Sarah Krevans, who was the first woman to serve as president and CEO of Sutter Health, will retire in early 2022.
The CEO of Sacramento, California-based Sutter Health announced her plans for retirement earlier this week.
Sarah Krevans, who has served as president and CEO of the integrated health system for the past five years, is stepping down in early 2022.
"I am grateful to have spent the last five years as CEO," Krevans said in a statement. "Sutter’s integral role in the communities we serve has been on full display during the pandemic. I see firsthand how incredible our people are — especially our staff and clinicians on the frontlines treating patients — and the significant benefits of an integrated network that can share best practices, resources and support."
Krevans, who is the first woman to lead the health system, previously served as Sutter's COO, and served as regional executive officer and president of the Sutter Health Sacramento Sierra Region.
The Sutter Health Board will be conducting a national search for the next CEO and will consider both internal and external candidates for Kevan's replacement.
"The Sutter Health Board and I are grateful for Sarah’s commitment to Sutter Health’s mission, vision and values during her 22 years with the organization,"Gubby Barlow, board chair for Sutter Health, said in a statement. "As CEO for the past five years, Sarah has been a leading voice in advocating for the patients and communities that Sutter Health serves."
During her tenure, Krevans focused on increasing the health system's culture of safety, leading it to be ranked as a national leader in care quality. She also committed to justice, equity, diversity, and inclusion initiatives for the organizations, becoming one of the first organizations in California to offer unconscious bias training for the system and clinical leaders.
Other accomplishments include expanding telehealth services, expanding mental health support, education, and access to patients and employees, and lowering the total cost of care for patients and payers.
Krevan's announcement comes a month after a judge approved a "landmark" anti-trust settlement agreement between Sutter, the state of California, and a group of health insurers. This ruling resulted in a loss of $575 million for Sutter, and new rules the organization must operate under to limit its ability to control the price of healthcare in northern California.
Ketul J. Patel will solely lead the health system after Gary Kaplan, MD, FACP, FACMPE, FACPE steps down as co-CEO at the end of 2021.
Co-CEO of Virginia Mason Franciscan Health (VMFH), Gary Kaplan, MD, FACP, FACMPE, FACPE, announced earlier this week he will step down from his position at the end of 2021.
Ketul J. Patel, who has served as co-CEO alongside Kaplan since January 2021, will assume the role of sole CEO, effective January 1, 2022.
"It has been the honor of a lifetime to serve Virginia Mason and our Puget Sound communities, and I’m deeply proud of the strong progress we have made in our first year as the new VMFH health system," Kaplan said in a statement. "As we enter this new chapter, I’m confident that Ketul is the person best equipped to lead VMFH through the next years of growth and evolution."
During Patel's first year as sole CEO, Kaplan will stay on and serve as a special advisor to Patel. Kaplan will also serve as a senior vice president at CommonSpirit Health, with a focus on promoting quality, safety, and patient experience across the health system.
"Gary has made a legendary impact on health care not only in our region, but across the country," Patel, said in a statement. "We are deeply grateful for his leadership and his commitment to infusing the constant pursuit of quality and safety improvement into the fabric of who we are as VMFH."
CHI Franciscan and Virginia Mason Health System merged in early 2021, creating an integrated health system with 11 hospitals and nearly 300 sites of care across Seattle and the Puget Sound region in Washington.
While Kaplan and Patel have co-led the newly formed health system, the dual-CEO structure was put in place as a temporary model to accelerate the integration between the two organizations.
Adhi Sharma, MD, who was elevated to lead the Oceanside, New York-based hospital at the beginning of September, is the first physician leader to command the almost century-old hospital.
Sharma, who served as the hospital's chief medical officer and executive vice president for clinical and professional affairs, is succeeding Richard J. Murphy, who is retiring at the end of the year.
Recently, Sharma spoke with HealthLeaders about how his background has prepared him for this role, and how he plans to lead Mount Sinai's flagship hospital.
This transcript has been edited for clarity and brevity.
HealthLeaders: How does your background as an emergency medicine physician impact your leadership style?
Adhi Sharma: As an emergency medicine physician, there are three things that we're used to:
1. Constant chaos
Working in that chaotic environment gives you a sense of calm within the storm, and that's helpful for us to have that mindset.
2. We work with all-comers
You never know what's going to walk through the door. You have to be prepared to take care of it and then you have to work with other team members to provide comprehensive care for certain patients. That helps because you work across the platform in the emergency department. We are not limited to one area of the hospital per se, even though it is one space in the hospital.
