Leadership is such a broad subject with many important subcategories.

We are in a time of great challenge to our leaders both inside and outside of healthcare. Great challenge creates great stress. Our leaders live and work in a fishbowl and must realize that every move they make whether it's verbal or nonverbal will be noticed and analyzed.

Good leadership, as with anything else, starts with character. Everybody wants it, but it has so many definitions. Everybody sees a lack of it in others but not in themselves.

I'm in the process of reading the book, "Louder than Words," by Andy Stanley. I'm not finished with the book but I'm enthralled with the subject matter. It focuses on the definition of character. Because I'm faith-based, I will adhere to Andy's following definition:

Character is the will to do what is right, as defined by God, regardless of personal cost.

So easily stated, it's so difficult to achieve. Perhaps it's like mastery, we strive for it, but never get there. For others who are not faith oriented, I would suggest defining what the right thing is but not changing the second half of the definition.

Leadership Starts Here: Doing the Right Thing

Secondarily, leaders did not get to where they are today without utilizing strengths that have made them successful. But under stress, those same strengths can become weaknesses. Beyond that, everyone has certain "derailers" that can be triggered by stress as well as other influencers. By giving into these triggers, the ability to keep good character intact becomes difficult.

Recognition, or awareness, of the "derailers" is not always present within the leader. Leaders should develop feedback mechanisms that they can rely on and will accept. Gaining awareness of these triggers/influencers is a highly valuable personal investment. Once these triggers are identified, passionately pursue how to change them.

In stressful challenging times, these two components are essential to successful long-term leadership.

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Healthcare expenditures in the U.S. exceed $2.9 trillion each year, representing more than 17.4% of the GNP(1). It should be noted that 80% of this expenditure is associated with chronic disease and, therefore, it is no surprise that Population Health is addressing the identification of at-risk populations and patients with early stage chronic conditions, not to mention the growth of our aging population. With Healthcare Reform driving the shift from volume to value, Urgent Care Centers (UCCs) represent a key care component of the Patient Protection and Affordable Care Act (PPACA) as well as the IHI Triple Aim that directly impacts access/convenience and reduced costs.

Between UCCs and retail medical clinics that are in stores like Walgreens, CVS and Target, convenient care is approaching 10,000 sites throughout the U.S. The Urgent Care concept originated in the late ‘70s and has proliferated in recent years, fueled by a shortage of primary care physicians and overbooked primary care offices, long emergency room wait times and the high cost of emergency room care. This leaves patients frustrated and feeling like they have no place to turn when they have an immediate need for medical attention but their condition is not an emergency. In fact the Centers for Disease Control and Prevention stated in 2012 that nearly 80% of visits to emergency departments were due to a lack of access to other healthcare providers(2). The niche market of urgent care therefore has a huge opportunity to make an impact.

To the credit of many physicians, they saw and are trying to meet the community need of access at lower cost by starting and owning a majority of the UCCs. These UCCs are designed to function for the convenience of the consumer on a walk-in, no appointment basis and be open for extended hours.

Health Plans, large Medical Groups, Hospitals and Health Systems are realizing the importance of establishing this type of convenient care model and have different strategies for providing Urgent Care such as building their own or affiliating with existing urgent care operators as strategic partners in providing quality outcomes at a lower cost with greater satisfaction.

For Hospitals and Health Systems, UCC affiliations are mutually beneficial. They can relieve excess volume in the hospitals’ overcrowded emergency departments and, by virtue of having a lower volume it will result in a reduction of the hospital write-offs. These relationships will generate downstream referrals for the hospitals when there is a need by the UCCs for a higher level of diagnostics, when specialist referrals are required and when patients with conditions requiring emergency care show up first at the UCCs and need to be directed to emergency departments. UCCs can also assist hospitals by functioning in the capacity of discharge clinics to reduce the hospitals’ readmission rates.

For Primary Care physicians and Medical Groups, there can be a delay of weeks or months for patients getting appointments. The number of aging patients with chronic diseases is increasing as well, making the timely delivery of care challenging. These physician groups can look to UCCs for arrangements to cover after-hours or for vacations as well as for more patient-convenient certified laboratory collections and testing, imaging, suturing, in-house medication dispensing and durable medical equipment.

For Health Plans, UCCs pose a more cost-effective alternative than emergency rooms. Additionally, as it pertains to population health, it is crucial that the respective electronic health records interface so that at-risk patients can be identified and treated for early stage chronic conditions. An EHR would allow a seamless connection with an ACO or a Medical Group as well.

