by Cindy Sanders | Jul 01, 2013

Nashville Medical News

Although the Affordable Care Act still poses many unanswered questions … and the best approach to health reform remains a topic of heated debate … everyone does seem to agree on certain key principles:

  • Healthcare is in the midst of major transformation to address the unsustainability of the current system.
  • Working collaboratively will be essential to delivering care going forward.
  • Quality, outcomes, and cost efficiency must work hand-in-hand.
  • It will take strong leadership across the broad healthcare spectrum to effectively align the many moving parts within the industry.

Enter the Nashville Health Care Council Fellows Initiative, an innovative program to empower the leadership of healthcare companies to develop strategic competencies and knowledge to carry the industry forward.

Judith Byrd, executive director of the Council Fellows program, said discussions concerning an executive educational offering have been on the table for several years, but the impetus to put the plan in motion really came from the members of the Health Care Council Board, who reaffirmed the importance of fostering and expanding Nashville’s legacy of innovation and entrepreneurship in the face of transformation.

“From the industry perspective, it was very important for the Council Board to be proactive as the industry comes upon this unprecedented era of change,” said Byrd. “Nashville has a legacy of innovation, success, management expertise, new ideas, and strategy development, and we want to stay at the forefront and drive the future,” she continued.

Former U.S. Senate Majority Leader Bill Frist, MD, readily stepped up to push the idea forward and reached out to health policy expert Larry Van Horn, PhD, to execute the vision. Van Horn, associate professor of Economics and Management and executive director of Health Affairs at Vanderbilt University Owen Graduate School of Management, is nationally recognized as a leading expert and researcher on healthcare management. Together, the two served as co-directors of the Council Fellows program, which launched in February with an orientation meeting and concluded with the graduation of the 33 Fellows on June 28.

In crafting the curriculum, Van Horn said the thought process was to address three key objectives – 1) to ignite a burning platform for system wide change; 2) to foster new ways of thinking by developing strategies and business approaches to create value in healthcare; and 3) to help hone the leadership skills to take organizations from where they are today to where they need to be in the future.

The outcome was a mix of classic MBA programming, including the utilization of case studies and guest lecturers, combined with emersion activities not typically found in an academic setting, interactive discussions within the class, and small group meetings centered on leadership development.

“We brought in Nashville’s storied leaders to talk very candidly in small groups to the Fellows specifically about leadership and career development,” explained Byrd, who added that each member of the 2013 class went through a leadership assessment. Tom Cigarran, Bill Carpenter, Herb Fritch, George Lazenby, Jim Lackey, Dee Anna Smith, David Black, Joey Jacobs and Harry Jacobson, MD, met with groups of six-eight for lively, two-way discussions.

In fact, Van Horn said the interactive dialogue … in the small groups, larger class setting, and informal conversations during breaks … might have been one of the most valuable tools.

“I’m an economist so I view the healthcare challenges through a particular lens,” he said. “Senator Frist is a physician, former politician and investor … so he views the system through those lenses. It’s the discussion though, from multiple perspectives, that develops a broader perspective for the Fellows, and what their place will be in developing the business solutions of the future.”

Van Horn stressed the participants accepted to the inaugural class were already executives with a tremendous amount of experience and insight into the industry. During the eight daylong sessions, these leaders from different sectors of the healthcare industry had the opportunity to share their varied perspectives on transforming the system.

“We’ve built relationships amongst 33 executives who are leading healthcare organizations, which will allow them to use that network to enact new business models,” Van Horn said.

“Collaboration is the key to fostering dialogue and change,” added Byrd. The Council Fellows program was, itself, a collaborative effort. Partner organizations BlueCross BlueShield of Tennessee, Community Health Systems, HCA, Healthways, LifePoint Hospitals and Vanderbilt University Owen Graduate School of Management joined forces with the Nashville Health Care Council to turn the Fellows concept into reality.

In the end, Van Horn said the goal was to encourage the Fellows to embrace change and shift their mindsets to power innovation. “The changing customer … the purchaser of healthcare … coupled with implementation of the Affordable Care Act will shift the determinants of success for healthcare organizations of the future,” he noted.

Although the unknown undoubtedly can be frightening, it can also be exhilarating. “The healthcare system is evolving, and there’s never been a more exciting time to be in healthcare as now,” said Byrd. “The change is coming at a rapid pace. There are a lot of things we can do as these opportunities present if you unleash the talent to find solutions and work towards value and improved patient care.”

As of June 28, there are 33 newly-minted Council Fellows who feel well equipped to work together to meet those challenges. “I’ve gotten letters from Fellows in the program expressing how this has changed and shaped the way they think about problems in their industry and how this has changed the way they work,” said Van Horn.

Byrd concluded, “We’re confident Nashville will be stronger and better from this annual experience. Its impact will be felt in the boardrooms and C-suites of healthcare organizations throughout the nation.”

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Applying for the 2014 Fellow Class

Applications for the second Council Fellows initiative are expected to open in September. While tweaks in the program could be made following the debriefing process, Executive Director Judith Byrd believes the general format will mirror this first successful outing. One change she does anticipate is moving the schedule up a month with orientation in January 2014 and graduation in May.

Council Fellows is open to executives of Nashville Health Care Council member organizations, as well as to those working for government agencies on a local, state or federal level. However, there is no geographic limit for qualified candidates. In fact, Byrd noted there were applicants from as far away as California, and at least two members of the inaugural group traveled to Nashville for class. “I think that does speak to it being a nationally unique offering,” she said of the broad candidate pool.