3. It gives you a sense of the clinical needs of an entire organization
In the emergency department, if we can't take care of that patient, we have to transfer that patient. We know what services are critical, what types of programs we need to have in place to support the community, and so emergency physicians are acutely attuned to that.
HL: After joining Mount Sinai South Nassau in 2014, you have served in several leadership positions including Medical Director for Utilization, EVP of Medical Affairs, and Chief Medical Officer. How has your internal succession history helped you to prepare to lead as president?
Sharma: From the beginning, I got an interesting introduction to Mount Sinai South Nassau, at that time South Nassau Communities Hospital. Medical utilization is an interesting space where you're looking at how effectively care is provided, where are your care efficiency gaps, and if we are doing the right things for the patients in the time that they needed done. Sometimes you're doing too much, and patients are staying longer in the hospital and are exposed to things they don't need to be exposed to. Sometimes you find the opportunities to provide more comprehensive care as well.
In the medical director for utilization role, I was able to meet with a lot of the different doctors and I was able to round on the units in a capacity where people were having candid and open care conversations. That gave me a good Introduction not only to the organization, but also to the medical staff. I got to work with every unit and department in the hospital and work with them almost on a peer-to-peer level, so I got to learn the organization from the inside.
When I stepped into my next role, which was Chief Medical Officer, that information was valuable for me to help design models of quality improvement and performance improvement. In a sense, in my previous role, I got to find out where all the skeletons were, and so I got to work on that directly with having that insider information.
Then all of that culminates into the final role, which was executive vice president in clinical professional affairs, as well as Chief Medical Officer at the same time. In that third role, I got to work with non-clinical departments, including IT, I worked closely with finance, had a lot to do with budgeting and all these other aspects of hospital operations that are non-clinical. If you add it all up, I had run the bases around the hospital and got "home" with an understanding and a perspective from each part of the ballpark.
HL: How have the COVID-19 patient surges affected the hospital?
Sharma: We were hit very hard. New York was not spared during that initial surge. Our hospital serves a population of around 900,000 in our primary and secondary catchment areas. For our size, we serve a large population of all potential patients. And we saw many of them. Thousands of COVID patients came through our doors. At our at peak in April 2020, we had 405 COVID patients in-house with nearly 100 on ventilators, and another 100 patients on top of that for other medical reasons.
While we normally run between 320-340 beds, we had a surge of over 500 at our peak. It tested our operational agility, it tested our staff, it tested our ability to provide care in all venues. I was proud to see not only how the organization responded, but also how our staff all rolled up their sleeves and got it done.
We surged to about a little less than one and a half times our normal volume, but we didn't have a single patient outside of a care area. We didn't have a patient in the cafeteria, we didn't have a patient in the hallway, we didn't have a patient in the conference room. All of our patients were cared for in areas where we provide patient care. We're proud of that fact because that demonstrated the ability of the hospital to effectively take care of these patients in spaces where they should be cared for.
HL: How have you led the hospital through the pandemic so far?
Sharma: We used our best ability to continue operations. We deployed staff. We got together in early February 2020, and we made purchases at that time including ventilators and things that we thought we might need, and we absolutely did need them. In fact, on the day when we were running out of ventilators, the shipment arrived. We had a very proactive team, leadership, and nursing leadership. We were able to secure many of the items we needed well ahead of their demand. That gave our staff the protection that they needed to care for these patients.
We are also part of the Mount Sinai Health System and being part of the system helped us tremendously with clinical protocols, getting certain treatments that were limited in access, personal protective equipment, and certain supply chain issues that we were having that the system was able to help us.
We were also able to do certain things independently and all of those things culminated in a strong response. Our staff felt they were protected and that our patients were cared for in a way that was appropriate and consistent with our commitment to quality.
We have 3,700 staff and everyone rolled up their sleeves. Our staff is just so resilient and dedicated to our patients. They've been doing this since March of 2020, so think about that. In some ways it's unrelenting; our staff are still going strong to their credit.
HL: What will your first 90-days as president look like?
Sharma: Dealing with the global pandemic, that's an ongoing concern. Despite the pandemic, we are growing the hospital and trying to provide additional services for our community. We have a $400 million capital program that's in progress. I have to make sure that we don't lose any momentum there, that we keep those programs growing and evolving and getting to fruition.
