ROX Interview: Brian Kellar

Brian Kellar, CEO of Banner Casa Grande Medical Center

Interview by Bea Lueck

Brian Kellar grew up with snow boots and snow blowers in South Dakota and thought about law school. However, a conversation with a business professor steered him toward health-care administration and eventually brought him to Arizona. Since September 2018 he has been CEO of Banner Casa Grande Medical Center. He’s a man who considers his work to be comprised of strengths and opportunities to keep people well. And he sees the “magic” in a local workforce.

GC LIVING: Thank you, Brian. We appreciate the time out of your busy schedule. You are the CEO of Banner Casa Grande Medical Center. Let’s get to know Brian as a child. Where did you grow up?

Brian Kellar: I was born and raised in Aberdeen, South Dakota, similar size to Casa Grande. The difference is, it was about 67 below with the wind chill two weeks ago. And it was 75 degrees here. (Editor’s note: interview took place mid-February). I don’t own snow boots or a snow blower anymore. And I’m great with that.

GC LIVING: Do you have siblings?

Brian Kellar: I’m the oldest of three. My brother, Jeremiah, lives in Bend, Oregon, and my sister, Jennifer, lives in Sioux City, Iowa.

GC LIVING: So, you grew up in Aberdeen, South Dakota. And then you went to the University of South Dakota.

Brian Kellar: Yes. I went to USD. I was a pre-law student. I majored in political science and minored in American Indian studies. A couple of semesters of Lakota language and culture was something I wanted to experience.

GC LIVING: Lakota is Sioux?

Brian Kellar: Yes. Part of the Great Sioux Nation. In Lakota language class most people spoke fluently, and had ancestry in either Lakota, Nakota or Dakota. I knew none of it and was one of very few non-American Indian students in the program. Being completely out of my comfort zone was an experience I wouldn’t trade for anything. I am blessed that I was able to understand how that can feel. It really changed how I see the world.

GC LIVING: What made you change from pre-law to public and health services?

Brian Kellar: (laughs). It was a semester before I started the orientation and process for law school. Back then there was a rule saying you could not have a job off campus your first year in law school. My parents weren’t in a situation to write a check for tuition so I had to work and save my way through college and the math wasn’t close to working out; I was devastated. I had focused four years in all the political science, pre-law programs, clubs, all of that. I had a plan, and it just got blown up.

When an incredible professor and friend named Diane Duin told me to try a health-care leadership class, I fell in love. Even before I finished grad school, I had an internship as a nursing home administrator and was promoted to lead a nursing home in small town Kansas. We’d never been to Kansas before and after an unpaid 6-month internship I called my pregnant wife to tell her we were moving and I couldn’t even remember the name of the town.

GC LIVING: So, your wife was pregnant, in the middle of winter …

Brian Kellar: Pregnant with our second, with a 3-year-old and a puppy.

GC LIVING: She loves you.

Brian Kellar: More than you know. 20 years ago, the smartest thing I ever did in my life was propose to Christel. We packed up Beverly Hillbilly style and moved Kansas.

GC LIVING: How long were you there?

Brian Kellar: Just a year- the family-owned company had some ugly infighting that made it volatile so I took a role at Sanford Health to lead long term care on hospital campuses- I had an amazing mentors in Mick Penticoff who went out of his way to develop my executive leadership to be bold and reimagine what is possible instead of just accepting what has always been done. In 2011, we took an anniversary trip to Arizona and Christel told me she guaranteed we would live here someday. As fortune would have it- in 2016 I was hired to Banner Health’s hospital in Page, AZ and our family has called AZ home ever since.

GC LIVING: Where did you meet your wife? You were high school sweethearts.

Brian Kellar: I met Christel on the Fourth of July at a minor league baseball game about a month before I left for college. I had a side job running the concession grill and they offered to pay a couple of us extra to stay around and clean up after the fireworks. Afterward, the whole place was trashed and everyone else bailed. As luck would have it, this cute gal offered to stay around and help me. We picked up trash until 2 am. Some first date, huh?

GC LIVING: How many children do you have?

Brian Kellar: We have three. Micayla is 18 and start CAC in the fall for nursing. Leo is 14 and a freshman here at Casa Grande Union High. Lincoln just turned 13 and is in 7th grade.

GC LIVING: Now you’re in Casa Grande. How does this hospital compare to Page?

Brian Kellar: The community and the demographics couldn’t be more different- Banner Page serves a much more rural region with an international tourist population on Lake Powell 130 miles from a larger hospital. Banner Casa Grande is a larger full-service medical center with diverse specialties and access to more on-site resources less than an hour from trauma centers and specialty hospitals. Their similarities are in how the two Banner hospitals collaborate in Mission, Values and countless shared services- I was able to work with Banner Casa Grande teams on a lot of initiatives years before I came here.

GC LIVING: The most recent construction was the women and infants center. My sources say the next big need is the emergency department.