Byrd also stressed that the original group of applicants held enough Fellows-level candidates to fill several classes. “There were incredibly talented people turned away just because of the sheer volume of applicants,” she said. Byrd strongly encouraged those still interested to consider reapplying for the 2014 class.

For more details or to apply this fall, go online to www.healthcarecouncilfellows.com. 

From the Fellows Perspective 

Laura Beth Brown, MSN, RN, Vice President Vanderbilt Health Services: Having just completed a fellowship with the Centers for Medicare and Medicaid Services, Brown said she experienced a moment of hesitation when Vanderbilt Health System CEO Wright Pinson, MD, asked her to apply for the Council Fellows. The interactive structure of the Nashville Health Care Council program quickly replaced any qualms about diving into another intensive Fellows program.

“It has totally exceeded any expectation I had,” Brown said. “Everything I’ve learned in this experience I have been able to apply or to look at my work with a different lens and a different way of problem-solving.”

She added, “I definitely think Nashville is a great place to have this Fellows program because of the resources and access to healthcare.”

The city’s robust healthcare industry enabled the Council Fellows program to select senior leaders from across the broad spectrum of healthcare services and management companies. “A lot of us in the room are competitors so you don’t naturally gravitate to your competitors to talk about work,” Brown said with a laugh.

However, she continued, the unbiased setting created an instant network that encouraged sharing and developing new ways to problem-solve. “It put us in a position to discuss solutions in a collaborative way regarding the challenges in healthcare rather than working, as we typically do in healthcare, in a very siloed, independent way.”

As the landscape changes, Brown said collaborative approaches are becoming the norm. “There are people now who I feel like I could just pick up the phone to call to solve a problem. I know the right people now.”

She continued, “I think it’s created a great framework to build on … I’m really interested in seeing what we do post-Fellows. I think this alumni class will continue to meet and to collaborate.”

Ted Lomicka, Vice President & Assistant Treasurer, Community Health Systems: Lomicka first learned about the Council Fellows Initiative through his involvement with Leadership Health Care. The more he learned, the more he liked. Knowing Judith Byrd’s organizational skills, and Sen. Bill Frist’s medical and political background, he was excited to apply for the inaugural class. Working with Larry Van Horn at Owen Graduate School was icing on the cake. “His ability to harness vast amounts of data and make sense of it really lends itself to a thorough study of healthcare reform,” he said. “Those three individuals make for a pretty powerful combination.”

As he dove into the program, Lomicka found his early enthusiasm wasn’t misplaced. He particularly enjoyed the timely, topical policy updates at the beginning of each session. “Having a forum where we’re able to discuss and debate healthcare policy as it is emerging is imminently valuable,” he said.

As co-directors, Frist and Van Horn contacted their network of colleagues to bring in renowned speakers to address the participants. “In particular, Harvard Professor Michael Porter taught us to define value as patient outcomes per dollar spent. This approach facilitates greater collaboration between clinicians and managers, allows for the fundamental restructuring of healthcare delivery, and initiates the use of an array of delivery system outcome tracking metrics,” he explained. “Following this approach will facilitate dramatic advancements in patient care.”

He added that Robert Kaplan, also a professor at Harvard, taught the group time-driven, activity-based costing. “It’s brilliant in its simplicity; and using this approach, you can easily discern the cost to provide healthcare services,” he said, adding, “That was a neat take-away. I’ve done that on several projects already.”

With his focus at CHS on improving the financial performance of hospitals and health systems, evaluating strategic transactions, and supervising corporate cash management functions, Lomicka said he is already putting the lessons learned to good use.

Shawn Morris, President – Development & Innovation, Cigna-HealthSpring: Working with one of the nation’s largest Medicare Advantage Plans, Morris is keenly aware the current healthcare system is unsustainable. “For the health of our country long term, we have to figure out healthcare,” he said.

Being a part of the solution attracted him to the Council Fellows Initiative. “I like change, and I think change makes things better,” he noted. The Fellows, he continued, has given him access to others from across the spectrum of healthcare who feel the same way. “It’s a very bright group of people,” Morris said. “Business begins with relationships. I think this environment really allows for that.”

While Morris noted HealthSpring was built on a collaborative business model, he recognizes more teamwork will be required in the future and will extend beyond payers and providers. Being exposed to Fellows with a background in technology, marketing, investment, research and other disciplines has been intriguing. “You kind of understand where the world is going from their shoes,” he said, adding the simulation and hands-on emersion elements also gave participants the opportunity to see healthcare from different lenses.

“Traditionally healthcare is very siloed, and that leads to a lot of the fragmentation we see. I think we will all have to think differently … with a collaborative mindset. Is that going to happen overnight? Absolutely not. But this type of class is a step towards that,” he said.

Like many of his colleagues, Morris gained a lot from the policy updates at each session. One he particularly enjoyed featured a Skype session with United States Chief Technology Officer Todd Park, who shared information about ‘Health Datapalooza.’ Morris said he hadn’t known about the event before Fellows but looked into it and ended up sending two of his staff members to D.C. to participate.

For Morris, though, the very best take-away might be the lasting connections with legacy CEOs and the coming generation of health leaders as they work together as change agents.