Similarly, we have this system integration with Sinai that's along a certain path, so I will have to make sure that we continue along that path. Any obstacles or hurdles that we hit for either our capital programs or system integration path will have be addressed, and we'll work our way through those and get to the objective, which is to be the flagship hospital for the Mount Sinai Health System on Long Island, and be able provide advanced tertiary care services to our community, and make sure they can get the care they need, when they need it, in their own backyard.
William Warren will lead marketing and communications for Stony Brook University's academic and research enterprise, Stony Brook Medicine, and Stony Brook Medicine Healthcare System.
Stony Brook has announced a new vice president for marketing and communications.
William Warren will lead all marketing and communications for Stony Brook University's academic and research enterprise, Stony Brook Medicine, and Stony Brook Medicine Healthcare System, starting September 13.
"I am absolutely delighted to have Bill join Stony Brook University at this critical juncture," Stony Brook University President, Maurie McInnis, said in a statement. "Bill is a proven leader who, in addition to his deep experience in higher education, brings a broad range of expertise from both the political and corporate worlds. As we emerge from an incredibly difficult year, I am thrilled to have Bill join our team as we launch bold, new initiatives and forge exciting, strategic partnerships."
Warren previously served as the University of Utah's first chief marketing and communications officer for a decade, where he built a marketing and communications team to launch crisis communications, issues management, digital strategy, and creative services. He also served as interim chief marketing and communications officer for the University of Utah's healthcare system and health sciences colleges.
Prior to that, he served as vice president of communications at CA Technologies, an independent software corporation.
"I am so pleased to be coming back to New York, to support President McInnis and her team as they showcase the excellence of Stony Brook — a true catalyst for social and economic change in the region and beyond," Warren said in a statement. "Stony Brook has a great story to tell and I’m enthusiastic about what lies ahead in the next chapter of this great institution — New York’s greatest public university."
Chief brand and consumer experience officer, Kelly Jo Golson, details the strategies behind the health system's consumer-first focus.
The pandemic has shifted the way consumers expect healthcare to be delivered. Technology is being further utilized to ensure a more convenient patient experience. In-person care is now among multiple options for patients, with the accelerated use of telemedicine and digital apps being introduced and adapted.
Advocate Aurora Health, a nonprofit health system with dual headquarters in Milwaukee, Wisconsin, and Downers Grove, Illinois, is among the health systems adapting to these consumer expectations.
HealthLeaders recently spoke with Kelly Jo Golson, the health system's chief brand and consumer experience officer, where she detailed the organization's strategies behind its consumer-first focus.
This transcript has been edited for clarity and brevity.
HealthLeaders: Why does Advocate Aurora have a consumer-first focus?
Kelly Jo Golson: We've been down this path of putting consumers first in all we do for some time, and certainly the past year and a half has accelerated that focus. As a healthcare provider, we see our role expanding beyond the traditional way of caring for the sick, and we see ourselves as playing a role to enhance the overall health and wellness of individuals and consumers.
We know the way that consumers experience the world. Whether it's through banking, leisure, education, their expectations on the experience, the ease of experience, and access has evolved, and we don't think that healthcare should be any different. We think that we should hold ourselves accountable as a healthcare system to deliver on that optimal experience for consumers in the healthcare and wellness space. We've been invigorated and committed to put consumers first in all decisions, and all things that we do from end to end through the whole continuum of health and wellness.
A lot of organizations are able to say they are "consumer first" or offer "consumer-focused care," but working within an organization that is putting that at the center of our strategic plan in all things we do is really meaningful.
HL: How does empowering consumers affect patient engagement and health outcomes?
Golson: The engagement piece is so critical. If you look at an individual patient who maybe is dealing with a chronic issue, and you look at the number of times that they are going to be scheduled for a live visit to come in to see a physician or provider, it's rather small in their whole span of a lifetime.
As we're able to put these tools of health and wellness at the fingertips and in the palms of consumers, we're able to enhance those outcomes. We're not only able to connect, and communicate, and offer them tools and resources at the time of care, but we're able to offer those resources 24/7. By allowing a consumer or patient to engage directly with their own health and wellness journey, we believe that ultimately improves outcomes on the back end of care.
HL: What marketing strategies have the health system utilized to further its consumer-first journey?
Golson: It all starts with consumer insights. If you're going to say consumers are coming first, then we need to go to the consumer and we need to learn their needs, their wants, where they see obstacles, and how we can best improve their experience in a meaningful way.
Starting with those insights has allowed us to focus on five key things.
