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Keith Loria is a contributing writer to Medical Economics.
How healthcare leadership is changing due to market trends, and the new skills healthcare executives need to thrive.
As health disparities continue to impact access to care and health outcomes in the U.S., and patients are demanding quicker access to care, easier communication with their providers and higher quality outcomes, healthcare leaders are seeking innovative ways to narrow the gap.
“With the growth of consumerism in healthcare, consumers are demanding the same of their providers and plans that they do of any other brand they interact with,” says Tom Wicka, CEO and co-founder of NovuHealth, Minneapolis. “They want to be treated like an individual, they want a personalized experience, and they want to be acknowledged for doing the right thing for their health.”
Healthcare leaders need to recognize this, put consumers at the center of their business, and align internally around a comprehensive strategy to engage and serve them. And that’s often meant a change in thinking from leadership and the need for new skills that can help them and their healthcare facilities better succeed.
Craig Samitt, MD, CEO of Blue Cross and Blue Shield (BCBS) of Minnesota, says over the past decade, the most successful healthcare executives have been the ones who have fiercely protected the status quo-a healthcare model which is progressively outdated, antiquated, and broken.
“The future of healthcare will require us to develop, nurture, and promote those that are inventive, collaborative, forward-looking, customer-oriented, and more value-based,” he says. “If healthcare doesn’t bring in leadership that will reinvent our industry from the inside out, disruptive innovators from other industries will reinvent it from the outside-in.”
Emad Rizk, president and CEO of Cotiviti, a leading analytics company in Atlanta, that helps payers improve programs affecting financial performance, says several trends are coming together to create a perfect storm of change, including rapid technological advancements, an aging population, skyrocketing costs and a provider shortage, to name just a few.
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“Beyond a new level of technological savviness, today’s leaders need to be courageous, collaborative and committed-they must have the courage to take calculated risks, and they must collaborate with other departments in the organization and stakeholders across the healthcare continuum,” he says. “Commitment must be demonstrated beyond words and reflected in actions to employees, clients, patients and the entire organization.”
Adnan Iqbal, co-founder & CEO of Luma Health, a San Francisco-based healthcare communication company, notes a result in this shift is the emergence of new titles such as chief patient experience officers, chief data analytics officers, and chief population health officers-all looking to effectively guide patients along their healthcare journey with the goal of driving (and tracking) strong health outcomes.
“We’re also seeing more roles being filled by executives from outside of traditional healthcare, which is a positive step towards designing care that is nimble and responsive to new patient demand,” he says. “Hand-in-hand, patient experience roles are being elevated to new levels-all with the goal of meeting new patient and payer expectations.”
Mark Prather, MD, CEO and co-founder of DispatchHealth, which provides mobile and in-home health services, says 30% of employees are now in a high deductible plan so as consumers pay for an increasing percentage of their healthcare costs, they will rightfully demand an improved care model that delivers more value for them.
“Leaders who are design thinkers are more capable of building care models that align with the needs of this new healthcare consumer,” he says. “The leaders that I admire, and that I think will be successful, are creatives and collaborators. They understand data and how to use it and possess the clinical acumen necessary to design systems that drive value for the consumer.”
Trends impacting change
The regulatory shifts brought on by the ACA and CMS’s focus on driving quality improvement via Star ratings have had a major impact on how the healthcare industry delivers care and is measured, and that has been a catalyst for some of the change happening in leadership. A more recent driver is the entry of Amazon and other retail giants that are redefining what care delivery looks like, raising the stakes for consumer expectations.
Wicka notes there are several macro trends simultaneously impacting the healthcare industry today. The first is the ongoing shift from a fee-for-service system to value-based care. The second is the increasing importance of consumer satisfaction and retention, as plans and providers alike face tougher competition and more consolidation in the market.
“Finally, we’re seeing rapid growth of consumerism in healthcare, driven both at a macro level by the entry of large retailers like CVS and Walmart, and at an individual level as consumers demand more from their providers and plans,” he says. “These trends all underscore the importance of engaging consumers in a meaningful way.”
Today’s patient population is demanding more from healthcare and expects high-quality care delivered with convenience and ease of access.
“They want to be able to make appointments online, reschedule, ask questions, and communicate with the care team digitally,” Iqbal says. “They want to interact with the healthcare industry in the same way they interact with just about everything else-via a mobile device.”
Providers can no longer take for granted that patients will find or return to them. They have to be proactive about their outreach and make sure patients can reach them easily whether it’s via a text message, online platforms such as Google or Yelp, or a virtual visit.
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“With the growth of retail clinics offering a new level of convenience for patients, executives in more traditional settings have to be responsive to patient demand in order to retain and grow their market share,” Iqbal says.
Samitt believes that the healthcare industry is no longer working for the customers it serves and that’s a market change that is greatly impacting what we’re seeing.
“From a service perspective, we’re complex, fragmented, bureaucratic, and not very customer oriented. From an accessibility perspective, we’re increasingly unaffordable and inconsistent in assuring that everyone has access to good care,” he says. “Given the glacial pace of change, it’s no wonder that more and more Fortune 500 companies are getting into the healthcare business-and that the likes of Haven, Google, Apple, Walmart, Best Buy, and others are making a bigger play in our industry.”
