Dealing with Disruption
June 5, 2011
Posted by chcablogadmin in : Innovation, Leadership
Managing change has become part of our business acumen and is more prevalant now than ever. We’ve asked change specialist Seth Kahan to offer several blog entries for CHCA CEOs on leading change. Some of you may remember Seth Kahan from his closing session at NACHRI’s Creating Connections conference in Baltimore in March. Seth has a unique approach to innovation and successfully managing change. — JR
by Seth Kahan
Seth Kahan
There was a time when change was all about dreaming up new ideas and implementing them. Today it often seems it is more about keeping afloat amidst a raft of policies and disruptions that make life much more difficult, pushing us into questions we hoped we would not have to answer or choices we preferred to avoid. For example, given current reimbursement and funding declines, how will we cut cost out of the organization while maintaining current clinical programs? Or, understanding that the old payment model will soon be extinct, how do I make sure the organization is open to innovation and new care delivery models?
Innovation has never been more important. Long considered a nice to have, innovation has become a necessary tool that is called upon again and again. Innovation is about more than blue sky. It provides ways to evolve capacity in a challenging world. Here are three guidelines for leaders who are serious about innovation in today’s challenging market:
1. Place a premium on talent, both development and recruitment. People with the right mindset are extraordinarily valuable. You need people who are not afraid of the pressures of the marketplace, but instead dive into challenging situations with an eagle eye for spotting solutions and the talent for crafting new processes in response to changing conditions. This means partnering with HR like never before. HR needs to come to the strategy table with solutions and help bring in the talent with the critical skill sets. Not all these skills need come from new people (though some will). There should be education, learning programs, knowledge sharing that builds the capacity of eager staff within, creating a core with the capability to take current factors into account and generate productive ways forward.
2. Take a market centric view, not an organization-centric perspective. An organization-centric perspective is one in which everything is about maintaining the organization, working out its survival. The mindset severely limits the options. Instead, focus on the market and how you are positioned to provide the most value. This way of looking at the world will open up options otherwise obscured from view. An organization-centric point-of-view misses new possibilities, emergent needs in stakeholder groups, shifting customer bases, and new opportunities.
3. Invest in intelligence. Every leader should be conducting a systematic effort for the early identification of risks and opportunities in the market before they become plain to see. This includes the examination of market statistics, financial reports, news, trends, forecasts, and business analysis with the goal of yielding the competitive edge that spells out success for the future. There is both strategic intelligence — looking at long-term growth strategies — and tactical intelligence — driving revenue in the short term. This is a non-negotiable in my mind, for leadership in our rapidly changing world.
Seth Kahan (Seth@VisionaryLeadership.com) is a Change Leadership specialist. He has consulted with CEOs and executives in over 50 world-class organizations that include Shell, World Bank, Peace Corps, Marriott, Prudential, American Society of Association Executives, International Bridge Tunnel and Turnpike Association, Project Management Institute, and NASA. His book, Getting Change Right: How Leaders Transform Organizations from the Inside Out, is a Washington Post bestseller. Visit GettingChangeRight.com for more info and a free excerpt. Learn more about Seth’s work at VisionaryLeadership.com.
add a commentACO Update: Issue #5
June 5, 2011
Posted by chcablogadmin in : Financial Viability, Healthcare Reform
In this edition of ACO Update we talk with M. Narendra Kini, M.D., MHA, President and CEO, Miami Children’s Hospital. Dr. Kini shares his thoughts on the basket approach to bundled payment, the urgency of implementing EMR across all children’s hospitals, and both independent and united paths to survive in an increasingly consolidated environment. Those of you at the Executive Dialogue this week will hear additional CEO strategies as well as those offered by Sue Benz of Goldman Sachs and Toomas Truumees of DSI.
I welcome your comments and suggestions as well as your questions. Please feel free to contact me directly.
Jacqueline Kueser, Vice President, CHCA
Jacqueline.kueser@chca.com
CEO Interview Series: Payment Reform and the Data Gap
June 5, 2011
Posted by chcablogadmin in : ACO Update
The following interview with Narendra Kini, M.D, President and CEO, Miami Children’s Hospital, is another in a series of CEO interviews with Jacqueline Kueser, CHCA Vice President, regarding children’s hospitals’ responses to the current and envisioned health care environment. Dr. Kini shares his thoughts on the basket approach to bundled payment, the urgency of implementing EMR across all children’s hospitals, and both independent and united paths to survive in an increasingly consolidated environment. This week’s Executive Dialogue will offer a facilitated discussion and visioning sessions on additional strategies. — JR
Interview with M. Narendra Kini, M.D., MHA, President and CEO, Miami Children’s Hospital
- Narendra Kini, M.D., MHA
Payment Reform
All hospitals are experiencing an evolution in payment reform in terms of how we manage cost and outcomes. The new payment scheme will be tied to diagnosis related groups (DRGs); the days of fee for service (FFS) are gone. This move toward basket payment for outcomes along with shifts in tort reform will drive significant changes in the provision of care and the investment required going forward.
Health Information Exchange
How will we achieve outcomes across a population? In terms of information exchange, it is a matter of numbers. Only 14 percent of hospitals are digitized. Where is the information that will fuel HIE? We will need a critical mass of at least 50 percent EMR adoption and thus HIE maturity is likely 5-10 years away.
Managing Population Health
In terms of population health, the trend to an accountable care model across the industry will require children’s hospitals to become centers of excellence and expand into primary care and secondary preventive care. We must have a footprint in prevention to have an impact in an accountable care environment. The challenge is the requirement to be extrinsically networked and digitized in order to intervene at the right time.
Independent and Merged Paths in a Consolidating Environment
Three necessary steps for children’s hospitals to become an independent accountable care model include:
- Create centers of excellence – including an extensive network of digitized information regardless of location;
- Outreach – moving to virtual outreach and telemedicine/ telepresence; and
- Knowledge transfer – providing knowledge to parents to make decisions early, e.g. home monitoring of diabetes patients. We need ways to scale these efforts.
If we don’t move in this direction, children’s hospitals risk being absorbed and we could end up with adult providers taking care of kids. The future consolidated landscape within 5-10 years means children’s hospitals must move quickly to ensure survival.
An alternative model is the creation of zones of pediatric systems for dominance via consolidation/merger. The risks of merging regionally include medical staff reaction, fiscal models of operation, payor mix, level of IT individualization (i.e. Epic, Cerner) and culture. It certainly seems necessary to consider the potential ideal environment for a merged model across children’s hospitals to ensure the best children’s care continues to be available in the Switzerland model.
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