It is a single, comprehensive, digital ecosystem that's connecting consumers with all things health and wellness 24/7. It lives out our commitment to provide ease of access and simplicity, anytime, anywhere.
We were on that journey and had already launched the app prior to the pandemic beginning, but what's happened during the pandemic is accelerated, whether it's because individuals were homebound because of some of the mandates within COVID, or perhaps they were just seeking to better connect to their overall health and wellness during that time. Our adoption of LiveWell has grown significantly over this past year and a half. We're to about 1.2 million users and downloads of our app.
Based on some of the things we saw during COVID, we've been able to add to the functionality of the app. As an example, we were able to track that more consumers were going to the guided meditation piece within our app. Over the past year and a half, we've taken that functionality within our app, which is offered at no cost to our consumers, and we've expanded on the offerings. You can pick the duration of time that you do a guided meditation, there's more options, you choose the music, you choose the background, and we're proactively pushing that out. It's something that we've been able to use even with our own team members.
We were also able to stand up a COVID symptom checker and our safe check access. So, as you're entering and going to go into one of our campuses, you can do some screening on whether or not you've got a temperature, or you've been having any of the signs.
Having that strong foundation before COVID started, and then listening to and watching consumers' needs and wants, and how they were utilizing the access, has allowed us to continue to grow and expand the offerings.
2. Telehealth
There has been the capability for providers to offer virtual visits for some time, and if you go back and look pre-COVID, nationally the adoption rate was low. The utilization was not on par with what the technology and the capabilities were. That has shifted now due to a couple of reasons.
Our physicians and providers embraced the utilization of virtual care. In addition to that, our consumers were anxious to find a way to stay connected to their health and wellness during that time. Our numbers grew, probably tenfold, from where they had been in pre-COVID times. The exciting thing is that's begun to change the dialogue. Instead of approaching things on why telemedicine won't work in that circumstance, we're flipping that to say how can telemedicine work in this circumstance.
It's important to note that we are in no way suggesting that all care is going to be delivered virtually. We think that in-person visits are critically important, especially for some chronic conditions. However, being able to add those virtual check-ins in between the live encounters is a huge value add for the patient as well as for the physicians and providers, and ultimately it will improve the outcomes. I would suggest we're beginning to scratch the surface of the many possibilities that lie within the telemedicine space.
3. Self-service capabilities
It's not just the ability to schedule online, it's the ability to search for your physician or your provider. It's the ability to understand who takes what insurance, who's closest to your home, then being able to schedule an appointment and finding one that works for your schedule. Then you're getting text reminders, you're checking in virtually, you're getting follow-up messages virtually, all of those things we're focused on in the enhanced scheduling bucket.
4. Digital platforms
One of the things that we have seen with continued growth in this area is consumers' utilization of digital content, to seek and find information on all things health and wellness. We're making sure that we've got those resources that are constantly updated and at the fingertips of consumers, and when they need that information that those resources are there.
5. Consumer engagement platforms
Our consumer engagement platform allows us to focus on a 360-degree platform that allows us to connect with consumers. Whether that's through consumer relationship management communication, we know who you are, we know what your needs are, we know what your preferences are. Creating that 360-degree viewpoint and connectivity with consumers end to end is our other focus.
Penny Wheeler, MD, will retire as CEO at the end of the year; Lisa Shannon has been named as her successor.
Allina Health announced two top executive moves on Thursday.
Penny Wheeler, MD, who has served as CEO of the Minneapolis-based health system since 2015, will retire from her position at the end of the year but will remain on the board.
Lisa Shannon, who currently serves as president and COO of the health system, has been named as her successor.
"Allina Health has enabled me to fulfill my purpose to improve the lives of others as both a physician and as a leader,” Wheeler said in a statement. "Along the way, I have collected countless stories from those who I have been so privileged to meet. It is those stories that I will miss the most, but the timing is right for me to step away."
Wheeler's tenure at Allina spans decades. Her career includes working as a physician, serving as president of the medical staff of Abbott Northwestern Hospital, and serving as chief marketing officer for the health system. She was also the first woman and physician to serve as CEO of Allina Health.
"I have tremendous gratitude and optimism for the future of Allina Health under Lisa Shannon’s incredible leadership," Wheeler added.
Shannon, who has served as COO since July 2017 and as president since September 2020, will continue to work closely with Wheeler during the leadership transition.
"I am deeply honored to have been selected to lead Allina Health and am privileged to have been able to work alongside Penny Wheeler for the last four years," Shannon said in a statement. "She has been an exceptional leader, mentor, and friend."
