Colby Kostur: “A leader is best when people barely know he exists, when his work is done, his aim fulfilled, they will say: we did it ourselves”

The cost of our premiums for individuals who are covered under insurance are just continuing to increase and making it more unaffordable to receive healthcare. The way the US system is set up, doesn’t allow for individuals to be invested in their health, and more importantly their preventative health; thus, only utilizing the healthcare system […]

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The cost of our premiums for individuals who are covered under insurance are just continuing to increase and making it more unaffordable to receive healthcare. The way the US system is set up, doesn’t allow for individuals to be invested in their health, and more importantly their preventative health; thus, only utilizing the healthcare system when something major happens to them. In addition, the US doesn’t offer universal healthcare allowing for individuals to not participate in the system.

As a part of my interview series with leaders in healthcare, I had the pleasure to interview Colby Kostur.

Colby Kostur is a Colorado native, growing up in the small town in Northwestern Colorado. After earning his Bachelor’s degree in Psychology from the University of Colorado, he immediately started working in the healthcare field. His passion for healthcare began in recruiting and moved into a management role in his three-year tenure at his previous company. Colby proudly joined Team Select Home Care in 2015 as the Operations Manager. Throughout his five years with Team Select Home Care, Colby has moved from an Operations Manager role to Area Director of Operations, where he proudly oversees Team Select’s Pediatric and Adult Long-Term Care division for the Colorado and Arizona territories. Overseeing these territories also enables him to work closely with the deserving families participating in the Family CNA Program in his home state of Colorado, while actively working to bring the program to additional states. Colby currently resides in Denver with his fiancé. Although his passion for the healthcare field is a major aspect of his life, travel and exploring the world are also incredibly important to him.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

Thank you guys for taking the time to chat with me. I’ve always had a passion and interest in healthcare, but to be honest I didn’t see myself directly working in this field. I come from a good-sized family, where second and third cousins feel are more like first cousins; and growing up we spent some time traveling to Albuquerque, New Mexico, during the summers. My cousin, who just turned 40 and lives in Albuquerque, was diagnosed with cerebral palsy (CP) at a very young age, and I was always in awe of his parents who are so graciously devoted to providing all of his care. Just being able to witness how much work is required by his parents to complete every single task for him, is really moving. From the moment they wake up, to the moment they put him to bed, it is their responsibility to help him achieve his own level of independence. Although that level looks completely different than mine or yours, to see his parents be the ones to provide that for him is proof that there is no one who could parallel the care they provide him with each day. The unconditional level of discipline that goes into caring for their son, has continually resulted in the best possible outcomes for his health and happiness. However, providing such a high level of endless care every day is demanding; it is trying, it is rigorous and non-relenting, and I’ve seen the strain that this can really put on a family. I grew up in town with a population just over 1600 and to say resources were limited would be a huge understatement. So, my current career path didn’t even exist in my mind. Upon completion of my college degree at the University of Colorado, I was fortunate enough to find a position working in home health. I had the opportunity to work with families one-on-one, to really help provide them with some relief by hiring and staffing qualified clinical personnel for their loved ones who had chronic illnesses. Whether they needed someone to help with activities of daily living and/or care from skilled nurses, I felt like I was able to help these families find the best care possible and help them get the relief they needed. The first time I had a family member cry over the phone because they had needed help for so long, or got told they could be reimbursed for providing their loved ones with care, made such a profound impact on me that I knew this was the career path I wanted to continue to pursue.

Can you share the most interesting story that happened to you since you began leading your company or in your position at the company?

One of the most impactful stories that has happened to me during my career was one of the main reasons I knew I was in the right field. We met this single mother who had been struggling for years with her child’s disability. She was in a revolving door of doctor appointments for her child, and in addition, a revolving door of employment for herself. As her child got older and his need for care only continued to increase, it completely removed her from being able to contribute to the home financially and hold down a traditional job. Due to her child’s diagnosis, having the option of traditional home care wasn’t something that was tangible for them. He needed constant care, and the only option was for his mother to be the one to provide the care. At a community resource fair, this mother came to our company’s booth for information about what it is we do, and our team explained the Family C.N.A program and how she could potentially become her child’s skilled caregiver. Instead of constantly missing work or not being able to hold down a job, she could earn an income by providing the best care to her son. At that moment she started crying. She’d never heard of the program and thought that it was too good to be true. She was able to successfully go through the training required, is now employed as a C.N.A. and her child is receiving the care he needs yielding the best outcome for him.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

