Podcast #10 – 2025 Healthcare Trends: StayWell CEO Don Thompson’s Vision for Wellness & Innovation
Doug Dvorak (00:01.424)
Good day Mission Podcast Community, I’m your host Doug Dvorak and I’m extremely excited to bring you inspiring stories from incredible guests. These individuals are on a mission to create remarkable possibilities that not only enhance their own lives,
but also make a lasting impact on the communities and individuals they serve. Stay tuned for some truly amazing conversations. My guest today is Don Thompson, CEO of Stay Well Healthcare in Waterbury, Connecticut. Hi, Don, how are you?
Don Thompson (00:43.842)
Great, Doug, this was exciting for me. This is the first time I’ve been on a podcast.
Doug Dvorak (00:47.798)
We got a podcast virgin. Well, Don, thanks for your time. I’m really excited.
Don has been at Staywell since 1985 and has served as its CEO since 1995. Don had received a Master’s of Professional Studies degree with a focus on health service administration from Quinnipiac University and a Bachelor of Science degree in business administration from Central Connecticut University.
And Don is also a current board member of Community Health Network, the Community Health Center Association of Connecticut, Brass City Charter School, and eHealth Connecticut.
Don was born and raised in Waterbury. Don still calls the city his home. He’s got five grown children who he enjoys traveling with and visiting with them in their various homes across the country. Again,
Don, welcome. I’m really excited. Healthcare, a huge topic.
Don, when I was researching for today’s podcast, I was shocked by some of the data points I read on the current state of health care in the U.S. We spend more than any other industrial or first world country. Last year, we spent $4.2 trillion that blew me away and we really not impacted the health outcomes for our patients. Cardiovascular disease, strokes, cancer and obesity are rampant.
In addition, rising healthcare costs, workforce shortages and burnout, elder care and aging population are growing, barriers to health equality.
Doug Dvorak (03:43.39)
cybersecurity, integration of advanced technologies, policy and regulatory changes, and a need for improved mental health systems. Don, can you please share a little bit about StayWell Health’s mission, focus, and charter?
Don Thompson (03:57.198)
Okay, thank you. Well, Staywell was formed in 1972, an outgrowth of the Model Cities program. By 1985, it was one of the ages of the Waterbury Health Department. That’s when I came along. And it was part of the Health Department until 1995 when we separated from the city to become a fairly qualified health center look-alike, which means you were a separate entity, but just didn’t get federal funding. In the year 2000, we got federal funding and expanded. And we went from
12 staff at the time to 250 right now. We went from one site to seven. We had it on full medical, cradle to grave, dental, behavioral health services. because of the whole change and dynamic where hospitals were getting out of the clinic business and there was a huge need in Waterbury, the need just keeps growing.
Doug Dvorak (04:28.726)
Wow.
Don Thompson (04:48.588)
We have right now a waiting list of 500 adult patients trying to come in. And because we have the physical plant space, we don’t have the providers to take care of people.
Doug Dvorak (04:48.715)
on book.
Doug Dvorak (04:59.68)
Wow. So what are some of the biggest challenges facing StayWell and the U.S. health care system in 2025?
Don Thompson (05:07.406)
Well, locally, because I like to think everything is local, and I’m very fortunate that I was born, raised, lived, and work in Waterbury.
So those contacts and the commitment to the city of Waterbury I think help. Especially from a funding level, people know who I am. And I’ve been doing this for a while. The biggest issues we have, a lot of it relates to money. There’s a shortage of money in the healthcare system. Our Title 19 rates have not increased in 23 years, other than what they call the Medicare Economics Index, which hasn’t kept up with inflation. The hospitals are hurting. They see the same Medicare and Medicaid patients that we do.
rates haven’t increased. And how much longer can you keep going without a raise? We also have the growth of medications, which are fantastic, and technology, which all cost money. And both state and federal governments have been hesitant to put more money into the health care system.