In conclusion, UCCs that are appropriately integrated in the healthcare delivery system will effectively meet the intent of the ACA and Triple Aim by providing greater convenience, satisfaction, reducing cost and be integral in achieving Population Health.

(1) https://www.washingtonpost.com/news/wonk/wp/2014/12/03/heres-exactly-how-the-united-states-spends-2-9-trillion-on-health-care
(2) http://www.cdc.gov/nchs/data/nhis/earlyrelease/emergency_room_use_january-june_2011.pdf

Tell me about yourself… (hint - you only have two minutes!)

The famous question, “Tell me about yourself.” This is not an open invitation to incessantly talk for minutes on end about your life from start to finish in exquisite detail. I used to think everyone else thought my life was as interesting as I thought it was - wrong! The fact is, no one really cares (that much). You have two minutes to answer this question. And, it needs to be a structured answer that includes the following:

• Humanizer - make a connection and be likeable/personable
• Career progression - make sense of your career moves
• Value proposition - what are you known for?
• Personalize - what do you like to do? Make a connection and humanize.

If you only remember two things, simply be brief (around two minutes) and clearly communicate your value proposition. What are you known for? What is your calling card? Remember, organizations have needs and people have skills. Be clear about your skills and match them with the organization’s needs.

Plan Ahead and Manage Effectively

From my experience working with executives over the past 27 years I have learned a great deal about how executives tend to do a poor job in managing and planning for advancing their own career.

Before I share my observations with you on advancing your career, let's define manage and plan:

Manage: Be in charge of, administer, run

Plan: Decide on and arrange in advance

Though desiring to advance, many healthcare professionals have plateaued in their career and are unsure how to regain momentum. Obviously, they had an idea of where they were going when they started, but never took the time to actively and consistently plan and manage their careers which have resulted in advancement delays.

Gaining the Right Focus

It is also not uncommon for well-meaning professionals to overlook particular skills that create the opportunity for advancement. Even if they were lucky enough to have a mentor, most of that effort and time was focused on expertise rather than the soft skills necessary to become an excellent leader. Aiming at the right target will yield the best results.

How much more successful would you be if you knew

how to plan effectively and manage your career?

Please join us for our upcoming webinar on May 25, at 2:00PM ET, where I will be sharing key ideas that will help you put momentum back into your career journey.

Learn More

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Do you know your numbers? (not just finance)

“It’s a nice day outside.” Does this mean it’s 65 degrees, 75, 82? It depends on who you ask. Unless you ascribe a numerical measure to something it will never be fully clear to an audience. So many executives I advise are not fully clear when talking about their career accomplishments- I’ve been guilty of this as well. “We grew revenue and patient satisfaction improved when I was at XYZ Health System” or “We set up this corporation, joint venture, committee, etc.” These are simply not clear statements when compared to, “We grew revenue by 35% and our patient satisfaction improved from the 12th percentile to the 67th percentile” or “We started a new joint venture that grew market share by 34% and grew net revenue by 40%”.

Many comparisons have been made between the airline industry and healthcare. The pilot knows where the plane is going by following specific numerical coordinates. Do you know your X-Y? What was the origin and destination of your last journey? This is communicated simply by knowing your X-Y’s in one or more of the following areas: service, patient safety, quality, growth, service line development, finance, community benefit, market share, cost containment, productivity, physician or employee engagement, turnover, etc. When X-Y’s are communicated well it sounds like this… “When I was at XYZ health system our HCAHPs went from the 23rd percentile to the 78th percentile over 4 years” or “During my tenure we reduced RN turnover from 35% to 16% in three years.

Organizations want results. If you clearly communicate that you achieve results, your chances for success improve when looking for your next job. Contact www.wiederholdassoc.com for more information on learning how to communicate your “X-Y’s” and taking the next step in developing your career.

Hospitals/Health systems across the country are faced with increasing financial pressure including slow economic recovery, decreases in reimbursement, increases in uninsured or underinsured leading to increased bad debt write offs, and increased operating expenses.

Not surprisingly the result is more and more organizations that were financially sound find themselves either in financial distress or at least moving financially in the “wrong direction.” Turning around a hospital where finances are in decline requires extremely strong leadership from the top, ideally a CEO with prior experience leading a turnaround. This initiative needs to be supported by the hospital senior leadership team and board, and reinforced by engaged employees, physicians, and even members of the communities served by the organization.

Hospital turnarounds are not just about cutting costs. You can’t cut your way to long-term growth and profitability. You need to build programs that will financially support the hospital and meet the community’s needs through physician recruitment and capital investment. Cutting costs are a short term sometimes necessary endeavor, but long term success will only come from program volume and revenue growth.

