Seema Verma, former administrator of the Centers for Medicare & Medicaid Services, shares what drives her to work in healthcare policy, her goals while serving on the board of directors for both Lumeris and Monogram Health, her thoughts on the Biden Administration, and advice for 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.
Since the beginning, Seema Verma’s career has been steeped in healthcare policy work.
She obtained a bachelor’s degree in life sciences from the University of Maryland, College Park, as well as a Master of Public Health, with a concentration in health policy and management, from the Johns Hopkins School of Public Health.
In her early career, she served as vice president of the Health and Hospital Corporation of Marion County and worked at the Association of State and Territorial Health Officials in Washington, D.C. In 2001, she founded a health policy consulting firm, SVC, Inc., an organization she was a part of until serving as Administrator of the Centers for Medicare & Medicaid Services (CMS) under former President Donald Trump from 2017 to 2021.
Now, she serves as a health policy expert, consultant, and board member for both Lumeris and Monogram Health.
In a conversation with HealthLeaders, Administrator Verma shares what drives her to work in healthcare policy, her goals while serving on the board of directors for both Lumeris and Monogram Health, her thoughts on the Biden Administration, and advice for future leaders.
This transcript has been edited for clarity and brevity.
HealthLeaders: What originally drove you to work in healthcare policy and what has kept you in this line of work?
Seema Verma: Healthcare impacts every single person in some way, even if you're healthy. [Healthcare is] a $3 trillion industry, it's complex and convoluted. But you can always count on healthcare to never being boring. I am always learning something new.
The other thing is that when you have an accomplishment, when you figure something out, you feel like you are impacting somebody's life. There's an old saying, ‘If you don't have your health, you don't have anything.’ That's the most important thing for every person.
HL: In early April, you joined the board of directors for Lumeris, a value-based care managed services operator. Why are you passionate about value-based care models and what are you hoping to accomplish while serving on the board?
Verma: What I like about value-based care is that it tries to get at the root of some of the problems that we have in our healthcare system today. We have a system that pays for sick care … and doctors are paid for volume or the services that they provide. Value-based care says 'Let's change the financial incentives here. Let's tell providers that we're going to pay them on the basis of cost and quality.' Essentially, they're at risk and so they're going to start making the types of investments to keep people healthy.
Lumeris is not just a Medicare Advantage plan, they're working with providers on the frontlines to implement value-based care, giving them the technology and data to understand their patients better, so that they can provide more coordinated seamless care.
It's the same thing with Monogram. They are focused on chronic kidney disease. Kidney disease in our country is one where the quality is concerning. You have a lot of people that are on dialysis and Medicare pays a lot for these services, but there are alternatives. People don't have to go into a dialysis center two or three times a week, there's home dialysis. If we do a good job on the front end, hopefully, we're preventing a person from getting to that stage.
Both of those companies are focused on value-based care and improving health outcomes. They're creative, innovative, and driving results at the patient level.
HL: Outside of addressing the COVID-19 pandemic, what are your thoughts on the Biden Administration's healthcare agenda thus far?
Verma: [The Biden administration] is focused on the vaccine rollout; we're all anxious for life to return back to normal, and so I appreciate the focus on that. There has also been a lot of emphasis on health equity and addressing healthcare disparities; those are long-standing issues that we face.
One of the things that I'm concerned about is that we have to still go back to addressing some of the key problems in our healthcare system, [including] addressing the drivers of healthcare costs. It's not just about expanding coverage. If you're expanding coverage, you're dealing with something more in the short-term, but you're not addressing the underlying issues of why costs are going up in our healthcare system.
There have been some delays on some of the models that have come out from CMS, which were promoting value-based care, [and] kidney care, which has real implications for patients. That model, which was delayed, was intended to promote home dialysis and create incentives for improving quality and transplantation rate. Delaying those types of things has a real impact on the lives of patients.
The other thing that is important is price transparency. The Trump administration had made some significant regulatory changes to require hospitals to display their prices. This is a significant effort that is important to patients, and so I hope that the Biden administration will be strong in enforcing the guideline.
Ultimately, we're seeing a lot of moves on the expansion of the coverage programs and trying to put more people on public programs. It's understandable for people, especially in the short-term, if they're without coverage, but I think it's important that we're focusing on costs, whether it's drug pricing, whether it's value-based care, whether it's addressing the healthcare monopolies and the lack of competition in the marketplace. There must be a parallel strategy, otherwise, costs continue to go up, the government continues to pay more, and employers [also struggle] to cover their healthcare costs.