Doug Dvorak (06:04.19)
Interesting. So if there hasn’t been a raise or adequate funding in several decades, is that forcing individuals that may have thought about a career in medicine, nursing, or physicians to not get into healthcare?
Don Thompson (06:21.132)
Yes, but I think part of the issue is people who are very bright and talented have other options. When I was a child, becoming a nurse or a doctor was an admirable profession. Now they want to go to Wall Street because they can do better and not have the stress and not have insurance companies or third party people telling you how to practice and run your business.
Doug Dvorak (06:40.532)
Interesting. Don, how have recent policy changes affected health care delivery and access?
Don Thompson (06:46.284)
Well, right now we’re dealing with lot of changes in Washington.
We get a 330 grant, which is about $320,000 a month, which helps float our boat. We also get certain federal grants. We have Ryan White A, B, C, D, and E. And the federal government, at least today, is holding up on releasing those funds. They want to take a look and see what these funds are being used for. That affects every hospital, nonprofit, and the country community health center. That’s really, for us, a 20 % cut in funding overnight. We hope that gets resolved.
in Washington, but that’s how fragile the system is.
Doug Dvorak (07:24.726)
Let’s talk about affordability now in health care with a potential increase in uninsured rates. How is StayWell addressing affordability for patients?
Don Thompson (07:32.718)
Well, we’ve been very efficient. We own all our buildings. We have no debt. We have pretty good cash flow until today.
So we’re, we manage and we’ve also to dealing with some of the staffing shortages. We’ve found a way to recruit retired doctors and dentists. They may come in and work for a day or two. So it fills up our slots. They’re very talented people. They’re from the community and that’s worked very well for people. The other issue we have is about 15 % of our visits are to uninsured people. have to charge 15. Okay.
Doug Dvorak (08:04.524)
15 or 50? 15. Okay, 15.
Don Thompson (08:08.736)
Most of our population is Medicare and Medicaid, a few commercials.
But 65 % of our income is fee for service, which we have to get from basically Medicare or Medicaid. But the federal government with the 10 % of our funding helps pay for the uninsured. So as an example, if someone came in and had a dental procedure that was $200, we may be charging them $10 for the visit. That gets them hooked in the care. It’s quality dental, full service, comprehensive dental care, and you’re paying $10 or $20 a visit.
care and keeps people into care.
Doug Dvorak (08:45.324)
amazing. What role do you think health centers like Staywell play in bridging the gap for those without insurance?
Don Thompson (08:52.578)
Well, I think because of the changing dynamics where a lot of doctors are retiring or selling their business practices off to larger corporations, they generally don’t take Medicaid and they certainly don’t take uninsured. And that’s where StayWell and places like StayWell come in because I think we’re the glue that helps hold the health system together.
Doug Dvorak (09:13.726)
Interesting. Let’s talk a little bit about Medicare and Medicaid. I know those programs have been expanded. How do recent reforms to Medicaid and Medicare affect StayWell’s operations and patients?
Don Thompson (09:25.826)
Well, let’s talk about Medicaid because there’s a lot going on right now and that’s where most of our patients come from, the Medicaid marketplace. Without an increase in fees in 23 years, you’re always begging and borrowing and it’s difficult to pay people coming out of college.
wages they’re looking for because they can go anywhere. Why go to a community health center? They would come to a community health center if they need student loan repayment or they need a visa and those folks are great and usually those commitments are three years but when a three year is up that they leave and we have to start over again.
Doug Dvorak (10:00.916)
Interesting. How about on the Medicare front?
Don Thompson (10:03.662)
The Medicare, our rates because we’re federal are a little higher than most and it’s a fee for service. We probably get paid 80 % of our expenses on Medicare. We get about 60 % on Medicaid.
So you do fundraising, or we have income from our pharmacy program, our 340-B pharmacy program, and up to this point, that’s closed the gap. But this year, we’re facing our first real deficit of about $2 million. It’s January, our fiscal year ends in June, and we got fingers crossed that we get money from the state or the federal government to keep everything going. We have 115,000 patient visits a year for 25,000 patients.