It’s now essential in the current evolving environment to negotiate favorable contracts with insurers and other networks who control patient access and also consider the development of Accountable Care Organizations and other population health strategies. Finally developing key affiliations and networks with other hospital and healthcare providers are essential to strengthen your gaps in services and geographic coverage.

While no two turnaround situations are ever the same, just as no two sick patients are ever exactly the same, there are some common elements that all successful turnaround situations will have.

These elements includes the following:

• A strong visionary CEO with proven experience in leading a successful turnaround.
• A strong committed board that will support the CEO and put what is good for the long term survival of the hospital ahead of long-standing personal friendships and relationships and agendas and the short term pain and changes that may have to occur.
• A good comprehensive and realistic turnaround action plan based on an in-depth assessment of the hospitals financial, operational, cost structure, market position and also physician and community perception and support. The plan should identify specific goals and objectives and actionable plans with quantifiable metrics and assignment of ownership.

Implementing the turnaround plan:

• Implement plan with sense of urgency.
• Monitor results and modify tactics where necessary.
• CEO stays engaged / leads from “the front.”
• Divides resources/removes obstacles/drive changes forward.
• CEO and leadership team “walks the walk” and “talks the talk.”
• Communication -- CEO establishes robust communication process so that employees & physicians are kept fully informed of changes occurring and why they need to occur and to gain their support for the long term benefit to the organization.
• Publicize and celebrate the successes. Nothing breeds success, like success.

Going through a “turnaround” situation is one of the most stressful events for any healthcare organization to go through. With great visionary leadership and a good “plan” the organization will emerge not only more financially sound but with a “high performance” culture ready to move on new challenges.

You can see Davide Carbone's LinkedIn profile here

A big piece of onboarding is the ability to manage up- how you effectively work with your immediate Manager. My experience in this area indicates that we don't give this enough attention. The conflict that begins here usually ends up in one being asked to leave the organization or perhaps exiting too soon on their own.

Often, different styles, as well as egos, get in the way. Change the way you look at this relationship, and you will be more successful in building it. I haven't come across many people who “manage up” t extremely well, and it's such a necessary skill to one's future success. Embracing the employee/manager relationship is a critical skill to hone and managing up helps you master it.

Managing up means that you go above and beyond the tasks outlined on your job description. You continuously go the extra mile. Your job is to make your immediate manager’s life easier.

Ways to effectively manage up:

• Listen well
• Learn his/her style
• Jump in when needed
• Project a positive attitude
• Deliver quality work
• Keep him/her well-informed
• Build key relationships
• Sell/negotiate when appropriate
• Recognize what he/she respects and honors
• Create early wins
• Execute great follow up
• Establish a comfortable level of transparency
• Establish the rules of effective pushback
• When you have a challenge, always offer a solution
• Communicate, communicate, communicate
• Close information gaps
• Have a voice beyond your boss
• Keep commitments
• Apologize when you are wrong
• Don’t make excuses

Learning to effectively "manage up" can put you in a great position to align with your immediate supervisor, integrate effectively with the organizational culture, receive great recommendations, and ultimately help you on board effectively.

Landing Your Biggest Sale, Yourself!

Facilitating a successful job transition and search is a complex and intensive process. I have found most healthcare executives are trained and focused in their healthcare leadership roles, but are not experienced nor educated on how to conduct a successful job search and transition.

Frankly, most tend not to be very good at it.

Why is that? Most of us are good at things we do most of the time. None of us would be very good golfers if we golfed every two years. Job transitions are just like that. Executives don't have the opportunity to practice these skills often and there is real value in finding a coach or a partner who can accelerate the process.

Let me share a case of an executive that had tried to go it alone in her job transition and learned that with the right coach, training and navigation she could be very successful in her transition. She had the wisdom to realize she needed guidance to be successful.

To give you some insight, the client was a very high-level executive in a large health system. She had been trying to find a position on her own for approximately two years without success. Her organization had merged with another system who had the stronger position in the merger. The position they had offered her was not at the level she had been at and she decided to move on. She began conducting her own search process and was not as successful as she wanted to be. Eventually, she reached out to me for transition coaching.

What did she learn:

• I didn't know what I didn't know.
• I was not familiar with the current market and how competitive it is.
• My approach to networking was limited and therefore I didn't have a deep or substantial network.

What were her outcomes:

• My perspective on networking changed; it's much bigger and deeper than I thought it was.
• My relationship building skills improved.
• My communication skills improved.
• Jim as a coach was always available to me. Especially at high anxiety points.
• I was shown how I could do things better in the process.
• My goals for the transition needed to be broadened. I was often coached to add another needed step.

