Good Ole Boys Be Gone

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Hospital CEOs at major systems have enormous influence over their institutions, but does that power necessarily translate into the ability to influence the behavior of an entire industry—specifically to transition the healthcare system from a place that treats the very sick to a partner in a system of improving health?

That may be the top issue that hospital CEOs nationwide face in the next few years. Some forward-thinking CEOs out there believe strongly that their future and the future of their healthcare organizations depends on seeking new ways of aligning with physicians and teaching people to use the system to keep themselves healthy. Yet I am left to wonder: As dynamic as some of these leaders are, will they be change agents, or will the system have to be changed for them—either by the forces of consumer-directed market dynamics or, less subtly, by government mandate?

Some members of this title set clearly want the system to be changed for them. They are content at this point to run a clean hospital, keep the doctors happy and hope for the best. Although that modus operandi has historically been the hospital administrator’s secret to success, the future may well force those folks out. Hospitals that are not prepared to swap inpatient beds for better disease management programs, to start competing on value, and to be transparent in their clinical and financial operations may very well struggle as the paradigm shifts.

Even those who have jumped willingly into the role of change agent have their work cut out for them. Outside the hospital walls, such CEOs face a political climate that is often hostile to the needs of providers, a public that has been inundated with more healthcare information that they can manage, some attorneys general who are convinced that the hospital industry is on the take, and employers who don’t really care why their healthcare bills are rising, they just want it to stop.

So why push the rock up the hill? The true leaders recognize that their role is somewhere between the two options above. Clearly, waiting for change is not the best path. On the other hand, CEOs may be limited in how much influence they have to shape the system in a way that is ideal for hospitals. But hospital chiefs will be a loud voice in a coalition of stakeholders who must change healthcare delivery in the next few years.

Hospitals will not get all they want. Everyone will share the pain. Margins are somewhat healthy now, so the real pain has not started yet. But it’s coming.

Jim Molpus




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