That’s a big percentage of the Waterbury Market. If we weren’t here, people would have nowhere to go. Two of our competitors have given up dental because of the expense of running dental. Our two teaching hospitals, who are wonderful, have given up all their outpatient programs, including dental, and they’ve left them over to us over the years, and we’re happy to take them. But inflation after COVID has hit everybody. It’s payroll, it’s equipment, supplies, workman’s comp.
Everything’s gone up a tremendous amount.
Doug Dvorak (11:19.742)
Interesting. Don, what can be done to protect vulnerable populations reliant on these programs?
Don Thompson (11:26.624)
Again, keep us funded on the federal side. Senator Bernie Sanders had always talked about doubling the dollar amount for community health centers. And there is, we have a lot of friends in Washington, but that hasn’t happened. And the issue is that not only the cost, it’s the fact that there are fewer providers out there. Because as I mentioned, they are finding other ways to run their business. Large corporations don’t want uninsured patients in their office.
There are very few private doctors offices left in the East Coast. They’re all working for corporations or hospital corporations, what we call a dock-in-a-box. They’re good at what they do, but they’re not there to take care of the underserved. And plus, we do a lot of people who are recent immigrants to our country.
There’s language barriers, there’s people with special diseases. We deliver 150 babies a year through our network. People come to us, know we’re here, and we take care of people in a very culturally sensitive way.
Doug Dvorak (12:28.308)
Excellent. Don, I’ve read in researching and preparing for today’s podcast the workforce shortage in a number of areas. How has the nurse and physician shortage, it’s now a national concern, how is StayWell managing this challenge?
Don Thompson (12:45.292)
Well, because we’re eligible to get new students student loan repayment, and we can do visas. We can attract people.
Doug Dvorak (12:53.824)
medical visas for.
Don Thompson (12:55.15)
Medical, right. Doctors, dentists, mid-levels, if they are from a foreign country and they make it through, I think it’s the J-1 visa program, the J-1 education program, we can get them in and we can sponsor them. So that helps, but there’s only so many slots out there because of the whole issue we have with immigration. It’s okay to walk across the border, but it’s not okay to come here with a medical degree.
And that’s something I wish we could fix. That would help quite a bit. Also too, Medicare controls the residency slots in hospitals and teaching hospitals. And I think they’re just talking about increasing it, but we have people lined up from other countries who want to come to America and there’s no slots for them to do a three-year residency. Or if they get a slot, they bump out an American who went to a foreign medical school, such as Guadalajara, Mexico or Granada.
They go there for school and then they can’t get into a residency program in America. How hard would that be to fix?
Doug Dvorak (13:59.66)
Wow, wow. So what strategies are you and Staywell using to attract and retain healthcare professionals in a very tight labor market?
Don Thompson (14:08.578)
Okay.
I’m happy to say we’re actually fully staffed right now on nurses. That was a big issue for a long time. We have a decent pay, but good benefits, nice working conditions. And Whataburger is a little bit off the track in Connecticut. We have major highways and major cities. Whataburger is the fifth largest city. So it’s not the most attractive place for people to come to, especially if their spouse is working in Harford or Bridgeport. The spouse likes to get a job in Harford or Bridgeport. We’re a little further away. But it’s a nice place.
to work. We’ve also attracted again part-time doctors and dentists who sold their practices or just want to retire from running a business and they come work for us two to three days a week. At this point we’re down two full-time doctors and one full-time dentist but we’re managing. It would be nice to have a full complement of staff.
Doug Dvorak (15:00.332)
Excellent. Next area of questioning is technology and healthcare. But before I ask you those questions, Don, I live in rural Idaho in a ski resort in Valley County. My local healthcare facility is a community-based healthcare, and I’ve got a great GP. We had a pharmacy in Cascade, Idaho that served the community. It burned down.
and they were without a pharmacy for years. I drove through and now I see a pharmacy and it relates and maps to technology and healthcare. It is staffed by a pharmacy assistant. They have the full suite of drugs and prescriptions available. If you want to have a consultation with a registered pharmacist, you go in a room and you zoom in
So one pharmacist is managing four of these facilities through technology, telemedicine, and AI. And it really blew me away. And I went, I picked up my prescription, I had some questions, and there was no wait. I went right in the Zoom room. Up came a registered licensed pharmacist, answered all my questions. So my question is, how has StayWell integrated telemedicine and AI into its services?