Working with this executive was a very rewarding journey for me because she had been out so long and was concerned about her ability to make a successful transition. We quickly moved her forward with the appropriate skills and were successful in helping her land a very good position. She was an excellent partner.

Transition and search is a very specific sales process – the process of selling yourself! With the right coaching, education and practice you can have a very successful result.

Here's to your success,

Jim

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When you think of an --Effective Leader-- what comes to mind?

You might picture someone who never lets their temper get out of control, no matter what problems they are facing. Or you might think of someone who has the complete trust of their staff, listens to their team, is easy to talk tThese are qualities of someone with a high degree of emotional intelligence (EQ). Research shows that EQ scores climb with titles from the bottom of the corporate ladder upward toward middle management. Middle managers stand out with the highest EQ scores in the workplace because companies tend to promote people into these positions who are level-headed and good with people. The assumption here is that a manager with a high EQ is someone for whom people will want to work, and always makes careful, informed decisions.

These are qualities of someone with a high degree of emotional intelligence (EQ). Research shows that EQ scores climb with titles from the bottom of the corporate ladder upward toward middle management. Middle managers stand out with the highest EQ scores in the workplace because companies tend to promote people into these positions who are level-headed and good with people. The assumption here is that a manager with a high EQ is someone for whom people will want to work.

But things change drastically as you move beyond middle management. For the titles of director and above, scores descend with CEOs, on average, having the lowest EQ scores in the workplace.

The truth is that for every title the top performers are those with the highest EQ scores. Even though CEOs have the lowest EQ scores in the workplace, the best-performing CEOs are those with the highest EQs. You might get promoted with a low EQ, but you won't outshine your high-EQ competition in your new role.

Your emotional intelligence is completely under your control. Work on your EQ and it will boost your performance. Your effort can also ensure that you don't experience declines as you climb the corporate ladder. Even if your employer promotes you for the wrong reasons, you'll still outperform your contemporaries.

To help you get started, here are some EQ-boosting strategies for leaders:

• Acknowledge Other People's Feelings
• When You Care, Show it
• Keep Your Emotions in Check
• Sleep
• Remove Negative Self-Talk

Focus on your EQ and your executive performance will soar!

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For years now, turnover rates for CEOs in the healthcare industry have been high. While they peaked at 20 percent in 2013, even today these rates remain decisively higher than in other industries. In the ever-evolving world of healthcare, it can be challenging for CEOs to plan for their departure. Even something as simple as deciding when to break the news to their team can involve endless considerations.

The plight of healthcare CEOs is unique in this regard. In many other prominent industries, it’s common for CEOs to give notice of their departure just weeks or even days in advance. On June 11 of this year, Twitter CEO Dick Costolo made an announcement that he would be stepping down on the first of July. In some industries, the announcement of departure may even take place after the CEO has already stepped down and a successor has been selected.

For CEOs in the healthcare industry, their departures are rarely that simple. While crafting a succession plan is crucial for all outgoing CEOs, sometimes just picking a date to make the announcement can be difficult.

Robin Singleton serves as the executive vice president and practice leader of National Healthcare Practice at DHR International. Singleton says if a departure announcement is made too early, the CEO might simply be fired. On the other hand, if they announce their departure too late, the board will not have adequate time to ensure a smooth transition.

According to Singleton, the average announcement of a CEOs departure in the healthcare industry comes between 9 and 12 months ahead of time. Paul Esselmen, senior executive vice president and managing director at Cejka Search, says that the transition time depends on the circumstances under which the CEO is leaving. At a minimum, Esselmen says that a CEO should provide 60 days’ notice to both their board and the executive team.

Singleton says that CEOs give their boards such advanced notice due to the culture in the healthcare industry. “They have a deep sense of commitment ultimately to their patients and they want to make sure their culture is protected,” says Singleton. For more information, visit:

http://www.beckershospitalreview.com/hospital-management-administration/when-should-a-hospital-ceo-give-notice.html

Are You Ready to Embrace the Possibilities?

Coaching comes in many forms but the goal is to help you become the very best version of yourself as a leader, executive, and whole person. Executive coaching is like a blend of therapy, strategic discussion, and athletic training.

The focus is on your advancement as you define it, a definition that usually evolves over time. It is important to find a coach with experience working within your industry and the vision to help you realize your evolving personal goals.

What does Executive Coaching aim to accomplish?

Coaches facilitate a process of change or development which enables individuals and organizations to realize their potential.

