Healthcare Issues & Trends

Advice & Insights for healthcare's Leaders & HR Professionals

Defining Employee Engagement is Complex

Posted on March 25, 2013 by Gallagher Integrated

Searching to define employee engagement is complex, that's why INTEGRATED Healthcare Strategies has put together a new video series on the topic that features our own Dr. David Rowlee making it Clearly Understandable.

These videos are a great resource for understanding employee engagement by taking out all the complex scientific terminology and explaining it simply and effectively. Please take a few minutes to take a look and we'll make understanding engagement…Clearly Understandable.

Check out the first few videos here:



Concierge Medicine Practices - A Growing Trend

Posted on March 18, 2013 by Gallagher Integrated

In 2012, there were approximately 4,400 physicians providing Concierge Medicine services in the United States, and research shows that the numbers will just keep growing.  A survey on practice patterns from Merritt Hawkins found that 9.6 percent of “practice owners” were planning to convert to concierge practices in the next one to three years.

Also known as Primary Direct Care, Concierge Medicine is appealing to physicians worried about cuts in Medicare payments and the end of fee-for-service medicine.

We've always been committed to providing the best healthcare industry data on current and future trends, so INTEGRATED Healthcare Strategies is pleased to offer healthcare organizations the opportunity to participate in one of the first surveys dedicated to Concierge Medicine.
Whether you currently have a Concierge Medicine practice or not, INTEGRATED wants to hear from you!
Key areas the Concierge Medicine Survey will report on

  • Demographics including number of FTE MDs providing Concierge Medicine services
  • Fee data including base annual, fee structure, services included in the base fee, and more
  • Compensation plans for Concierge Medicine physicians (i.e., base, base plus incentives, revenue less expense, per patient, wRVU, etc.)
  • Program accessibility (physician availability, on-call rotation program, etc.)

For participating in the survey, you'll get practice benchmark data not currently available in the industry - all participating healthcare organizations will receive a FREE copy of the results!
Deadline:  April 16, 2013

Click Here to Take the Survey Now

The Force Behind Decreasing Union Representation: Human Resource Leaders

Posted on March 12, 2013 by Kevin Haeberle

Since 1983, the percentage of private sector employees represented by a union has decreased from 16.5% of the workforce to 6.9%.  In those 30 years, union leaders have looked for answers through a self-examination which has returned a litany of results:  blaming and attacking each other, launching corporate campaigns, creating strategies around a radically new direction of political influence, and then back to an organizing and striking focus.  Despite all the efforts and gnashing of teeth, no significant union membership growth resulted, and instead even produced a political backlash culminating in Michigan becoming a “right to work state.”

Why are Unions Failing?
Even with hundreds of millions of dollars spent from members’ dues, labor unions have experienced one failed strategy after another.  There are a number of possible variables contributing to the failure, but one thing remains constant over the same 30 year period - an ever-improving employee relations workplace environment led by Human Resource leaders across the country.  Simply put, employees today are managed and led better than they were 30 years ago.
Findings from the INTEGRATED Healthcare Strategies Employee Engagement Surveys show that most healthcare employees believe they have a meaningful voice in the workplace, they are paid competitively, they are treated with dignity and respect, and they have trust in their leadership team.  Even job security concerns are low, both from indiscriminate employment action and staff reductions.  With these type of results dominating the landscape in healthcare, there is little opportunity for union leaders and organizers to exploit employee discontent. 

What are Union Leaders to Do?
It is in a labor union’s  nature to be adversarial and to attack.  A nature that has resulted from the federal labor law that governs and manages union relations. The National Labor Relations Act (NLRA) was enacted in 1935, and unfortunately cemented the workplace relationship of the early industrial period.  Over 80 years ago, lawmakers never thought that the workplace would become more of a partnership and that an industrial-based workplace would be replaced by a service-based economy.  Congress members from 1935 would be amazed at the incredibly positive workplace relationships that now exist (especially compared to 1935).
Union leaders are faced with quite a dilemma.  Employees generally have a positive view of their workplace and a good relationship with leadership.  Further afflicting their cause, union leaders have still not figured out how to make their product more attractive to this new generation of workers.
The solution is as simple as it is beguiling.  If you cannot convince a majority of employees to vote for a union, simply change the rules so that the union only needs a small number of disgruntled employees to bring in the union.  But, this cannot possibly happen in a democracy, right?
The proposed regulatory changes for how unions initially get into a workplace are designed to create such a world.  The changes range from a very short education campaign period which results in the majority of employees being uniformed and not motivated to even vote, to creating small voting units in non-acute care settings.  The unions have thrown any political nicety aside and are using their current influence to simply change the playing field from a level surface, to one heavily tilted to their side.
Our research shows that 6% to 10% of the workforce is inherently negative.  This group of employees is naturally skeptical to the point of paranoia, and believe the organization and its leaders are acting badly no matter how positive the news.  Unions have always marshaled this group of employees to be their internal organizers and usually to become union stewards and negotiators if the union wins the election.  Fortunately, in most healthcare workplaces, the negative voice of this small number of employees is usually drowned out by the positive attitude of the majority.  As long as an employer created an overall positive workplace, the threat of a successful union organizing attempt was minimal.

