Mark Shaver is the inaugural CSO for the University of Maryland Medical System. He's coming into the role with a plan for making healthcare collaborative and community-driven.
Mark Shaver doesn’t think the future of healthcare lies in one big hub-and-spoke model. Growth and sustainability, he says, will come from empowering regional providers and those in small communities to deliver more care.
“The old model was an academic hub and spoke,” says the new Chief Strategy Officer for the University of Maryland Medical System. “You have these community hospitals and all they do is feed the academic beast for complex care. We need to think differently.”
Shaver, who became CSO this month, steps into the role with a strong background that belies his strategy. An associate professor at the Johns Hopkins School of Public Health and former SVP of Strategy, Physician Services and Business Development in the UMMS network, he spent three years guiding business strategy and health system initiatives for Welltower, an international corporation focused on developing ‘wellness housing communities’ for seniors in the U.S., Canada and the UK. Prior to that he had been Director of Business Development, and then Head of Strategic Alliances and Global Services, for Johns Hopkins.
Mark Shaver, Chief Strategy Officer for the University of Maryland Medical System. Photo courtesy UMMS.
It's that focus on collaboration that drives Shaver in this new role, the inaugural CSO for the 11-hospital, $6 billion-plus health system that delivers roughly a quarter of all inpatient care in Maryland. He says the work he did at Welltower to create sustainable communities for seniors dovetails nicely into the idea of the health system of the future.
“There are unique opportunities,” he says.
That includes developing programs that take into account social determinants of health, such as transportation, housing and food insecurity, and working with payers to move away from traditional fee-for-service models and create effective care management programs. He wants programs that rely on partnerships and community, rather than the ED and ICU.
Shaver says his role revolves around four key components: Health equity and outcomes; ambulatory platform growth; AI integration to improve efficiency and outcomes; and the development of advanced therapies and precision medicine.
Dealing With a Unique Payment Model
The challenges in addressing those goals, he says, are primarily threefold.
First, Maryland operates under a unique reimbursement model, called the Total Cost of Care (TCoC) Model. This system sets rates for all payers, including commercial insurers, Medicare and Medicaid, and is combined with a global budget for hospitals, creating a fixed annual revenue for managing costs and promoting value-based care.
While this gives UMMS a fixed budget and eliminates some of the uncertainty, Shaver says it also places some limits on expansion and innovation.
“I think it's going to be just as important to decide what we're not going to do in addition to what we're going to do, where we're going to invest time and resources, because we have finite economic resources, human resources and bandwidth,” he says.
The second challenge, is in scaling expansion and innovation. Good ideas might not have the runway to take flight, and need to be measured in increments and defined by different metrics.
“We can't always look to growth and volume to solve financial challenges,” Shaver says. “We have to look at improved outcomes, improved efficiency. Because you're operating within a global economic cost base.”
Finally, there’s the bugaboo affecting every single healthcare organization in the country: Workforce. The patient base is growing, especially the senior ranks, and not enough new doctors, nurses, and other care providers are coming up through the education system to fill in the gaps. That’s why it’s important, Shaver says, that UMMS lean into its educational foundation – the oldest public school of medicine in the country – to develop the next generation of clinicians that know the environment and the technology they’ll be using and can hit the ground running.
Emphasizing the Community
That also ties back into partnerships with small and rural providers, creating a network where there are many hubs and spokes, rather than just one big network emanating from the center. This is where digital health and virtual care can provide those connections so that care is delivered in the community.
There are estimates, Shaver says, where 25% of the care being delivered now in hospitals will shift to other sites in the near future. And that percentage may even be low.
“I'm sitting right now in the in the northern part of the state, which is considered rural, and the amount of advanced care, advanced cancer care, advanced spine care, advanced colorectal and GI care that happens up here in this community would not have existed 10-15 years ago in a community like this,” Shaver points out.
“We're leveraging technology inside the four walls of the hospital, but also out into the community,” he adds.
Leveraging technology includes finding and supporting new ideas, including from within. Among the strategies, Shaver says he’d like to borrow the playbook from other health system who have nurtured innovation in-house and developed a revenue stream from new tools and techniques.
“I think that’s becoming increasingly popular,” he says. “Health systems like Providence and Northwell and Ascension are doing this well. Systems like ours really are positioned well, especially considering the national role we play in driving value-based care and the uniqueness of the Maryland model.”
These are all heady ideas, and Shaver says that while technology may affect much of a health system’s transformation strategy, it’s just a tool. True transformation, he says, begins with a united purpose.
“We have 30,000 team members across the state, and the majority of our team members who are delivering care every day are removed from that C-suite level,” he notes. “So how do we make sure our mission, vision, [and] values emanate across the state through our team members, through those who are providing care? Helping with the messaging and working together is going to be important. We should not get distracted from our core responsibility of providing care to the community.”
“While I am as excited as anybody about innovation, technology and improvement, understanding the true challenges, the social challenges, the healthcare challenges, the societal challenges that we face every day - and we face them in rural markets, urban markets, community markets,” Shaver concludes. “It's eye-opening to see how we need to balance the excitement about innovation and the challenges our communities have.”
Eric Wicklund is the senior editor for technology at HealthLeaders.