Atrium Health acquired Wake Forest Baptist Health in October 2020.
Wake Forest Baptist Health and Atrium Health have announced a strategic brand combination to further unite the two organizations.
Under the new brand, the Winston-Salem, North Carolina academic medical center and health system is now named Atrium Health Wake Forest Baptist.
"This is another milestone in our journey to come together for the benefit of our patients and the communities we serve," Julie Ann Freischlag, FACS, FRSCE, MD, CEO of Atrium Health Wake Forest Baptist, dean of Wake Forest School of Medicine, and chief academic officer for Atrium Health said in a statement. "We were pleased we were able to retain our legacy brand, which is so important to our region, to Winston-Salem, and to our affiliation with Wake Forest University."
Atrium Health acquired Wake Forest Baptist Health in October 2020, with Wake Forest School of Medicine becoming the academic Core of Atrium Health, expanding the enterprise to a 42-hospital academic health system serving communities in four states: North Carolina, South Carolina, Georgia, and Virginia.
"People in the North Central and Western North Carolina will soon see our new brand rolled out in advertising and marketing materials, followed by signage and other types of branding in all locations over the next year," Denise Potter, vice president and chief communications, marketing, and media officer for Atrium Health Wake Forest Baptist said in a statement.
The new branding will feature Atrium Health's Tree of Life logo. According to Potter, each of the logo's seven tree branches represents a "guiding principle" of the organization, including gentleness, generosity, humility, prudence, wisdom, kindness, loyalty, and courage.
Editor's note: This article was updated on 9/9/2021.
Deborah Hayes details her career journey, speaks on the health system's culture, and offers an inside look at the hospital's COVID response.
For the past 34 years, Deborah Hayes, RN, MS, MSN, MBI, MBA, NEA, BChas, worked at The Christ Hospital Health Network, where she has climbed the ranks from a student nurse aid to leading the Cincinnati-based health system.
Over the years, The Christ Hospital has received numerous accolades during Hayes' tenure as a leader, including recognition for being one of the top 50 hospitals in the country and being in the top 95th percentile in patient experience.
In a recent HealthLeaders interview, Hayes shared her career journey, spoke on the health system's culture, and offered an inside look at the hospital's COVID-19 response.
This transcript has been edited for clarity and brevity.
HealthLeaders: Your journey started at The Christ Hospital as a student nurse aide and critical care nurse. Can you detail what your journey has been from then to where you are today?
Deborah Hayes: I started here in 1987 as a student nurse aid, I graduated from nursing school in 1989, and I started my career as a nurse in the critical care units here at The Christ Hospital.
During the time I was a nurse there, I also became the director of what was then called "the critical care nurse residency," which was a training program that they had created back in the late 1980s, because there was a huge nursing shortage in Greater Cincinnati. The Christ Hospital had built the program so new graduates could go straight into the ICU and practice. It was successful and we still have it to this day. It's called the "nurse residency program" now.
As part of my career progression, in 1996 I became a manager and progressively was given additional responsibilities over multiple units in the cardiac care units, the cath lab, and cardiovascular services.
Around 1999 I became a director of nursing, and then in 2003 I became the chief nursing officer for about 12 to 13 years. During that time when I was chief nursing officer, in a dual role I was the chief information officer for the organization. That was during a time when our health system was splitting apart and there needed to be a leader over our information technology systems and processes.
Subsequent to that, I took on some additional responsibilities, hired a chief information officer, and then became the chief operating officer and the chief nursing officer in a combined roll. In 2015, I hired a chief nursing officer because our health system was continuing to expand, and we needed to allow nursing to have a singular voice and leader. I remained the COO until October of 2020, when I was named interim CEO for the health system, and then I was formally appointed to the president and CEO role in May of 2021.
HL: What aspects of the organization made continue your career journey there?
Hayes: The organization has a culture of development, a culture of opportunity, a culture of excellence, and those are the kinds of things that are attractive to any employee because you have the ability to be proud of what you do.
Our hospital is the most preferred hospital in greater Cincinnati and has been so for about 23 years. US News & World Reportnamed us among the top 50 hospitals in America for seven years in a row; we're number one in the city, number four in the state, and our cardiology program is now number 47 in the country. We have exceptional physicians here, exceptional nurses. We've been Magnet® designated three times.
