Stephen M. Mooney

President and CEOConifer Health Solutions

How can healthcare leaders disrupt while maintaining growth?

A curated discussion about agility, disruption and innovation

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AN EXECUTIVE DISCUSSION

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P olitics, regulation and health policy continue to shape the healthcare industry. Meanwhile, there are equally important trends such as consumerism, volume-to-value, disruption and innovations that are driving profound changes in your already-crowded market. All of these issues demand executives’ attention even as they face relentless pressure from

stakeholders to grow. How do health systems strategically prioritize growth while balancing their mission to deliver high-quality care when every misstep has a cost?

Stephen M. Mooney, president and CEO of Conifer Health Solutions, sat down with four healthcare executives at Modern Healthcare’s 2019 Leadership Symposium to explore the strategic initiatives that leaders are undertaking to drive growth and explore how those plans align with their organizations’ missions and other imperatives.

STEPHEN M. MOONEY: What innovations have you implemented, or plan to implement in patient experience or physician satisfaction? How do you foresee these innovations supporting growth in your organization?

SANDRA VAN TREASE: This is everything we do. We think about innovation in a cohesive way, relative to growth and relative to addressing consumer centricity. From a patient engagement perspective, we must encourage innovation to achieve frictionless, high-value care. For us, much of that has come in creating seamlessness as we build partnerships.

PETER BANKO: We think consumer experience is a differentiator and we’ve identified two things that bolster it: giving the physician more control over the consumer experience and giving the consumer more control over their own experience. But peeling that back, we don’t really know who our consumer is, at least in the way that Walmart, Target or Amazon does. So, we’ve spent the last six to nine months assembling all the consumer data, and we’ll continue to do that for another year or two. Internally, we want to be able to ask big questions about our patients and then pull data that can answer those questions. To help us with this, we’ve hired someone outside of healthcare who understands data just to get an understanding, because we want to know our consumer like retail companies do.

PAN

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TS Debra Canales

Executive VP and Chief Administrative OfficerProvidence St. Joseph Health

Clint MatthewsPresident and CEOTower Health

Sandra Van TreaseGroup President BJC HealthCare

Peter BankoPresident and CEOCentura Health

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DEBRA CANALES: We have to focus on this notion of consumerism as a differentiator — as a tool for relevancy, especially as we think about the quadruple aim’s — we add caregiver experience to the traditional triple — move toward a bigger focus on experience and consider the impact on cost containment and affordability. That’s what the consumer wants. They want access and convenience. I want to use my phone, I want it now and I don’t want to go into the doctor’s office. I want an instant solution and I don’t want to have to pay for it. We have a number of leaders on our executive team who have technology experience, and they’ve brought skill sets that have really challenged our conventional thinking and helped us become more consumer centric — while also focusing on helping our care providers deliver the highest quality, safest care possible.

CLINT MATTHEWS: Access is a big issue, in terms of ensuring access across the continuum of care. It has to be easier for people to access healthcare than it is now. We’re working on it, but what we’ve found is, nobody’s good at it. I think most health systems are good at being caring and compassionate, but we need to focus on the patient’s perception of that, the family’s perception of that compassion, that empathy that we have. And sometimes, that compassion needs to be about, “How do you access care?” — rather than just the perception of the nurse or physician at the bedside.

SM: I recently heard an analogy about the consumer experience that I thought was fascinating. When it comes to airlines, you have an incredible experience before you get on the airplane. Everything’s online, you can book your ticket online, you can pick your seat, everything. The experience is amazing before you show up and after you leave. But it’s not necessarily a great experience while you’re on the airplane. Healthcare is more or less the exact opposite. The experience is amazing when you’re in the hospital – you’re treated by incredible nurses and you’re supported by great technology that enables your care. But the experience to get into the hospital and experience after you leave is not that great. So, there are a number of disruptors in our space that are looking to resolve those issues. What big things are happening in your market that you identify as disruptive to your health system? And what are you doing to mitigate, or in some cases, embrace this disruption?

PB: In crafting our strategic plan, our team looked to growth in the S&P 500 over the last 30 years, most of which has come from disruptors like Amazon and Google. We determined that this is how companies are growing, and it’s probably how we need to grow. My frustration is, we’d always talk about organic growth. Well, both provider and payer market share haven’t really moved for most

organizations in a decade, so we need to be conscious about building centers of excellence that people will visit, even if it means driving past two of our competitors. That means we must use our physician organization as a differentiator, paying attention to our physicians rather than treating them like an afterthought. We’re bringing them into conversations and then looking for payers and other potential partners that can help us grow businesses together.

CM: Tower Health has recently partnered with Drexel University College of Medicine, one of the largest schools of medicine in the country, to create a branch campus in our region. We recognize that physicians traditionally stay within the area that they’re trained, so we’re creating this new campus to develop and train the physicians for our region for years to come.

DC: It’s important to consider unconventional partnerships. We just announced a partnership with Cedars-Sinai to redevelop Tarzana Medical Center in California. That makes me say, “wow,” because these two major healthcare providers are partnering instead of competing. It makes me ask, “How can we dance with other partners that may be unconventional?” How do you do that for the greater good and the greater purpose of access, and the mission to

“We have to focus on this notion of consumerism as a differentiator – as a tool for relevancy.”

