The market tumbled and gridlock at the FTC looks to be broken. Get ready for a wild ride in the world of healthcare consolidation.
Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.
“Twenty-nine hospital CEOs exited their roles in the first three months of this year, nearly double the 15 chiefs who stepped down from their positions in the same period of 2021.”
(four-minute read)
The doctor is in. But the CEO may be out.
Whether due to retirement, ouster, opportunity or entrenched burnout, we’re in the midst of significant turnover at the top levels of healthcare.
Even before Q1 2022, healthcare executive turnover was high: The hospital sector had the fourth-highest number of CEO exits in 2021 of 29 industries evaluated in a 2021 year-end report from Challenger, Gray & Christmas. The study also found that hospital CEO departures were up 11 percent relative to 2020.
Why? There are a few possible contributing factors…
Those are some “whys.” Now let’s flip the script and consider executive transitions, as, well… an opportunity. An opportunity for the board and other leaders to evaluate and retool; an opportunity for the new leader to bring new ideas. If you’re staring down – or anticipating – an executive transition, here are just a few opportunities and challenging either/or options people will be considering, whatever their vantage point – on the board, in the C-suite or leading a marcom team.
This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.
Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.
Prior to the pandemic, hospitals spent about 4.7 percent of labor expenses for nurses on contract travel nurses. That figure grew to about 39 percent in January, according to AHA report. The current trajectory for hospital expenses isn’t sustainable.
“The dramatic rise in costs of labor, drugs, supplies and equipment continue to put enormous pressure on our ability to provide care to our patients and communities,” AHA President and CEO Rick Pollack said in the statement.
It was a dismal first quarter for healthcare providers. Of course there are some hospitals andhealth systems that are in a better spot, getting good marks from Fitch and Moody’s. But on the whole, the numbers have been bleak.
Today, we’re looking at forces currently pushing and pulling the industry and inevitably reshaping the provider landscape. The definition of success here is both idealistic and practical. It is both financial viability and the ability for a system to appropriately deliver on its mission to care for patients. We know the balance sheet must add up, and your CFOs need a clear path to sustainability, but ideals are also good.
So, let’s put the numbers aside for a moment. What will it take for healthcare providers to evolve successfully for the future?
Certainly, there’s a long way to get from today’s messy Point A to an idealistic Point Z, but a shift in what constitutes risk and a willingness to undertake hard change will be critical to sustainability – and maybe allow your CFO to sleep better at night.
Here are our bets on what factors will contribute to a system winning or losing in the new healthcare ecosystem.
Healthcare Winners
The core trait of a healthcare organization that will make it through is a recognition that creative transformation is less risky today than taking a defensive posture. Remodeling, not rearranging furniture, is needed to establish sustainable models of care going forward. Other aspects the winners should consider:
Here, it’s largely the opposite traits. If flexibility and risk-taking wins, rigidity loses. Yes, there are some factors that are tough to control or change – like serving largely susceptible populations. But doubling down on the way things have always been done will only compound those concerns.
This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.
To keep pace with consistent client growth, the national healthcare strategic communications firm Jarrard Phillips Cate & Hancock has added 11 new staff members in the first four months of the year, according to President and CEO David Jarrard.
Growth occurred across all three client advisory practices and the firm’s professional services team. Headlining the new talent are Jason Poteet, vice president of business development and Abby McNeil, vice president in the firm’s National and Academic Health System practice.
Poteet joins Jarrard Inc. with more than two decades of experience in performance improvement, revenue cycle and revenue growth strategy. Previously, he served as a client solutions leader within the healthcare provider vertical of the global technology companies Wipro and NTT Data.
McNeil is a seasoned marketing and communications expert with an extensive track record helping healthcare brands engage employees and grow market share. Immediately prior to joining the firm, she oversaw corporate communication and public affairs for CHRISTUS Health, including leading their COVID-19 response.
“These are highly-experienced, strong additions to our team,” Jarrard said. “Jason’s background helping healthcare clients identify new avenues of opportunity and strategic growth dovetail perfectly with the goals for our firm as we ourselves evolve and grow. Abby’s track record in helping provider organizations navigate the historically difficult imperatives of the past two years demonstrates her creativity, nimbleness and shared commitment to our mission to make healthcare better.”
In addition to Poteet and McNeil, the number and breadth of the new hires reflects an increasing demand for long-term strategic planning and communications engagements among health services companies, hospitals and health systems.
“While most of the operational challenges borne out of the pandemic have receded, a new wave of pressure is creating uncertainty for healthcare provider organizations,” Jarrard said.
