Sparking change through collaboration, shared learning experiences 

Earlier this year, the Nashville Health Care Council announced its 2024 class of Council Fellows—a cohort of 32 leaders, selected from healthcare organizations of all sizes and 13 distinct industry sectors, who are poised to move our nation’s healthcare industry forward. 

Now in its 11th year, the Council Fellows program connects the industry’s brightest minds, most influential leaders and top drivers of change in an effort to improve care delivery, bolster workforce engagement and increase value for the U.S. healthcare consumer. Led by a faculty of industry experts, the five-month intensive program addresses topics ranging from data and AI to preventive medicine and social determinants of health. 

In late January, Council Fellows engaged in a two-day opening retreat designed to help cohort participants establish common ground and develop the tactical skills to solve for win-win outcomes and cross-continuum solutions. Subsequent sessions on cost of care, health equity and health policy rounded out the initial months of programming, laying the framework for ensuing conversations on strategic avenues to realize value-based care for more Americans. 

Innovation as the pathway to value-based care  

At the program’s midpoint, Fellows returned to Nashville for their fourth experiential learning session—an in-depth look at concept creation, stakeholder adoption and market diffusion with some of the industry’s leading-edge innovators.  

In conversation with Council Fellows alumnus Todd Park, former U.S. Chief Technology Officer and Co-Founder/Executive Chairman of Devoted Health, Fellows were advised on critical steps to create and sustain innovation, beginning with the imperative to define their mission correctly, and without ambiguity. 

“Define a mission that’s meaningful and will actually be helpful to people in some material way,” said Park. “If you can’t clearly answer the questions of who you are serving and how you’re making their lives better, then start again.” 

Park also coached Fellows on the importance of diverse teams to ensure diverse perspectives, aligning the business model to support the mission and optimizing for speed of learning— especially in the early stages of concepting and development.  

“The probability that the initial idea you drew up on a white board is the optimal solution is essentially zero,” said Park. “Your job is to learn, as quickly as possible, which of your underlying assumptions is wrong. So instead of building a car, first build a skateboard, and then go talk to some users about it.” 

Session speakers also included Liz Fowler, Deputy Administrator and Director of the Center for Medicare and Medicaid Innovation, and Winnow AI co-founders and Fellows Program alums Ray Guzman and Paul Vernich. Sharing insights and entrepreneurial lessons learned along their journey as founders, Guzman and Vernich cited the Fellows Program as the source of their inspiration to innovate a technological physician recruitment fix—as well as the springboard that made Winnow’s eventual founding possible.    

“Winnow began with a Fellows story, and now it’s ending with one in terms of how our experience might influence your own,” said Guzman. “The Fellows network actually has the potential to do what it was created to do, which is position healthcare leaders to talk about issues, figure out what to do about them, build solutions together, partner to take new ideas to market and actually change healthcare at scale.”  

Beyond incisive conversations in the classroom, Council Fellows had the opportunity to engage in an onsite immersion at Meharry Medical College, meeting with School of Medicine Dean Dr. Sonja Harris-Haywood to discuss the physician recruitment crisis and specifically, subsequent implications for medical education in the form of a posed 30% increase in student admissions. 

Uplifting the imperative to remedy the workforce shortage so individuals with limited means and complex medical needs are not left without care, Dr. Harris-Haywood also spoke to the challenge of increasing medical class size against the conundrum of residency cap limitations. She emphasized the critical importance of partnering with academic medical centers to help solve for more residency slots and protect access to care for our most vulnerable populations.  

“Meharry is focusing on diseases more likely to affect the community we’ve committed ourselves to serve,” said Harris-Haywood. “Alongside our partners at Vanderbilt, we are the advocates for the Nashville community—especially those who are uninsured or underinsured. For many populations, we are the beacon of hope.” 

Before departing Meharry, Fellows were broken into small groups and completed four patient care simulations in the Meharry Medical College Simulation & Clinical Skills Center, assuming clinical provider roles to navigate scenarios ranging from acute trauma response and social needs assessment to delivery of difficult news to a patient. Of the cohort’s 32 Fellows, two-thirds come from a non-clinical background and collectively reported on the simulations as “eye-opening”, “vulnerable”, “profoundly humbling” and an exercise that significantly deepened their appreciation and respect for clinicians.  

