Becker's Hospital Review

24 How Providence is 'deconstructing the health system' By Andrea Park A t Renton, Wash.-based Prov- idence, "there's nothing that is not changing," according to Mike Butler, the health system's pres- ident of strategy and operations. During a keynote address to open the Becker's Hospital Review 8th An- nual CEO + CFO Roundtable on Nov. 11 in Chicago, Mr. Butler discussed Providence's drive to "deconstruct the health system," the guiding principle of the health system's ongoing trans- formation across nearly every aspect of the organization. That idea of deconstruction, he ex- plained, "is to take everything we do and deconstruct it in a way that we thought would best serve our customers, make it a great place for physicians to practice medicine and have each one of our ministries and businesses be successful." He continued, "When we say 'de- constructed,' it's literally taking ev- erything that we do in primary care, urgent care clinics, express care within Walgreens, ambulatory care networks — the whole nine yards — and deconstruct it in such a way that we have access within 15 minutes for 15 million people, which is the general size of our primary markets. It's been really remarkable." In recent months, Providence has partnered with Microsoft, re- branded from its decades-old mon- iker of Providence St. Joseph Health and launched an "Optum-like" ser- vices and solutions company. The health system also opened around 40 new care sites in 2019. This near-constant stream of change is integral to the health system's DNA: "As a community-based orga- nization, we have the opportunity to not just be advocates, but catalysts for change," Mr. Butler said. n CEOs' confidence takes nosedive in 2019 By Emily Rappleye G lobal business leaders' con- fidence was down more than 20 percent between 2018- 19, with the biggest drop in confi- dence recorded among CEOs in the U.S., according to an analysis from Worldcom Public Relations Group. The analysis used an artificial intelli- gence tool to examine the social me- dia engagement of more than 58,000 business leaders around the world, and then gauge whether that engage- ment indicated confidence or concern related to various business topics. Five key findings on U.S. business leaders: 1. U.S. CEO confidence dropped the most — 51 percent — of any country's business leaders from 2018-19. 2. In particular, U.S. business leaders have below-average confidence in attracting and retaining talent, upskill- ing and reskilling the workforce, eco- nomic migration, crisis management, the impact of sexual harassment, and brand reputation. Many of the work- force-related concerns were felt by business leaders across the globe. 3. U.S. leaders were also concerned about global trade agreements and tariffs, with confidence slightly be- low their Chinese counterparts. 4. U.S. business leaders were also be- low average in their confidence relat- ed to larger societal issues like global warming, extreme weather, global in- stability and the threat of war. 5. The results indicated business leaders in the U.S. have above-aver- age confidence in data privacy and protection, and that they have low concern about cybercrime. n S&P: 7 healthcare trends to watch in 2020 By Alia Paavola H ealthcare leaders should keep tabs on several trends in 2020, including a con- tinued threat of industry disruption, deterioration of credit ratings, and mergers among payers that will pressure pricing, ac- cording to a report from S&P Global Ratings Seven key trends: 1. Changes in healthcare may speed up. In an election year with healthcare as a top, hot-but- ton issue, S&P expects policies could result in a faster pace of change within the industry. 2. Industry disruption will continue. Insurers will continue to look for ways to save money, placing pressure on providers and drugmakers. Ongoing investment in the sector may also lead to new ventures and new business models. 3. Rating deterioration will continue. Credit rating downgrades outpaced upgrades in 2019, and S&P expects that trend to continue in 2020. e rating agency blamed more pressures to cut care costs and more debt from mergers and ac- quisitions for the rating deterioration. 4. Mergers among payers and other players will pressure pricing. Two major mergers in the insurance realm — CVS-Aetna and Cig- na-Express Scripts — were finalized in 2019. S&P expects that if they succeed in cutting healthcare costs, other payers will follow suit and put more pressure on healthcare organiza- tions to cut prices. 5. M&A activity in the healthcare industry will remain elevated. Across the board in the healthcare sector, S&P expects M&A activity to remain high as "service providers seek to expand their offerings and size and scale, and pharmaceutical companies look to deepen their pipelines and diversify their portfolios in response to ongoing disruption in the industry." 6. Opioid litigation settlements will acceler- ate. Opioid settlement discussions will pick up the pace in 2020 as more trial dates near, plac- ing pressure on pharmaceutical companies, wholesalers and pharmacy chains. 7. Medical devicemakers will see a stable 2020. Relative to other providers and phar- maceutical companies, devicemakers will see a stable 2020, S&P predicts. n

• Cover