High Stakes

First Aid for Hospital Leaders: You Must Transition to Being Conveners of Healthcare

First Aid for Hospital Leaders: You Must Transition to Being Conveners of Healthcare

The systems that succeed tomorrow will bring the right people to the table today to truly impact health and wellness

Healthcare is broken and spending is unsustainable, as anyone devoted to improving the industry knows.

Nevertheless, the facts are still startling. Healthcare spending is 17.9 percent of the Gross Domestic Product in the United States today, according to the Centers for Medicare & Medicaid Services, and is projected to be over 20 percent of GDP by 2026. Multiple factors contribute to the high cost of care including drug prices, industry instability, an aging population with chronic conditions, clinician training, public health epidemics such as the opioid crisis and many others.

But to consumers, the reasons behind the rising costs are irrelevant – they just want us to fix it. They have no stomach for the blame game. Public demand for collaboration between healthcare leaders has never been greater. The upside is, nobody is better positioned to drive change than you – the leaders of the nation’s health systems.

You are uniquely positioned because consumers trust providers and trust is essential for change. Your organizations have established relationships with the stakeholders that need to be at the table to drive real change. You can – and should – harness the political capital that you (and your organizations) have developed to become the convener of the conversation, the incubator for solutions.

A “convener” is a healthcare organization that not only treats patients at the point of care, but also unites the right group to drive action on the factors that impact health: affordable, safe housing; access to nutritious food; transportation; jobs; child care and other services.

Many healthcare leaders know they need to take charge, and some already have. Take ProMedica in Toledo, Ohio, which has implemented a holistic approach to address social determinants of health. But few are as far along as ProMedica.

In fact, according to recent survey results from Deloitte, 80 percent of hospital respondents reported that “leadership is committed to establishing and developing processes to systematically address social needs as part of clinical care.” Yet, the report continues, much of hospitals’ work in this area lacks a solid strategy.

The good news: You have the tools necessary to develop a coherent strategy for becoming a convener because nobody else who needs to be part of the conversation has the same level of credibility or the same access to the communities you serve. When it comes to their personal health, people don’t trust the government, insurance companies, pharmaceutical makers or device companies the way that they trust their providers. And as leaders of providers, it is your – our – responsibility to be part of the solution.

But public trust is fickle, and leaders of organizations in other industries are losing it. “Trust in companies headquartered in the U.S. has dropped five points from 55 to 50 percent just in the last year, after having already fallen from 61 percent in 2014,” according to an article published in conjunction with Edelman’s 2018 Trust Barometer. The report also explains how the public has lost its faith in specific institutions, such as the media.

Seize the opportunity to keep healthcare from suffering a similar fate by becoming the convener that drives the future of health and wellness. It won’t be easy – health systems earn money via a business model that leaders must disrupt to survive. But forward-thinking healthcare leaders aren’t just building the plane while they’re flying it, they’re building a new plane while flying – and getting paid because of – the old one. Still, there’s a crushing demand for a better plane, and every engineer needs to start somewhere. So, let’s start that conversation – before someone else builds tomorrow’s plane and there are no seats for hospital leaders.

Step one:

Deliberate about who in your community, market or state needs to be at the table and invite them to join. Your list should include key players from pharma, device and insurance companies who are willing to search for common ground. But it should also include pastors, metro public health employees, housing department representatives, education officials and chiefs of police. Leaders who cultivate a diverse group of voices will see a distinct advantage.

Some systems are already seeing the payoff from thinking like conveners. In 2016, Geisinger Health partnered with organizations in the community to launch a Fresh Food Pharmacy to help food-insecure patients with diabetes access proper nutrition.  In an effort to reduce unnecessary ER visits, UI Health in Chicago partnered with the Center for Housing and Health last year to provide homeless patients secure housing. These systems are part of the public health conversation in a positive way.

Step two:

Identify where you can best help. Not everyone should start a food pharmacy or take on housing.

Start with projects that combine urgent community needs with areas where your system and your partners are best positioned to make a difference. Leaders should ask, “Where can we make measurable progress together?” Once the first projects show results, more members of the community and the industry will get on board – and there’s strength in numbers.

Step three:

Clearly articulate your shared vision. Too often, diverse groups working together for the common good tacitly assume that they share a vision. Take the time to discuss it, write it down and get buy-in from everyone in the group. To succeed, you will need to name the wins you are working toward and tell a compelling story about how you plan to get there.

Step four:

Share the workload whenever possible. This may mean partnering with organizations that, in other contexts, are competitors.

In 2016, Vanderbilt University and Saint Thomas Health in Nashville partnered to submit their Community Health Needs Assessment – a report that the Affordable Care Act requires from tax-exempt hospitals. In 2013, the hospitals filed their CHNA’s separately, but found that they served an overlapping population. The 2016 report was not only bolstered by more robust data from both institutions, but also strengthened the relationship between two essential providers in Middle Tennessee.

Step five:

Inventory your leaders’ community involvement. Assess whether executives at your health system are on the boards of key organizations. If they aren’t, consider implementing a policy that you expect leaders to form relationships that will help your organization become a true convener.

Finally, don’t wait for the groups you want to bring together to get on board before you start. If some critical players are initially reluctant to join, progress without them. Your success will ultimately motivate their participation – or consumers may push them to join you.

What is clear, is the time is now. If you don’t convene the group, someone else will and they likely aren’t positioned to successfully lead the charge – and the change – like you are. Don’t miss your moment to help shape the future.


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