Fellow Reginald Holt, CEO at Meharry Medical College Ventures—a holding company subsidiary of Meharry Medical College created to address health inequities by connecting faculty and students with healthcare experts, advisers and investors—offered his reflections after witnessing his Fellow colleagues experience the clinical excellence taking place at Meharry. 

“Visiting Meharry Medical College with my Fellows cohort was a truly eye-opening experience and a powerful opportunity, especially as many individuals in our class had never been to Meharry or been exposed to the incredible work being done at HBCUs to train diverse physicians and positively impact health equity,” said Holt. “Witnessing my peers’ reactions to the outstanding training environment and experiencing the clinical simulations firsthand was incredibly fulfilling. Many in this cohort currently lead, or will lead, institutions that can support MMC’s efforts to make a difference for those most in need, and I am hopeful this experience stoked the awareness needed to garner support from the collective as opportunities arise to provide it.” 

Zeroing in on rapidly changing consumer preference 

In a subsequent session on market segmenting, Fellows explored the power of data-driven market segmentation as a tool to better understand, and engage with, consumer audiences when bringing new innovations to the marketplace.  

Examining three evolving dynamics that have accelerated consumerism in healthcare—namely, smartphones, the emergence of High Deductible Health Plans and tailwinds from other consumer-driven industries—Fellows evaluated unique consumer characteristics by generation, discussed assumptions as obstacles to understanding their markets and broke down the five necessary criteria for market segmentation to work. 

“One of the interesting misconceptions of market segmenting is that it’s static, or that it’s only utilized to figure out how to reach the audiences to whom you’re communicating,” said Council Fellows alumna Shannon Hooper, walking cohort participants through the four facets of the brand and marketing lifecycle. “In actuality, market segmenting should in many ways be informing how you’re thinking about what you bring to market with each new iteration.” 

As president of Unlock Health, a tech and services platform focused on helping providers understand, find and engage their market, Hooper offered Fellows valuable insights into using segmentation to not only define and unlock consumer nuances, but identify meaningful operational pain points, redefine services and promote better patient data flow. 

The notion of tailoring services to individual consumer needs, or nuance, was also raised in conversation with presenter Marcus Osborne, CEO of RightMove and former Senior Vice President of Health Transformation at Walmart. 

Drawing heavily on his experiences facilitating the launch and expansion of Walmart Health, Marcus shared both success stories and failed attempts in terms of meeting the healthcare consumer where they are, encouraging Fellows to put patients’ needs first and ask thoughtful questions of their market for the best chance at building transformative, scalable solutions.  

“Scale matters because when you start to do things in a repeatable way, the focus isn’t just on quality and consistency—it’s on affordability,” said Osborne. “At the same time, and as one of the great advantages of digital assets, you can introduce components to the experience that enable the individual you’re engaging to feel like they’re special and unique, and that this experience has been specifically crafted for them.” 

Nashville Health Care Council goes to Washington  

Fresh from conversations about digital solutions and effecting transformation at scale, Fellows traveled to our nation’s capital for the inaugural Council-wide D.C. Delegation, joining more than 90 NHCC stakeholders to facilitate conversations and forge connections vital to the future of healthcare in this country.   

Alongside Council Board members, professionals from the Council’s Leadership Health Care program and other key NHCC stakeholders, Fellows spent three days engaging in candid dialogue with elected representatives and other government officials on the critical topics of workforce, behavioral health, cybersecurity and data & AI. Delegates also heard topical legislative updates and asked industry-specific questions of Tennessee Senators Bill Hagerty, Marsha Blackburn and Former Senate Majority Leader Bill Frist, M.D., who founded the NHCC Fellows program in 2013.   

