Helping Healthcare Scale
Imagine you're friends with multiple CEO's of billion dollar organizations. You can call them anytime you like and ask them all that they've learned about real estate and investing, including some of their biggest mistakes.
That's the mission of this podcast, to teach the insider strategies used by the big guys to everyday healthcare operators in order to get access to the best strategies and real estate at the best prices.
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Helping Healthcare Scale
Mark Reddinger Scales Urgent Care and Autism Services through Healthcare Real Estate Mastery
Embark on a journey through the intricate landscape of healthcare real estate with Mark Reddinger, a seasoned expert whose two-decade career has shaped the urgent care revolution. From his early days dealing with Florida's healthcare regulations to his current role at Unified Autism Care, Mark's narrative is a testament to the power of strategic growth and operational excellence. His success in launching new clinics every 90 days with Solantic Urgent Care and St. Vincent's First Care is not just a tale of expansion, but a masterclass in the delicate balance between savvy site selection and delivering top-notch clinical care.
As we converse with Mark, we uncover the secrets behind transforming common retail spaces into thriving urgent care clinics. Remember the old Blockbuster video store down the street? It could have been your neighborhood go-to for medical care, thanks to visionaries like Mark. He shares the critical factors that elevated locations and partnerships, including those with renowned hospital networks, propelling patient loyalty and solidifying a business's foothold in the competitive healthcare market. This episode is a goldmine for anyone fascinated by the intersection of healthcare services and prime real estate.
Finally, Mark opens up about his heartfelt venture, Unified Autism Care, a beacon of hope for families navigating the challenges of autism. We delve into the significant rise in autism prevalence and the impact of early diagnosis, while also exploring how real estate plays a crucial role in delivering specialized care. Mark's dedication to creating accessible, family-friendly centers for intensive therapy is as much a strategic move as it is a mission to enrich lives. For those intrigued by the business of care and the care in business, this episode is a profound look into an industry leader's pursuit to make a meaningful difference.
Get in touch: Email mark@unifi.care
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Three years later I had clinics. I had 12 in Jacksonville, three in Gainesville Ocala area, seven in Orlando and then a few more in Southeast Florida. So it really was, it was constant.
Speaker 2:The goal of this show is to help healthcare organizations scale by leveraging real estate strategies and interviewing high-level healthcare executives in order to pull out lessons learned along the way. If you'd like a free site selection analysis from our team, or you'd like to learn more about how we're acquiring real estate through our fund on the blockchain, visit us at wwwreuniversityorg and drop us a line. That's re as in realestateuniversityorg.
Speaker 3:Hello, welcome back to Helping Healthcare Scale. I'm Austin Hare. I'm really excited to have our guest today. Our guest is Mark Redinger, and he's been involved in healthcare space for 20 years Now. He got started with the Salanic Urgent Care, then founded St Vincent's First Care alongsidea private equity group, where they grew from zero to 12 locations, then later became the COO of Premier Health Urgent Care and now is the CEO of Unified Autism Care. So you've had quite the career.
Speaker 1:It's been nice to see the industry change over time. Certainly Urgent Care has, and now I feel like I've got a great opportunity to really help shape the identity. Futuristic, future thinking, forward thinking, autism care for the next years to come.
Speaker 3:Yeah, it's always so interesting Like I get. I'm sure the younger self would have never guessed like that you would be CEO of an autism group and it's like the path that life takes us on is just so unpredictable. So I just love hearing about stories, maybe as your younger child, if there's anything entrepreneurial that you did or the way that you were raised with your parents or maybe there wasn't, but what was that like? Is there anything that stands out to you?
Speaker 1:It's not really so much entrepreneurial that is in my heart but it's really I just come from a strong operational background I think my first entry into the private side of healthcare, because I did work prior to jumping out with Celine. I worked for the state of Florida and part of the regulatory responsibilities that I had was medical clinics and dental offices. Really, my first jaunted to healthcare dates back to being on the care delivery side and was more on the regulatory side, doing inspections and enforcement actions to the industry itself. But yeah, who would have known? And really it was lucky that I got into it in the first place.
Speaker 1:There was a couple of key individuals that founded and operated Slantix as one of the first urgent care operators in the state of Florida. One was Rick Skye. He was the owner-founder of Slantix. He had a pathway for the emergence of urgent care as a critical health care delivery arm in terms of the continuum of care and he had come from HCA Columbia. So this is before he had become governor of the continuum of care and he had come from HCA Columbia. So this is before he had become governor of the state of Florida. So I had run into him just because I was already at the state capitol in Tallahassee doing my work and then his CEO has a nice woman named Karen Bolling who was just the graph from the beginning of Solanek. So just by virtue of knowing them, we had talked about me coming on board.