If you're considering coaching, here are several key benefits:

• Better Performance - greater productivity, career advancement, business results

• New insights - about yourself, how you're perceived, where you can improve
• Accelerated action - advancing faster and with greater precision
• A safe place to dialogue- talk through challenges and gain perspective
• Greater Awareness -of perspectives, beliefs, and attitudes that may be limiting your success
• Support and encouragement - it feels less lonely at the top
• Feedback that others won’t share
• Help with improving specific skills - communication, delegation, conflict management, team building, persuasion, etc

Effective coaching requires someone to have a desire to learn and grow.

If you're the type of person who wants to grow and improve, and is willing to trust someone to support you, I highly recommend working with a coach.

Ready to get started?

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Compensation comprises everything from salaries to bonuses to stock options and it’s a subject with many perspectives in the healthcare industry. An Executive Compensation Survey in 2014 sought those divided opinions from over 400 respondents and the results were quite revealing. The survey results were published by HealthLeaders Media Intelligence in a report titled “Reforming Executive Compensation to Accelerate Change.”

A total of only 18 percent of those surveyed said no enhancements were necessary in their executive compensation structure and a mere 7 percent said that their organization’s executive compensation was aligned ideally with their organization’s strategies. In contrast, 82 percent admitted that either minor or even major enhancements were needed. Ultimately, in order to meet the needs of the healthcare industry today, more than a third of those surveyed said that changes are needed in executive compensation strategies.

Nearly a third of respondents said that, while changes were needed, there was no plan yet in their compensation strategy to address evolving patient care objectives in the industry. Additionally, a sizable minority of those surveyed said that they did not expect their organization to modify their team incentives in preparation for the shift from free-for-service to value-based purchasing.

Looking at the executives themselves proved interesting as well. In the case of organizations with medium to higher levels of net patient revenue, a majority of executives received a greater portion of team-based incentives. Additionally, 43 percent of executives surveyed admitted that their organization had not taken steps to match incentives with values such as clinical outcomes.

Operating margins played a role in compensation also. Nearly half of all those surveyed said that operating margin targets formed the very basis of their individual incentive payments. To learn more, you can download a complimentary version of the report here:
http://healthleadersmedia.com/intelligence/detail.cfm?content_id=310136&year=2014

Today, the concept of population health is more important in the healthcare industry than ever before. It has played a large role in many healthcare trends from payer-provider collaboration to hospital-community partnerships. Yet it remains a somewhat subjective term with many different views and interpretations.

The term “population health” first originated in 2003 with David Kindig and Greg Stoddart. They described it as “the health outcome of a group of individuals, including the distribution of such outcomes within the group.” Yet many criticize this definition for being incomplete, saying it focuses only on outcomes and not on the actual healthcare providers that directly influence those outcomes. In a recent survey of healthcare leaders, only two out the 37 surveyed cited the 2003 definition. The prevailing opinion is that this definition itself is in need of an update.

A large number of healthcare leaders saw population health primarily as “an opportunity for healthcare systems, agencies, and organizations to work together in order to improve the health outcomes of the communities they serve.” Other survey participants like Dr. Richard L. Gilfillan, president and CEO of Trinity Health in Michigan, cited the Triple Aim Initiative. The Institute for Healthcare Improvement developed the Triple Aim initiative, which includes improved care, improved outcomes, and reduced costs. Many of the other healthcare leaders who participated in the survey saw the discussion on population health as an opportunity for healthcare systems and agencies to collaborate to improve health outcomes for the populations that they care for.

While there may not yet be a comprehensive, universal definition of population health, the discussion itself shows that the attitudes of care providers are constantly evolving as they work to make the health of their patients a top priority. For more information, visit the resources below:

http://mha.gwu.edu/what-is-population-health/

The first few weeks and months of an executive’s tenure are critical. Getting it right can dramatically accelerate the transformation of a new recruit or promotion into a fully functioning business leader. But getting it wrong can be very costly.

In fact, recent studies indicate that 30-50% of newly hired leaders fail and leave within 18 months. Failure to establish key relationships and failure to align with company culture are indicated as leading factors that derail new executives early in their leadership roles.

Organizations that spend thousands or hundreds of thousands of dollars in efforts to recruit key talent, recognize the critical importance of ensuring cultural fit as part of the hiring process. But often, the rigor, focus and attention given to the recruiting process don’t seem to carry forward to a solid commitment to assimilate and positively onboard new executives.

Executive onboarding is far too important to leave to chance. The stakes are high for the individuals and the corporations involved. The impact on revenues, employee morale and the company’s corporate image when an executive fails in a newly-assigned role are felt by the organization long after the executive has departed.

Onboarding, not orientation.