Targeted panel discussions on key topics highlighted healthcare’s mounting workforce crisis both in broad brushstrokes, to the tune of an estimated shortage of 125,000 physicians and as many as half a million nurses in the next 10-12 years, and in specialized fields like behavioral health, where more than 50% of Americans currently live in markets where these providers are in severely short supply. Fellow April Hansen, MSN, RN, who currently serves as group president of workforce solutions for Aya Healthcare, the nation’s leading healthcare talent software and staffing company, spoke to the labor challenges at hand in an opening night executive level-set for delegation members. 

“We don’t have enough healthcare workers in this country and we don’t have them in the right places, so the demand for services is outstripping the supply and that gap is only expected to widen in the next ten years,” said Hansen. “But the problem is greater than a simple supply and demand issue because we also have a distribution disturbance—namely, families in rural areas having to travel unconscionable distances to access the basic, and critical, care they need.” 

Encouraging Council delegates to remain committed to “actionable, real solves that can help diminish these challenges” if even slightly, Hansen charged the group to advocate for expanded education and training offerings, improved immigration efficiencies to globalize the talent pipeline and repairs to the industry’s image problem, working to effect changes that posit careers in healthcare as more attractive and sustainable to those entering the workforce.   

On the subject of long-term sustainability, provider burnout was a recurring theme spanning all panel discussions, as were the topics of equitable compensation and empowering clinicians to work at the top of their license. Pay equity was uplifted as particularly critical in the behavioral health space, where recent studies show psychiatrists and psychologists practicing at the top of their field are consistently paid less than physician assistants in other fields.  

“Bringing people together to hear from both federal and private policymakers and stakeholders on behavioral health parity is imperative to move the issue forward and eventually realize the promise of parity,” said Fellow Risa Weisberg, licensed clinical psychologist and Chief Clinical Officer of RealizedCare. “However, parity in reimbursement of time spent with human behavioral health providers is only the tip of the iceberg. If patients are unable to access a behavioral health provider due to the extreme workforce shortage, true parity doesn’t exist. We need continued work to realize reimbursement for digital therapeutics for behavioral health problems, if we want to achieve full parity.” 

Digital solutions as a gateway to realized parity and workforce relief were the focal point of a Fellows-only immersion experience at the MedStar Institute for Innovation, as well as a delegation-wide panel discussion on “Getting AI Right in Healthcare”. Fellow Greg Aaron, Global Vice President of Client Relationships for Oracle Health, repped the Council and his cohort peers as a session panelist, offering insights into his organization’s strategy to ensure responsible development and deployment of artificial intelligence, or AI.  

Emphasizing transparency and interoperability as paramount, Aaron spoke to the importance of discoverable algorithms, the avoidance of discrimination and bias, and the prioritization of personal data protection, as cloud platforms are now housing “data at a scale that’s unbelievable.” In accord with other panelists, Aaron also discussed the roles AI might play within the reimagined workforce social contract, operating as a conduit to reduce the administrative burden currently driving provider burnout across all sectors and specialties. 

“I look forward to giving two to three hours of pajama time back to our clinicians that they currently spend every night on tasks like charting,” said Aaron. “I also look forward to positioning patients to interact with AI and get their questions answered in meaningful ways, and to reducing some of the financial burdens on our systems and providers that will help them get back to healthy financial margins.” 

Envisioning, planning for healthcare’s future direction 

In the cohort’s final speaker session, Council Fellows engaged in market trend analysis and speculation on the industry’s future direction with health futurist Paul Keckley, biotech entrepreneur/investor Julie Yoo and nonprofit health system executive Rob Allen, evaluating both the challenges surrounding legacy healthcare models and the potential inherent within new innovations. 

Yoo, a General Partner at a16z, leveraged her expertise as a biotech founder and investor to spotlight those areas where she currently sees the industry’s greatest unrealized potential, from the gradual erosion of the “incumbent advantage” to the new AI-powered industrial revolution. Emphasizing the critical (and eternal) question of “whether the startup will get distribution before the incumbent gets innovation,” Yoo praised new tech’s massive potential while also encouraging Fellows not to let technology become a stumbling block.  

“I’ve learned that one of the failure modes of the startup world is overthinking technology,” said Yoo. “One of our most successful businesses is using text messaging to engage its customers. Innovation doesn’t necessarily require fancy tools or AI; it just takes a thoughtful approach and the right packaging to reach the end consumer.” 

