to not only have access to that data, but also to clinically collaborate more easily.

As an example. we have two programs that benefit from that value. The first is our “SET” protocol, which is “screen, evaluate and treat.” Basically, it’s a falls risk program. It integrates into the falls program of our customers in skilled nursing, as well as our assisted living and senior housing customers.

We look at every resident and see if they are taking medication that could be a risk factor for falls. Then if there are any changes that need to be made, we can do that. Of course, therapy is also assessing all of the clinical elements. We collaborate as clinicians, and then we work with the nursing departments of our customers to support them in fall prevention and recovery, if there actually is a fall.

Then because we have access to the data, we track the data, and we’re able to provide our customers with relative, real-time dashboards that show how effectively we are collaborating. We have a similar program for wound therapy that includes pharmacies cooperating with our lab, and so forth, so we’re using all that clinical data plus the overarching outcomes data.

The second program operates almost like a group purchasing partnership. If you’re doing business with us, we have better pricing because it’s more efficient, and we call that our Shared Savings Plus. By having all of those services with one vendor partner, we’re able to de-lever the cost. With one overhead and one administration, we are much more efficient.

On the customer side, it’s beneficial as well. If you have to coordinate something and you have to reach out to three different vendor partners, that’s more work. Here you make one call, you have one account management representation, you have one relationship.

How have your customers responded to Synergy Through Synchrony?

There has been great market reception to Synergy Through Synchrony. I think coming out of the pandemic, everybody’s challenged on workforce time, availability and becoming more efficient. As soon as you say efficiency, everybody thinks about cost and price and saving money, but our time is so valuable. We’ve been certainly put through the ringer over the last three years of the pandemic, and there’s hidden value in efficiently when partnering with people that can align with you. That has led to our growth.

Another interesting thing that we battled for years at Trilogy was people saying, “Hey, we don’t want to do business with your pharmacy or your rehab company because you’re part of Trilogy and they’re a competitor.” But the pandemic changed that competitive landscape. We all learned how to collaborate for best practices, and now Trilogy is first class in terms of quality.

By partnering with us, you actually get that expertise and capability because Trilogy, under my leadership as well as Leigh Ann’s, is an open book. If you want to understand how we do something, come see it. Our thinking is that if the industry does better, we all do better. If you want to understand how we staff our facilities without using agency nursing, we’ll tell you. If you want to understand our apprenticeship programs, we’ll show you how that’s done.

I think there is a hidden benefit to having such a great partner like Trilogy. Candidly, when we want to try something new that’s going to benefit our customers, we engage Trilogy first and they let us play in their sandbox, and so we don’t have to take a program out to a customer and say, “Hey, this is a new program.”

Our book of business is growing and while Trilogy is growing a little bit, much of the growth is outside of Trilogy.

How has Synchrony’s internal culture impacted your business vision and operations overall?

Our employees have embraced a lot of the changes that we brought to both businesses, and that has been rewarding. First of all, I can’t get off a phone call without bragging about how good they are at what they do. And they love us. I know that because our retention rates are very high — we only have 6% annual turnover among therapists in our company.

We just completed our annual Great Places to Work certification. For the first time ever we’ve done that as a standalone process outside of our Trilogy parent, and we scored an 87, which would put us in the top 100 companies in the country. Our culture works, and because of that, our employees stay with us.

It’s always started with doing the right thing for every employee. I have a strong passion for that. They can see it and they hear from me via video once a month through a system-wide town-hall meeting. They know management’s successful and cares about them.

What future offerings do you envision adding to your integrated solutions approach?

Currently, we are missing two major service constructs. One is diagnostic mobile imaging and mobile X-ray. The other is more holistic in that there’s a real medical model in skilled nursing, and around nurse practitioners/primary care physician involvement, that creates more comprehensive clinical collaboration.

We collaborate when we’re in the facility with them, but what if we were all either joined together under a Synchrony umbrella, or we partnered with somebody who was aligned in those outcomes I think the closer you can align physician services to all the other services we’re providing in a skilled nursing community, the better it goes.

When I say partnering, that could be a variety of things, like a capital investment or affiliation agreements. We’ve been talking about that and trying to learn more.

Finish this sentence: “In the skilled nursing industry, 2023 will be the year of…”

…complexity.

Editor’s Note: This interview has been edited for length and clarity.

No matter where a patient is in the healthcare continuum, Synchrony is right there with them. This means better care transitions, better communication within the interdisciplinary care team and between hand-offs, lower risk of medication errors, and faster turnaround on important lab results. Synchrony’s approach to integrated solutions means providing higher-quality care at a lower cost for post-acute providers. Click here to learn more.

The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].