Onboarding is not the same as orientation. Consider whether your organization’s internal process achieves the following:

• Identifies executives’ strengths and developmental areas, and ensures they have the key competencies for success
• Brings role clarity
• Accelerates integration with organizational culture, strategy, and leadership team
• Maps key relationships
• Delivers critically timed feedback from key stakeholders
• Offers counsel on goal identification
• Provides early warning indicators and hazard avoidance

The Solution for Success

Our Onboarding services pick up where the executive search process ends, and help organizations integrate new executives in a more structured and effective way. Focusing on the early stages of an executive’s tenure, we reduce the time it takes for new executives to start making a meaningful impact, and maximize the leader's personal engagement with the organization and culture. We believe in customizing our program to our clients needs and work with new hires and internal promotions.

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Becker’s Hospital Review recently published a comprehensive roundup of statistics related to rising healthcare costs. This week’s blog looks at some of the key takeaways.

With each passing year, healthcare spending in the United States has continued to rise and 2015 will be no exception. To fully understand these rising costs, we must understand where the money is being spent as well as how much we are actually spending.

In examining costs in the healthcare system, it’s important to appreciate the occasionally confusing distinction between cost in comparison to charges and payments. A hospital’s charges are simply list prices for the medical services they offer. Such “charges” are merely the point where insurers begin to negotiate discounts for their members. Actual payment depends largely upon one’s healthcare plan. For instance, the payment rates set by Medicare are typically less than the actual cost of care. Hospitals themselves must also consider input costs, which consist of everything from the salary of clinicians to the cost of buildings and equipment.

The cost of hospital services themselves has been increasing. In 2000, expenditures on hospital services totaled over $400 billion. By 2013, that number had gone well over $900 billion. Between 2011 and 2013 alone, the prices hospitals set for common procedures increased by more than 10 percent.

Recent statistics from Kaiser State Health Facts showed that the average day’s stay at a state or local government hospital in 2013 cost $1,878; that price wasn’t far off from the average stay at for-profit hospitals, which totaled $1,791. In looking at for-profit hospitals in different states around the nation, North Dakota had the highest cost per day at $3,714 and Maine had the lowest cost per day at $815.

While healthcare spending today is certainly increasing, it’s worth noting that it is increasing at a lower rate now than in past years. Some of the lowest premium increases for employers and their workers were seen in 2013. Generally speaking, a wide variety of factors contribute to the diminished increase in overall costs, from sequestration to a historically weak economic recovery. Many predict that the situation is only temporary though. The Centers for Medicare and Medicaid Services (CMS) project that, between 2015 and 2023, healthcare spending will grow 6 percent annually.

Out-of-pocket healthcare costs consist of both premiums and deductibles. In 2013 alone, Americans spent $339.4 billion on out-of-pocket costs. Between 2000 and 2013, these costs saw a 68 percent increase.

This year saw a steep increase in the price of prescription drugs with a 13.6 percent jump in costs. In contrast, the average annual increase over the last five years was only 6.8 percent. All in all, the Kaiser Family Foundation found that between 2000 and 2013, health expenditures increased on prescription drugs by more than 123 percent.

Finally, the “Cadillac tax” is also expected to influence employer healthcare costs. It consists of a 40 percent excise tax on certain costly plans that employers provide for their workers. Ultimately, the tax is meant to reduce healthcare costs and, if current employers do nothing to change their health plans, about one third of them will incur this tax by 2018 according to a recent survey.

For the comprehensive roundup of healthcare cost statistics, visit: http://www.beckershospitalreview.com/finance/50-things-to-know-about-healthcare-costs.html

For Dr. Loren Hamel and Dr. Benjamin Chu, the key to innovation within the healthcare industry lies with people. Dr. Hamel serves as CEO of Lakeland Health, an organization responsible for numerous hospitals, practices, and clinics across Southwestern Michigan. Dr. Chu serves as executive vice president of Kaiser Foundation Hospitals and president of Kaiser Permanente Southern California. Both men have demonstrated their ability to make big changes by taking a closer look at the people in their systems. In their eyes, focusing on the experiences of patients and caregivers alike is crucial to innovating in an evolving healthcare industry.

Dr. Hamel recently faced a daunting task in addressing the mediocre patient satisfaction scores at Lakeland Health, stuck between the 25th and 50th percentile. Yet his ultimate solution would take those scores to the 95th percentile a mere 90 days after his new ideas were implemented. This was achieved through a “Bring Your Heart to Work” campaign, which succeeded with little to no additional financial resources and a lot of help from Lakeland Health’s employees.