Debra Canales | Executive VP and Chief Administrative Officer, Providence St. Joseph Health

Sandra Van TreaseGroup President BJC HealthCare

serve more people? We’re also expanding our ambulatory care network with the goal of being 15 minutes away from 15 million people in our communities. This is great for consumers, but disruptive for our current delivery model because it will move a lot of our services away from how we’ve traditionally provided them — inside hospital walls.

PB: Our industry has, for some reason, struggled with that. Behavioral health should, in my view, be a collaboration of the entire community, yet we are challenged to get all the parties at the table to do that. I’ve struggled throughout my career just to get other people to listen and say, “let’s put aside our competitive nature and do something.”

SVT: It’s exactly those sentiments that prompted us to create the BJC Collaborative over six years ago as we sought to get ahead of disruptions. We have eight Missouri and southern Illinois based health systems in our collaborative. Collectively, across our respective organizations, we serve about 11.2 million people. Our collaborative has been a driver of cost savings as we are all focusing on the value equation, consumer centricity, population health and lowering the total cost of care anywhere we can. And, as we get more sophisticated and start really using data in a more comprehensive way, we’ll be thinking about how to approach the market relative to these value-based objectives together. Not only are we building relationships, but we’re also learning from the challenges and successes occurring in other markets.

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SM: We’re seeing more and more of that. You’re right, it’s been tough I think for the industry to get there, but you’re seeing more and more of that happening. What would you identify as your health system’s largest priority to support an overall growth strategy?

PB: Our relationship with our physicians. We’re trying to be less of a hospital organization that happens to run physician practices and be more of a physician organization that runs world-class hospitals. I don’t think we can achieve safety, experience, or growth metrics — or frankly any of our metrics — without our physicians driving the changes. That’s where we spend most of our time right now.

DC: Smart coalitions and collaborations continue to be our priority. We’re okay with admitting that we don’t have all the answers to everything — so how do we partner with those that could bring that intelligence? We’re seeking innovative partners who can help continue to push our edge as we look at the bigger vision of health as a human right and think creatively about how we’re going to get there together. We’re considering what we need to shift that experience and really put the patient or caregiver at the center of that.

CM: We’re constantly trying to maximize our footprint. We’re watching new organizations entering our space that are untraditional and very good at consumerism, but not very good at healthcare. They really don’t understand the mission and overall struggles. Our focus is trying to get to that first premium dollar, because it’s not insurance companies, and it’s not the federal government or state government that manages the cost of care that you talked about. It is physicians and it is hospitals. We’ve more than tripled the number of physicians in our clinically integrated network over the past year and a half, as we’ve grown. We’re also partnering with payers, but many will say, “yes, we want a relationship. You take deep discounts and we’ll sell more product.” And that just doesn’t work, because we have created demand destruction as we’ve improved healthcare, as we’ve improved access, as we’ve shifted toward more ambulatory work and minimally invasive surgeries. This is all occurring as pharma and equipment costs increase. We have to get into that premium dollar space, in order to preserve our longevity.

SVT: We are focused on increasing the number of people who find our organization and our partner organizations indispensable and being a value-based provider of health services. This is important because we are available to meet comprehensive healthcare needs 365 days a year, not just for one episodic visit. But to do that, we are destroying demand in the traditional sense, as Clint said. Providing comprehensive care means we’re keeping people out of the emergency department, keeping them from being readmitted, meeting healthcare needs outside of traditional

“Access is a big issue, in terms of ensuring access across the continuum of care. It has to be easier for people to access healthcare than it is now.”

Clint Matthews | President and CEO, Tower Health

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clinical settings – that’s our role today in care management. And, we have to develop a new way to continue funding our capabilities to do that.

SM: If resources were no object, what one thing would you do differently to drive innovation and growth in patient care and consumerism, revenue and margin improvement, or competitive differentiation?

DC: Investing in the social determinants of health – such as housing, food, clean water and education – is the right thing to do and will take on greater strategic significance for major health systems. I’m interested in continuing conversations about how we can partner with communities to tackle homelessness with more urgency and invest in affordable, long-term housing options, especially for complex patient populations.

SVT: Wouldn’t it be great if the model was one where compensation and the way we provide care were truly about keeping people healthy and helping them live their best possible lives given their current health status, whatever that might be? That would range from the young invincible population to adult patients who have an opportunity to be healthier, to people who are really struggling with some very intense episodic or chronic health realities. We would invest a lot in care management, whether that involves nursing, social work or pharmacy, and we’d have the resources to do that based on how we’d be reimbursed. If we could start over and start from scratch and resources were no object, I think that would be my dream.

PB: Our vision is that every community, every neighborhood and every life is whole and healthy. If I could wave a magic wand and

make it so that everybody in our communities has access to healthy food and water, I would be happy. Many of the issues we face in the system — social determinants — could be helped if every individual just had three healthy meals a day and a safe water source. That would make my job a little easier.

CM: Yes, I think that we must look at health status — I think it’s our responsibility. I wish that the consumers would also see it as their responsibility. There are so many chronic conditions that obesity affects, including diabetes, joint pain, heart failure and depression. We need to solve that issue and help people eat healthier food.

About Conifer Health SolutionsConifer Health Solutions brings 30+ years of healthcare business expertise and is a strategic partner to clients in 130+ local regions nationwide to help strengthen their financial performance, serve their

communities and succeed at the business of healthcare. Learn more at coniferhealth.com.

“We’re trying to be less of a hospital organization that happens to run physician practices and be more of a physician organization that runs world-class hospitals.”

Peter Banko | President and CEO, Centura Health