Don Thompson (16:03.938)
Mm-hmm.
Don Thompson (16:10.624)
you
Don Thompson (16:15.596)
Hmm.
Don Thompson (16:26.804)
Okay, well we do do telemedicine. Waterbury is blessed because it’s a city of about 110,000. We have numerous pharmacies and everyone is in our network. And we also connect with pharmacies all over the country for specialty care, different types of biologicals and stuff that may not be readily in Waterbury. So that’s worked out well. We do telemedicine and medical, dental and behavioral health. And we also do…
Another type of service where it’s referred to, let’s say someone came in, we can do a retina scan and refer it out to an individual outside of Waterbury who can breathe the scan and let the patients know you need this or you need that. We also do allergy. We do podiatry. We try to do as much as we can inside. But Waterbury is still a community that there’s still enough people out there in specialties that will take Title 19.
And we have some grants for people who are, instance, vision care. We have some grants that pay for people. We can do the screening here. We send them across the street and we pay for the glasses through a grant.
Doug Dvorak (17:34.07)
So Don Unpack, what is Title 19? I’ve heard of Title 9, but I’ve never heard of Title 19.
Don Thompson (17:38.094)
Okay, Title 19 is local Medicaid, state Medicaid. Title 18, it actually goes back to think the Social Security Act, Title 1, Title 2. Title 18 was Medicare and Title 19 is Medicaid. So in the state of Connecticut, our Medicaid matched with the federal government is between 50 and 70 percent depending on the age and diagnosis. So the state would pay
Doug Dvorak (17:54.732)
Interesting.
Don Thompson (18:06.444)
that percentage and the Fed will pay the rest. But at other states where the poverty level is higher than Connecticut, the federal government may be paying 50 percent and the other state, the state pays 50 percent.
Doug Dvorak (18:18.238)
Interesting. So what barriers have you and Staywell faced when adopting new technologies?
Don Thompson (18:25.29)
It’s the initial cost. We usually shop for grants to find, and grants are out there, but you may get a grant and they say, we’ll fund you in nine months. And we have to wait nine months.
The state of Connecticut has been very generous in what’s called bonding dollars. They’re general revenue bonds they sell and they give the proceeds to the community health centers. But it takes years. We’re actually working on a program right now that was funded eight years ago. They’re just releasing the money. So sometimes it’s good, sometimes it’s not so good. But we generally rely on taxpayer funding to get things done. Again, we’re in a building that needs some work.
All those projects we try to line up and get bonding dollars so we’re not using our revenue to fix buildings up.
Doug Dvorak (19:11.402)
Interesting. Let’s morph over to public health and policy. How do you think policies like Project 2025 will shape public health infrastructure?
Don Thompson (19:21.038)
If it’s the program I’m thinking of, I think it’s going to hurt because I don’t think Washington fully understands.
that there are awful lot of people out there that just need help. They just need that one little thing. They just need help paying for a prescription. I’ve had some surgical procedures the past couple years and I have great health insurance, but also I have a health savings account. If I didn’t have both those two, who knows where I’d be? But the co-pays and deductibles for a procedure may be $1,500, $2,000. And if you’re uninsured or underinsured, where do you go?
Doug Dvorak (19:55.242)
Yeah, my businesses are in Chicago and about 20 years ago I was diagnosed with cancer, had Blue Cross Blue Shield. I was dropped, believe it or not, and I had to go through the state of Illinois, the insurer of last resort. So fortunately I had means for good healthcare, but I…
can’t imagine if you’re economically constrained or if you’re at a certain income level that you’re fighting to put food on the table and raise your kids, that you’re one illness away from bankruptcy or financial ruin. you talk about some of the safety nets that exist in Connecticut at the federal level that people don’t have to lose their house, their entire savings if they have a horrid disease or health?
situation.