HL: What has been your experience as a woman working in healthcare policy?
Verma: Generally, I would say that my experience is not very different from other leaders, including my male counterparts. There are also increasingly more women in leadership positions, so I don't think that I'm a unicorn anymore.
We must be careful in suggesting that women are different when it comes to leadership, and if they're different, then that means that they're having different experiences, and they could be producing different results. That suggests that perhaps women are not capable of doing what men can do, and I don't think that that's true at all.
As a woman, I want to make it very clear, I don't think that I need any special treatment or support, and I don't want anyone to hire me, because I'm a woman or a minority. I only want to be considered on the value of my work, what I bring to the table, and what I can get done.
HL: What advice do you have for women and others who want to serve in leadership roles in the healthcare sector?
Verma: When you are the leader of an organization, your job is setting the direction for your organization, and you're making decisions all the time based on that direction. It's important for all leaders to have what I call a 'decision framework.' It's an internal checklist so that when things difficult decisions come to you, you can look at your checklists and say, 'Does this meet the criteria?'
When I was at CMS, my criteria were all about putting patients first. ‘How is this going to impact patients? How is this going to impact the program?’ I would be looking at the finances, the operations, I'd be thinking about providers and what the reaction was going to be. It's important to have that framework and understand what those priorities are.
It's important to always listen to all sides of the story. Those that are positive about the direction that you're going in, but also those people that don't agree. You learn a lot from the naysayers. When I think about my best work, it's when I have been able to listen to the other side and take their viewpoint into the final product.
The other part of that is, once you make a decision and once you set that goal, there's always going to be the naysayers. You have to learn to keep going in the face of adversity. If you've made your decision with that decision framework, and you feel strongly that this is the right thing to do, you can't get deterred by those people that are trying to knock you down. You must stay focused, not only for yourself and what you're working on but for your entire team. That is the essence of leadership, to keep everybody moving in the right direction, despite that outside pressure.
Sean Duffy, CEO of Omada Health, speaks about the company's vision, the plan behind the creation of the Insights Lab, and how other recent initiatives were launched.
Omada Health, a San Francisco-based digital care company, recently announced the launch of The Omada Insights Lab, a data-driven initiative to further the organization’s vision in transforming care delivery and outcomes.
This new initiative follows Omada's mission of empowering those with chronic health conditions to lead healthier lives. The Insights Lab will take Omada's data science, behavior science, clinical and product design, as well as care delivery learnings to not only apply it to their members but also share some of its results within the healthcare industry to foster innovative change.
In a recent interview with HealthLeaders, Sean Duffy, CEO of Omada Health, conveyed the healthcare technology company's vision, the plan behind the creation of the Insights Lab, and how other recent initiatives were launched.
This transcript has been edited for clarity and brevity.
HealthLeaders: Why does Omada want to transform healthcare delivery and outcomes?
Sean Duffy: I [previously] worked in tech, then was in medical school, and I wanted to do something that combined tech and healthcare in different disciplines. The recognition when founding Omada was that we needed an entirely different approach to supporting people, especially with longitudinal care. Back then, digital health or care delivery was always viewed as the icing on the cake versus something foundational.
For a long time, we at Omada have carried a viewpoint that has gone from provocative to a frank reality of healthcare, and that was in-person care should be option B. If you can safely and effectively solve someone's care needs without dragging them into your waiting room, why on earth wouldn't you? Done right, [digital care] can broaden access, create more affordability, and be an extraordinary enabler.
This was particularly important in chronic care areas where you needed to support someone daily, not see them every three months. Early on, we sat in people's homes who had diabetes and pre-diabetes, and there was just no way that the current healthcare system was set up to help them be successful; people were just falling through the cracks.
We viewed it as a compelling business opportunity, and almost like a societal obligation, to take a crack at thinking through how digital care could be applied to these areas that are important. That was kind of the charter from the beginning and remains the charter today.
HL:Can you talk about the Insights Lab and why this innovation is needed?
Duffy: Omada has a multidisciplinary approach to care. It combines technology, data science, product and clinical design—a broad group of stakeholders. What I saw internally at Omada as we scaled were these cross-functional collaborations in the spirit of changing care, as well as improving and iterating the program. Insights Lab has an opportunity to pour even more fuel on that, because sometimes those things that you see happening in the background organically, you can use as kindling to light a fire and galvanize the effort.
There are two purposes to Insights Lab. The first is internal in the ways that we support our members; [continuing] to institutionalize this multidisciplinary approach that we've had in Omada. It's starting to become more powerful as we get more data and people.
