Healthcare leaders can no longer afford to assume that communication is happening effectively. This might be why communications were a focus of the recent article in Becker’s Hospital Review titled 10 Areas of Focus For Health System CEOs, CFOs Heading Into 2021 that talked about best practices for organizational excellence, organizational culture, and accountability. In this episode, you’ll hear how Michael, Scott, and Jared react to the list – what stood out, what made sense, and what surprised them.
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Michael: Welcome to the “Paradigm Shift of Healthcare,” and thank you for listening. I’m Michael Roberts, here today with my co-hosts, Scott Zeitzer and Jared Johnson. Today’s episode, we’re talking about healthcare leadership, and wow, what a time to talk about healthcare leadership. It’s not easy at any point, I’m certain, but there’s been a lot going on this year for sure. So, a lot of our discussion today is going to be based on an article from “Becker’s Hospital Review” on November 13th, titled “Ten Areas of Focus for Health Systems CEOs, CFOs Heading into 2021.”
So, this article was talking about best practices for organizational excellence, organizational culture, and accountability. So, let’s talk about it. Let’s talk about some of those points that really stood out to us. I’m going to start off with point number eight from the article. And this will be the last thing I read, guys, so we can jump into actual conversation here, but this is pretty important to kind of talk through this particular point. It says, “Health systems are sharpening communication strategies to advance population health initiatives during the pandemic. Facilitating the appointment process, connecting care coordinators and care planners, and continuing communication with patients after discharge have contributed to improved outcomes in care quality when in-person visits have been limited.”
So, it’s a lengthy quote, but the first thing that I thought about when I was reading through this quote was, hey, here are all these things that have happened that is a way to kind of get through all this mess. And we’re doing this while in-person visits have been limited, but this is now standard, right? And we’re expecting this kind of behavior from health systems going forward. This is the new normal.
Scott: Yeah. You know, to jump on that, as you’re saying that to me, and all of us listening to this podcast are all thinking about how much healthcare has changed over the years and how much it’s accelerated during COVID. We should expect good quality customer service from anybody that we pay, including for medical care. I’ve always been fascinated by the disparity between what is considered good customer service in say a Walmart, where they’re starting to do healthcare, and your local doctor’s office. I think that now that COVID’s hitting, a lot of the things in a lot of hospitals, a lot of ambulatory surgical centers, practices have all been thinking about doing, they’ve had to start putting into place.
Jared: Yeah, Scott, I think about the wording of this point where it says, “Health systems are sharpening communication strategies,” not introducing, not even the fun optimizing word, you know, those words we always think about, but sharpening communication strategies. So, am I reading that right? That we are starting to have more of a mature look at the importance of communications and trying to figure out how to do it better and just recognize, because maybe it’s just something that was taken for granted, that we are communicating in the right ways. I’m not exactly…maybe it’s all of the above.
Scott: Yeah, it’s a good question. I wonder. Michael and I talk to a lot of medical device companies, pharma companies, etc., and, you know, 10 years ago, 5 years ago when we just simply heard they were communicating, it didn’t even matter what they were communicating. You know, it was like, “Wow, you’re actually talking to patients? Good for you,” whereas now it seems like, “Well, that’s great that you’re talking to them, but what are you telling them, and what kind of message are you delivering, and is anybody listening to it?” It’s important.
Michael: This concept around bridging all these different points of communication, I think, is like the most exciting thing in terms of what needs to happen now. You know, how many people are really, really doing that well, but, you know, so many times like you run into a particular issue with your health system. And that’s its own island and you can’t figure out who knows anything more about that particular thing. So, if you can get something beyond just that initial appointment, you know. And we’re seeing that certainly with some of the larger health systems that we’ve talked to where they do kind of own the entire patient experience and they can deliver that, but it really creates this sort of disparity between those types of organizations and anything smaller. And that’s going to be a real challenge for everybody else to keep up with.
Scott: Yeah. And I think it’s also an opportunity. Whenever I hear challenge, it’s an opportunity. So, you’re right, Michael. When it’s a large hospital system, they have the money, the wherewithal, the research, etc., to go out there and perhaps educate their patient, follow up with their patient, get other patients to come in because of this good service that they’re offering. And then you’ve got these smaller practices where they’re like, “I don’t know what to do.” You know, and here’s a place where we have spoken to quite a few companies about, “Well, here’s how you can help empower all of those doctors to basically get the word out about a particular procedure.” I think it will be critical to those smaller practice’s success. Essentially, the smaller practices are nothing more than small businesses, right, guys? And anything that will help them take better care of their patients, they’re going to be happy to hear about.