Those are the kinds of things that you're proud of as an employee, and then as you become a leader, you get to see the extraordinary work from a different lens. I love this organization, its reputation in the community is amazing, and I'm proud to be part of it.
HL: What strategic initiatives does The Christ Hospital have going on that you're excited about?
Hayes: We have been known as the region's heart hospital for as long as I have been in this organization, and we have several exciting programs that we are initiating here in the cardiovascular space. We have several Centers of Excellence Contracts, direct-to-employer contracts that we're working on. We have a precision medicine program that we launched about two years ago and that is an extraordinary program.
Our physician division and our ambulatory capabilities continue to expand. We have about 400 in our physician division now, that's physicians and advanced practice providers and that continues to grow. We're expanding primary care and providing specialty programs in oncology, musculoskeletal, and women's services to serve the community.
HL:What was your experience transitioning from COO and interim CEO to permanent CEO in May 2021?
Hayes: With every opportunity that one gets presented in their career, there are different doors that open because of your willingness to step up and take on a new challenge. In the middle of a pandemic, it's important to have strong leadership with operational skills to lead through it. I always think of it as the right person at the right time, and I think I was it.
The transition into the CEO role has been rewarding. You get to see a different lens and your focus becomes more community focused, it becomes more externally focused, but yet you still have to be strategic with where the organization is going. You also have to be organizationally savvy to enable and empower your team.
HL:How is The Christ Hospital Network working to combat COVID and the delta variant?
Hayes: It's very unfortunate. We built a playbook, just like everyone else did back when the pandemic was new, and then used that playbook successfully as we've experienced these waves. This wave is a little bit different. We do have a playbook and that is helping us to manage through the day-to-day operations, but the resilience of our staff and the emotional toll that this is taking on our physicians, our registered nurses, and quite frankly on all of our staff regardless of their role here is quite extraordinary.
I liken it to a war that never ends. You have to be able to bring in fresh troops sometimes to give those who are on the front lines a break from the catastrophic loss of life that they see. Unfortunately, that's not always possible in a pandemic. Our focus is on how we support our staff, physicians, clinicians, and nurses to bolster their resiliency, bolster their emotional reserves, so that they can continue to care for the patients.
HL:What do you want to say to those who haven't received the COVID the vaccine yet?
Hayes: The scientific evidence is emphatically positive, and the science doesn't lie. This is a life-saving vaccine. This pandemic can come to an end as long as all of us do our part as citizens of this great nation, and choosing to get vaccinated is one of those things.
Brian Colburn, senior vice president of corporate development and strategy at Alegeus, spoke with HealthLeaders about the steps that consumers, employers, and payers can take to mitigate this situation.
A recent study conducted by West Health and Gallup found that one in six working adults with employer-sponsored healthcare stay in a job they want to leave, in fear of losing their health insurance benefits.
According to the study findings, "Approximately 158 million people, or more than half of the U.S. adult population, receive health insurance via their own employer or the employer of a household member."
This means 16% of workers who remain in their jobs for health insurance are reluctant to find a new job, because the benefits frequently extend to other individuals in their family.
The study revealed that this fear is most pronounced in Black workers, with 21% of them staying in a job they want to leave in fear of losing their health insurance benefits. Additionally, 16% of Hispanic workers and 14% of White workers are in a similar situation.
Additionally, workers who earn under $48,000 a year are 28% more likely to stay with their job for health benefits, as opposed to 10% of those who earn $120,000 to $180,000 a year.
Brian Colburn, senior vice president of corporate development and strategy at Alegeus, spoke with HealthLeaders about the steps that consumers, employers, and payers can take to mitigate this situation.
This transcript has been edited for clarity and brevity.
HealthLeaders: What can consumers do to get the best of both worlds, meaning have a job they want, while also receiving affordable healthcare coverage?
Brian Colburn: More and more people are getting smarter around the healthcare element earlier in conversations with employers. In the old days, you would wait until you had an offer, and then you would [ask] what type of health insurance [they] offer. It is important to understand where you are in your existing plan and what the new plan is, so you can understand what costs you're going to have to bear in the middle of the year, for example.
Consumers can start to ask questions around the Individual Coverage Health Reimbursement Arrangements (individual coverage HRA) model. A lot of newer companies that are being founded by Millennials are talking about shifting away from group insurance and more to the individual coverage HRA. When you get into that model, it gives you a lot more flexibility as an individual to switch jobs because your health plan goes with you.