Purpose two is to share some of the insights with the world because there are fascinating things that we've learned that we think are beneficial to care delivery and digital health.
[The Insights Lab is] going to run a dual purpose. You'll see a lot of content, insights, and things we've tested come to light in the public domain soon.
HL: What steps were needed to make the Insights Lab a reality and what are the Lab's goals?
Duffy: You must do a sanity check, [and ask] 'is this something that our teams will like, will it actually work, and is it going to improve [care delivery]?'
Step one is listening, pulling the thoughts that are executing against the craft into the design, and getting thoughts on how to do more of what you're doing already. That was the biggest step.
Step two [was setting up the purpose.] We had to come up with a vision on why we wanted to share some of what we're doing, and what purpose would that have.
Every year, we want the Insights Lab to create even speedier innovation in the way we personalize care, support our members, combine disciplines. That's the ultimate objective. In digital health, especially, if you have created all the needed pieces yourself, which Omada has, all the data is kind of connected so every single person that joins the program has a chance to make it more valuable for the next.
The number one charter for Insights Lab is to not forget that we're in a unique position where we can speed up the innovation velocity in the company.
Number two is to raise all boats and allow some of what we've learned to inspire other digital health entrepreneurs, maybe prevent them from making mistakes, and inspire other product teams that are working in clinical areas that are adjacent.
It's going to be something you and the world will be seeing even more of. It's been fun to watch the teams at Omada latch on to it and get so excited about it.
HL: What are some other strategic initiatives has Omada recently announced?
Duffy: We've made some neat announcements that are characteristic of our priorities.
We launched Physician Guided Care, which is the industry's first virtual cardiometabolic clinic [for members with chronic conditions.] Omada has great clinical capabilities in areas like diabetes. In times past, when we recognized that someone would need a medication change, one of our care teams would [tell the patient to make an appointment with their PCP and produce data for the patients to bring to the doctor.]
What we recognized after a lot of thoughtful planning is there are ways to take on, at the member’s choice, some of those needed clinical services ourselves. So then, [instead of telling them to make an appointment,] we can change medicines, inform and keep their PCP in the loop, and coordinate data and care. We can do it in minutes, rather than you having to go make an appointment, [wait, then show up to the doctors' office.]
It's a special new capability for Omada, and it's one of those where, in healthcare, there are sometimes these trade-offs between an engaging experience and cost and outcomes. Members love it because they don't have to take the time to show up at their PCPs office, and because we're leveraging digital, we can accomplish some of these clinical tasks with a great cost profile. That visit alone to maybe alter your medicine could cost the system $150 or $200.
It allows you to quickly iterate on medication approaches in chronic diseases like diabetes. By doing that fast and frequently, you can help someone get to clinical health goals far more speedily.
There's also a belief system at Omada where we think the real power of digital health comes from integration between people and technology, and clinicians and technology, versus technology alone. We just launched computer vision capabilities in our Musculoskeletal Care Experience where a physical therapist [PT] can essentially prescribe a functional test to someone [through their phone.]
They put their phone down with the front camera on, and they walk back and when they're in the bounds of the box it turns green. Based on the functional tests the computer vision measures angle function so if the PT wants to track your shoulder function, they'll have you do this functional test [that they can record and] track over time. The idea is to slowly restore shoulder function and give the PT a diagnostic tool in a way that's fun and interesting.
Those surveyed include the general population and insurance industry representatives across three "megatrends" in the healthcare market, including the COVID-19 pandemic, technology and innovation, and policy reforms.
eHealth shared findings from a research report examining health insurance trends Wednesday morning.
The survey solicited responses from the public as well as insurance industry representatives related to three "megatrends" in the healthcare market: the COVID-19 pandemic, technology and innovation, and policy reforms.
More than half of insurers don't anticipate raising rates due to the COVID-19 pandemic, the survey found, while 39% do anticipate raising rate, but by no more than 5%.
Additionally, one-third of insurers are likely to make changes to plan benefits due to the pandemic, including 88% of payers indicating that changes are likely to affect telehealth and mental health benefits. Most plans also reported a 50% or more increase in the utilization of telehealth benefits prior to the pandemic.
"COVID had an enormous impact on how Americans view the current health care landscape, and the public’s appetite for new solutions," Michael Zundel, the national director of recruiting at UnitedHealthOne, said in a statement in the report. "Many jumped at the opportunity to obtain ACA-compliant coverage [due to mass unemployment] … it's also led to an explosion in telehealth benefit utilization … [and] between the fallout from the pandemic and the current political leadership there appears to be a very good chance that the Medicare eligibility age is reduced."
