Becker's Hospital Review

18 18 THOUGHT LEADERSHIP 4 CEOs share their uncommon — or unpopular — opinions By Kelly Gooch B ecker's regular series of conversations with CEOs of the nation's health systems asks leaders questions about their respective roles and the industry. In some of the interviews, CEOs shared an unpopular (or uncommon) leadership or healthcare opinion they have. Here are answers collected by Becker's this year. Note: Answers were lightly edited for length and clarity. Mark Keroack, MD. President and CEO of Baystate Health (Springfield, Mass.): I know this is an unpopular opinion because I've chatted with folks from around the country about it. I'm a physician, but I'm also trained in public health. So I firmly believe that we're better off as a country when we cover all of our citizens with a basic set of health benefits. And I think we as a health system deliver better care when we're under a globally budgeted or capitated payment arrangement. I think they create proper incentives around wellness and prevention. They also help us focus on some of the social issues that impact health. Todd LaPorte. CEO of HonorHealth (Scottsdale, Ariz.): I get looked at kind of funny sometimes by peers and community members when I say, "HonorHealth wants to keep people out of hospitals." We're not just a hospital system. We provide a whole array of services that range from trying to help people be well as well as how to be in lower-level settings. But nonetheless, it is a victory for us if we can keep people out of hospitals. As baby boomers keep aging, the demand for healthcare services keeps rising because of this acuity that keeps rising in our country as well. And yet we talk all the time about a labor shortage of healthcare workers. So we're going to have a real supply-and-demand issue that's going to come at us, and frankly, we have to do this as a defensive posture. But the real reason we do it is because that's our mission. Our mission is to improve the health and well-being of those we serve. It also happens to be a matter of self-defense that we may be challenged with having enough supply of caregiving to meet the demand. We need to get out on the front end. We're doing it, for example, by promoting as a community leader, a Blue Zones project in one of the communities in our backyard. We're starting with this in one of our communities we serve, and we hope to expand it. We're doing this in formal cooperation with a national Blue Zones organization that has done it in 70 other communities across the U.S. We're the first in Arizona. It's about how to improve the built-in environment of our community that makes it easier for people to live healthier lives and allows them to live better and longer. Bob Riney. President and CEO of Henry Ford Health (Detroit): It's hard for me to judge how uncommon it is. But for me, it's the fact that we can, and we should, compete and collaborate at the same time. It's not an either/or. It's a both/and. And I still find a lot of the industry looking at it as an either/or, and to me, we can compete on our service. We compete on our access. We compete on those things that stakeholders care about. But we should be collaborating on backroom support to continually try and drive value in the industry. And we should be collaborating on the sharing of breakthrough best practices when it comes to specific quality outcomes. Bill Robertson. CEO of MultiCare Health System (Tacoma, Wash.): If you look at healthcare today, there tends to be this move toward health systems becoming operating companies. That means they move a lot of the decision- making related to their distributed delivery assets toward a more corporate structure because they're going to get more efficiency in the decision-making and more consistency in the decision-making. And I have this odd idea that actually healthcare is way more local than that centralized decision- making does. It's really hard for a corporate person to build all the relationships necessary in every market where business units operate. So the idea that being an operating company is the ideal model for healthcare, I reject. I think it's a mix of things like holding company behavior for some things, where you build the right teams in the relevant markets or the relevant clinical activities, and you let them have a lot of leeway to lead and make decisions in the best interest of patients and team members and market position. And then, for a more limited set of things, you have an operating company model where you have the economies of scale that a shared revenue cycle platform delivers, or a treasury function, or maybe group purchasing. But the day-to-day local strategic agenda is ill served by the "everything is an operating company" model. It is not a broadly embraced worldview, as I have observed. n " I have this odd idea that actually healthcare is way more local than that centralized decision-making does. It's really hard for a corporate person to build all the relationships necessary in every market where business units operate. So the idea that being an operating company is the ideal model for healthcare, I reject." — Bill Robertson

• Cover