Jared: Yeah. When I think about like any CEO’s list that I’ve ever kind of come to expect where their focus is for the coming year or the coming quarter or really any time period, communications are so rarely on that list, from what I’m aware. So, for this to be one of the things that was pointed out in the article, it’s a good surprise. To me when I think the three of us never have any question about the need for improving communications, I’m finding in any situation just about with anybody in any organization, it’s just taken for granted that we’re able to figure out what we should be saying, how we should say it, when we should say it. And it’s one of those things, it’s almost like IT in some ways. No one notices it’s there. It’s invisible until it’s broken.
Scott: Yeah. I wanted to bring up a point that I found interesting. It was article number three in that whole list of things that were brought up in that panel discussion. And essentially it’s this, so let me read it. “The health system of the future will need to account for variables that have been long-coming for healthcare, such as the move to outpatient and home settings and the rise of health retailers. And fundamentally, health systems will have to grapple with the fact that their cross-subsidization business model where commercial payers offset government reimbursement is rapidly losing buy-in from stakeholders and patients.”
So, you know, guys, that’s a long-winded point to make that, hey, the Walmarts of the world are here and starting to be a big player. Amazon for sure is dipping their foot in the water now, both just as a point of where to buy prescription items, potentially, who knows what else? As we mentioned, a lot of hospitals are starting to become bigger and bigger, right, with primary care, etc. So, that’s one point that is potentially pushing and squeezing a small old school practice of a couple of people. And at the same time, you’ve got Medicare and Medicaid are reimbursing lower and lower. And the desire to go after private paying health insurance, as well as cash payers, is becoming needier and needier, and therefore, more difficult, right?
Jared: Yeah, exactly. Take a look at how many fewer people have employer-provided coverage, period. And I don’t see a time…I don’t know anyone who’s seeing a time, at least in the short-term, so in the next 8 to 12 months, perhaps where we get back up to a hundred percent of those with commercial coverage actually are there, and the ones to market to, to communicate with. That really has been the strategy of the last several decades. And so, from what I’ve seen, from what I’ve been reading, folks would be thrilled if it gets back up to 80% of the number of those with any type commercial coverage, with private insurance, with employer-provided coverage.
That’s sobering at the very least, and I’m not surprised that that part is on this list because that’s the new reality. That’s not one that we can shake our heads and just wait for things to get back to where they were. They’re not going to, and if they do eventually get up to those levels, it’s going to take a long time. And so, we can’t stay financially viable as any kind of provider organization, and just wait for things to get back to that point. So, I think this is just a part of the planning of seemingly every aspect of our business right now.
Michael: You know, the whole call-out that they have there towards home settings, in particular, is really intriguing to me. I mean, first of all, of course, pandemic, everybody stay home, right? So, that’s one factor that goes into all that stuff. But then as you do have this generation that’s aging, that’s a much larger generation, you know, than, you know, the whole baby boomer population, that’s really going to add like a big shift in where those opportunities, as Scott once labeled them. That’s where those opportunities are because you’ve got a lot more people now that are calling for that kind of service. I mean, you know, in our family, like extended family, we’ve certainly seen how that type of experience happens. You know, the in-home care and it’s hard. I mean, it’s just hard to make it happen.
And in a lot of cases, it’s really expensive. So, what’s gonna happen when we have more and more people moving towards that at a time when, you know, who knows what’s going to happen with the economy, you know, all those kinds of different factors that go into it? But it just really does throw a big question mark on a lot of these things because business as usual has just gone out the window. It’s ridiculous right now.
Scott: Yeah. And I think the companies out there, the healthcare providers, the pharma companies, the MedTech companies out there that help empower providers to better adapt to these changes are the ones that are going to lead the way and be the most successful. You talk about taking care of patients at home. Well, what products are out there that will help with that process, you know, whether that’s just standard rehab and PT or whether it’s long-term care kind of issues like you’re bringing up, Michael, but I think again with change comes opportunity. And you know, the joy of capitalism, I think there are a lot of companies out there right now that are trying to figure out how they can best help people kind of adapt.
Jared: Definitely, I see the role of leaders being more impactful than ever because this is the type of thing that’s going to have to trickle down. There’s going to be so much confusion and misdirection at every other level within the organization, and everyone’s just going to have to really lean in to the fact that things are going to be different. And that really does start at the top. I mean, that part is nothing new, but the need for it, I think, has just accelerated along with everything else.