Speaker 1:And Rick had a different point on operating an urgent, successful urgent care. That was in scale. It really was hire the best providers and clinicians to provide great clinical care and find the best operators to run the business. And really a lot of that was the same concept he had, I think, probably back to his HCA. Columbia days really focused on metrics medicine Again find the best clinicians to do clinical work and find the best operators to really make sure that you're running a good, clean business. So that provided me with the opportunity, just because I had a sense of operational background, to jump in into medicine, which now it's 20 years later, the path would have taken me this far.
Speaker 3:Yeah, yeah, that's cool. So maybe we can talk just high level, a little bit about what you learned working at Solantic, both in terms of running a business and were you involved in the site selection component during that stage.
Speaker 1:Absolutely yeah, and we were in growth modes. We were roughly opening a new clinic up every 90 days. Wow, that's nuts. Yeah, yeah. And we were in growth mode, so we were roughly opening a new clinic up every 90 days.
Speaker 3:Wow, that's nuts.
Speaker 1:Yeah yeah, we were expanding the market presence around the state. So I think when I started, I had five clinics under my responsibility in the Jacksonville market and by the time I left three years later, I had clinics. I had 12 in Jacksonville, three in Gainesville, ocala area, seven in Orlando and then a few more in Southeast Florida. So it really was. It was constant. Basically, we had the right model, we had the right square footage. We do exactly what real estate we were looking for and really just was one after the other.
Speaker 3:What kind of real estate were you looking for?
Speaker 1:Retail spaces 100, so freestanding 3,000 square feet. Really, we still laugh about it now, at least in the urgent care industry. I think probably 60 to 70% of all closed Blockbuster video stores in all of America are now urgent cares. That industry died and it was at the right time when the emergence of the urgent care industry was happening and it just happened that the Blockbuster square footage one they were all freestanding, they were all roughly 3000 square feet and they all had great amounts of parking.
Speaker 3:And they were all made from a retail. That's such a perfect. It's so hard to find retail space now for that to line up like that. Yeah, and then picking them up, you're just plucking them off right, just going along looking for the blockbusters and just popping urgent care in there.
Speaker 1:That is exactly right. Wow. And as those all dried up, there was an. Then we had the market crash and a lot of banks went by the wayside and then there's been, god said, a virtual base. So that's actually been a secondary focus point for the urgent care industry is identifying banks that are closed down and taking those as urgent care spaces, and a lot of those, especially post-pandemic operators we were one of them that identify a bank. You keep the drive-through infrastructure as it is. It converts to drive-through urgent care operations as well as a clinic. So the constant evolution of healthcare, right.
Speaker 3:Yeah, so then why did you switch over? So actually I'm getting confused. This is Salantic, right? This is before you founded St Vincent's.
Speaker 1:Yeah, I did Salantic and then I did St Vincent's. Yeah. So, Rick, we were continuing to grow. Everything was in growth mode at Salantic. In the meantime, Rick saw a pathway to possibly run for office. He did run. He was elected governor of Florida office. He did run. He was elected governor of Florida At that time, being the elected governor of the state plus running a for-profit urgent care operation in the state I'm proud upon. So he did his holdings of Solanic to our minority investor, which was the equity company Wells Carson, and at that point they were going to move the corporate office from Jacksonville, which is where it was founded, to Nashville, Tennessee.
Speaker 1:I still had some desire to stay in Jacksonville for family reasons. It was approached by a couple investors that were just really looking to diversify their portfolio post the construction finance collapse. So they approached me to work with them to get an urgent care company up and running and off the ground. So I did that. So I switched to Xelantic to form the startup company, which was originally going to focus on work comp occupational health medicine. I converted that model to include urgent care, really before we even had our first clinic up and running, and that also suggested that for us to be strategically successful that we wanted to partner with a hospital. So I approached St Vincent's Hospital, which is part of the Ascension Health Network nationwide. They didn't have an urgent care footprint in their Jacksonville market and were very interested in having one, so they joined venture with us and that formed the startup company St Vincent's First Care, which is still in operation today.
Speaker 3:Wow, okay, and then yeah, all de novo. So I guess, same real estate strategy, just 3,000 square foot single freestanding buildings, corner of Main and Main. Good visibility. Were you competing with Cilantic at this stage?
Speaker 1:I was competing with CELANTIC at that stage, I sure was.