Those pressures include the end of COVID-19 relief funds, the shortage of healthcare workers and recruiting challenges, increasingly tense negotiations between payers and providers and rising costs as part of the inflation seen across the US economy.
“All of these challenges are linked, yet each one has a distinct set of features that must be addressed,” added Jarrard. “Solving for the future is very much a matter of ensuring each leg of the stool is in place operationally, and then communicating about each element of change in a way that bolsters support for the organization both internally and externally.”
Jarrard Inc.’s new team members add to the firm’s ability to be extraordinarily responsive to client needs and the rapidly shifting healthcare landscape, while also helping broaden the depth of specialist expertise available to provider clients. Additional new hires are:
Meg Crowley, senior managing advisor, Regional Practice. Crowley was most recently assistant director of communications at Duke University, where she gained a reputation for developing compelling content for diverse needs and audiences. Crowley also spent time in media relations for a public policy think tank.
Angela MacDonald, senior managing advisor, National and Academic Health Systems Practice. MacDonald is an expert in organizational integration, with a career that spans higher education, law and Catholic healthcare. Prior to joining Jarrard Inc., MacDonald served in multiple roles within the Mission Integration Department of CHRISTUS Health.
Liz Nix, senior managing advisor, National and Academic Health Systems Practice. Nix joined Jarrard Inc. from Vanderbilt University Medical Center where she served in multiple roles, most recently as a learning and development leader, but also including facilities planning and management.
Alison Panella, senior managing advisor, National and Academic Health Systems Practice. Panella focuses on internal engagement, strategy development and operational support. She achieved these skills in part during her eight years at Interactive Forums, Inc. a strategic marketing and research firm.
Hannah Boggs, senior advisor, National and Academic Health Systems Practice. Boggs brings years of experience in program management, talent acquisition, internal communications and internal assessments across healthcare and corporate entities. She came to Jarrard from Northwestern University’s Feinberg School of Medicine, where she was a program coordinator in the Department of Medical Social Sciences.
Nina Buckhalter, senior advisor, Health Services Practice. Prior to joining Jarrard Inc., Buckhalter served as a content strategist for a marketing agency serving nonprofit organizations. There, she developed effective social media and content strategies to position clients as thought leaders as they addressed core barriers to healthcare.
Katie Collins, advisor, National and Academic Health Systems Practice. Collins most recently served in various roles at Performance Health, a sports medicine and rehab company. As a member of the marketing team there, Collins spearheaded data analysis projects and provided project management and change management strategies for internal team members.
Emily Magnifico, project manager, Growth Services Team. An experienced marketer, Magnifico has an extensive background in building and optimizing project management practices. Most recently, she served as project manager for marketing and branding agency Anchour.
Luke Levenson, copywriter, Growth Services Team. Levenson brings a reporter’s eye to the nuanced writing necessary for healthcare marketing and strategic communications. He joined Jarrard from Premier Productions, where he served as a media buyer. Prior to that, he was a publicist for a major music label and freelance journalist.
Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.
“The healthcare and health-insurance giant, the first industry heavyweight to report first-quarter results, posted double-digit revenue growth at both its Optum and UnitedHealth care units.”
Must be nice.
While insurance companies appear to be doing well, our hospitals are staring at some bleak Q1 numbers. Why? Well, consider that:
What to do? A traditional response by health systems to these pressures would be to cut costs through layoffs or service closures.
One possible source of at least partial relief is renegotiated payer contracts. We’re hearing from more provider organizations in our network that they’re considering – or undertaking – new negotiations. Payers will likely respond aggressively, and with increasing tension between the two, patients are at risk of getting caught in the middle. And that’s never good.
However, some payers are willing to come to the table in recognition that we’re all in this together and the distinction between payer and provider is merging. Where those constructive conversations can take place, it serves as an example of the wider opportunity for partnerships of all stripes – which also include joint ventures with private equity back partners, shared-service alliances with other systems or outright sales for scale and financial stability.
For health system communicators, get ready for change. Again. Here’s how to brace for it:
This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.
Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.
“The move follows an unrelenting barrage of criticism regarding the agency’s handling of the pandemic over the past few months. ‘The lessons from the COVID-19 pandemic, along with the feedback I have received inside and outside the agency over the past year, indicate that it is time to take a step back and strategically position the CDC to support the future of public health,’” Director Dr. Rochelle Walensky said.
(3-minute read)
The story of the CDC matters because:
What happened: The CDC has been sharply accused of offering conflicting, inconsistent, confusing and politically charged messages that undermined the public’s trust in it during a global pandemic. And that’s putting it mildly.
