The COVID-19 pandemic has tested every healthcare executive’s ability to adjust — and adjust again. From mid-March through summer and now early fall, the ups and downs of the outbreak have occurred at a furious, unpredictable cadence.
Is it fair to say that leadership in today’s healthcare environment is more challenging than ever?
The COVID-19 pandemic has tested every healthcare executive’s ability to adjust — and adjust again. From mid-March through summer and now early fall, the ups and downs of the outbreak have occurred at a furious, unpredictable cadence. The only certainty has been more uncertainty.
The following experts cited both new skills and new reasons to pursue older proficiencies. Although they made their statements before the oubreak of COVID-19, the insights they shared became more relevant than ever.
Eyes are on you
“Leaders are constantly observed and modeled,” says Darnell Dent, CEO of Dent Advisory Services and member of the Managed Healthcare Executive® editorial advisory board. Closed-minded, top-down leaders cannot hide, especially now. They are judged by what they say and don’t say and what they do and don’t do. And when a leader is not visible, misinformation will spread.
As a result, healthcare executives need to be transparent in a way that is more real than ever. For important decisions, they should involve more, not fewer stakeholders. True collaboration makes for greater alignment, better decisions and better execution. “Executives don’t have to give up their power to make the ultimate decision,” says Dent, but they need to keep in mind that leadership is a team, not an individual, sport.
Sometimes transparency means saying, and doing, things that make people unhappy or uncomfortable. Executives need to be careful about overcommitting and overpromising. They have to be willing to say no to requests they cannot fulfill, and then be clear about the reasons why.
Keep lines of communication open
“Whenever there are three or more emails in a chain, it’s time to talk,” advises Virginia Calega, M.D., vice president of medical affairs for facilitated health networks at Independence Blue Cross in Philadelphia, who is also a member of the Managed Healthcare Executive® editorial advisory board. “The richness of conversation helps avoid misunderstandings,” she says. In today’s social media–fueled world, it’s easy to mistake the quantity of our communication for quality. Of course, COVID-19 has put a premium on video conferencing and real-time talk, be it through Microsoft Teams or Skype — or the old-fashioned cell phone.
Does this mean that C-suite executives need to talk to everyone who has a problem or raises an issue? Of course not. “Middle management is still necessary to prioritize and direct the flow of information up and down the chain of command,” says Don Hall, M.P.H., principal of DeltaSigma LLC and member of this publication’s editorial advisory board.
“You’ve got to be informed on what’s happening in your market,” adds Hall. Critical information — emphasis on critical — must be allowed to flow quickly from the front line of an organization to the top. Hall likens the ideal flow of information within an organization to the body’s nervous system. “You may not actively think about your toes, but when you hit them against something, your body sends a distinct message!”
“I was wrong” is OK
“Healthcare executives need to consider the ‘what-ifs’ seriously,” says Sherry Rohlfing, who is a principal at DeltaSigma with Hall. Whether it’s the latest twist and turn of COVID-19, an unexpected competitor, or a disruptive technology, change doesn’t call ahead and make an appointment. It’s there, at your door.
But you don’t need to be caught flat footed. “Leaders need to look within their organizations to find and appoint others to research and prepare for these changes, should they occur,” says Rohlfing.
Leaders should strive to make the right decisions (of course) but also be prepared to be wrong. “You need to save yourself from being the emperor who has no clothes,” says Dent. “People in your organization must feel free to tell you both bad (and good) news.” With some notable exceptions in some very high places, gone are the days of being the last to acknowledge a wrong decision.
“You need to learn to appreciate people who do not think like you,” says Donald Pirc, vice president of managed care at Promedica Health System in Toledo, Ohio. Building teams of like-minded people results in weak teams, without different points of views, expertise and experience. Attempting to clone one member, regardless of performance, results in a weak team. Leaders of all levels can play to their strengths when they are not imitating others. And often, varying skills and ideas are required to maximize a team’s results.
Dent recalls his transition from Marine Corps officer to corporate America. “One of the first things my mentor told me is that, here in the corporate world, you can no longer simply issue orders and expect them to be followed.” Collaboration, vertically and horizontally, and between organizations, is essential.
When leaders democratize the flow of ideas, they can receive them fresh, from unexpected places. “Not only can frontline employees warn you of what’s coming, but they’re sometimes the best source for understanding what’s happening right now,” says Hall.
Integrate behavioral health
“Many well-meaning leaders of insurance companies are physicians who received limited training in behavioral health,” says Sam D. Toney, M.D., a psychiatrist and healthcare consultant in Tampa, Florida.Part of the problem is discordant measurement. “One measures a patient’s LDL with blood work. The severity of major depression is measured using patient feedback,” says Toney.
So, how can providers and payers work to offer behavioral services in a cost-effective way? “With the extensive data sets we have today, we can correlate the risk between physical and behavioral conditions,” comments Toney. “We can see, for example, how a patient’s level of depression affects their adherence to diabetes care.”
Cost control as a quality booster
“I believe that everyone has the best intentions, which is to help people get and stay healthy,” says Calega. “However, ours is a complex business, especially when it comes to ensuring people get the right care at the right time in the right setting.”
Cost containment may seem to run counter to delivering the best care; it often looks that way to outsiders. But many times, just the opposite is true. “Higher-cost care tends to result in lower-quality outcomes,” says Hall. More visits and tests and can be a sign of a treatment path gone awry.
Data and their analysis can help strike a balance between cost control and good outcomes. “The data we collect through our value-based contracts and share with our providers help us to explore problem areas and collaboratively design programs to address potential solutions,” says Calega.
Value-based payment: Embrace it
“Many healthcare executives grow comfortable with their current system of compensation,”says Dent. In some cases, they have figured out how to maximize their current system for personal gain. Plus, as Dent notes, “every organization has a certain level of inertia.”
Instead of fighting value-based payment, Dent adds, healthcare executives need to pause and ask themselves, “How do I get that done?” The answer to this question again requires transparency and collaboration.
Chris Pawar is a medical writer based in Cleveland, Ohio.