Other key findings in the report from the general population and Medicare consumers include:
COVID-19
Seventy percent of those surveyed said they had received at least one COVID vaccination.
Among Medicare beneficiaries, over 82% had received at least one COVID vaccination.
Most respondents said COVID vaccines should not be required by law while 53% said domestic and international travel should require proof of vaccination.
Technology and innovation
Almost half of those surveyed said that "private enterprise" does a better job than the government regarding healthcare innovation, 20% said the government does a better job.
While 53% of Medicare beneficiaries said that "private enterprise" does a better job than the government regarding healthcare innovation, 14% said the government does a better job.
Public policy reforms
Three-fifths of those surveyed are in favor for expanding Medicare access in some form; 28% said Medicare should be available to all Americans, 18% said the eligibility age should be lowered to 60, and 14% said adults ages 50 or older should be able to buy in early.
Nearly half of the respondents said Medicare should continue to "be run through public and private cooperation between government and insurers," while 16% said the government should run it alone.
About 75% of those surveyed said the federal government should negotiate directly with drugmakers to lower costs; 86% of Medicare beneficiaries feel the same.
Both provider organizations are managed as part of an affiliation agreement with West Des Moines, Iowa-based MercyOne, where the system offers administrative support and additional resources as needed.
Catherine Hillestad will join Adair County Health System in Greenfield on July 7, where she will lead the rural hospital and clinics.
Hillestad has experience in leading community and rural healthcare systems, having previously served as the practice administrator at The Iowa Clinic in Des Moines. Prior to that, she served as interim CEO for Davis County Hospital in Bloomfield, which is also an affiliate of MercyOne.
"We look forward to welcoming Catherine. She brings a great deal of energy and understands the challenges for rural hospitals," Willard Olesen, chair of Adair County Health System board of trustees, said in a statement. "Catherine knows what is needed to continue to deliver quality care in Adair County, which is vital to our community."
Joseph Mangiameli will join Ringgold County Hospital in Mt. Ayr on July 26.
He is a registered nurse by training, with over two decades of clinical experience in cardiovascular care, intensive care, emergency care, and public health. Additionally, he served in leadership nursing roles for the United States Army Reserves and the Nebraska National Guard.
Most recently, he served as market vice president of operations for CHI Health in Omaha.
"We are very excited to welcome Joseph," Kathi Braby, chair of Ringgold County Hospital board of trustees, said in a statement. "In addition to his administrative roles, Joseph’s hands-on experience in the medical field gives him a great understanding of employee needs."
In a move to advance diversity in healthcare, the Nashville-based healthcare provider will allocate funds over the next three years to institutions in communities near its hospitals.
HCA Healthcare announced Thursday afternoon that it will be investing $10 million in Historically Black Colleges and Universities (HBCUs) and Hispanic-Serving Institutions (HSIs).
In a move to advance diversity in healthcare, the Nashville-based healthcare provider, with 196 hospitals over 20 states and the United Kingdom, will allocate the funds over the next three years to institutions in communities near its hospitals to "create a more diverse pipeline of healthcare professionals and leaders," according to a company press release.
This announcement follows HCA's announced sales of hospitals to Piedmont Healthcare and AdventHealth earlier this month, marking a series of moves to increase the organization's financial flexibility for future investments and initiatives.
"HCA Healthcare serves diverse communities across the country, and we know our ability to continue to do that most effectively depends on a workforce that reflects the diversity of our communities," Sam Hazen, CEO of HCA Healthcare, said in a statement. "We are eager to build productive and collaborative relationships with many of the nation’s leading HBCUs and HSIs to attract Black and Hispanic/Latinx candidates into the many exciting career paths in healthcare."
As part of the new initiative, HCA will be offering opportunities for students who are interested in joining healthcare, including internship programs, investments in curriculum development, and scholarships for those students.
"Our partnerships with HBCUs and HSIs allow us to help bridge the gap in Black and Hispanic/Latinx representation in healthcare leadership positions, a challenge our industry faces as a whole," Sherri Neal, chief diversity officer of HCA Healthcare, said in a statement. "Advancing the diversity of our talent pool will ultimately help us to deliver more equitable, culturally competent care."
The announcement comes only three months after the disbandment of Haven Healthcare, a joint venture between Amazon, Berkshire Hathaway, and JPMorgan Chase.
JPMorgan Chase announced the launch of Morgan Health, the company’s new healthcare venture, Thursday afternoon.