Allen, a nationally recognized leader in innovative health and wellness solutions, also advised Fellows on perspective shifts that might steer them toward simpler, more value-based solutions. As President and CEO of Intermountain Health, a not-for-profit healthcare system operating 385 clinics and 34 hospitals across seven states in the American West, Allen is a faithful champion of Intermountain’s mission to help people live the healthiest lives possible—and his organization stands as one of the nation’s strongest examples of value-based care in practice.   

“Too often, we look at the landscape around us thinking that our competitors are other healthcare organizations, and we set our strategies around how we’re competing with those entities,” said Allen. “But in healthcare, our true competitor is actually disease. And if our competition is disease, then success in healthcare takes on a different form, reframing the field and positioning us to bring other players to the table.” 

In small group discussions following the speaker presentations, Fellows expressed the tensions often felt between striving for Intermountain’s mission-based care model and navigating the American economic landscape—a tension Keckley gave voice to just minutes into the day’s conversation. 

“What’s clear about healthcare in the U.S. is that we’ve embraced capitalism,” said Keckley, Principal of The Keckley Group and author of an independent weekly compilation of health news, studies and perspectives. “We embrace a private system that’s going to continue to grow, though in different directions and in different ways.” 

Asked how each of their teams sees the future, cohort participants aimed for a middle ground between abject cynicism and unbridled idealism, acknowledging reality while envisioning actions that might yield lasting meaningful change. 

Speaking on behalf of his small group, Fellow Mike McAlevey reported, “Our group’s two primary takeaways were that as healthcare leaders, we all have a responsibility to spend at least some portion of our time thinking about the future of care in this industry, and we also need to be capable of thinking about the next practical steps. Essentially, we each need to simultaneously be futurists and incremental improvers, or we’re not doing our jobs.” 

McAlevey, who currently serves as Chief Legal & Administrative Officer of HCA Healthcare, went on to share his personal takeaways with the cohort.  

“What I take from this experience is optimism—clearly from the energy and talent, but equally important, from the character in this room,” said McAlevey. “The Greek philosopher Heraclitus said ‘character is destiny’. Listening to each of you and hearing from each of you, I feel very good about the future of this industry.”  

Closing chapter for 2024 Fellows class 

Council Fellows returned to Nashville in mid-May for one last immersive learning opportunity—a closing retreat designed to help participants unlock key takeaways, craft personal mission statements, zero in on opportunities for future collaboration and map out next steps following the program’s conclusion.  

In preparation for the retreat, Fellows reflected on the program’s most valuable lessons and homing in on new frameworks through which to address the industry’s far-reaching challenges, particularly regarding the need for greater investments in public health. 

Returning to the omnipresent issue of health equity and mounting disparities around access, cost and caliber of care, Fellow Nate Akers, Senior Partner at HealthScape Advisors, echoed the sentiments of many of his classmates on the critical importance of social services and preventive medicine. 

“We’ve had a lot of discussions in the past about precision medicine, and I think over the next five years we need to shift to a focus on precision health, moving care further and further upstream to keep people healthier,” said Akers. “If we can innovate and invest in ways to keep each individual feeling better, we can prevent them from cycling through the system and in turn, promote lower costs of care and a higher quality of life.” 

While Fellows agree on the myriad benefits of shifting care upstream through investments in prevention, participants also acknowledge that the industry is currently trending toward exponential spending on breakthroughs in pharmacology—a sector primed for rich clinical innovation, but also one oriented more around treatment than prevention. As such, class members also voiced the importance of introducing incremental changes to the system’s incentive structure, collaborating across sectors to spur greater momentum toward truly value-based care. 

Although the cohort’s five-month intensive closed on May 17, many 2024 Fellows feel their work together is just beginning.  

“I need this group and these relationships to evaluate and solve problems with a wider net,” said Fellow Lindsey Bussabarger, Senior Vice President, Insurance Controller, Trend Analytics & Forecasting for Humana. “With respect to this program, my ‘why’ gets clearer every time our cohort meets, and I anticipate carrying this experience and these connections with me for many years to come.”