A lot of people say, 'it's not going to happen'. My view is the world is always searching for equilibrium. What you see in healthcare, it's far from the natural state, but that is the gravitational pull. Is [the switch to an individual coverage HRA model] going to happen in the next year? Probably not. Is it going to happen in the next 10 years? Almost certainly, because it's hard to defend a system that doesn't make sense given today's more transient workforce. It gives the consumer the opportunity not just to move between jobs, but to get a health plan that's best for you, not the one that's the best fit for the 500 employees at your current company.
HL: What can employers and Payers can do to help consumers in this situation?
Colburn: The best thing that they can do is to help consumers understand the issue of deductibles and mid-year plans and what it means for them. Often, what happens is you don't realize that your deductible starts all over when you start the new job until you get there. It can be helpful in terms of avoiding surprises, but it can be harmful in terms of adding to the financial pressure people feel not to make a move.
For employers, the thing that they could do is offer an individual coverage HRA plan. But the reluctance they're going to have, particularly the big employers, is they're going to view that as a way to make it easier for employees to be more transient.
The question becomes, why won't employers fight this individual coverage HRA plan, why would any of them would adopt it? Here's why I think they will. If you look at retirement, 30-40 years ago, most people had a pension plan. It's a defined benefit because you know exactly what you're going to get. They moved that to a 401k which is a defined contribution [where] the company says, 'I will tell you what I'm going to put in, but ultimately, when you retire, if it's not enough, that's on you as the employee.'
Healthcare is moving in that direction as well. If you look at High Deductible Health Plans, and frankly any plan, more and more of that incremental burden is shifting to the consumer. A lot of employers are saying 'look, I want to get out of the health care business, because I don't know year to year whether my premiums are going to go up by 2% or 10%, and so it's hard to plan.'
In the individual HRA plan model, they can just say, 'look, we're going to give you $12,000 a year to put toward medical insurance, and we're going to increase that $12,000 by the amount of inflation each year. But if premiums go up by 10%, that's on you as the consumer to bear that additional burden.' For a lot of employers, that is an attractive part of this extra model. They have the stickiness, but they get more control over their budget and the cost of health care over time.
Halee Fischer-Wright, MD, shares her career journey and her experience leading as a woman physician and CEO, as well as advice for aspiring future leaders.
Editor's note: This conversation is a transcript from an episode of the HealthLeaders Women in Healthcare Leadership Podcast. Audio of the full interview can be found here.
Halee Fischer-Wright, MD, is a well-known business consultant, physician leader, and president and CEO of the Medical Group Management Association (MGMA). She also co-authored Tribal Leadership, a New York Times bestseller, and authored Back to Balance: The Art, Science, and Business of Medicine.
Before joining MGMA in 2015, Fischer-Wright served as chief medical officer for Centura Health's St. Anthony's North Medical Center in Colorado. Prior to that she served as lead physician and then president of Rose Medical Group in Denver. She started her career as a practicing physician.
Recently, Fischer-Wright spoke with HealthLeaders about her career journey and her experience leading as a woman physician and CEO, as well as shared advice for aspiring future leaders.
This transcript has been edited for clarity and brevity.
HealthLeaders: How would you describe your leadership style and how has your background as a physician impacted your style?
Halee Fischer-Wright: People's leadership styles don't traditionally stay in one domain. When I first started as a physician leader, I would describe my style as autocratic. I think that's how, as physicians, we're often mentored, because we're taught that we're leaders, but we're not taught about leadership. You're tasked with making decisions right off the bat.
As my career path has moved me into leadership positions, my natural gravitation was toward more of a transformational style. In other words, I was always thinking about the future, I wanted to change everything. I was always moving the goal line farther and farther ahead. For people that work with you, that can be a real challenge.
As I head into the middle part of my career, I want to be more of a coaching style. I see that I'm making that transition between transformation and coach style. What I mean by that is identifying the unique traits in my staff and giving them the opportunities to express their strengths in a way that benefits the enterprise. That's a win for our employees. It's also a win for the enterprise.
HL: Health organizations are making the difficult decision on whether to mandate vaccinations for the workforce. What advice do you have for those leaders on making this decision?
Fischer-Wright: Almost all the medical societies and clinic clinical entities have suggested and signed up together to mandate vaccines for clinical settings. The challenge that I have to acknowledge is, because I am a traditionally trained physician, I am incredibly biased for the vaccine for our clinical setting for mandatory vaccination in people delivering clinical care.