The initiative, which will aim to tackle "quality, efficiency, and equity" for employer-sponsored healthcare, will be led by CEO Dan Mendelson.
The announcement comes only three months after the disbandment of Haven Healthcare, a joint venture between Amazon, Berkshire Hathaway, and JPMorgan Chase.
"We need to try to make the U.S. healthcare system work better," Jamie Dimon, JPMorgan Chase chairman and CEO, said in a statement. "We have the best healthcare in the world in terms of doctors, hospitals, pharmaceutical and medical device companies, but we certainly do not have the best outcomes. Many of our problems have been around for a long time and are not aging well. There are ways we can make significant improvements and we intend to take a disciplined approach to solving some of these issues in a meaningful way."
Haven was first announced in June 2018 and led by Dr. Atul Gawande until he stepped down in May 2020. Speculation around why Haven failed centers on a lack of traction towards goals, unfocused execution of organizational strategy, a high turnover rate in the C-suite, and the fact that disrupting healthcare is not an easy feat.
But JPMorgan Chase isn't ready to throw in the towel yet.
Initially, Morgan Health will focus on serving JPMorgan Chase employees and families, while also being a model for other employers. JPMorgan also stated that it aims for Morgan Health to partner with other organizations in a step to make a bigger impact on healthcare.
The health venture has outlined three areas in which it will focus on:
Accelerating health system improvement through a $250 million capital investment towards healthcare solutions and system improvements for JPMorgan Chase employees, and beyond.
Improving healthcare benefits for its employers and others through strategic initiatives and collaboration
Promoting healthcare equity through the communities and employees it serves
"JPMorgan Chase has been focused on improving healthcare for its employees for many years," Mendelson said in a statement. "We are going to take what we’ve learned and accelerate healthcare innovation in the employer-sponsored healthcare market, partnering with and investing in companies that share our goals, and measuring key health outcomes to show what works."
David Dill, president and CEO of LifePoint Health, and William Fulkerson Jr., MD, executive vice president for Duke University Health System, detailed how the joint venture continues to improve the quality of care provided, along with the strategies they hope to implement in the future.
The joint venture currently operates across 14 hospitals across four states: North Carolina, Virginia, Pennsylvania, and Michigan. Duke LifePoint partners with community hospitals through acquisitions, shared ownership, and joint ventures to help the organizations reach success around quality care and safety, physician recruitment and retention, and the ability to expand services.
Prior to the joint venture’s founding in 2011, Duke and LifePoint partnered to increase the quality metrics of Maria Parham Health, a hospital that LifePoint had acquired in North Carolina, due to a pre-existing referral partnership, according to William Fulkerson Jr., MD, executive vice president for Duke University Health System. He also noted that Maria Parham, the first hospital to join Duke LifePoint, saw its quality became best in class and garnered the attention of other hospitals in the area.
Fulkerson and David Dill, president and CEO of LifePoint Health, recently spoke with HealthLeaders to reflect on a decade-long partnership, how the joint venture continues to improve the quality of care provided, and what strategies they hope to implement in the future.
Starting small
"Smaller community hospitals began reaching out to us … and wanted to know if Duke would acquire them," Fulkerson said. "We run great hospitals, but we don't run smaller community hospitals. It occurred to us that this was an opportunity, perhaps, to introduce LifePoint to these organizations, and to think about what a joint venture would look like between Duke and LifePoint."
Even back then, LifePoint had a strong tradition of running successful hospitals in non-urban communities, Fulkerson said. Duke felt that by leveraging LifePoint's operational and financial strength with its strength in program development, safety, and quality, the two organizations could make this joint venture work.
"It's in our vision statement that we are a quality-driven health system, and realizing that being able to deliver safe, high-quality care in a smaller community is absolutely necessary to the success of the enterprise," Fulkerson said.
"This partnership wasn't founded initially to just go out and buy hospitals or contribute hospitals into it," Dill said. "It was what Dr. Fulkerson said: the relationship started to help improve care at the bedside. I think because of that, it had a great chance of success from the beginning."
One of the avenues to success includes a joint venture board, in addition to the standard hospital governing boards. Both Fulkerson and Dill participate on the board, which reviews results, strategies, and identifies new ways to deploy capital into the future.
The two systems also operate a Quality Oversight Committee as part of their program, which is made up of a group of clinicians from LifePoint, to review the quality results of each of the Duke LifePoint hospitals.
"At least once a year, every one of our CEOs is accountable for communicating their results, follow-up items from the previous meeting, and also taking feedback to continue to push their organizations forward," Dill said.