Sometimes it was simply a matter of not clarifying that scientific findings and the realities of public health were changing rapidly, and the guidance needed to do the same. Sometimes it was a matter of public health authorities being a bit too definitive about what was known, which became problematic when the current understanding or best practices changed.
Regardless: This was a moment for public health to shine. Coordinating a national response to a pandemic requires a coordinated communications plan. The CDC didn’t completely fail, but it certainly didn’t come through with perfect marks. Hence the “comprehensive re-evaluation.” Good for them.
Therefore: If you’ve come under fire, are under fire, think you might come under fire or simply want to prepare to avoid the mistakes that brought the CDC under fire (we think this list now includes everyone), here are points to ponder as you bring your team around the table.
This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.
Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.
“A local trial focused on a former Vanderbilt University Medical Center nurse has sparked nationwide interest. RaDonda Vaught was found guilty on Friday of criminally negligent homicide, after accidentally giving a patient a fatal dose of the wrong medication. ‘I’m terrified that I’m now in a profession where, God forbid, I do make a mistake,’ said one nurse outside of the courtroom.”
2-minute read
That quote serves as an intense summary of the concern felt by caregivers across the country, and it adds another layer of pressure on provider organizations already struggling to fill nursing roles. A joint statement by the American Nurses Association and Tennessee Nurses Association says, “The criminalization of medical errors is unnerving, and this verdict sets into motion a dangerous precedent. Like many nurses who have been monitoring this case closely, we were hopeful for a different outcome. It is a sad day for all of those who are involved, and the families impacted by this tragedy.”
The whole situation is awful. The tragedy of Charlene Murphey’s death and everything surrounding it. The worry this adds to an already exhausted healthcare workforce, many of whom were considering their future in the profession before the verdict. And it adds to the trouble that no provider organization needs with staffing the number one concern across the country.
We will continue to watch and discuss this situation and potential fallout. It’s a tense moment that will further strain the relationship between staff and administration. It’s also one that could exacerbate existing challenges both for individuals and healthcare institutions. For now, a few brief thoughts for leaders of provider organizations:
This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.
Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.
A good Monday morning to you: Today’s Quick Think is 773 words, a 3-minute read.
A four-year-old media company has risen rapidly to provide excellent reporting in an ultra-consistent, bullet-based format that is arguably changing the way we look at our inbox.
Why it matters: because in true absurdist fashion it gives us an excuse to pile on and, like the Times, pay our own homage to the newsletter phenomenon sweeping our inboxes. Seriously, we just checked our subscriptions and came up with Axios AM, Axios PM, Axios Vitals, Axios Sports and Axios Nashville. Not to mention competitors Morning Brew and 1440 Digest.
Why it really matters: Because the Axios style of communication works, and we see it every day with clients. Lament short attention spans all you want, but tight prose and well-written bullets are extraordinarily effective at getting the point across.
What’s happening: The rise of sound-bite newsletters is one of two things, or more likely a bit of both.
Between the lines: During the pandemic, we observed – and may have occasionally participated in – the overwriting of a lot of content.
Reality check: The Axios model provides lessons for healthcare marcom, as well.
This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.
Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.
3-minute read
“Not-for-profit and for-profit hospitals report similar levels of unreimbursed Medicaid costs even though not-for-profits receive billions of dollars a year in tax subsidies, new research shows.”
Key graf: “’The nonprofit hospitals have not done enough to deserve their tax subsidy,’ said Ge Bai, an accounting professor at Johns Hopkins University and lead author of the study. ‘Taxpayers subsidize hospitals to help struggling, working-class Americans, but many nonprofits are not doing enough.’”
Another brick pulled out of the wall.
Hospital critics have picked up another powerful, compelling dataset in the national campaign to paint hospitals as Big Business more focused on profits than on care. Painful though it may be to hear, the Modern Healthcare article is a strong piece about the situation some hospitals across America find themselves in. Even our own research shows that just 41 percent of people strongly feel their hospital is a good community partner. In addition, these situations signal the expectations among the public and state and local regulators about where those community benefit tax-equivalent dollars are spent. In short, they want to see more than just sponsoring the local minor league baseball team.
This conversation isn’t going away. The Big Business narrative will continue to build momentum if hospitals don’t tell their own story, are unable to or, worst of all, have a story that doesn’t line up with the reality.
Two things to bear in mind about these articles:
So here’s our advice this week:
Check your story. Now – Put time on your calendar to have a real conversation. Soon.
The knives are out, the narrative has taken shape and the numbers very often don’t look great. It’s not a time to spin and, frankly, even if you wanted to it’s not going to work anymore. It’s a time to buckle down and get it right, to match the desired outcome with the actual outcome, to match the stated mission and the desire and passion of you and your team and your clinicians and staff with the way care is delivered – both medically and financially.
