Healthcare delivery and financing models are evolving rapidly as healthcare reform means hospitals and systems need a sharpened focus on the healthcare trifecta—the patient experience, operational efficiencies, and financial health. Unfortunately, many are faced with gaps in operational knowledge as they reinvent themselves. Never has the call for strategic collaboration been stronger, but as hospitals redirect their time and resources to unfamiliar areas, success hinges not only on their ability to start or change initiatives, but also on targeted operational and clinical support that can be turned on and scaled up quickly. Collaboration has become more than a leadership philosophy. In the value era it is a key business strategy that can trim costs while providing direction and solutions in areas vital to a healthy bottom line, including technology, workforce, revenue cycle, and supply chain. An enterprise management approach to healthcare can provide proven teams that are focused on their respective areas of expertise, allowing executives to effectively focus on their core mission: enhancing clinical processes to improve healthcare quality and patient outcomes. [Sponsored by Parallon]
The healthcare industry is experiencing a dramatic shift in key competencies with the advent of new incentives and requirements, and new skills are needed to engineer the merger of clinical and financial priorities. Leaders must delegate risk management, case management, and medical informatics, among other priorities, while staying on course with strategic goals. Thinner margins mean that CEOs must take an active role in maintaining a healthy balance sheet. Top executives need to broaden their capabilities and serve as a bridge between clinical and financial priorities. While chief executives must provide the vision, they must also cultivate their own financial expertise while helming an executive team that is flexible and innovative in the face of rapid change, and that keeps financial self-sufficiency at the top of the priority list. [Sponsored by Bank of America Merrill Lynch]
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Hospitals and health systems increasingly must work with providers across the continuum of care to meet the demands of value-based purchasing, reduced reimbursements, new payment structures, and readmissions penalties. But replacing the current fragmented system of care will require nothing less than a business and clinical transformation. Healthcare executives say that care coordination and the care continuum represents their single greatest organizational challenge (HealthLeaders Media Industry Survey 2013, CEO Report). Executives and physicians must work closely on patient transitions, including a population approach to patient care, coordinated financial and clinical operations, and healthcare IT expenditures. Alignment—the sought-after state of agreement between hospitals and physicians—has never been more critical or challenging. [Sponsored by TeamHealth]
What attributes make for an effective leadership culture at healthcare organizations? Different hospitals and healthcare systems have succeeded with different approaches to leadership. Boards and CEOs are often preoccupied with establishing lasting leadership values, yet there is no easy method of doing so. Most healthcare organizations have created mission and values statements (combining clinical and business goals), some have developed formal leadership development programs, and many apply the standard tools of performance reviews, organizational charts, and succession planning, among others. Leadership must always be accountable for results—the right results for the organization. Four executives recently gathered with HealthLeaders Media for an in-depth, three-hour conversation on leadership, organizational culture, and the difficult environment for decision-making.
Healthcare organizations' concerns about capital access and long-term viability are driving a boom in mergers, acquisitions, joint ventures, and other affiliations. Increasingly, these agreements result in nontraditional partners: nonprofits with for-profits, academic medical centers with investor-owned firms, faith-based systems with secular systems, and affiliations across the continuum of care. Ownership and governance structures also vary in terms of control. Today's healthcare leaders must base their M&A search on a host of factors, including capital access, local market needs, financial support, and growth opportunities—and the risk of being left out. Time and effort must also be invested in priorities after the merger or acquisition is completed. Careful planning around managing the business as well as direct and indirect relationships post-consolidation need to be near the top of every leader's to-do list. [Sponsored by Bank of America Merrill Lynch]
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Healthcare leaders are preparing for the shift away from volume-based reimbursement by experimenting with different structures for population health. Organizations must learn how to collaborate with new partners, including erstwhile competitors. Population health management also requires internal bridge building; executive and physician leaders must work together to create networks. Primary care physicians could be in short supply, while specialists are likely to see their payment, work mode, and degree of control turned upside down. Good data and analysis of the patient population is absolutely necessary, but not sufficient. The most important determinants of success or failure will be so-called soft factors: trust, culture, and leadership. [Sponsored by MedSynergies.]
The economics of value-based healthcare are driving individual hospitals to seek system affiliation and health systems to partner with other health systems. At the same time, healthcare executives face funding demands for capital needs, including burgeoning IT investments.
Access to capital is a critical need for the great majority of organizations, but the equations are changing; access is now predicated on expectations of margin, not just volume alone. Healthcare financial leaders must understand the fine points of different sources for funding, including banks, bonds, private equity, and philanthropic donations. They must join capital considerations with strategic planning to ready their organizations for the new era of healthcare.
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