A Round of Applause for the Human Resource Professionals
The constantly evolving Human Resources teams have helped lead the way in creating and maintaining a workplace where most employees have a positive outlook, and trust that the organization has their best interests in mind.  This incredible transition in the last 30 years has pushed union representation to become almost negligible in the modern workplace.  Unfortunately, unions have possibly come up with a  successful strategy in circumventing all of HR’s hard work.
Human Resource leaders know the issues.  How do you gain the attention of healthcare executives to a problem that does not yet exist?  With all the pressures of the changing healthcare environment facing healthcare leaders, directing any of their precious leadership focus time to prepare for a potential union strategy onslaught is no small feat.  It does not help that predictions over the last five years that the union “sky is falling” have not come to fruition.  So, it will probably take a major event before the issue gets attention.  The year 2013 appears to be the time when a major event may occur at a number of hospitals across the nation.
The message here is that healthcare organizations need to prepare now so they are in the best shape to stand up against their labor union adversaries when they attack, and not wait until it is too late.

Bozeman Deaconess Health Services (BDHS) Selects Kevin Pitzer as President and Chief Executive Officer

Posted on March 8, 2013 by Gallagher Integrated

We're happy to offer our congratulations to Kevin Pitzer, recently selected as the President and CEO of Bozeman Deaconess Health Services (BDHS)!  Mr. Pitzer starts his post on or before April 15, 2013. 

The announcement also calls for congratulations to MSA Executive Search, an INTEGRATED company and the search firm that conducted the nation-wide search that presented Mr. Pitzer as a top candidate for the position.

According to a press announcement released by BDHS, Terry Cunningham, Chair of BDHS Board of Trustees, said, “Throughout the interview process, Kevin displayed a keen knowledge of the health care industry, and importantly, a firm grasp of and firsthand experience with the coordinated, collaborative care models that will be driving the future of health care delivery. In addition, Kevin has a history of being able to build strong bonds of trust with physicians, and the ability to identify and communicate a strategic vision throughout an organization.”

Jane Groves, Executive Vice President with MSA Executive Search, tells us there was widespread support for Kevin Pitzer as the ideal candidate to fill both the cultural and operational requirements for this position. Members of the Board, Medical Staff, Senior Leadership and Management, plus employee feedback, all reinforced Mr. Pitzer as the best leader to drive BDHS forward.

The announcement provided by BDHS noted that Pitzer’s depth of experience working with physicians will also be of great benefit to the Montana healthcare organization.

Mr. Pitzer was most recently a Senior Vice President of Essentia Health and Chief Administrative Officer of the Essentia Health-West Region which serves eastern North Dakota and western Minnesota.