Scott: I agree you 100%, It’s critical when you’re leading your group to understand the changes that are occurring here, come up with some sort of game plan and work with people who understand it, and then get the word out both internally and externally. It’s not just about selling what you’re going to do to a customer, an external customer, perspective patients say, but you’ve got to get that point across, excuse me, to all of your fellow people. I think that’s so very important and underestimated. It’s not just about selling to people, “Hey, here’s what we’re going to do.” It’s selling internally to your own group how important this is, how success will be made or broken on this change that your company may be about to take.
Michael: You know, to that point, like sort of internal communications, like that whole concept, like this year and like whatever company type you are, I mean, if you’re not really investing in internal communications, you know, human resources, like whoever handles that type of back and forth within your company, you’ve just gotta be hurting right now because there’s just been so, so many changes. And, you know, with all the different company types that we work with Scott, and Jared, I’m sure, you know, with all the different companies that you work with, in particular, like everybody’s been through a major, major change, right? Everybody’s had to take some kind of big shift and everybody’s had to take some sort of step of going back to their own people and going like, Okay, everybody, here’s where we’re going now. And here’s the status of it,” because everybody’s got some level of uncertainty going through this year.
And so, you know, we’re talking about leadership, we’re talking about all of these kinds of things, but not having your team on-board right now is just the death knell of your organization if you’re not keeping everybody informed and really hearing back too, you know, that two-way communication. So, it’s not just about blasting messages out at everybody, but really being able to hear concerns come back because concerns that you never imagined as a leader are going through people’s heads right now. How are you ever going to hear about them? How are you going to get them back?
Scott: That two-way communication conversation is so critical. We, as a company, have been in some ways remote and/or having remote employees and/or working-from-home employees, which are slightly different. So, work-from-home employees are people who are always away. You know, if your company’s based in say New York, and you’ve got people in California, that’s essentially a work-from-home person. They’re not coming in every day. And then a remote employee might be somebody who comes in every now and then. You know, they’re local, but they don’t want to come in. And everything that I’ve read and everything that I’ve done, and we’ve done it for quite a while with our company, has always been about over-communicating in some ways.
Don’t assume that the first time you mentioned something that it really kind of sunk in. Yes. Especially when you’ve got all these people working remotely about making sure you’re getting feedback from people to make sure that it’s being heard, heard the way that you think you want it to be heard, right? That’s a big deal because, you know, when you’re in your own office, somebody can kind of just happen to come by, see you at the water cooler, you know, etc., maybe just go grab a bite for lunch. Those things are impossible now. And having the ability and the openness and a plan in place where you can not only talk about what you’re hoping to accomplish, but get feedback and make sure it’s being heard, that’s going to be critical, critical to everyone’s success.
And the same thing goes to all the doctors out there who are going, “Okay, but that’s not my thing.” It’s like, “Yes, it is,” because if you’re going to be talking to your patients and they’re not coming in, how critical is it to get that information about what you need them to do and how you got to hammer that home correctly? Very different from when they come in. And again, opportunity for the med device company, the pharma company. If you can help empower that communication, that’s a real win. And those doctors are going to love you for helping them.
Jared: No, they really will, Scott. And you mentioned just the part of assuming that it’s happening or assuming that it’s happening effectively. And I think we’re seeing how critical that is and how common that part of it is. And then Michael, to your point about things being on the minds of leaders, that whether or not they were…the things that weren’t on every leader’s mind, but really seem to be now, there are a few things that are at least out of the forefront, and the spotlight’s on them now. And the time has finally come to kind of bring those things up. And to that end, a couple of the points that stood out to me were really similar to me from the article and they were points number four and number nine.
Number four was this. It said, “COVID-19 has made it clear that addressing health equity needs to be among health system executives’ top priorities. Many things that end up being health needs start out as social needs, and the pandemic has highlighted this.” Then number nine to me was kind of related. Number nine was, “The pandemic has pushed population health programs to focus on patients’ social determinants of health. It’s critical to understand factors such as where patients live, their total spend, and where they get care so health systems can integrate that data into better care plans.” So, those two points together when you’re talking about where does a leader focus moving forward, those are things that I hope they never actually leave the limelight now.
I hope these are parts of every healthcare strategy conversation from here on out because there’s just been this thought or belief that you either make a profit or you help address making your community better. And I hope that’s not as pervasive as sometimes I wonder, but it sure seems like some healthcare organizations act way, that they can either do one or the other. They can make life better for their business or for patients. And the intersection of those two things is what I’m hearing in those points, that addressing health equity needs to be among the list of top priorities because of how that actually affects your strategy. Those things aren’t necessarily mutually exclusive. So, I think it’s the start of an interesting conversation.
