Every year, B. E. Smith, a Lenexa, Ks.-based healthcare executive search firm, analyzes its surveys of more than 300 healthcare leaders, and partners with the American Hospital Association (AHA) on an environmental scan that reflects upon the most crucial trends expected to impact healthcare leaders through the new year and beyond.
The 2015 Healthcare Trends white paper identifies nine trends that span a range from institutional realignments, new competitive forces, patient demands, population health implications, and workforce development and engagement needs. Through all of this, B. E. Smith executives say that one point stands clear—the current environment, in all of its complexity, stands to greatly impact leadership planning, strategies and technologies to adapt to this ever-evolving landscape.
Recently, HCI Associate Editor Rajiv Leventhal spoke with Laura Musfeldt, vice president of senior executive search, and Mick Ruel, vice president of executive search about the white paper, and the IT and policy-related trends that will affect patient care organizations nationwide as they move forward in the new healthcare. Below are excerpts from those interviews.
What were the most significant trends you found related to IT and policy?
Mick Ruel: What I found most significant is how technology and technical solutions are being tied more into clinical results, as well as the drive for better results and better quality outcomes. Things will vary from organization to organization, but the trend is utilizing the data. Healthcare has always done a great job of collecting data, so now what do we do with that to help drive towards better clinical outcomes?
Laura Musfeldt: In addition to that, when you think of federal policy, we have had the Health Insurance Portability and Accountability Act (HIPAA) in place long enough now that we really can ensure privacy for patients. That will allow us to move forward with having a direct dialogue, as you can log into a portal and ask a question and get a response back. We have advanced enough to be able to do that. We can measure quality outcomes, and that’s driving things from a reimbursement perspective. Those organizations that have good data on what their outcomes are will be in a stronger position as they negotiate with payers. It’s a win-win for everyone.
Ruel: Yes, you’re seeing more healthcare leadership with the change in reimbursement models—leadership has had to take a key role in developing policy in helping the organization overall in the new reimbursement model.
How are organizations doing a better job of “utilizing the data”?
Ruel: You have clinicians who have taken the lead in understanding the data and applying that back to generate better outcomes. Physicians are getting more involved in that, rather than telling them what the scorecard is afterwards, which is what used to happen. Then they started using that data to make decisions proactively in advance for better outcomes. That’s been the trend until recently, and now you’re starting to see healthcare leaders get involved because of the way they’re going to get paid and the way revenue is going to be generated. They’re taking the key role. You had scorecards that told them how they played and what they had done, and now they’re using that to drive how they do things before they get involved in decision-making clinically.
How are providers reacting to the shift to a value-based healthcare, when they’re still getting paid in a fee-for-service model?
Ruel: What I have seen from our clients is that even if they are being reimbursed that way, they’re being proactive, knowing that the landscape will change. Steps are being taken now to make that transition. Dollars are to be had even now, if you can provide outcomes-based service, or avoid service with population health. That’s probably the biggest key and change. Smaller organizations that can be nimble are doing that sooner, while larger health systems are looking for ways to reduce expenses in preparation for lower reimbursement.
Musfeldt: I do quite a bit of work with physician leaders, and every one that I talk to is really paying attention to evidence-based medicine. Decisions are being made by that collective database that tells us, for example, when is the right time to give that antibiotic to the patient before he/she goes to surgery? They know that, but now they can put mechanisms in to ensure that it happens. They might not all be at risk now, though their thinking is in line with that.
So you aren’t seeing pushback from providers?
Musfeldt: I’m not sensing that, because these are savvy, smart leaders, who understand the risk factor. That’s increasing every day—physicians will be on risk-based reimbursement just like the hospital is. So if they don’t follow evidence-based recommendations, they will be the outlier. They don’t want that, they want to hit it right every time. I don’t see pushback.
How are mergers and acquisitions affecting the landscape?
Ruel: I don’t know if they’re affecting things, but you are seeing the fear of a smaller reimbursement coming, so how do we streamline and become more efficient? I’m working with some independent hospitals, and they would like to stay independent, but as much as they want to, there has to be some relationship and affiliation by their choice or not. So I don’t know if M&As are affecting the landscape, as much as the landscape as allowing more of that to happen.
What are the biggest concerns of healthcare organizations as we move forward?
Ruel: The uncertainty about the future is the biggest thing I’m seeing from my clients in terms of fear. We know what’s happening, where it’s all going, but how will it impact us? How will we be reimbursed, will we remain independent? That’s what I am hearing. Having to deal with all of those things and not knowing how it will affect the way they do business today is the biggest challenge.
What key pieces of advice would you offer healthcare organizations as they forge ahead in 2015?
Musfeldt: This is where leadership comes in—a strong leader will anticipate and develop the next generation plan. The most successful ones are the ones investing in IT leadership, and that includes physicians being part of that decision making at the high end.
Ruel: You better embrace the change and have the leadership to adjust to the changing landscape. Physician engagement is getting there, but it’s not where it needs to be. It’s all about clinicians, in a broader sense, how they tie in technology, and finance into deliverables to patients. That’s the key moving forward. Leaders that embrace that get it. We’re seeing more turnover in the CFO role, and we’re seeing the CIO role evolve into more of a strategist with the organization, rather than providing technology like they traditionally have. I can’t talk enough clients into creating a CMIO position, I think its critical. They better find a physician champ that supports and understand technology.