Speaker 3:You guys are competing for space then too, and everything.
Speaker 1:Competing for space, competing for market share, competing for lives. Yep.
Speaker 3:So what happens Like how did it work out?
Speaker 1:I think that was part of the benefit of my strategic decision to joint venture with a hospital. So we had already done a joint venture at CELANTIC with Baptist Health. So creating and founding FirstCare and then immediately partnering it with and branding it as part of the St Vincent's Hospital Network immediately gave us legitimacy, st Vincent's being a century-old health system and hospital providing care at Jacksonville Market. So we, in a sense, just by virtue of partnering with St Vincent's, we were able to immediately gain market share which you wouldn't have realized if you were just doing a pure play startup with a white label babe. So it kickstarted us and jumpstarted us in terms of already having a successful base. And then I really for urgent care, service and convenience are key. So I just did everything I could to out-service and out-provide better care. To specify that maybe what do you mean when you say out-service and out-provide better care?
Speaker 3:Specify that maybe. What do you mean when you say out-service and provide better care? What would that specifically be for somebody who wants to implement?
Speaker 1:Yeah, Real estate is real estate. When it's all said and done. Real estate will get a patient in the door one time. The quality of care will get them in a second time, right.
Speaker 3:Yeah, okay.
Speaker 1:Especially as a market gets more and more saturated. You'll have one or two options within a two, a one or two or three mile radius max. That patient will typically stop by the clinic that's most convenient for them, first, and then after that it's all about did they get quality care? Did they have? Was customer service top notch? Was a clinic, was a facility clean? Was it technologically advanced? So we were one of the first companies, I'd say, to do full paperless registration. So gone were clipboards. We had wireless pads so as a patient walked in they could fully register, including pay their copay, et cetera, without touching a pen, touching a clipboard, touching a piece of paper. Trying to stay advanced and advancing as technology advances, trying to stay ahead of that and incorporate it into your delivery model, was always important. Those are the differentiators Again urgent care being frontline, the most retail of all healthcare service lines. You really have to think about it in that respect and know that patients are only as loyal as the convenience you're providing them, right.
Speaker 3:Yep, yeah, okay, how did you transition into Premier Health?
Speaker 1:So, yeah, I was approached by Premier. They were in a position of wanting to scale.
Speaker 1:They had I think roughly 25, 28 clinics, almost all exclusively based in Louisiana where they were headquartered. And so they approached me to come on as COO and help really scale, build the infrastructure and scale the company, which I did over the last seven years and we had one joint venture, so you seem to be two joint ventures with health systems. When I came on board, when I left a couple of weeks ago, we had over 20 active joint venture relationships with different health systems, including big ones like Trinity Health nationwide. We were their selected urgent care partner for all of their urgent care operations. So it's been a fun seven years. We went from under 30 clinics to over 90 clinics, one state to 12 states, two hospital partners to over 20.
Speaker 3:It was a fun time. Yeah, and it was all I know. It was joint venture, but all de novo at that stage.
Speaker 1:Mostly de novo. We did have some tuck-in acquisitions, a couple private operator acquisitions, and then we had quite a few hospital contributions where a hospital might've been running one to three urgent cares. Not happy with their performance, they reached out to us to do a partnership where we bought into equity and then assumed management control of the operations. More of a turnaround in that scenario.
Speaker 3:Okay, and I know it was at that time that you met my partner, nate, and then started working with leaders. So what was that process like? How did you get in touch and what was it like working with leaders for you guys, for the real estate?
Speaker 1:Yeah, I think the big thing is I talk about metrics medicine. That I learned from Rick Scott and I've owned that concept ever since. So when I say I came on board to Premier to help scale the company, absolutely, You're talking about scaling just brick and mortar, right. New locations, grow your foot. But equally, if not more, important is scaling the infrastructure of the company To. That is a ton of investment in infrastructure and metrics medicine, right, Knowing where every penny is being spent and where every penny is being earned and managing at a microscopic level. It just provides for a better operation. Obviously it's providing for better financial outcomes, which allows you to grow. But I've owned that concept in all things healthcare.
Speaker 1:Probably the gap that I saw was not spending as much time really thinking about the data driving real estate selection. So it's easy to say, hey look, we're a health system and we want to any one town, so Baptist Atlantic, they wanted to own Jacksonville. Yeah, you can just say here are the different suburbs that we just need to have a clinic in every one of those suburbs. But what we were lacking is really looking at the real estate piece from a purely analytical standpoint, not necessarily what real estate is available for renovation? What available real. All right, that's okay. That's great to say what part of the west side of Jacksonville do we want to be in? Do we want to be in the northwest corridor of the west side? Do we want to be in the southeast corridor?
