When 40 opinionated, proven healthcare leaders gather for two days to dissect what really works in leadership, teamwork, efficiency, strategy, growth, and transparency, the ideas flow fast. In the pages that follow are highlights from the 2008 Top Leadership Teams in Healthcare Conference and Awards. For more of the best lessons in leadership, visit www.topleadershipteams.net.
Leadership Panel: CEO Roundtable: Reinvent Now
David White, Chairman and CEO, Iasis Healthcare Corp., Franklin, TN
Stephen Badger, CEO and Treasurer, The George Washington University Medical Faculty Associates, Washington, DC
Jerry Miller, MD, Founder and President, Holston Medical Group, Kingsport, TN
William Holman, President and CEO Baton Rouge General Medical Center, Baton Rouge, LA
The key relationship between the physician and the hospital has always been evolutionary. What works today won't work much longer. What may be a constant in the relationship now, however, is that the only doctor/hospital bonds that work are created on solid partnerships.
CEO panelist David White says he learned long ago that in the hospital business, "you are in the relationship business."
"I think things have changed over the past 15 years with the physician makeup. I will say to the physicians in the room that I don't think it has improved. It has gotten worse. As we see physicians who now think as more blue-collar workers—please don't take this as too cynical or too overly critical—but so many of the new physicians that come out want to work no weekends, work during the day, no call, want to be employed."
White says he is seeing a return of the employment movement that was tried and abandoned over a decade ago, but is now being handled with more discipline and skill.
Stephen Badger says his multispecialty practice has grown by 20% a year recently by, in part, understanding what they do well and what the hospital does well.
"We have a relationship with one of the community hospitals that is starting to employ physicians that is now all employing them through us, instead of having the hospital try to do [physician group] billing and collections, which they don't understand, and without them having to buy an ambulatory EHR, which they do not really know how to roll out in the physician environment. The physician environment is dramatically different than the hospital environment," he says.
Jerry Miller, MD, says the key to growth for his multispecialty group is a plan they mapped out called IDP: Inefficiency is targeted and eliminated. Diversification means 32 to 36 cents out of every dollar paid to providers from something other than EMM codes and CPT codes. Partnerships include not just hospital systems, but also large employers and health plans.
The Baton Rouge, LA, area has had growth thrust upon it with refugees from Hurricane Katrina taking up permanent residence, says Bill Holman. So his two-hospital system has looked at ways to grow geographically, but also with focus on areas like mental health and alternative and complementary medicine because of the projected demand.
Finance Panel: Lay Waste to Waste: How to Cut the Cost of Doing Business
Ronald A. Paulus, MD, Chief Technology & Innovation Officer, Geisinger Health System, Danville, PA
Kevin Brennan, Executive Vice President and Chief Financial Officer Geisinger Health System, Danville, PA
Jeff Thompson, MD, Chief Executive Officer, Gundersen Lutheran Health System, La Crosse, WI
Jerry Arndt, Senior Vice President of Business Services, Gundersen Lutheran Health System, La Crosse, WI
Charles Stark, Chief Executive Officer, Firelands Regional Medical Center, Sandusky, OH
Daniel Moncher, CFO, Firelands Regional Medical Center, Sandusky, OH
If you see it in the trash bin, waste is easy to identify. But to see it in business practices takes a much more discerning eye.
Healthcare administration makes up 30 cents of every dollar spent on care, in large part because healthcare has been slow to adapt to techniques that can cut the cost of doing business. With reimbursements falling, borrowing costs rising, and the rise of a more consumer-oriented healthcare model, waste must be eradicated for an organization to achieve success.
Providers that thrive will cut down on administrative costs and complexity and transfer those savings to the consumer through lower prices. Top Leadership Teams attendees heard panelists' ideas about both strategy and execution that they could take home and use at their own facilities.
For instance, Gundersen Lutheran Health System has executed cost-saving initiatives ranging from cutting its energy costs by 20% over the next three years to a construction management reorganization that has saved the system more than 20% over previous construction contracts. The Dartmouth Atlas Project identifies Gundersen as providing the highest quality healthcare at the lowest cost.
Geisinger Health System's team reduced waste most famously through its ProvenCare model, a comprehensive episode-based care program that offers one price for a continuum of care—a goal that has been elusive for other healthcare providers. Geisinger's pioneering new model of care delivery works not only to reduce length of stay for its patients but also to reduce admissions—directing patients to lower acuity care within its system.
Firelands Regional Medical Center has embarked on a cost-saving and efficiency management program that achieved nearly $3.5 million in cost savings over the past four years in the midst of a payer mix that skews 50% Medicare, 10% Medicaid, and 22% commercial. Meanwhile, the community hospital system quadrupled its EBITDA earnings over five years.