HealthManagement, Volume 18 - Issue 1, 2018
ThewayforwardforUShealthcare
ExpertsdrawtheirconclusionsontheAmericanhealth systemandwhatneedstobe donetoeradicatethemanyproblemsthatcontinuetomanifest.
In arecentlypublishedbook,healthleadersDr. Denis CorteseandAntonyBellofferaradicaloverviewofthedissatisfactionofthe Americanhealthcarequagmireandenlistwayswhichwoulddissolve themanyproblemsthatexist.
Accordingtotheleaders,theAmerican healthcaredeliverysystemisbreakingandbeyondfixing. Intheirbooktheyexplainthatthe
onlywayoutof thisquandary
isleadershipitself.Thebooktitled "Rescuing healthcare:Aleadershipprescriptionto make healthcarewhatweallwantitto be,"was releasedin2017 andexplainsthemainwaysthe healthcaresystemissoflawed;somuch sothat itiscommonlyfoughtoverby
politicians,debated endlesslybypeoplealloverthecountryandyetno realchangesareenacted.
Cortese,aFoundationprofessoratArizona State Universityand formerpresident and CEO ofthe Mayo Clinic,andBell,CEOofLeaderDevelopment Inc.,afirmthat helpsleadersinseveralsectors transformtheirorganisation,believethattheonly way forthehealthcaresystemto getbackontrack andprovidequality careatareasonable cost,isfor medicalpractitionersto beempowered.Thiswill allowthem tocreatemeaningfulchangeforboth thesystemandwhatmattersthemost:patients.
In a recent interview, Dr. Cortese and Antony Bell speaktoHealthManagement.org about theirbookandwhatvisionaryleadershipmeans to them.
Whatelseisneededfromseniorpoliticiansin ordertoimprovethe healthcaresystemwithin theU.S?
A clearvisionforwhattheywantoutofhealthcare. 100% coverageisneeded; high-value healthcare delivery;alearningorganisationforhealthcarein theUSA (sothateveryoneinthehealthcaresystem knowswhat thesystemknows);andiftheywant highvaluecare theyshouldhavesystemsofpaymentsthatarerelated tohighvalue–notfeefor
service.
For example:“Insuranceforall”shouldmean thatallUScitizensareinthe sameprogramme. Thiscouldmeanasinglegovernmentpayersuch asMedicareoritcanmeanthat theUScitizensget thesameinsurance programme that allourFederal employees and politicians have - the Federal employees benefit plan. This is agovernment-regulatedprogramme;withfinancialassistancefrom
the governmentforthose whoneed it;andfreedom of multipleinsurance privateplans.Leadershipmeans leading–andthismeansthatEVERYONEisinthe sameinsuranceprogrammetogether.
Whatdoesitmeanto beasuccessfulleader today?
Letussummarisekey pointsfromourbook(Rescuinghealthcare:aleadershipprescriptiontomake healthcarewhatweallwantittobe)asfollows:
a. personal traits –highmoral andethical character;leadershipcompetence. One withouttheother willfail.Unfortunately,wehavelittleofbothtoday intheleaderswehearmostabout
b. skillsinatleastthreedomains ofleadership:
organisational leadership skills –create visions and direction; sell and communicatethevision; aligntheorganisation;selectpeopleanddelegate responsibilities
operationalleadershipskills–planning,organising, measuring,settinggoals,settingincentives
people skills: selecting and matching the
right people;explainingandclarifying;motivatingand developingpeople
c.dealing withseveral elementsofleadership simultaneouslyandover time.Sharedvision;shared reality; strategy; tactics; culture andalignment; skills ofthestaff;technology;implementation.
How is this "shared vision" to be implemented?
Inthefieldof healthcare,the“organisational”leader willneed toworkwithasmallgroupofkeyleaders to successfullydevelopavisionthattheywillall support.Ofcoursetheorganisationalleaderwillplay amajorroleinthe visionbuthastobeprepared to modifypreconceivedideas as the team develops ideas that areevenbetterandmoreappropriate. Oncethevisionisclarifiedthehardworkbegins –relentlesscommunicationtoallthestaff andall theemployees.Thecommunicationneedstobe repeatedasoften asneeded andinasmanysettingsaspossibleuntilthe employeesandprofessionalstaffbegintothinkthatthevisionwasall theiridea.
How do you think this vision differs from otherhealthcaresystemsaround theworld, aside fromitbeing apay-for-servicesystem?
Thevisionof highvaluehealthcare–bestoutcomes, highestsafety,bestservice andat lowestcostsis the visionforhealthcareinthe world.Andithasto beaccompaniedbyapaymentsystemthat keeps thebestprovidersinbusiness.Itisveryunlikelythat atraditionalfeeforservicesystem willeveraccomplishthat goal.NewmodelsofpaymentintheUSAmight,such as:bundledpayments,capitation,or providersowingtheirownhealthinsuranceplans.
Do you think there is a serious issue of burnoutamongstUShealthcarestaff?
Yes,indeed. Allthesocalledstakeholdersinthe USAhavefoundwaystoreducetheiradministrative workloads,andsellmoreof theirproducts byshiftingall responsibility andaccountability toproviders. Who,overtime,havebecomeoverburdened with required orregulatedactivitiesthathavenothing to dowithdirectpatientcare.Whowouldn’texperienceburnout?
In order for healthcare to be financially sustainable, what are the most important factorsthat comeinto play?
Torelentlesslyseekoutthehighestvaluecareand reimbursethoseprovidersinsuch awaythatthey can remain inbusiness.Forinstance:use reality pricingbasedontheveryhighestqualityproviders whoareabletokeeptheircostsdown.Thenpay insuch awaythattheycancovertheircostsand accomplisha2-4% profit.Evennon-profitsmust makesome moneytoremainin business,innovate, replenish/replacetheirfacilities. Anewregulatory mindsethas tocome intobeing,such as wesee inregulatedutilitiesthat provideacriticalsocietal need (electricity,water,etc.).
"Rescuing healthcare: a leadership prescription to make healthcare what we all want it to be" is published
by Morgan James publishing.