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Nashville Health Care Council Fellows aims to shake up health care

Nashville Health Care Council Fellows aims to shake up health care
by Shelley DuBois | The Tennessean | Oct 15, 2014

There’s one week left for health care leaders to apply for the Nashville Health Care Council Fellows class of 2015. The co-chairs of the program, which is in its third year, hope this new cohort will help turn the industry on its head.

“The Nashville health care industry has been incredibly successful building big organizations,” said Larry Van Horn, a Vanderbilt health care and economics professor and the co-chairman of the Fellows program.

But a history of success is not enough, he adds. The question, he says, is whether these companies who benefited so much from the status quo can now disrupt and innovate.

“My goal, my dream, is to get these folks to think about how they can create disruptive forces in their own organization so that it succeeds, instead of having somebody from the outside come in and disrupt it.”

That is a tall order. Van Horn wants Fellows to start thinking about upending an industry that many of their employers helped create.

Both co-chairs – the other is former Sen. Bill Frist – believe that Fellows can do this. They hope to recruit a diverse class, including people from start-ups and established institutions alike, to discuss some of the most pressing issues in health care. This year, Van Horn predicts class members will talk about huge legal issues such as the Halbig vs. Sebelius case, which challenges the validity of premium tax credits for federal exchange health care plans. Fellows will also grapple with major shifts in the industry, including increasing consumerism and the general movement of care away from hospitals.

These are complex challenges that people in industry silos often don’t discuss with one another.

“This allows them to have that palate cleanse,” Van Horn said, “to come in a safe space and just throw down their ideas. And fight. And yell at each other. I want more of that.”

He is the more pugnacious of the two co-chairs. But both agree that drastic change is needed, and that Nashville should lead the charge.

“Nashville, over the last 30-40 years, has consistently produced health care managers and operators that are the best in the country,” Frist said, starting in the early days when entrepreneurs developed the first for-profit hospitals (a phenomenon the Frist family understands better than most). Since then, Frist added, “the human capital kept educating itself.”

Now, he believes that smart human capital has a responsibility to make health care better.

“Nashville – and I don’t mean to be overly critical – has been a bit closed-minded and has not participated at the level that it could,” he said. “The companies know how to do things – they identify problems, they fix the problems, they can move to the next stage. I want to encourage future leaders here in Nashville to say that’s good, but we also have a responsibility to apply that ability to fix things to hundreds of other issues we may not be addressing.”

In other words, Washington won’t do it alone, and the country can’t afford for Nashville’s private sector to take a back seat.

“My concept is to bridge those two – to connect nimbleness with the policy,” Frist said.

He also believes Fellows will elevate Nashville’s position on the national map. Thought leaders from all over the country speak to fellows classes, hopefully creating a two-way dialogue that should last outside of the program’s eight day-long sessions.

It’s early days, but previous participants have already done some serious networking, Van Horn said. A handful of venture funds have pursued investments based on conversations that happened in class, he said. Others have hired experts who spoke during the program as consultants.

The program had a direct impact on Laura Beth Brown, an alumna of the inaugural Fellows class of 2013, and currently the vice president of Vanderbilt Health Services and the president of Vanderbilt Home Care.

“There are a few times in my life that I have had what I would call a singular opportunity to invest in myself, and this was a really good example of that,” she said, citing not only the ability to network and solve problems, but the way the program changed her understanding of the health care system.

Each member of the 2013 class actually learned about his or her genetic makeup via DNA testing kits. As an exercise, many took the results to physicians.

“This was an opportunity for us to come together as a network of fellows to solve health care problems,” Brown said. But also, “there were lots of presentations that really made me think differently about my own health care.”

That may seem small, but Frist and Van Horn hope the Fellows program will have a big impact by making the world of health care a little bigger for select high-power individuals. Frist is optimistic. He says during his career as a physician, he saw major advances in seemingly unsolvable problems such as open heart surgery and treatment for HIV/AIDS.

“Every major problem that I have been involved with – by applying the best of policy coupled with market-driven, entrepreneurial strategic thinking – has been solved,” he said.

Van Horn may be more of a glass-half-empty guy. But he’s comfortable pushing buttons.

“Everything I want to do is completely politically intractable,” he said. “The reason these guys are as successful as they are is because they know how to take challenges and turn them into opportunities.”

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