Speaker 4:Where are?
Speaker 1:our patients actually coming from. So that's really what Leaders was able to provide was a much more thoughtful approach of real estate selection. When we talk about wanting to enter a market, let's just say any city, that's great to say I want to be in that city, but post that, it's the leaders, it's the work that they do that really sets us apart, where they're able to say okay, if you want to be in Chicago, we're now going to tell you what parts of Chicago you want to be in to be successful through your model.
Speaker 3:Yeah, yeah, no, and we appreciate that. Yeah, it's just, there's so many metrics that you can use and a lot of times we just like to go off gut feeling right, and then you really dive into the data, pay for the subscription services and analyze any data from the company insurance records, patient records, hospital records, combine that with the grocery store anchor data that you can provide and then other subscriptions. It takes a while to really paint a picture, but once you do, then that's power. Like that, knowledge that you get is power. That's right.
Speaker 1:That's right, yeah, and that's been very successful. The positive there is we've got a long track history now clinics that we worked in partnership with leaders to identify. This is our strategic growth plan for this emerging market for us. And now I've got statistical proof that shows these clinics ramped quicker than our forecasted pro forma models. Or we've got intrinsic additional value because the health systems are receiving more downstream revenue through clean and concise referral management. But that's because we positioned the clinic in the right location to then better serve the community right. So there's been lots and lots of again statistical data that shows that our models are working.
Speaker 3:Was there anything that was surprising to you about the site selection process, about when you found good locations? You know.
Speaker 1:Probably the one thing that surprised me was the success. So we had identified, at least in the urgent care space, a long time ago, that medical office buildings, while good for a lot of health care services, not good for urgent care and lots of health care systems trying to put urgent cares inside a big boxy medical office space. It's not convenient, it's not what a consumer wants. What I did find surprising is we had identified three different preferred models for de novo growth in the urgent care space, one being, again what we've talked about 3,000 square feet of freestanding retail, focused retail place space with a lot of dedicated parking, preferably not a right in, right out, you want it at a lid intersection. Two, we had good success in co-locating with a primary care. So, again inside of a joint venture model, we would partner with our hospital partner, open the DeNovo urgent care but under that same roof, a separate suite for an active primary care provider or group of providers. That model has worked out really nicely, not just for us but for our hospital partner, because the ramp for that primary care is much quicker if it's a new primary care trying to establish a patient base and grow it, because if they've already found the front door from a convenience factor for urgent care, they're probably going to be equally happy to come back for a regular primary care visit. Right, because it was already a convenient location.
Speaker 1:What I didn't think would be let me say I didn't think it wouldn't be successful, but I was surprised by how successful it was was a new play, a new take on a hospital MOB. And that's the same square footage, but let's make it a retail building. So instead of an MOB that's inconvenient to get to, not positioned in and around other retail services, like a big trade hub inside of a town or a city, let's put the medical office building in that space. Let's purpose build it and design it to be convenient. Let's also have a separate front entrance for the urgent care. So we've built quite a few of those and they've been unbelievably successful. So that's a scenario where you know, hey, you're still talking a massive building, a ton of different medical services all under the same roof, but by just tweaking the location, the design and then the layout and the patient flow, it's surprisingly successful, way more successful than any other MOB I've ever seen.
Speaker 3:What did you learn? The biggest thing you learned, maybe working at Premier Health, that you didn't know when you were at St Vincent's Probably just the ability.
Speaker 1:I don't know, I'll have to think about that one, probably just the. I spent more time building. I spent more time and certainly a lot more knowledge on really scaling a company to multi-state right, multi-state managing multiple hospital partners, managing multiple investor groups.
Speaker 3:Yeah. What does your day-to-day look like at that stage?
Speaker 1:With Premier.
Speaker 3:Yeah.
Speaker 1:We're in a ton of different halves because I might talk to 12 different hospital partners, all with completely different strategic initiatives that they're working on and that are important to them. So you think about it most organizations from a CMO perspective. You'll go report to a board on a quarterly basis and whatnot to talk about the success and challenges of the company. Well, premier, we had 20 plus boards right. 20 plus boards right. So you had your premier board. Then all of your separate joint venture, legally legal entities, legally separate businesses, really knowing what had to put on and then managing all of those relationships. All again very important, right? Every hospital relationship is important, but then the fact that they're all equity partners is it makes it even more important.