Dr. Hamel asked staff and caregivers to take an emotional interest in the experience of their patients. He described the process saying, “Every time you interact with a patient, tell them who you are, what you’re there to do, and then share a heartfelt why.” The “why” was designed to make the patient’s fears and hopes a top priority for the employees interacting with them. Not only did patient satisfaction skyrocket but many in the work environment also became less tolerant of coworkers with rude or impolite attitudes.

At Kaiser Permanente, Dr. Chu, much like Dr. Hamel, had to consider how performance data offered a window into the affairs of his organization. Kaiser Permanente launched a system called POINT, or Permanente Online Interactive Network, to offer providers a closer look at performance data for physicians. Dr. Chu describes transparency of performance as crucial, particularly for physicians.

Dr. Chu also sought to decentralize Kaiser’s healthcare campus, even rebuilding several medical offices. First, they sought the opinions of their members before looking to administrators, physicians and nurses to seek their opinions on changes that could be made. Talking about these reforms, Dr. Chu said, “If you take the time to really think about a framework that taps into the hearts and minds of the frontline people, you can really accelerate transformation in a big way.”

While technology played a key role for both Dr. Hamel and Dr. Chu in understanding their organizations, it was their focus on people that ultimately yielded innovation. This was a focus on patients, members, staff, caregivers, and even administrators, which helped to create something new and better than what had existed before. For more information visit:

https://hbr.org/2015/06/you-innovate-with-your-heart-not-your-head

http://www.beckershospitalreview.com/healthcare-information-technology/push-and-pull-how-kaiser-permanente-is-bringing-innovation-to-scale.html

Early in my 30 year career in executive recruitment and coaching, I was responsible for recruiting and training sales executives at NCH Corporation. I find my background in sales training to be extremely helpful as I work with executives in transition.

When I was in my sales position with NCH corporation, I learned several key things:

• We had clear plans and targets for sales and we didn’t go home until those were met. We had the tenacity to reach out and make contacts and have clear goals to achieve.
• People buy from people they like. The primary focus is to build relationships with clients as part of the sales cycle.
• Practice is essential and role playing is a key part of training.

Executives in transition are shifting from leading and operating organizations to selling a commodity, themselves. A successful transition, like a successful sale takes focus, energy, a clear plan, and intentional action. You have to know your product, have a clear brand, a value statement, know your market, identify your sales targets, and be confident in representing your product.

I find most executives have no formal background or training in sales and often feel very unprepared for the demands of a successful job transition and search. My role is to be a coach and guide, to help executives in transition find their rudder, set their course and make a successful journey.

Executives successful in transition are the ones who use the time in transition to learn more about themselves and their goals for the future. Creating the right attitude and exuding confidence is a key to mastering your transition and achieving your goals.

In my practice I primarily work with healthcare executives. So I know the market, the role demands, and the key tools required to be successful. I not only provide my clients the tools, I provide the coaching and support for clients to learn through their journey and find a successful path forward.

I’m proud of the many executives I have helped through my 30 years and find the wisdom and experience to be a valued commodity for my clients.

Here’s to your success!

Jim

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Hospitals & Health Networks (H&HN), a publication of the American Hospital Association (AHA), featured an article this month on the traits needed to be a successful CEO in today’s environment. This week, in the second part of a two-part blog post, we’ll look at some of the new challenges and the new skills needed for success.

The ideal CEO must be data-driven. Paul H. Keckley, managing director for Navigant Center for Healthcare Research and Policy Analysis, says that hospital performance data is now available to both buyers and patients alike. Today, more and more insurers are using these commercially available analytics, so it is important for CEOs to be familiar with such data also.

CEOs must be motivated to take action as well. Peter Rabinowitz, executive recruiter and president of P.A.R. Associates Inc., says that when a board wants to rationalize the organization, a CEO may be tasked not only with building the organization up but also taking people out when needed. While a changing healthcare environment sometimes means layoffs, there are other times when employees can simply adapt to new roles. For instance, Scripps Health in San Diego underwent complete operations reorganization and saved hundreds of millions in costs, all without a single layoff.

Clinical competence is another quality CEOs must aspire to. Boards will frequently look to physicians as ideal CEOs, but this might very well be a mistake according to Phil Dalton, senior vice president of physician strategies at VHA Inc. “They [physicians] are highly intelligent and talented, but their experience is generally not in running organizations,” says Dalton. Michael Rowan, president for health systems delivery and COO at Catholic Health Initiatives, says that nurses are often far more likely to have the management background to take on such a leadership role.

Financial focus is another especially important skill in light of the realities of declining Medicare payments and the recent requirements of the Affordable Care Act. “It means having to think about efficiency across the entire spectrum of care,” says Carol Geffner.