Fulkerson added that the joint venture also employs patient safety officers, a set of staff primarily comprised of registered nurses from Duke that work at LifePoint hospitals.
Creating success over the last decade
Dill said that of the joint venture achievements, he's most proud of is a 39% reduction in preventable harms between 2011 and 2020. Some additional highlights include:
A 62% reduction in hospital-acquired pneumonia
An 85% reduction in hospital-acquired urinary tract infections
A 62% reduction in venous thromboembolisms
Duke LifePoint has also seen "significant improvement because of this framework within our national quality program," Dill said.
"That's just proof positive of what we're about," Fulkerson said.
The joint venture also became a member of the Hospital Engagement Network (HEN) through the Centers for Medical and Medicaid Services, Fulkerson said. Organizations involved in the network help identify solutions that have reduced hospital-acquired conditions and share those learnings with other healthcare organizations.
"We had the largest reduction in preventable harms of anybody participating in the HEN then. In fact, we were recognized with The Joint Commission’s John M. Eisenberg Patient Safety and Quality Award in 2018," Fulkerson added. "It's a prestigious national award for achievement and patient safety and quality, and we're proud of that."
Duke and LifePoint have also invested over $1 billion of capital into the joint venture.
"Those are investments in the communities where we operate, but what we're building and what we're investing in is growing and expanding service lines in each of these companies," Dill said. "Revenue started at zero, and now we're up to around a little over $1.5 billion per year in annual revenue is rolling through the partnership."
Duke LifePoint also brought clinical affiliations to the communities, through the Duke network, Dill said. Depending on the needs of the community, Duke can provide clinical teams for cancer, telestroke, heart programs, and more to the hospitals.
"There are reasons some of these types of partnerships are successful and some aren't," Dill said. "We haven't agreed on everything, but we work through it together."
He added, "When I think about the real reason the partnership has been successful, there's a lot of trust and respect for both organizations. But that shared vision from the very beginning is a great reminder that if you start with that, then everything else just gets a little bit easier."
Future strategies
Both leaders are bullish on the prospects for the joint venture, with plans to continue to bring quality care and patient safety to hospitals in the region.
"Continuing quality is a journey; you're never done," Dill said. "We're looking for ways to continue to grow the footprint of hospitals or other ancillary services that support changes in the delivery of care. There are a lot of lessons learned through COVID, and one of them is people may want to receive care a different way, and we need to be ready for that."
He added that there may be investments in technology due to the changes in patterns of how patients receive care.
"We'll continue to look for acquisition opportunities going forward, where we think we can bring a unique product to the table for organizations with a tremendous track record of success," Fulkerson said. "I've been impressed with Duke LifePoint's and LifePoint's ability to build on the communities we serve today with more vertical integration and expansion of physician services in those organizations that just serve to bring more and more services to the communities there."
He echoed that Duke LifePoint made about 10 years' worth of progress in virtual healthcare and telehealth in six months during the COVID pandemic, and the systems plan on continuing to assess their strategy there.
Dill added that those who are interested in building partnerships need to account for how much work it takes and that if leaders go in with a shared vision, success is achievable.
"I don't think there will ever be another partnership like this one," Dill said. "The amount of time that we spent together, the work that we've spent, what we have built together, it is the barometer of all partnerships."
Richard Simone, CHC, CEO of Central Consulting and Contracting, shares how the pandemic impacted healthcare construction and what trends to expect in the future.
Just as the COVID-19 pandemic affected hospitals differently across the country, the same is true with healthcare construction across the industry.
While some organizations had to cancel projects or put them on pause due to the pandemic's financial impacts, others found it more financially feasible to go ahead with their planned projects.
CHRISTUS Health announced in February that the healthcare organization would be building a new corporate office, forgoing a building lease, and having the flexibility to design it from the ground up. Additionally, Allegheny Health Network built a new hospital during the pandemic, slated to open in September.
Richard Simone, CHC, CEO of Central Consulting and Contracting, recently spoke with HealthLeaders about how the pandemic impacted healthcare construction trends, how various provider organizations were affected differently, and what trends to expect in the future.
Simone said that while some non-critical construction projects were put on hold, those same organizations then initiated renovations of existing patient care units to create more ICU beds.
"We saw both things happening in a 'one door closing, another door opening' kind of scenario," he said.
While some healthcare organizations were too far along in certain construction projects to pause them, he noted that others accelerated existing construction schedules, working overtime to bring services online sooner to have extra room when increased volumes were expected.
"Every health system is different and unique," Simone said. "Some of them have projects that are critical to their master plan and overall financial well-being … so those projects have no choice but to move forward, while other systems have put projects on hold or canceled projects completely."
