Change will drive how consumers and providers relate for the coming decades. We live in a period of rapid evolution; some might call the current environment “revolutionary,” in our industry. Technology is forging new ideas and tools at a pace which we have not seen before. Governmental intervention and regulatory thinking is moving at a faster pace than we have previously experienced. The consumer, we used to label us “patients,” now has more and more responsibility for themselves, their families, and other people within organizations with whom they associate (i.e. employment; civic groups; social service agencies; religious enterprises, etc.). Leadership of our healthcare enterprises must face all of this change and encourage flexibility, nimbleness, conscious collaboration and cooperation amongst all parties.
In this three-part assessment, we identify critical activities to organizational success. At the leading edge in building toward the future Leadership should assess:
As a business enterprise, every organization needs to invest the time and resources to assess your current environment. Specific areas to examine include:
Define the goals of your organization, including input from the Board of Directors, the Physician Enterprise and System Leadership through the involvement of all interested parties in broad and deep conversations and analyses.
Define your Physician leadership for the entire clinical enterprise and integrate their goals for the future into your Organizational Structure.
Determine the relationship of Health System/Hospital Leadership and Physician Enterprise Leadership, culture, clinical objectives, economics and principles of operation and outcome expectations.
Through the use of an “Environmental Scan” confirm that Leadership appreciates all of the community attributes and influences affecting the business.
Define the overall financial, operational, market position and Health System delivery goals for the clinical services lines.
Prepare a Comprehensive Strategy to achieve the goals and define an organizational structure that can execute the overarching goals.
People make the Difference in executing strategy:
Human Capital – Understanding Your Work Force
Your organization must take stock of the people who are in place and include evaluations of turnover caused by attrition due to early burnout or departures due to better opportunities elsewhere. Using countermeasures to address these risks via evidence-based resilience and emotional intelligence (EQ) training will engage the people of the organization
Assess your needs in a five-year window, at a minimum.
Prepare for resource shortages within health professions levels (Physicians; Nurses; Technicians, etc.) and in levels of support roles (e.g. IT resources, accounting & finance, revenue cycle, HIM, etc.)
Develop a collaborative relationship with the educational institutions within your geography. Dialogue concerning the resource skills and experience your organization will need can be addressed by working with educators to execute the needed programs. Be mindful of the lead time to execute new academic curricula.
Have succession planning in all critical departments, not just for providers. The institutional knowledge that your senior staff possesses cannot readily be replaced or transferred.
Wage and salary pressure will occur on all staff levels as the external environment (locally and nationally) will impact your strategy. Specifically, if any
determined changes cause wage compression within your resources. Employers must be involved in these conversations.
Proactively consider how to attract new talent to your staff and deliver financial support to those entities who are training the workforce of the future.
In Part II, we examine critical investments leadership should include in your overall planning and in Part III, we contemplate your CRM characteristics.
You are well aware that change is the standard now and bringing the right resources to bear on how your organization responds and adjusts will create your future.
Change will drive how we invest in facilities, people, technology and responsiveness to governmental regulation and oversight. Leadership of our healthcare enterprises must face all of this change and encourage flexibility, nimbleness, conscious collaboration and cooperation.
To wade into the future we must consider several critical areas of resource investment for the benefit of the people you serve and the organizations with whom we are involved, whether it is employment or independent association.
Government and the Regulatory Environment
- Within the tenants of the Affordable Care Act, requirements implemented in calendar years 2016 through 2020 are imperative to your success or failure within the construct of the Law. The ACA parameters are now becoming more intrusive to your organization as the changes in the HI Marketplaces; impact of the Medicaid expansion or not is being better understood; and, the effect of the various taxes and fees which have been deferred until now (e.g. the Cadillac Tax; the Employer mandates; the Individual mandates; the Insurance company tax; the excise tax on Pharmaceutical companies, etc.) evolve.
- The five year period beginning in 2016 may be unprecedented in the tenacity and temerity of regulatory actions at the Federal Government levels. In the past year we have two major new Laws (MACRA and the BBA of 2015) which are just now beginning to be put into regulation. Within the language of the ACA, specific entities and agencies (e.g., CMMI; the I.R.S.; OCR; and the ONC) have evolved and are now having a more substantive impact on how we run our businesses.
- An entire new language of acronyms has followed, including: APMs; ACOs; CHNA; MIPs: etc. Leadership will need to dedicate funds and resources to focus solely on the implications of the regulatory activity and to aid in the development and communication of strategies and change for your organization.
As the transition to a new Federal Administration begins, your organization needs to project an active voice at both the State and federal levels. Advocacy begets returns from your efforts.