LEADERSHIP SKILLS FOR HEALTH REFORM
Colette CrozeSandy Forquer
ACMHA LEADERSHIP SEMINARDecember 16, 2010
Leadership Skills for Health Care Reform
AgendaWhat are some of the pressures that Health Care Reform presents to Behavioral Health?
What kind of leadership skills will be required to manage within Health Care Reform?
PRESSURES FROM REFORM- Colette Croze
• PERFORMANCE• PURCHASING• FINANCING• INNOVATION
THE TRIPLE AIMENHANCED HEALTH CARE EXPERIENCE
IMPROVED HEALTH REDUCED COSTS
PERFORMANCE
• POPULATION HEALTH• CONTINUOUS WELLNESS• PATIENT ACTIVATION/SELF-CARE• HEALTH HOME• TEAM-BASED MEDICINE• NEW CLINICAL MODELS (E.G. SBIRT FOR MH)• TECHNOLOGY• CRITICAL MASS: VOLUME, INFRASTRUCTURE,
QUALITY
PURCHASING
• SAFETY NET: COVERAGE FOR PEOPLE• BENEFIT PACKAGES, NOT PROVIDER SUBSIDIES • SUBSIDY “CROWD OUT”• COORDINATED BENEFIT PLANS: MEDICAID, HEALTH
EXCHANGES, INDIGENT CARE• DELIVERY SYSTEM DESIGN
FINANCING
• BENDING THE COST CURVE• PAY FOR PERFORMANCE• BUNDLED REIMBURSEMENT• POTENTIALLY AVOIDABLE CONDITIONS• NEVER EVENTS
INNOVATION
• BALANCE COST AND QUALITY• EXPECTATION• EXNOVATION A GIVEN• COMPETITIVE SURVIVAL
WOULD ANY OF US ACCEPT THE CANCER TREATMENT OF TEN YEARS AGO?
LEADERSHIP- Sandy Forquer
• New leadership challenges in the health reform era
• New leadership skills you’ll need in your tool box
• New roles for your Board
New Leadership Challenges
• “Health care reform is a journey to top performance”
• Shift from acute care focus to a population management focus – Shift from “sick care” to “health care”
• IT systems will need new “robust” functionality for bundled payments, sub-capitation and data reporting in order to manage risk effectively in new financial arrangements– New time spans– New responsibilities for holistic care
New Leadership Challenges (cont.)
• New relationship between quality and finance– Recent article in Hospital and Health Networks, November 2010
discusses finance-quality integration– “Quality will explicitly determine how you are paid”– Finance needs to understand the quality measures attached to
payment; quality needs to understand the financial impact of each quality/performance measure and its cost if not met
– Value-based purchasing
• New focus on top performance both inside your walls and outside in the community-at-large– Taking health care to the community vs. bringing the community to
you– New community relationships– Care coordination and clinical integration
The New Leadership Tool Box
• Community relations and networking skills– Identify community partners– Community orientation– Relationship building
• “Mastery” of change management and change leadership ( both the technical and human components of change strategy)
• High level knowledge of quality tools and getting staff to use them
• IT system development to manage new payment methodologies and track performance to payment
More Tools• Assumption-Based Planning
– Defined in Wikipedia as “a post-planning method that helps companies deal with uncertainty. Used to identify the most important assumptions in a company’s business plans, to test these assumptions, and to accommodate unexpected outcomes”
– Example: if you have no experience with a payment methodology such as bundled payments, method allows you to test different performance assumptions and to develop “what if” solutions if performance falls short of expectations
– Resources on Assumption-based planning include:• Critical assumption planning by D. Dunham & Co. • Assumption-based planning by RAND• Discovery-Driven Planning by Rita Gunther McGrath and Ian C. MacMillan
New Roles for Your Board
• Your Board may want to establish a community relations committee to focus on relationships with other healthcare/behavioral healthcare organizations
• Brainstorm on how the organization can develop a community orientation
• Recruit members with experience in complexity management – Strong relationship building skills– Change leadership skills– Collaboration skills