Scott: Yeah. You know, I call it the win-win-win, not just the win-win. And so, what I mean by that is when it’s a win-win-win, there’s a win for the healthcare organization, whether it’s a hospital, physicians group, etc., a win for the providers of medical care, the doctors, the nurses, etc., and then, of course, the most important, the win for the patient. That win-win-win is something that can be and should be always strived for. There is no reason why we can’t figure out a way to take better care of our patients, whether that is say in orthopedic surgery, where we happen to be…we do quite a bit of work, or whether that’s something like pediatrics where both of my children are well beyond that. But I think that that win-win-win of trying to figure out a way to make it work for everybody, and there are a lot of instances that we can come up with, that’s a good goal for all healthcare leaders to strive for.
Michael: And talking about the shift in mindset that has to happen to make that work, you know, once you get to that sort of scale where you’re talking about the community’s health, and you’re talking about really how do you help people that are all these different stages of life, right, whether financially and socially and all these kinds of things, it really does transform a healthcare’s profit structure, right? Like you can’t just go after the most profitable procedures, and that’s what we saw so much happening this year where, “Hey, now we’re all treating COVID. And so, all these different procedures that were making us a lot more money aren’t necessarily happening.” How do we think that people can make that happen? I mean, it’s not something where you can just pay it lip service and have it work out. Like, there has to be some real shifts happen.
Scott: Yeah. There’s no doubt about it, Michael, you’re right. It’s one thing to acknowledge it, which we are now seeing. This has been essentially something that’s been acknowledged quietly, you know, but never really attacked, and it’s going to have to be. To your point, it’s much more profitable in the land of orthopedics or cardiology or neurology than it is say in obstetrics or pediatrics, but man, you know, both are really important, right? You know, so how do you come to terms with that and how do you balance that out, both on a local level, say for a particular hospital and on a national level? And I don’t have the answers for this show, but it will have to be attacked.
Michael: It’s interesting talking about that type of scale, because you know, you look at the individual doctor, you look at…you know, even go back to like look at the different schools and organizations that are training up physicians right now. Are we equipping for the right type of need right now? Do we have enough of the right types of, you know, doctors for what’s coming and for what we’re facing now? And so, we don’t have the magic answer to throw out there, but I do think that that’s the challenge that we can leave people with, something that we can really call on leaders to continue to discuss because this is a big piece of it. The way that we pay for healthcare right now went through a major, major upheaval this year, and, you know, I’m sure we’re not done. Like, we’re going through another spike right now in COVID cases. So, how are these kinds of organizations going to be solvent and provide the care that’s necessary? And, you know, Jared, I think it’s a really wonderful point. To use Scott’s word, there’s a big opportunity here. There’s a lot to raise, you know, to come up with and to have the potential to do here.
Scott: You know what? It’s going to have to be a team approach, right, guys? I mean, these are major changes that need to take place. So, on a governmental level, a corporate level, on a provider level, there’s just a lot of hard work that needs to get done. I will leave you guys, everybody listening with one area of hope. My son is in med school. He’s going to hopefully get a doctor of osteopathic medicine. And they’re really pushing. There’s a lot of DOS about primary care and a lot of different opportunities in primary care, which I think we all need to hope that we have more than enough primary care providers. And primary care can be anything from just being the primary care doctor, to the hospitalist, to the say neurologist, OB/GYN. There’s a lot of different ways to be a primary care provider. I have a broad definition for it. And man, I can’t tell you how many of that classroom are just embracing that, how many people in that class are embracing that and looking for ways to just help to grow and hopefully help their patients as they graduate. So, I don’t know. I’m always an optimist, but yes, there is opportunity.
Michael: Yeah. I know what else to say. You know, look back through some of the episodes that we’ve had previously, some of these issues, these social needs, some of these kinds of things. Like, we have had amazing conversations with people like Dan Dunlop and several others that are talking about how people are getting out there and addressing these challenges. But yeah, it’s great to see this as not just like a charitable act.
Michael: Or not just as something that people are thinking about, yeah, we should also include, but yeah, it’s at the forefront now. Like, 2 of these 10 points are focused around this need. So, that’s fantastic.
Scott: Yep. Very good.
Michael: Yeah. So, plenty of opportunities for the leaders out there. Thank you everybody for listening today. And we just hope you have a great week. Thanks so much.
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