The legislative battle over how to change the laws governing Michigan's health insurance market for individuals might continue into late 2008, as the state House took a procedural vote that signals there won't be an agreement on the possible rules changes until after the Legislature returns from its summer break. The Democrat-led state House has passed a plan favored by Blue Cross Blue Shield of Michigan, while the Republican-led Senate has passed a version with some elements preferred by Blue Cross competitors.
With congressional leaders engaged in heated brinkmanship, the Bush administration has given a reprieve to thousands of doctors expecting to get hit with a 10.6% cut in Medicare payments on July 1. The Department of Health and Human Services will essentially freeze the current pricing system because Congress left for a midsummer break without approving a price fix, Secretary Mike Leavitt announced. Congressional aides said the freeze could last 10 days. Each side of the debate has accused the other of playing politics with Medicare, the program that covers many healthcare costs for the nation's elderly and some people with disabilities.
All senior leaders say they support cultural diversity. Sure, we want a multicultural workplace. And, definitely, we want to address the needs of patients from diverse cultures. But when push comes to shove, cultural diversity is often just a do-good initiative that starts and ends buried somewhere in the HR department.
Leaders can no longer afford to let that happen, at least according to a number of recent news articles on this topic.
An article in this week's BusinessWeek says a diverse workforce isn't just a nice-to-have; it's a necessity. To be innovative, companies need employees with fresh ideas, unique experiences, and new perspectives. And some of the world's most innovative companies (DuPont, Pfizer, Raytheon) are also the most diverse, says the article.
A different publication (Human Resource Executive) highlights the need for diversity in the workforce. "The war for talent is raging," says the article, and it is becoming more and more difficult for organizations in all industries to fill staffing holes with qualified workers.
Nowhere does this ring as true as in healthcare, where staffing shortages and diverse patient populations increasingly require organizations to engage a culturally diverse workforce.
At Beth Israel Medical Center in Lower Manhattan, for example, almost 40% of the 5,000 babies born annually are of Chinese decent. Having a culturally diverse workforce is essential to the hospital's ability to provide patient care, and Beth Israel's parent system, Continuum Health Partners, is dedicated to seeing that diversity extend from the rank and file level to leadership.
That's why Continuum has made cultural diversity an organizational imperative, led not by HR but by Executive Vice President and Chief Operating Officer Gail Donovan, who co-chairs the organizations' Cultural Diversity Initiative. I spoke with Gail earlier this week and asked her to share with me some of the key components to increasing diversity in healthcare.
Ask the people: Before Continuum implemented any changes, they spent a lot of time surveying different groups of staff, asking them, "What are your concerns? What would you like to see happen?" You can't make changes without truly understanding the needs of your workforce, Donovan says. Sometimes these discussions reveal very basic areas that need improvement. At Continuum, for example, employees expressed concerns about the quality of everyday verbal exchanges. Employees felt that staff, especially managers, were often just conducting business with each other without taking time for pleasantries or human interaction. "We heard a lot of very tough messages frankly-some that we expected to hear and some that we didn't," Donovan says.
Define diversity: As Donovan learned first-hand, everyone has a different definition of diversity. Before establishing an organization-wide definition, leaders must talk to various groups of people and learn how they define diversity. You can't set goals without defining what you're working toward.
Define specific areas for improvement: A key part of Continuum's Cultural Diversity Initiative was defining specific areas that needed improvement, such as succession planning and mentoring. Previously at Continuum, mentoring at a management level was episodic and inconsistent, but they are working to make the process much more formal. Rather than hoping that mentoring relationships occur naturally, Continuum leadership now pairs senior-level managers with junior employees and then monitors the mentoring process.
Communicate: Cultural diversity programs don't always get a good rap. As Donovan says, there's a "healthy degree of skepticism that this not be the flavor of the month." Employees may not be able to see immediately the changes you've made to recruitment, retention, and mentoring efforts. That's why leaders need to continually talk about and promote the organization's process for recruitment and retention, as well developing employees from within. Organizations must track the results of their diversity programs and share those results with staff on a consistent basis.
Diversity for all: Continuum's efforts to beef up the diversity of its leadership don't stop with the hospital staff. "Our board needs to be representative of the communities that we serve," Donovan says. To this end, Continuum has made diversity a board initiative as well, and they've appointed several new members to increase the board's diversity.
Continuum's Cultural Diversity Initiative has been in place for a few years, but Donovan acknowledges there's still a lot of work to do. They've seen an improvement in the diversity of front-line managers, but Donovan hopes to see this extend into more senior-level leadership positions. "At a corporate level, we feel like we have less diversity than we need to have to serve our community," Donovan says.
Chances are, New York City's a lot more diverse than your city or town, but that doesn't mean you can ignore the need to increase the diversity of your workforce. Maybe you're not located in a border state or near your city's Chinatown, but, if you're like most hospitals, you still need employees.
And if you're not yet thinking about how to better serve a culturally diverse staff and patient population, you should be. As Donovan told me, "If you can't basically understand the cultural distinctions and be able to communicate with your employees, you will not be in business. There's a quality piece here but there's absolutely a business drive, too."
Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.
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Doctors face a 10% cut in Medicare payments beginning July 1 after the Senate failed to take up legislation that would have averted the cuts. Republican senators blocked efforts by Democrats to call up the bill, which was approved in the House by an overwhelming bipartisan vote. Nancy H. Nielsen, MD, president of the American Medical Association, said the cuts would force many doctors to "limit the number of new Medicare patients they treat."
New Jersey took a step toward becoming one of the first states with universal healthcare after lawmakers approved a bill expanding a health insurance program for low-income families. Lawmakers included $8.9 million in a bill that would require all children in the state to have health insurance and expand FamilyCare, the state health insurance program, to include more poor parents.
Two well-known, independent cardiac surgeons are joining the University of Pittsburgh Medical Center and will no longer see patients at rivals Jefferson Regional Medical Center and The Western Pennsylvania Hospital's Forbes beginning in the fall. In a joint letter to other doctors, Venkat Machiraju, MD, and Dr. Claudio Lima, MD, said the transition would begin July 1 and the new affiliation would "improve the financial security of our practice, provide us relief from its administrative burdens, and most importantly, give us better on-call coverage as we participate in a larger practice." Their move from RAJ Cardiovascular Associates to UPMC is part of a trend of private doctors choosing the safety of a large health system over the vulnerability of running an independent medical practice.