According to Simone, some projects such as medical office buildings and doctors' offices, were either put on hold or canceled altogether as they were less critical in serving COVID patients. He added that some of the paused projects that are coming back have been value-engineered for a smaller scope of work due to the financial impacts of the pandemic.
Anticipating future trends
While no one knows exactly what will happen with healthcare construction trends in the future, Simone shared a few insights into what he's observed and heard from others in the industry.
"I think that what we're going to see are more health systems moving out to the communities and trying to get healthcare more local to the rural areas," Simone said. "One of the things that [patients] experienced was the travel time to get to the acute care hospitals, and the distance they are in some rural areas."
During the pandemic, rural communities also experienced an increase in racial and ethnic health inequities, leading to more death.
Simone also mentioned that some health systems are planning on building micro-hospitals and ambulatory facilities closer to their "catchment areas. While telemedicine and virtual care are also experiencing mainstream popularity due to the pandemic, Simone said this won't necessarily have a negative effect on construction trends.
“The pandemic has proven that telemedicine can work for a lot of things, especially primary care visits. I'm hearing that there's going to be a big influx of telemedicine going forward and most are planning for telemedicine departments in the future," Simone said.
Organizations may also create smaller, more accessible locations with social distancing still being utilized, or larger emergency departments with more spatial concerns between patients and visitors, he said.
Currently, architects are talking about making separate entrances of the hospital to separate patients with infectious diseases from those who are not infectious, Simone said. He concluded that hospitals are just starting to get back into finalizing construction plans they had before the pandemic and it's been a slower takeoff than what was anticipated.
"I thought this was going to happen closer to the end of last year or in January … it's going to start picking up a little bit more here in the third quarter, not as robust in the second quarter as we had anticipated," he said.
This deal marks HCA’s final divestiture in the areas surrounding Atlanta and erasing the organization's presence in northwest Georgia.
HCA Healthcare has signed a definitive agreement to sell Redmond Regional Medical Center to AdventHealth, the healthcare provider announced Thursday.
The 230-bed hospital based in Rome, Georgia will be sold for approximately $635 million. Pending customary regulatory approval, the transaction is expected to close in the third quarter of 2021.
For its part, AdventHealth welcomed the transaction and stated that there would be a "seamless transition" for the hospital’s team members.
"We are excited about the opportunity to offer our unique promise of whole-person care and look forward to working with and caring for the team members, physicians, and residents of northwest Georgia and the surrounding area," Terry Shaw, CEO of AdventHealth, said in a statement. "By affiliating with Redmond Regional Medical Center, we will be well positioned to continue providing excellent care in the community."
This deal marks HCA’s final divestiture in the areas surrounding Atlanta and erasing the organization's presence in northwest Georgia.
This announcement comes almost two weeks after HCA announced plans to sell four Georgia hospitals in Piedmont Healthcare for $950 million, and three weeks after the Nashville-based for-profit hospital operator recorded a net income of $1.4 billion in Q1.
According to the press release, this move is setting up the organization's strategic value by "increasing financial flexibility" for future investments and initiatives in HCA Healthcare's core markets.
In February, HCA agreed to pay $400 million for 80% of home health and outpatient company Brookdale Health Care Services. At the end of March, NorthCrest Health agreed to join TriStar Health, an affiliate of HCA.
Bill Gassen, who assumed the CEO position near the end of last year, shares what it was like being elevated during the pandemic, how COVID-19 altered the organization's focus on growth strategies, and why the organization is poised to transform rural healthcare delivery.
Sanford Health experienced internal and external turbulence towards the end of 2020.
Like many hospitals and health systems, Sanford faced significant clinical and financial upheaval related to the COVID-19 pandemic. Additionally, longtime CEO Kelby Krabbenhoft issued an email to Sanford employees stating that he would not be wearing a mask following his recovery from COVID-19.
He resigned shortly thereafter, ending a more than two-decade tenure at the integrated, nonprofit health system based in Sioux Falls, South Dakota. Weeks after Krabbenhoft’s resignation, Sanford and Intermountain Healthcare suspended an $11 billion plan to merge.
Bill Gassen, who worked for Sanford for over nine years in leadership roles including vice president of human resources integration and corporate services, chief human resources officer, and most recently chief administrative officer, assumed the position of CEO and immediately took charge of the organization. His focus as a leader has been on serving the system’s patients, communities, and staff while providing a steady hand after months of uncertainty.