Don Thompson (20:45.302)
Right. I can’t speak on the federal side, but on the local side, we have teams of people that work at Staywell, community outreach workers, and they also work at the two hospitals. And the hospitals refer us patients that they’re uninsured. And we do our best to get people covered on Medicare or Medicaid. And we also oftentimes can work with the pharmaceutical companies to get free prescriptions delivered to their house.
Again, everything is fragmented and it takes an awful lot of staff time to piece things together. And if a patient has language barriers or is homeless, we have a huge homeless population in Connecticut. Trying to deliver health care services to someone who doesn’t have an address is very difficult.
And some of these patients show up at the emergency room every other day to get checked in or also sometimes a place to be warm. And again, the hospitals are very good with that population. But it’s an expensive population and the care is fragmented.
Doug Dvorak (21:43.927)
So drug abuse and prevention is a central theme in some of my philanthropy. It’s impacted my family’s life. And I’m involved in an organization called MAPTA, Mothers for the Awareness and Prevention of Drug Abuse. And we see it firsthand every day, how drug abuse and fentanyl. Can you speak to this fentanyl pandemic and how it’s impacted, if it has impacted you and Staywell?
Don Thompson (22:11.342)
Okay, thank you for that question. We have a program that dispenses Suboxone, which is a drug that helps people who are addicted to fentanyl and other narcotics. And they have to come in every week, they get checked out, we try to see if they’re clean. Sometimes they’re not, but we still treat them. And they’re usually given a seven day amount of pills so that they have to come back and make sure they’re still hooked into the healthcare system.
It’s very difficult because people who have been on drugs for so long, it affects your cerebral cortex, which is what we call executive function. And some things that we would think would be very normal to take care of yourself, they’re not thinking about it. They’re thinking about their next high. So it’s very difficult. even though we have about 400 patients visits a month, it’s a very sickly, needy population. And it’s very difficult to cure.
Doug Dvorak (24:59.372)
Don, what can community health centers do to advocate for equitable health care access?
Don Thompson (25:05.07)
Actually, we do that every day. And we do it through our elected officials, and we do it through our towns, we do it through our staff. The issue is funding for a lot of our programs is very competitive. Some of the funders in Connecticut are saying, do we fund the community health center, or do we fund an after school program, or do we fund a program that helps homeless people?
It’s very difficult and very competitive. But we’re really doing it every day. We treat people the same at all of our sites and all of the other health centers in Connecticut too.
Doug Dvorak (25:37.804)
Interesting. So you know, you hear a lot about health care in Western Europe, in Canada, you know, government run health care. Any thoughts you’d like to share comparing and contrasting what you know about, you know, government health care and our health care program, the sort of the future or benefits and downfalls of both?
Don Thompson (26:01.294)
Well, I think people also like to compare us to England and Canada, but health care up there is rationed. And so are pharmaceuticals. People often wonder why. In Connecticut, even on Title 19, Connecticut is a very generous state in terms of the programs they offer and how deeply they offer within the program. But Connecticut covers on Title 19, I’m going to say 99 % of the pharmaceuticals in the marketplace. England and Canada are probably 85%.
So as a matter of fact, the drug we all like to talk about, GLP-1s, which are about a thousand bucks a month. Many states cover them, but in Canada and England you’re not going to get that. And that’s one of reasons our costs are high, because we offer everything to everybody.
Doug Dvorak (26:45.928)
Interesting. So what are some of your ideas, goals, and visions for StayWell Health Center over the next five years?
Don Thompson (26:54.496)
Okay, I’m glad you gave me five years. All right, thank you, thank you. Well, keep going. I feel very fortunate that we have boots on the ground in Waterbury.