Geffner also pointed out the importance of matrix management. Traditionally, hospitals are vertically organized into departments: radiology, cardiology, etc. However, now that hospitals are changing, Geffner says that horizontal structures are being created as well. “Now that hospitals are becoming health systems, they have to have not only these vertical structures, they are creating horizontal structures,” Geffner says.

Resolving conflict is another vital skill, since change is constantly afoot in healthcare. Leonard J. Marcus, founding director of the program for Health Care Negotiation and Conflict Resolution, says that two steps are needed to change conflict to consensus. First, he says fears must be acknowledged and addressed as they crop up. Secondly, he says that it is important to find ways in which the organization can meet everyone’s common interests in some form or another.

Agile learning is another skill that all CEOs must have and it might very well be the most important skill. At Korn Ferry, the world’s largest executive search firm, learning agility is actually considered the leading predictor of success in leadership.

Finally, strategic vision is critical. While innovation and creativity ranked very highly, strategic planning and critical thinking were listed as the top skills needed to lead in the world of health systems in the coming years.

To learn more, visit the AHA’s online publication, Hospitals & Health Networks: http://www.hhnmag.com/Magazine/2015/June/cover-new-health-care-CEO

Rick Schooler is a man whose daily work hinges on his ability to prioritize different objectives. As Chief Information Officer (CIO) and Vice President of Orlando Health, he says he is occupied with as many as 100 or more projects in tandem ranging from his work in the supply chain to pharmacy retail. “I’ve been in healthcare for 24 years and I learn something new every day,” says Schooler.

Schooler’s top priorities at Orlando Health are those that are required by regulation. “We take care of what’s absolutely required first, and then those things that are ‘should dos’ or are a ‘nice to have,’” says Schooler. A formal IT governance process ensures that the flow of money and resources is first diverted to that which is mandatory, as well as things that are truly strategic for the organization. Only after those priorities are addressed can Schooler set to work on other tasks. He describes his management style as “transparent” and says his management team has a firm understanding of their business. Ultimately, he says that their time, money, and efforts must be spent on those things that will bring the most value.

Security is also vitally important in the role of CIO. Everything from data loss prevention to antivirus programs is Schooler’s responsibility. Data loss resulting from hacking is a very real threat that Schooler says can only be met by spending the money needed to combat it and having a team of intelligent and skilled IT professionals to defend against it.

According to Schooler, one of the greatest challenges he faces in his work is knowing that, with limited resources, there will always be someone who will be left unhappy. He says that the essence of demand management is working to ensure that his organization does not make the wrong person unhappy.

Finally, in looking to the future, Schooler says that CIOs will be forced to use demand management as a tool to assess offerings within the cloud, such as tech platforms. He sees the job of CIO as evolving into coordinating information management, rather than actually implementing it.

To learn more about Schooler’s priorities as CIO, visit: http://www.fiercehealthit.com/story/demand-management-biggest-challenge-orlando-healths-rick-schooler-qa/2015-05-12?page=full

Medicare recovery audit contractors (RACs) are costing hospitals significant sums in terms of expenditures related to managing audits, denials and appeals. Some hospitals report spending hundreds of thousands of dollars, even millions, addressing RAC audits. The hospitals say the money would be better spent on improving the healthcare provided to patients.

The American Hospital Association (AHA) conducted a RAC survey September 2014, which was answered by 402 hospitals; 311 hospitals completed all questions in the survey. As a result, the AHA is calling for a reform of the RAC payment structure. One problem: RACs are paid a commission—between 9.0% and 12.5%—on each claim they deny. Hospitals say the contingency fees should be eliminated so that RACs are no longer incentivized to deny claims.

The AHA cites evidence to support its conclusion, including the fact that “more than 70% of appealed hospital Medicare Part A denials are fully overturned at the third level of appeal, when the case is heard not by a contractor, but by an administrative law judge.” Additionally, it can take years to settle claims that are disputed.

Legislation to improve the situation is pending; if passed, the law would “replace the RAC contingency fee structure with a flat fee to reduce the financial incentive for overzealous auditing practices; rationalize payments to RACs by lowering payments for poor RAC performance; fix CMS’s rebilling rules to allow hospitals to rebill claims when appropriate; and require RACs to base their inpatient claims decisions on only the information the physician had when treating the patient.”

In the meantime, hospitals are continuing to add new staff and hire consultants to process their appeals and manage the RAC audits. The burden is especially great on smaller hospitals. A seven-page report published by the AHA includes case studies and an overview of the various processes used during RAC audits. You can access the report at: http://www.aha.org/content/15/hospsurveyreport.pdf