I also say on the other side of my mouth, my organization is an administrative organization. We've struggled with the decision, should we mandate vaccination or not? Ten percent of my staff have not received vaccines, and not for reasonable medical reasons; they're not immunocompromised, pregnant, etc. But one of the things we're faced with is the economic reality of if we mandate our vaccine, then we may lose staff members.
What I recommend is asking, "Do you think it's the responsible thing to do to mandate vaccination?" If you're in an administrative facility, you'd have to decide what are the pros and the cons, and ultimately, what is the right thing to do?
HL: Prior to the pandemic, healthcare workers were feeling burnt out and healthcare organizations were facing staffing shortages. This of course has been exacerbated by the COVID-19 pandemic. What advice do you have for hospitals and health systems that are facing decreased staffing levels and increased burnout?
Fischer-Wright: One thing that I'm talking about quite a bit in media interviews is there's no trend that we're seeing now at this phase of COVID that we didn't see before COVID hit the world. What we have seen, though, is an increase in the velocity of those trends, and certainly burnout is one of them.
Often when you do a deep dive into burnout, besides being overworked and working too many hours, you take a look at the jobs that people are doing and how much of that job is either redundant or unnecessary. For hospitals and health systems that are facing this, my recommendation is to reevaluate the workflow. What part of that job doesn't need to be done? Can we streamline? What are inherent redundancies and inefficiencies?
What part of those jobs can be reallocated into a technological solution that decreases the work for the healthcare provider? There are ways to implement technological solutions that are focused on end user satisfaction, which is not the traditional history of the electronic health record.
I acknowledge that the length and intensity of the pandemic in the United States has been exhausting and traumatic for healthcare professionals. Whereas a year ago, we were recognizing healthcare workers, but we're not talking about how healthcare professionals are heroes today.
A lot of times when we talk about burnout and healthcare, we talk about lifestyle. This is far more than lifestyle, we need to talk about how our expectations of our healthcare providers, which haven't dramatically changed since the 1970s, are out of alignment in a 2020 to 2030 world, and how do we build those systems to that alignment so that we don't burn out our staff?
HL: What originally drew you into working in the healthcare sector?
Fischer-Wright: I was the first person in my family to graduate from college. Neither one of my parents had gone to college. When I was a child, I was curious, I loved science. When I saw my pediatrician, who is incredibly well respected, I loved how he was a part of the family, even though he wasn't part of our family. I loved that when my mom was worried about our health, he was the person who comforted her. I loved that he was the smartest man in the room. My pediatrician was my role model. When I was in medical school, I did a rotation with my pediatrician 20-some years later, and the cool thing was he was still the smartest guy in the room.
HL: What has been your experience working as a woman physician leader and CEO?
Fischer-Wright: I'll be honest with you, it's been a challenge. At the highest echelons of healthcare, up until about five years ago, if you were a woman at a meeting, the assumption was either you were a nursing leader, or you were an assistant to one of the physicians that were present.
There was a meeting that I attended during my first year as CEO of MGMA, and two of the other attendees at this very prestigious meeting had asked me to go get them coffee, because they assumed I was someone's assistant. And that wasn't unusual.
I am convinced, and I do think that you are seeing it play out in COVID, that women bring a unique set of assets to the role of being a CEO. We all have come to understand that a little more emotional intelligence equals a lot more success in the enterprise. That's where women can show up, they can hold the enterprise responsibility in one hand, and women have perhaps a little more experience with emotional intelligence.
One of the things that I often speak about though, is women are not present in the same percentage as men, and we're not compensated the same. My husband is a physician, and I remember that with my first high executive level position, we were negotiating my salary. I basically said, "This is what this job pays, and this is my expectation." And she said, "Well, you don't need that much money, your husband's a physician." We're still navigating some of that.
HL: What advice do you have for women who want to serve in leadership roles in the healthcare sector?
Fischer-Wright: It's crucial that women participate in leadership roles in the healthcare sector. I think it's crucial because we are going to have to redefine what healthcare is post-COVID, where is that care going to be delivered, our traditional models of admitting patients to the hospital, and taking care of patients in a practice are probably going to shift over the next decade to 20 years. The creativity, innovation, emotional intelligence, and leadership that women can bring to that conversation are crucial for us to be successful in navigating those transitions. I encourage any woman who is willing to pick up the mantle of leadership; I heartily encourage them.
The one piece of advice that I have given even to women in my own organization is there is something to learn from men, and that is, do not assume that you're going to be automatically recognized for the work you do. You have a personal brand and you do have to promote your personal brand.