Doug Dvorak (26:57.396)
I’ll give you a 10 if you want it.
Don Thompson (27:05.242)
I know some of our patients, know our staff, I know the elected officials. It’s kind of nice. And that works both ways. But we, all of us who run nonprofits, have to think about funding. It’s tough to think about expanding a program somewhere where if you’re not sure your current funds are going to be there, let alone new funds. And like I said, it’s very competitive. Connecticut spends a lot of money on healthcare. It’s good at what they do. And it’s very broad and very deep. But yeah,
There’s only so much money in the budget.
Doug Dvorak (27:38.028)
So, Don, how do you see community health centers evolving by 2030?
Don Thompson (27:44.494)
Well, I think we’re going to further step into technology. Therapeutics are important. I think over time, when I was a kid, no one heard of a mid-level. You went to see a doctor, that was it. I think you’ll see more work spread out to mid-levels. It could be what we call an APRN. It’s a nurse that went to school and got an advanced degree or a physician assistant. Very capable, well-trained.
Doug Dvorak (28:01.26)
Unpack what a mid-level is, please.
Don Thompson (28:13.634)
There’s a lot of those out there. But also too with the shortage of nursing, some of those duties have been pushed down to med techs and medical assistants. And also too, our patients, even though we’re dealing with people in poverty, they’re pretty savvy on technology. They can convince, check themselves in, they can ask for things on the phone. And I think we’re gonna see more and more of that.
Doug Dvorak (28:35.276)
Excellent. So Don, now we’re at the tail end of our podcast. This this section is called rapid fire questions. I’m going to ask you a question rapid fire response from you one word or a short word phrase. Are you ready? What’s the one word you’d use to describe health care in 2025? Telemedicine game changer or temporary fix? Biggest disruptor in health care right now.
Don Thompson (28:40.43)
Okay.
Don Thompson (28:44.598)
Okay.
Don Thompson (28:51.479)
I’m ready.
Don Thompson (28:56.706)
Fragmented.
Don Thompson (29:01.048)
Game changer.
Don Thompson (29:05.228)
Washington.
Doug Dvorak (29:06.77)
One healthcare innovation you’re most excited about.
Don Thompson (29:10.338)
Hmm.
I got to say pharmaceuticals.
Doug Dvorak (29:16.107)
Excellent. If you could wave a magic wand, what’s one thing you’d fix in the US healthcare system today?
Don Thompson (29:22.316)
immigration because that relates directly to the health care system.
Doug Dvorak (29:26.39)
best piece of advice you’ve ever received as a healthcare leader.
Don Thompson (29:33.08)
Treat everyone the same.
Doug Dvorak (29:35.136)
Finish this sentence. The future of healthcare is.
Don Thompson (30:18.456)
Patients have to take control of their healthcare.
Doug Dvorak (30:21.566)
Excellent. And last question. If you had a time machine, it can go back 40 years to visit your younger self. What’s one piece of advice you’d give your younger self?
Don Thompson (30:32.204)
Have faith in yourself.
Doug Dvorak (30:33.908)
Excellent. Well, thank you, Don. My guest has been Don Thompson, CEO of Stay Well Health in Waterbury, Connecticut. They’re doing incredible work in Waterbury and the community, serving those who are in desperate need of health care. Don, if anyone wants to check out Stay Well Health or get a hold of you, how can they reach you?
Don Thompson (30:55.318)
I’m DThompson at staywellhealth.org
Doug Dvorak (31:00.992)
Don, would you please share with our Mission Possible podcast community what your website is and how people can donate?
Don Thompson (32:44.546)
Yes, staywellhealth.org. Click the top button where it says donate.
Doug Dvorak (32:49.79)
Excellent. Our guest has been Don Thompson, CEO of StayWell Health, doing some incredible, incredible community service and taking care of people and providing much needed healthcare. We appreciate you, our Mission Possible podcast community. Check us out at missionpossible.biz. Thanks for your time and Carpe Diem.
Don Thompson (33:11.246)
Thank you.