Unfortunately there aren’t many funny mistakes that I’ve made, so to speak, but there have been plenty of mistakes made over my career and I definitely feel that it’s important to look back at those mistakes and learn from them. One mistake that I will never forget –I pitched to my supervisor, at the time, a new product that I felt would greatly increase our business and generate more revenue for the company. The cost to us was very minimal and it seemed like a layup, I simply couldn’t imagine him saying no. After I pitched it to him, he responded with a full page of information that he still needed to know before deciding. As I worked through each question, it was becoming more and more obvious that I didn’t in fact, have a full understanding of the product and jumped the pistol asking him to approve something I simply didn’t vet through. Before I could finish his questions, I reached out and retracted my request, understanding our company already had platforms that achieved the same goal I was trying to get to. This mistake stands out to me because it taught me to be extremely thorough if I want to succeed; it taught me to look at all possible angles and do my research, especially before presenting it to my leaders.

What do you think makes the company you work for stand out? Can you share a story?

I think there’s a long list of reasons why Team Select Home Care stands out in the home health industry, ranging from having a robust data analytics department to our innovative approach to patient care. Nevertheless, at the end of the day it’s very simple, we focus on supporting our employees, ensuring they understand their value, and as a result, our patients receive the best care possible. In home care, most employees are working in the field and very infrequently are heading into their local office. As a result, showing those field employees appreciation provides a challenge. In recognizing this challenge, we needed to think more creatively about how appreciation can be shown to employees, which is why we took the initiative to integrate a software platform that can highlight the performance of the field clinicians. This way, the work they are doing is not only being recognized by the whole team, but really provides the opportunity for the team to emphasize and praise the clinicians work so that with every big or small achievement, they are shown how valued they are.

What advice would you give to other healthcare leaders to help their team to thrive?

There are many things leaders can do to help their teams succeed and thrive but I’m a firm believer in the power of servant leadership. Focusing on showing your team that you’re more than willing to roll up your sleeves and help do anything needed goes further than telling or instructing them to do something. By investing your time on teaching and showing your employees they’re the most important asset to the company, they in-turn, care for our patients in the same way and provide the best customer service.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high-income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

It’s shocking, and honestly, pretty disappointing. Providing suggestions to improve the healthcare system in the US is a complex question, but there are some reasons why we’re ranking so poorly. In the book, Broken, Bankrupt, and Dying: How to Solve the Great American Healthcare Rip-off, Dr. Brad Spellberg does an amazing job explaining the historical reasons why our healthcare system is failing in comparison to other nations. The cost of our premiums for individuals who are covered under insurance are just continuing to increase and making it more unaffordable to receive healthcare. The way the US system is set up, doesn’t allow for individuals to be invested in their health, and more importantly their preventative health; thus, only utilizing the healthcare system when something major happens to them. In addition, the US doesn’t offer universal healthcare allowing for individuals to not participate in the system.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

This is an extremely complex question that I think many people are trying to figure out, but I think everyone can agree that something needs to change. My first suggested change, would be the focus on preventative care and trying to be proactive instead of reactive. The impact of preventative treatment has been proven to keep costs down and yield better outcomes for individuals. My next suggestion would be to focus on consolidating services for the best quality of care and outcome. This shouldn’t be confused with consolidation of providers or companies. When our company receives a referral for Physical Therapy to be provided in the home, our therapists assess all the needs we could provide as an agency. By doing this, we’re ensuring that all the client’s needs are being met and consolidating the care to make sure that we’re providing the best quality of care at the best price for the client or their insurance company. Next, we need universal healthcare coverage. Many people in the US use universal healthcare synonymously with single payor healthcare and that’s not the same. Whether that be a single payor, private multi-payor, or a combination of both, which has worked, it’s essential for everyone to have healthcare coverage. In addition to having everyone be covered by healthcare insurance it’s an absolute necessity that everyone contributes to healthcare coverage. Meaning, there are no gaps in insurance coverage and that we work on reducing all the additional premium costs associated, like the extremely high deductibles and out of pocket costs. Those costs can overwhelm individuals and can range from 7,000 dollars to over 20,000 dollars. Therefore, individuals and families who are covered and paying into insurances still might not be able to afford healthcare. My final suggestion would be to ensure that every individual contributes to the healthcare system. I don’t think it’s a surprise that individuals with chronic sicknesses or individuals who are ill, are a vast majority of the cost for healthcare. But if you have a system that allows for healthy people to opt out of coverage, it offsets the cost and the premiums will increase, and with healthy people choosing not to contribute to coverage, the cost of medical care will not be able to be covered by the sick individuals as the cost will be so high. As I mentioned at the beginning, it’s an incredibly complex question, with not one simple answer for a solution.

Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities, and d) leaders do to help?

Systematic changes need to be initiated from the leaders of this country and it needs to be a top down approach. The biggest hurdle to take on is that fixing the healthcare system is a bipartisan issue. From an individual position, people should focus on utilizing the preventative care they already have through their coverage if they’re covered. Every individual should also educate themselves on healthcare service resources that are available to them in their communities. Corporations should work on offering affordable coverage for their employees to ensure that every employee is covered and their healthcare premiums kept as low as possible.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health, and general health. What are your thoughts about this status quo? What would you suggest to improve this? Something needs to be done about the status quo and understanding of mental health in the US. With a higher concentration on our general healthcare systems, we see more money and resources are being utilized towards it compared to our mental/behavioral health system. More studies are being published showing evidence-based treatments for helping improve the outcomes for individuals affected by mental health, and by allowing enhanced access for these services, you’ll see the quality of mental health services increase.

How would you define an “excellent healthcare provider”?

I’d define an excellent healthcare provider as someone who doesn’t lose sight of the fact that every patient is a person, and every process and policy is based around the best outcome for that person.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

Again, servant leadership is very important to me. One of my favorite “Life Lesson Quotes” was said by Lau Tzu and states, “A leader is best when people barely know he exists, when his work is done, his aim fulfilled, they will say: we did it ourselves.”

Are you working on any exciting new projects now? How do you think that will help people?

The main project that I’m focused on, is expanding the coverage for medically fragile children and their families through the Family CNA Program. By states approving the Family CNA (Certified Nurse Aide) Program it would allow parents and family members of medically fragile children to become their children’s caregivers instead of constantly missing work and losing wages to care for their loved one. Continuity of care is so important for these medically fragile kids to receive the best outcomes, and traditional care is limiting those positive results. This solution helps the patient first and foremost, but in addition, puts dollars back into the economy since these parents are being employed by home care agencies. I am proud to say that qualifying families in my home state of Colorado are eligible to participate in this program, and look forward to continuing to work to bring this program to families in need in additional states.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

I spend a lot of time traveling in my role, and have really taken to podcasts. Some of my favorites that inspire me are: Healthcare Executive Podcast, The Business of Healthcare and Healthcare Tech Talk. However, I would say the podcast that I listen to the most is The Journal. Although it’s not specifically a healthcare podcast, I like taking topics that they discuss and see how they can change or interact within healthcare. My goal is to think outside of the box from other industries and see the ways in which we can implement and launch positive change in our day to day business.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.

I’d really like to see the Family CNA Program be available nationwide. The outcomes that it provides these kids with is amazing, and in addition, the benefits it could provide across the economy would be profound. Currently, if families need home health for chronic illness, their only option is Private Duty Nursing (PDN). This is where a nurse goes into the home and is one-on-one with a patient for multiple hours per day. The current nursing shortage will only worsen by 2030, and most states will continue to have nurses below the demand. Further, not all families live in a city, and the rural access to care drives the cost and limits the access of care. Right now, medically complex patients are a small portion of the population but a large portion of the cost. Medically complex Medicaid enrolled children are only 6% of the market but account for 40% of all children’s Medicaid dollars. Also, 48% of children that need nursing care at home are delayed in the discharge process from hospitals due to staffing challenges. This isn’t a sustainable solution for these patients. The Family CNA program reduces the cost to the health plan by incorporating CNA hours where appropriate, while retaining clinical quality and needed support for the patient. It provides relief for families and patients by improving the quality of care, offering needed consistency in the delivery of care, and provides compensation to the family care giver. This is a program that only has positive outcomes and I’d love to see it become adopted nationally.

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