Successful organizations are often tempted to hunker down and keep the secret formula to their success under wraps. But many healthcare executives at top health systems, medical groups, and health plans have a different view. These leaders feel it is their responsibility to share their knowledge with other industry leaders in an effort to improve the quality of patient care and the healthcare industry overall.

One of the things that I enjoy about our annual Top Leadership Teams in Healthcare Conference, held last week in Chicago, is that it provides a forum for senior healthcare executives to exchange ideas and hear how some of the industry's top performers are not only surviving the current challenges in healthcare—such as reimbursement, the regulatory environment, physician relations, and staff shortages—but thriving. My head is brimming full of story ideas gleaned from the conference, and attendees came away with a "few jewels" of wisdom, as well.

Chris Van Gorder, president and CEO of Scripps Health in San Diego (this year's TLT winner in the large hospitals and health systems category), says the strength of the program is the speakers involved. "These are practitioners who are out in the field experiencing the same crises that we may be in, and [they] have found innovative ways of taking their organization through that mine field. It is very practical and very pragmatic," he says. "I have already jotted a few notes down electronically and there are some people that I would like to talk to after this to get a little bit more detailed information."

Here are just a few examples of the ideas that were shared.

• Executives from Gundersen Lutheran Health System in La Crosse, WI, discussed how they saved more than 20% on construction costs. Some the best practices they followed were:
  • Building in base pricing to their contracts so if they wanted to change a plan on the fly, it would cost them. Taking more risk on themselves forced them to be more disciplined. Many of the impromptu changes dried up as a result, says Jerry Arndt, senior vice president of business services.
  • Forcing local construction companies and vendors to compete more on price by expanding their search grid. The local companies still got preference if the costs were equal.
  • Training internal staff to oversee construction projects, which has yielded huge dividends, says CEO Jeffrey Thompson, MD.
• Jerry Miller, MD, from the Holston Medical Group in Kingsport, TN, discussed how they were commercializing their services. For example, they are rolling out electronic medical record systems to other medical groups and servicing them. "IT one of best things that we did," says Miller. They also have 37 clinical trials that bring in revenue, and educational programs that they are rolling out to schools, payers, and businesses.
• Involving physicians in quality and transparency initiatives from the start is considered good practice. But many organizations involve doctors only in the clinical components of their transparency efforts. Panelists Bruce Crowther, CEO of Northwest Community Hospital in Arlington Heights, IL, and Thomas C. Royer, MD, president and CEO of CHRISTUS Health in Irving, TX, said that if they had it to do all over again they would involve physicians not only in the clinical elements of their transparency initiatives, but in other areas like the patient satisfaction components, as well.

We'll be sharing more in-depth coverage of each of the panels along with profiles of the 2008 winning teams in the December issue of HealthLeaders magazine.

The 2008 Top Leadership Team in Healthcare award winners are:

• Scripps Health, San Diego: Large Hospitals and Health Systems (500 or more beds)
• Griffin Hospital, Derby, CT: Community and Mid-size Hospitals (100-499 beds)
• Lakewood Health System, Staples, MN: Small Hospitals (Less than 100 beds)
• Bangkok Hospital Medical Center, Bangkok, Thailand: Global Hospitals
• HealthTexas Provider Network, Dallas: Medical Group Practices
• CareSource Management Group, Dayton, OH: Health Plans

Balance billing is officially illegal in the state of California. The practice, which is when physicians bill patients for services not paid by a health insurer, had been common practice in some California facilities. Opponents of balance billing say the policy puts consumers in the middle of insurer/physician battles. The California Medical Association has bought suit against the state's Department of Managed Care in hopes of reversing the state's decision.

Ascension Health will provide Caritas Christi with $100 million in funding, raising the possibility that Ascension could eventually take over the six-hospital chain owned by the Archdiocese of Boston. St. Louis-based Ascension agreed to buy $100 million in low-interest bonds from Caritas Christi to help shore up Caritas Christi's finances and improve its network of hospitals, which include St. Elizabeth's Medical Center and Carney Hospital. Caritas Christi is New England's second-largest hospital system behind Partners HealthCare.

In the past decade, baseball has experienced a data-driven information revolution, and numbers-crunchers now routinely use statistics to put better teams on the field for less money. In this opinion piece for the New York Times, Billy Beane, Newt Gingrich, and John Kerry say the United States' overpriced, underperforming healthcare system needs a similar revolution.