Healthcare Issues & Trends

Advice & Insights for healthcare's Leaders & HR Professionals

Healthcare's Most Talked About Topics

Posted on December 20, 2012 by Gallagher Integrated

INTEGRATED Healthcare Strategies just published our latest insights and reviews on some of the healthcare industry's most talked about topics.

Here are summaries of the featured articles.  Click here to see the full enewsletter.

Protecting Your Executives and the Hospital from Adverse IRS Audit Findings
Executive compensation is already highly scrutinized - so during an IRS audit, you can expect abnormally large figures will raise questions.  There are often good explanations for the high compensation numbers on Form 990 reports, but you'll want to follow these three tips to make sure you protect your executives and organization.  Read more>>
Market Trends in Cardiology Compensation
As payments shift from volume to value, the compensation models for cardiology will continue to shift from individual to group incentives.  Focus on productivity will continue to be encouraged with consideration for financial performance and patient access, but models will continue to evolve to incorporate shared savings and panel size.  In addition, financial affordability and commercial reasonableness concerns will be paramount during the transition period.   Read more>>
"Right to Work" in Michigan -  Why It Happened
Michigan is the latest state to enact anti-union legislation.  Though one of the union stronghold states for over a half-century, the economy in these states has shifted to service-oriented jobs. This has resulted in a growing number of citizens adopting an attitude that unions had their place, but are no longer needed, and can even be a problem.  Read more>>
Physician Leadership Training - What Are the Essential Elements?
Effective physician leadership development programs should teach both "hard" content (operational, legal, policies) and "soft" skills (people management).  In addition, they need to focus on core competencies for successful leadership programs, and incorporate flexible teaching formats that blend multiple techniques to produce the best results.  Read more>>
Effective Leaders in US Healthcare Set Cultures of Celebration
As demands for enhanced patient care experiences increase, a premium is being placed on leaders who can create and nurture high-performance organizational cultures. Follow three steps to begin developing cultures of celebration that yield personal and organizational successes.  Read more>>
Extended Deadline:  Salary Increase & Benefit Trends Survey
The latest in our quarterly INTEGRATED Salary Increase and Benefit Trends Survey opened last month. The deadline to participate is January 18th, so don't miss your chance to submit your survey and get a complimentary copy of the results report!  Read more and participate>> 

AHA Webinar Event: Organizational Culture, Clinician Engagement & Physician Integration - Keys to Success

Posted on December 18, 2012 by Gallagher Integrated

INTEGRATED Healthcare Strategies would like to invite you to attend a webinar hosted by the Physician Leadership Forum, an American Hospital Association (AHA)-related organization.  This free webinar event will focus on the topic of: Organizational Culture, Clinician Engagement and Physician Integration: Keys to Success. We are proud and excited that two of our senior consultants and respected thought-leaders - Dr. William F. Jessee and Dr. David Rowlee - will be presenters. Keep reading for more details and how to register.


Tuesday, January 15, 2013
3 pm ET
(2 pm CT, 1 pm MT, Noon PT)
(90 minutes with live Q&A)

The relationship between hospital and physicians has undergone major transformation over the last 30 years and the pace of that change has accelerated dramatically in the last five years. Physicians have gone from independent practitioners working as guests in hospitals to serving a key role in integrating the delivery of care across the system. Today’s health care consumers and purchasers are holding physicians and hospitals more accountable for delivering care that meets objective measures for quality, safety, cost-effectiveness, and patient satisfaction; driving physicians and hospitals closer together, but without engagement, there won’t be integration.

Join us for a 90-minute webinar to hear from William F. Jessee, MD, FACMPE, and David Rowlee, PhD, of INTEGRATED Healthcare Strategies about the pathways to achieving physician engagement and integration and the influence of culture as a key driver.

To participate in the live event, you will need a telephone line and a computer with an Internet connection.


Click here to register. There is no charge for this webinar.

Healthcare's Senior Leadership Pay Continues to Rise

Posted on December 17, 2012 by Gallagher Integrated

As originally written by Karen Minich-Pourshadi, as appeared on HealthLeaders Media, December 14, 2012.

Across the C-suite, salaries and total cash compensation continue to rise, though changes to incentive structures may be influencing the size of the increase.

INTEGRATED Healthcare Strategies' 2012 National Healthcare Leadership Compensation Survey reports that though the use of annual incentives for executives remains very common, with approximately 80% of all hospitals and systems providing this type of plan for executives, the use of long-term incentives is slowly increasing, explains Kevin Talbot, Executive Vice President and Practice Leader at INTEGRATED Healthcare Strategies.

He notes that an INTEGRATED study indicates from 2001 to 2011 hospitals and health systems began slowly adding more long-term incentives into the executive compensation model. The INTEGRATED data also indicates the most common performance category for annual incentives remains financial (generally, operating margin) though clinical quality and patient satisfaction are also in the incentive mix.

For not-for-profit CEOs nationwide the median total cash compensation (base plus incentives) increased 3% to 6.7% over last year, and these organizations' senior leadership teams gained similar pay increases, according to IHS' survey...