Speaker 3:Yeah, okay, that makes a lot of sense. Let's talk about your new venture now.
Speaker 1:Unified Autism Care. What made you decide to transition from here of care, which does drive me as well as just running a successful business, but knowing that I'm touching and shaping lives through the delivery of the company is important to me. That was very important. Premier was really front and center in the reaction to the COVID pandemic. We were one of the first, the emerging care company, really one of the first healthcare providers in America that was doing instant tests before any of our hospital partners.
Speaker 1:Even so, there's always been that desire to do more and be better. Clinically. I see that as an opportunity in the autism space, so I think it just was a match made in heaven. The fact that it's an industry that is well overdue for a higher level of focus and improvement for the betterment of the patient and the community and that's what the Art of Unified model is is really cutting edge. But then for me, what keeps me getting up every morning is the ability to found and shape the identity of a company in the viewpoint of what I see will be the absolute best. And then knowing that every day what we get to do is make the lives of autistic children better, that drives me all day, every day.
Speaker 3:That's awesome. Yeah, I think it's such a good. I think it's such a good cause and a good thing to do With autism. It seems like it's becoming more prevalent too. Are you seeing that as well?
Speaker 1:Yeah, one in roughly 26 kids now born. What do you think is causing that? I think a lot of it's early diagnosis. I think I don't know if there's other environmental factors that's causing a higher level, a higher diagnosis percentage. I do think that part of it is just the advancement of early diagnosis of different levels of the spectrum. Probably in prior years you had to be fairly pronounced autistic from a spectrum perspective. Now the spectrum is so far to the left and so far to the right that I think there's a higher population that could be impacted by some form or level of autism and need care. Right, so it doesn't, you could be fully functioning and getting ready to head off to college. Right, so it doesn't, you could be fully functioning and getting ready to head off to college. But that that doesn't mean that you're not going to get diagnosed, because there's a little thing here there that that that appropriate therapy will help you with, to make you more successful in your life yeah, no, that's cool.
Speaker 3:so then, yeah, what about, like, in terms of real estate? Are you guys like what? Maybe just explain to the audience, like exactly what you're looking for? And I know you guys typically don't like to buy the real estate, which is why we work together as well, but, yeah, I would love to just hear your explanation of things.
Speaker 1:Yes, different model. I say it's a different model For me. Are we still looking for close to Maine and Maine? Absolutely. The difference in urgent care and autism therapy is urgent care you're in and out, hopefully under an hour. We're just there when you need us right.
Speaker 1:In autism therapy we could have a child anywhere from 20 to 35, 40 hours a week. So we are we're their school before they go to school and with that, having it still be an extremely convenient location for the family and for the parent is really important. So that's still a significant driver in our site selection processes. Where is it convenient for the family and for the parent is really important, so that's still a significant driver in our site selection processes. Where is it convenient for this family member to get to and from? And that also incorporate the rest of the things that they need to do in their normal daily life to be successful parents and family members right.
Speaker 1:The square footage is significantly different. We're in more of a 7,000 to 15,000 square foot facility, still absolutely looking at freestanding and actually as much as parking was important in urgent care, it's 50 times more important in autism therapy. Most ABA therapy is one-on-one therapy. So if I have 20 children all in the facility at one time, then I have 20 staff members also in a facility at the same time. So different model, certainly requiring a different view on in terms of what the appropriate and best clinical footprint is.
Speaker 3:That's great. Okay, is there anything that we didn't get a chance to talk about that you'd like to talk about before we wrap?
Speaker 1:No, I think that's good. I appreciate you having me on and maybe we do a check-in. I'm still new to this. I'm literally only a couple months into the creation of Unibody, so I think let's make sure we connect over the course of the next 12 months and hopefully I'll have a better update. We'll have 10 or 15 locations up and running and I'll have a much better idea about what the landscape of the autism industry looks like and certainly what the real estate needs are.
Speaker 3:Yeah, absolutely. Look, you had a great track record. So yeah, I have no doubt that, given enough time, it'll be successful. But yeah, that's cool. Anybody who wants to reach out and learn more about what you're doing what's a good resource for that?
Speaker 1:Yeah, absolutely, you can email me. My email's easy, it's mark at unifycare and that's U-N-I-F-I, u-n-i-f-i dot care.
Speaker 3:Dot care. Perfect, okay, mark, thanks very much. My pleasure, thank you.
Speaker 4:If you need help finding the perfect location for your practice or you're ready to invest in commercial real estate, email us podcast at leadersreecom R-E, as in realestatecom, or go to leadersreecom and fill out our form. See you next time.