Read the full press release

Hospitals and Healthcare Leaders Portrayed as the New Villains

Posted on March 3, 2013 by Kevin Haeberle

The stories and jokes have been around for some time—$500 for a hammer; $1000 for a toilet seat; $50 for a single bolt.  The private defense industry and what it charges and gets paid has continually been the source for late night television humor and examples of public indignation on an industry run amok.  Now, those of us who have committed our careers to leading healthcare delivery ask, “Are we next?”
A Time Magazine cover story titled, “Bitter Pill, Why Medical Bills are Killing Us,” (February 2013) placed hospitals and hospital leaders in the crosshairs of accusations for what is wrong with healthcare in the United States.  Other articles and congressional testimony, as well as advocacy groups and labor unions, are mounting a well-funded and focused attack on hospital business practices, particularly non-profit healthcare providers.
All of this is not new, but the public reaction is.  In the period leading up to DRG’s (Diagnosis-Related Groups), the attacks on healthcare costs were constant and well publicized.  Hospitals were paid on a cost plus system, which actually penalized efficiency.  Stories of a $40 aspirin or $1000 for simple x-rays were included in newspaper stories across the country.  But in those glory days of healthcare, the community and politicians regularly came to the defense of the hospital.  The rationale was that the people in the hospitals were committed to patient care, and it was the fault of the system, not the people leading healthcare institutions.  Oh, how times have changed.
The Time Magazine article represents only the tip of the Titanic-sized iceberg.  Hospitals and hospital leaders are portrayed as the new villains.  Characterized as uncaring, greedy, arrogant and overly compensated—hospital executives and non-profit hospitals are being depicted as money-driven with a focus on building empires instead of the needs of the communities they serve.  Those of us who have devoted our lives to healthcare know that this is far from the truth.

Why do the Accusations Against Healthcare Leaders Continue?
Simply put, hospitals and healthcare organizations need better public relations.  They do an excellent job marketing services—Top 100 heart  hospital; the most Board Certified Physicians; billboard time pieces showing how short the wait time is in their Emergency Department.  But many healthcare organizations do a poor job communicating themselves as a valuable, mission-driven asset to the community, or as a complicated business and requires highly talented leadership.
Of course, facts need to back up marketing efforts.  The Time Magazine article made much about the chargemaster and how arrogant hospital leaders are in their approach to what is “publicly” charged.  What healthcare organizations charge and what they get paid for are two separate concepts.  For instance, what is paid results in many other costs not being paid, which causes more items to be priced in a way that “subsidizes” the others.  Then there is the fact that recruiting top leaders into a very complicated business model requires competition for talent with the private business sector.  All of this healthcare leaders know, but they are reluctant to effectively communicate it to the public—missing an opportunity to change harsh opinions into understanding ones.
If you don’t think public opinion matters, consider the next time the hospital needs support to expand the street in front of its facility, or to extend a stoplight an additional 15 seconds so patients and visitors can cross easier.  How will the community and political leaders react?  In cities across the country, hospital leaders now face extreme opposition to a simple construction plan request.  Labor unions have fueled high levels of public distrust to rally anti-hospital support that has not only caused problems for hospitals, but resulted in healthcare leaders losing their jobs.
Another sign of the growing tide—a potential for legislative action on controlling leaders’ salaries if the organization accepts federal funding.  This notion would have seemed far-fetched just a few years ago, but in today’s climate, it will pick up speed.

What are Hospitals and Healthcare Leaders to do?
Possible solutions come from examples of other industries and institutions that have faced similar attacks.  A number of years ago, the railroad industry was seen as outdated and incredibly inefficient.  Much of this attack was led by the developing and burgeoning trucking industry, but railroad company leaders’ responses were limited.  They held on to the belief that the public viewed railroads as the foundation of what made America great.  “How could anyone think that railroads are bad?” they naively reflected.
But as railroads looked for more government financial support so they could compete with the trucking industry, little public support existed unless the railroads made changes.  What happened?  Change did begin to occur, but it moved too slowly to alter public opinion.
The railroad industry realized it had to be proactive in changing public opinion.  The industry began an extensive public ad campaign specifically designed to improve its image—not to sell their product or service, just to convince people to view railroads more favorably.  As a child, I recall being perplexed by the ads since I figured most people reading them would never actually buy any railroad cargo transportation.  It seemed to be a wasted use of marketing money.  Only later did I realize what the real objective of the ads was to change public perception—and it worked.
One CEO who I had the privilege to work with was quite insightful about the public opinion of hospitals, and particularly, hospital leaders.  He made a comment that rings so true today—being a healthcare leader is like being the mayor of a city.  If you look at the mayors of large cities, they promote their city and themselves.  A mayor’s staff should include someone whose main job is to ensure the public perceives the mayor and other city leaders as tireless servants committed to the well-being of the community.  Some of us may see this a “politics,” but if we accept that healthcare leaders are like mayors, then that type of politics should become part of the modern leaders’ skill set.
If hospitals and healthcare leaders take a defensive or even victim-like approach, it is likely the governmental change brought on by the Affordable Care Act will pale in comparison to the next wave—where hospital and healthcare leaders are perceived as a problem that needs to be controlled at the highest level possible.

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