Brian Kellar: Your sources are smart! We’ve been waiting for an ED expansion for a long time. In the 5 years since Banner’s arrival in Casa Grande, we added a new Women and Infant Center and have been catching up a lot of smaller construction projects like the plant’s medical system and equipment needs so that our infrastructure can handle an ED project and other life-saving services people need.

The ED will have to be expanded in phases, and the logistics of it are taking a lot of planning because our ED can’t close or fail to meet every single regulation during major renovations and construction.

It can’t happen soon enough for anyone- the wait times are too long and we need more space- this impacts far more than just the people of Casa Grande, but people in all of the communities of western Pinal County that we serve. This has a significant impact on patients and staff alike.

GC LIVING: Health-care technology is constantly evolving. I remember when technology was mobile. Major equipment was housed in trailer units that traveled on a hospital circuit. You didn’t have an in-house CT scanner. It was in a trailer parked outside a couple of times a month.

Brian Kellar: And now we have two and planning a third.

GC LIVING: I remember when you got a 16-slice CT scanner. What’s the slice count now?

Brian Kellar: The standard needed for a trauma center is a 64-slice that we already have. We are planning to upgrade to a 128 for faster whole-body scans and sharper cardiac and neuro imagery. This reduces dosage and increases accuracy- critical to patients and their physicians alike. When seconds count- tech saves lives.

GC LIVING: How much do you see a change taking place in health care in general? The focus is now on doing more on the preventative side versus the reactive correction side?

Brian Kellar: Maybe my favorite topic. Here in Casa Grande we’re a microcosm of what we see throughout heath care where change is endless. While medical advances help us live longer our healthcare needs increase substantially; Much is preventable, but diseases like Alzheimer’s and ALS are increasing at a rapid pace; it is not just incurable, it is emotionally devastating and wildly expensive. For this, research and innovation are crucial. Since the vast majority of research is funded by the government, the cost of research is now competing with the cost of care. With our U.S. population aging rapidly, healthcare spending is taking up a larger and larger piece of the pie- eventually it just isn’t sustainable. We have to think differently- we have to disrupt yesterday’s care delivery and make it more affordable; this means moving services from inpatient hospital-based locations to clinic delivery and forcing out-of-pocket costs down-in Casa Grande, Banner has done this with outpatient imaging and outpatient physical therapy in the past 18 months.

The next key a lot of healthcare costs are associated with cardiovascular disease and obesity- both of which are mostly preventable. How can a healthcare organization help prevent people from developing type-2 diabetes with diet and exercise when people have a constitutional right to be reckless? Unhealthy food is cheaper than healthy food and the overabundance of sugar and salt in our diets is literally killing people.

Government can’t mandate healthy lifestyles, so how can we incentivize it? Does health insurance eventually behave like life insurance or auto insurance and base premiums solely on behavior? How about people without insurance? Medicaid is covering more and more people every year and our federal government carries so much debt, Social Security and Medicare’s coffers are filled with IOU’s that we aren’t sure how to repay. Partisan politics bottleneck federal progress so health systems are needing to venture into the space of innovating population health- it isn’t easy, but it really is critical to save the health of the nation. Our Mission, Values and annual initiatives at Banner are centered around healthier populations- it will take a lot more than a health system, but it must start with us.

GC LIVING: Let’s look at the business side of hospital operations. The emergency department sees a higher demand by people who don’t have the ability to pay for the emergency department services. You are federally mandated to treat those who walk through the door regardless of the ability to pay. How do you compensate?

Brian Kellar: This isn’t unique to Casa Grande and is one of the unintended consequences of how the American healthcare system works. Frankly, hospitals anticipate for this to be the case with 9.4% of people uninsured- its why the business of healthcare must be so much more than an ED and inpatient services. We expand into many outpatient services to reduce preventable ED visits. Diversified care strategies, economies of scale and cost reduction are some of the value propositions of healthcare systems- it is why independent hospitals either join systems or close.

GC LIVING: Where do you see health care in Casa Grande going five years, 10 years from now?

Brian Kellar: We’re never done strategic planning- it is crucial to have a roadmap that provides clarity while allowing us to be nimble as external factors change. We’re prioritizing physical plant changes, upgrading state of the art technologies as well as building relationships with community partners to meet our Mission of “Making health care easier so Life can be better.”

Aside from upgraded spaces, our workforce will look and behave very differently. A lot of people will be in jobs that don’t even exist yet. The population increases will pass a threshold making our community more attractive to specialists so access to intensive care will be more and more local. The boomers will have largely retired and a workforce that values innovation over tradition will have emerged.

GC LIVING: Where do those people come from?

Brian Kellar: That is the magic question, isn’t it? Everywhere. We must help people realize that healthcare needs more than doctors and nurses. There are so many different jobs you can have in health care and continue to live in the community that you love. We have to engage tomorrow’s workforce on what those are, connect them with higher education; and offer the right opportunities. It’s every bit as important for people to work in our culinary department, human resources, nursing leadership, finance, environmental services, or patient access. You can have a wonderful career and not leave the town you love.