After those conversations, get ahead. What’s interesting about the tax-exempt line of attack is that there’s no mention of outcomes. The criticism is purely financial. The push from critics as currently constructed is to spend the money, not to spend the money and achieve <X>. So that’s a fantastic opportunity for provider organizations. Align on where the money is going – get clear on charity care and all the rest – and then talk about how you’re not just spending it but also moving the needle towards better outcomes and equity. “Our critics say we don’t spend enough in the right places. We’re not just spending it but investing it in our community, and here are the returns.” That’s a winning, mission-driven message to leapfrog the Big Business naysayers. Just make sure it’s true.
This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.
Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.
2-minute read
The workforce shortage is perhaps the biggest topic of conversation across the industry right now. While some providers and staffing agencies are offering large sign-on bonuses, others are going for retention bonuses and raises. Everyone is trying to staff up, whatever it takes. Many, especially but by no means exclusively rural hospitals, are barely hanging on.
Pandemic shortages accelerated the growth of temp and travel nursing, effectively changing the compensation model for RNs. That’s created a feedback loop where the shortage has become both cause and effect. Hospitals can’t maintain the tab for travel nurses – yet many can’t properly staff up without them. The jaw-dropping $40,000 signing bonuses are stopgap and not sustainable.
Dawn Carter, a veteran healthcare strategist and founding member of the Rural Healthcare Initiative, likened the situation to The Lorax, Dr. Seuss’ foray into environmentalism that describes the dangers of overusing a resource to the point that it disappears. We need nurses, and they deserve to be well-compensated. Full stop. It’s incumbent on us to design a system that allows that to happen. A system that sustains the forest.
While many are working feverishly to discern the long-term foundational changes necessary to compensate caregivers what they’re worth while keeping labor costs manageable, the land-grab nature of the current healthcare recruitment push continues. And it just might be catastrophic for smaller providers who can’t keep up.
We’re not parachuting in with 750 words to solve a very complex problem. But we do think Carter’s insight on how provider organizations, particularly rural and independent hospitals, might mitigate the damage now with their existing staff – is imminently shareable. Her suggestions cover both tactical interventions and messaging.
An extra week off. Literally, give your staff an extra week off. Maybe two. More hospitals are taking this approach because that time away may help with burnout and is a relatively low-cost benefit to the employee. Many hospitals are already offering other smart benefits – subsidizing gym memberships, meal delivery services and so on. But if we’re talking about people who are thinking about leaving, giving them extra space to recharge may be a wise step towards keeping them.
Professional development. What else can your employees do? Whatever it is, show them that. From the moment they first consider a healthcare career through their entire time with your organization, make clear the ways a team member can grow in the job or grow into another one. Many hospitals are already helping finance additional technical/educational investments. They should make those opportunities known.
Carter cited a speaker from last week’s South Carolina Hospital Association virtual meeting who suggested hospitals ensure that high school students understand the low-cost path to a high-paying job. Someone paying two years of technical college tuition and coming out of it with an RN can enter the market making $60,000, but there’s the potential for $200,000+ by pursuing a CRNA.
Clarity. Carter noted that much of the money paying for those stopgap measures like travel nurses is stopgap funding (federal stimulus and relief dollars). It’s temporary. This is an important point to make when addressing staff nurses who are justifiably frustrated seeing the compensation packages for their traveling peers while they’re receiving far lower raises/bonuses. Hard conversation, but it’s worth sitting down with staff to really talk about the current dynamics and explain why those levels of compensation aren’t sustainable as the one-time relief funds run out. Yes, you’ll still hear questions about why that one-time money is going to temps and not staff, but it will hopefully provide helpful context.
Connection with leadership. The critical message is that the core problem is a broken system, not uncaring leadership. This is no time to be defensive and complain about trying to operate a hospital in today’s brutal environment, especially with nurses who’ve been stretched beyond reason by the past two years. The point, rather, is to have deep, heartfelt conversations with staff about leadership’s position on the issues and the various imperatives they’re balancing.
To imbue those messages, Carter underscored the enduring value of leader rounding and one-on-ones. Find time to build relationships with staff, listen to their concerns and show genuine humanity. Sometimes that means telling your own story, too. We’ve heard from clients whose leadership spoke during town hall meetings about their toughest moments during the pandemic. Showing that level of vulnerability was powerful and helped dampen some of the tension that had been building.
Note that these conversations shouldn’t be used as distractions from or substitutes for practical interventions. They should be a supplement, a way to both solicit helpful information about what staff need and to demonstrate that you and the organization are working towards a collective solution.
This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.