Read full article

Why M&A Deals Crash Down on Two-Thirds of All Healthcare Organizations

Posted on December 14, 2012 by Gallagher Integrated

From an article originally authored by Mark Wade, Senior Vice President, INTEGRATED Healthcare Strategies.

Merger and Acquisition (M&A) activity in healthcare has reached its highest point since the mid-1990s, according to Irvin Levin Associates.  The recent wave of M&A activity does not necessarily indicate that a facility being acquired is having financial difficulty.  Many organizations, especially rural hospitals, view a merger, consolidation or affiliation with a larger system as a proactive way to deal with the uncertainty presented by the Affordable Care Act.  A consolidation strategy can provide an organization with access to capital, increased market share, operational synergies in areas such as technology or supply chain, and increased physician alignment.
It is disturbing, however, that given the significant increase in transaction activity, nearly two-thirds of all transactions fail to achieve pre-deal expectations. 

Seven key reasons for deal failure (as published in the PricewaterhouseCoopers (PwC) 2011 M&A Integration Survey):

  1. Overpaying
  2.  Culture clashes
  3.  Lack of due diligence
  4.  Failure to retain key employees
  5.  Excessive debt
  6.  Lack of communication
  7.  Extended integration

Despite the numerous reasons an organization may contemplate a transaction, all deals have one thing in common – people.  The moment that a transaction is announced, hospital employees immediately begin to ask questions:
“How will this affect me?”

 “Will this change my benefits?”

 “Will I still have a job?”

While this is true in virtually every industry, it is especially critical to have caregivers focused on patients and not the uncertainty that a transaction can bring.  Yet, too often, HR plans, programs, and integration strategies are the last item considered.  This is unfortunate since, according to the  PwC reasons for deal failure, five of the seven directly impact people.
The lack of a thorough HR due diligence can create numerous financial, legal, and operational liabilities.   Often organizations have different benefit plan structures in health benefits and retirement programs.  Also, different compensation programs including base and differential pay, can make it difficult for employees to move between organizations.  Redundant technology platforms such as payroll, time and attendance, and a Human Resource Information System (HRIS) can create financial waste.
When contemplating a transaction, each human resource plan, program or initiative should be closely evaluated for historical and future expense, compliance with regulations (i.e. Employee Retirement Income Security Act and the Department of Labor), and potential barriers to integration.  A proactive integration strategy should contemplate what plans will be combined or left alone and what are the operational and financial implications of these decisions.  It should also include a communication strategy for employees.  Too often, a communication strategy consists of a senior executives saying “Don’t worry, nothing will change.”  There is always change in a merger, but identifying the change and communicating openly with employees will greatly reduce “merger anxiety.”
Thorough HR diligence and creating an integration strategy is not a guarantee that the transaction will be a success or that there will not be challenges.  It will, however, greatly increase your odds that caregivers will remain focused on what’s important – the patient.  This will inevitably impact quality and patient satisfaction which is something that we in healthcare are all focused on.

5 Components for a Culture that Promotes Physician and Employee Engagement

Posted on December 14, 2012 by Gallagher Integrated

From the original article authored by Dr. William F. Jessee, MD, FACMPE, Senior Vice President and Senior Advisor with INTEGRATED Healthcare Strategies.

“Engagement is a pronounced state of enthusiasm characterized by belonging, pride and loyalty which fosters a mutually committed relationship between physicians/employees and organizations resulting in an enduring pursuit of organizational goals and career enrichment.”

That how we define employee engagement at INTEGRATED Healthcare Strategies. 

So how do you achieve measurably outstanding performance?  Without question, it starts with the work force----not only employees, but also physicians, board members, volunteers and others---who are actively engaged in helping the organization achieve its goals.  In the past, managers strived to achieve “alignment” with their physicians and employees---usually defined by creating an atmosphere of mutual trust, open communication, and involvement in strategic decision-making.  But most organizations have found that alignment alone is no longer sufficient.  To succeed today, you need to have active engagement and true integration of your workforce.
Healthcare organizations need to carefully assess surveys on physician and employee engagement, for in reality, many are no more than general  surveys of satisfaction and “happiness” with the work environment.  A truly effective engagement survey genuinely assesses the extent to which employees, physicians, and volunteers are, in fact, “engaged” in helping the organization excel.
Only when your physicians and employees are truly engaged can you then move to the “integration” necessary to achieve high performance.  Real integration is FUNCTIONAL, rather than structural, and is characterized by:

  • Focus on the patient
  • Outstanding communication between caregivers, the patient, and the family
  • Extensive use of care integration tools, such as the patient-centered medical home, medical neighborhoods, case management, lean techniques, etc.
  • Patient involvement in their care
  • Extensive use of IT to support care coordination
  • Enhanced delivery of preventive services
  • Alignment of compensation with performance

In most organizations, achieving alignment, engagement, integration and performance can only occur if the organizational culture demands it.  

Five Components to Achieving a Culture for Physician and Employee Engagement

  1. Passionate, dedicated leaders
  2. Incredible persistence
  3. Communication
  4. Mutual trust
  5. Recognition and reward

Read the full article

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