GC LIVING: Currently, Banner operates an urgent care here in Casa Grande.

Brian Kellar: Yes- the busiest urgent care in the Banner system.

GC LIVING: I wouldn’t doubt it. Years ago, CGRMC operated a nursing home and then an acute rehab facility. Any plans to reopen either?

Brian Kellar: A nursing home is its own very specialized type of health care. It’s residential. They were once overseen by hospitals, but they’re so different that it needed to become its own specialty. Nursing homes and long-term care are best served by people who are specializing and have an exclusive focus in caring for people in a residential living situation. As for the space where our nursing home operated- it is at the end of its life and wouldn’t have much use outside of training and office space.

GC LIVING: What about acute care, a step-down unit? You don’t need to be in the hospital, but you still need some hospital-like services.

Brian Kellar: We have two observation floors where people are there for a short period of time after some sort of an event, treatment or procedure to get ready to have a more fluid discharge home. They’re not acute but they’re not ready to be home yet.

GC LIVING: What about rehabilitation services?

Brian Kellar: Inpatient and outpatient rehab continue to grow here so Banner partnered last year with Select Medical to share expertise in the outpatient space while we continue to see growth in our inpatient rehab as well. Today we have a pretty extensive outpatient rehab clinic right on Florence Blvd.

GC LIVING: And Banner is expanding the medical offices on McMurray this summer.

Brian Kellar: Yes. We just added a Nurse Practitioner, Laura Stager, to join Dr. Beroit and have another physician coming this summer as well. Pinal County has the lowest physician: population ratio in the state, so we need to respond to a pressing need here. Primary care is the least expensive and best place for routine healthcare and can help people manage their health factors better to prevent chronic illness or an ED visit.

GC LIVING: What is the role of the Casa Grande Hospital Foundation?

Brian Kellar: The Casa Grande Community & Hospital Foundation raises funds to create philanthropic opportunities that has a host of community partners to provide health services throughout our region. While it is a wholly separate organization, the relationship with the hospital is very close and they complement one another so that we can identify needs whether it is a woman who can’t afford her copay for a mammogram or provide scholarships so local citizens can receive an education to create a career to serve the health needs of the people and communities around us. Added bonus- the Board members, volunteers and the events they plan every year really are a ton of fun!

GC LIVING: Our winter visitors are an excellent source of volunteers for the hospital.

Brian Kellar: They sure are, and so are the local volunteers who are here year-round. Our volunteer army is impressive- Kaitee and Karen coordinate the most giving people you will meet- they drive valet carts in 100-degree heat, run a gift shop, chaperone patients to appointments and endless other support for the people who provide and receive care here. In many cases- a volunteer is the first impression someone will get of not just Banner Casa Grande, but Banner Health as a whole- we love our volunteers and they are as much a part of our success in improving lives as anybody.

GC LIVING: So, let’s look at what it takes to have a hospital. The residents of Maricopa have been screaming, “We need our own hospital” for years now.

Brian Kellar: I can’t blame them. I know the city leaders in Maricopa have been very diligent in that pursuit- and rightfully so. We continue to grow our primary and specialty clinic services in Maricopa, but the local population wants to see that next step of surgery and an Emergency Department. I wish I could speak more to that future, but it’s just not a loop I’ve been in- but am reliably asked about it every time I am in town!

GC LIVING: What do you see as Banner Casa Grande’s strong point and challenge?

Brian Kellar: I say this all the time: Everything we do is either a strength or an opportunity to become a strength. Our strengths are the 900 professionals that make up our comprehensive health campus and the outcomes of the healthcare we provide. We match up with any major metro medical center because Banner Health relentlessly pursues improvement and innovation.

Our greatest challenges are growing space and people fast enough to meet customer needs and availability of healthcare professionals. We are in the midst of the greatest nursing shortage we’ve ever seen, and we see enhanced demand for services and new service lines at Banner Casa Grande- We’re blessed to have a CAC partnership that grows deeper and deeper each academic year.

GC LIVING: Didn’t Banner Casa Grande get an improved rating on a recent Leapfrog study?

Brian Kellar: Yes, we’re an A-rated hospital by Leapfrog. The hospital’s direct care and support professionals consistently earn an A or B rating for a while now. Leapfrog focuses on quality outcomes, and our grade can have as much to do with our care quality as the follow up care when people leave Banner Casa Grande- it really is an A rating for the entire healthcare community- not just our local Banner hospital.

Healthcare is endlessly complex and rapidly evolving. Every time an experience is short of perfection we study it and learn how we can be better. It’s why the pursuit of providing health care for other human beings is a never-ending challenge; Every year we care for 48,000 people in our emergency department, 4,000 in surgery, 29,000 inpatient days, nearly 40,000 outpatient visits and not one interaction was 100% routine or predictable. We relentlessly work to respond to that challenge every minute of every day. Luckily, our Team Members don’t flinch and follow their life’s calling of service to others- how lucky are we to do that every day?