Gassen recently spoke with HealthLeaders, where he shared what it was like being elevated during the pandemic, how COVID-19 altered the organization's focus on growth strategies, and why the organization is poised to transform rural healthcare delivery.
This transcript has been edited for clarity and brevity.
HL: How did your internal succession prepare you to lead Sanford Health?
Gassen: I was fortunate that Sanford Health has been intentional about prioritizing succession planning, which allowed for a smooth transition for me.
I've had the opportunity to gain holistic exposure to the organization starting in the legal department. I had an opportunity to provide support directly to our physicians, clinics, hospitals, and to our rural health footprint. That was the first part of my time at Sanford, which gave me an incredible grounding in the mission of the organization and the way in which we provide care for our people, patients, and the relationships that we have with our communities as well.
Moving on from that invaluable exposure, I came through the role of chief human resources officer. The organization [has] an incredible responsibility and opportunity to make sure that we're doing a great job taking care of our people so that they're able to do an incredible job of taking care of our patients.
HL:What was it like taking over Sanford during such a turbulent time and what have your first five months leading looked like?
Gassen: In many ways, the unprecedented challenges brought by the pandemic have provided clarity about our priorities moving forward. This organization, like many around the country, had to coalesce around this fight in the pandemic. It allowed us to come together and make sure that we're completely united around that fight.
Through that timeframe, I gained an increased appreciation for our physicians, researchers, nurses, the long-term care staff, and all the non-clinical employees that we have as well. Over the last year, these individuals got up with one thing in mind, and that was making sure that we did everything we possibly could to take care of our patients, residents, and communities, and make sure that we're able to win in this fight against the coronavirus.
HL: What are Sanford's growth strategies for this year and beyond?
Gassen: At Sanford Health, we've benefited significantly over the past decade or more from growth. We've added some incredible communities and well-established organizations that comprise what is Sanford Health today.
[Where we are today], growth is not a top priority for me. I want to look at growth as a tool, as opposed to an objective for us. Right now, we're focused on making sure that all of our energy and resources are concentrated around [those we serve].
If we have a growth opportunity that's presented to us that I believe is going to allow us to improve our quality, allow us to improve our safety, increase access, and expand service lines, then that's something I'll be interested in. If it doesn't do that, then we're probably going to take a pass on that. We want to make sure that any growth that we enter in the future is going to allow us to be better at what we do.
Gassen: [Intermountain is] a great organization that I have a lot of respect for and have a lot of respect for their leaders. The decision, that I made along with our board, to not go forward with that [merger] had absolutely nothing to do with Intermountain but had everything to do with Sanford Health.
What I mean by that is that Sanford Health needed to focus inward. We needed to make sure that we were doing everything we could to fully optimize and capitalize on the assets and resources that we have, to make sure that we're doing everything we could for [our communities].
As opportunities present themselves, and we've had some come forward, we have to evaluate those through that lens of [whether] it is in the best interest of our patients, of our people, and our communities.
HL: In March, Sanford announced a $300 million initiative to transform rural healthcare. What is driving this initiative and what do you hope to accomplish with it?
Gassen: One of the goals that we have at the organization is that we want to be the leading rural healthcare provider in the country. To do that, we need to make sure that we are equipped to do well in the future. One of the ways that we're able to do that is by securing the physician pipeline. Today at Sanford, we've got over 1,600 physicians and 1,000 advanced practice providers who come in every single day and provide primary care, specialty, and subspecialty care.
Through Mr. [Denny] Sanford's gift, a big portion of that $300 million is dedicated specifically to standing up eight new graduate medical educational programs, and those programs are going to allow us to have the assurance that the great physicians that we have today are going to be here tomorrow.
Physicians who train with us through their residency and fellowships end up staying with us oftentimes. It's an incredible recruitment tool for us that is going to allow us to assure those communities that the great care that they receive today is going to be there for them and for their children and grandchildren tomorrow.
HL: What other health system initiatives are you excited about for the upcoming year?
Gassen: In addition to the incredible benefit that we're going to see through the expansion of the graduate medical education programs, we have to invest back into the health and wellness of our community as well.
Mr. Sanford's generosity is allowing us to construct outdoor fields for children. We've saved for athletes of all ages, [skills], and ability to pay. We want to make sure that people know that the softball, baseball, soccer fields are going to be made available to the community. We want that to be a community asset where people come and find healthy ways to grow and expand within the community.
Beyond that, we're focused on a virtual strategy. That’s the next phase of Mr. Sanford's giving. What we intend to do is continue to expand the services that we provide today in the communities that we wouldn't otherwise be able to access.