Today’s executives have a particular challenge-they need to know how to position their clinics for success in the traditional, fee-for-service environment, while simultaneously preparing for value-based care.
“Providers have to optimize their capacity to meet a high level of patient demand, implement new services such as online scheduling, and elevate their online presence to attract and retain their patients,” Iqbal says. “But they also have to keep a watchful eye on quality and effectively guide patients along their healthcare journey.”
For example, are diabetic patients controlling their blood sugar levels appropriately? Are children getting their vaccines on time? Iqbal adds that today’s healthcare executives have to implement new technology solutions and processes to keep innovating toward the move to new payment models, all while meeting patients where they are today.
Wicka believes that today’s leaders must possess clear communication skills to be successful.
“From payers to providers, healthcare organizations need to talk to members and patients like people, not policy numbers,” he says. “And the communications need to be personalized. What specifically do you want that consumer to do? Does he prefer email or SMS communication? Is she on track with her care plan, or is some motivation required? The language of consumer engagement is one that every healthcare executive today needs to learn.”
Adapting to these changes also requires making bold moves. The key is having a plan that connects each team’s work to the goal, so everyone understands their own role in the process and can see the path to achievement.
Christopher Logan, a healthcare industry strategist, says changes to patient care models, increased financial pressures, and significant swings in the industry’s workforce, have sparked a need for a new era of leadership. Gone are the days of looking at how healthcare operates from a single pane of glass, with the complexities of both internal, as well as external pressures, leaders need to learn to adopt new leadership principles and traits.
“Leadership skills are rapidly evolving and some of the attributes that are going to facilitate success in this new era are having the ability to dissect and implement new vision/strategy, a heightened concern for and deeper awareness of integrity, developing open lines of communication with the ability to collaborate beyond the walls of your institution, and finally be agile in your decision making,” he says.
Technological advancement is one of the main drivers of the need for a leaderships’ changing skillset. Prather says it’s imperative for today’s executives to have at least a rudimentary understanding of data science and technology.
Artificial intelligence, machine learning and natural language processing (NLP) have all made their ways into the healthcare space sooner than anyone expected. Many organizations are now using machine learning across many disciplines throughout healthcare-such as combing through medical charts and extracting data using NLP-while payers are using AI to streamline claims intake and prevent fraudulent billing.
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“I think the most important skill is to be technology-aware,” Rizk says. “Leveraging interoperability within healthcare and new technologies such as machine learning, NLP, and AI in healthcare is critical at this junction of our evolution.”
Additionally, he says that to be a strong leader in today’s healthcare environment, one needs courage, collaboration on a broader scale, and commitment to employees and the organization like never before. An example of a leader with these traits is Bernard Tyson, CEO of Kaiser, who pledged to find housing for underserved people in his organization’s purview.
“He is taking on responsibility for things that health plans have never done before,” Rizk says. “He is re-examining his role, and that takes courage.”
He also sees some of the mergers occurring in healthcare right now as companies with leaders making courageous moves. For instance, UnitedHealth, led by CEO David Wichmann, decided to acquire DaVita Medical Group a couple years ago, expanding the health plan’s reach into the provider space. CVS President and CEO Larry Merlo has been a driving force in the company’s purchase of Aetna, which would give the combined entity unprecedented reach into the payer and pharmacy sphere.
“If leaders don’t keep up, or are afraid to make bold choices, they become irrelevant,” Rizk says. “Leaders need a lot of courage and they need to be comfortable taking a risk for something they believe in.”
Leaders of the future
Healthcare executives of the future should adopt some of the skill sets that leaders in other high-performing industries have long used to assure sustainable success, Samitt says.
That includes strategic nimbleness, with the realization that healthcare needs to be reinvented, and the bravery to avoid becoming the next Kodak, Blockbuster, or Borders; collaborative intent, with a goal to achieve partnerships between doctors, hospitals, payers, patients and vendors that have aligned incentives and interests all directed at delivering better care at a lower cost; and execution discipline, with a goal to move beyond incremental progress in improving service, quality and cost, with more relentless speed to improve the performance of our industry.
Rizk notes the leaders of the future need to be adept at collaboration in ways new to healthcare. For example, in the past, collaboration tended to focus more within a department or defined area, but given everything is so interdependent right now, collaboration must become much wider.
“You must collaborate, not just between physicians or nurses, but with every department-and perhaps with other organizations in the larger healthcare ecosystem,” he says. “No leaders are worth their salt unless they demonstrate commitment to their team and people. You need actions to back up the words. People follow leaders who care for them and who show commitment to them. Leaders must break down organizational hierarchy and work on building connections with all of their employees.”
Healthcare systems are doing the right thing by implementing new leadership positions to elevate roles around digital health, data analytics, and patient experience. Making access and quality key organizational priorities should always be top-of-mind.
“Key Performance Indicators (KPIs) and executive compensation will also be aligned to capitalize on these trends,” Wicka says. “From executive bonuses to member and patient satisfaction, payer and provider KPIs will go beyond measuring services rendered to include broader goals such as medical cost reduction, quality improvement, and improved NPS scores.”
Keith Loria is an award-winning journalist who has been writing for major newspapers and magazines for close to 20 years.