designing our future: hospital leadership in innovation ... · designing our future: hospital...

Designing our Future: Hospital Leadership

in Innovation and Transformation

LHA 2019 Rural Health Leadership Conference

Andy Shin

Chief Operating Officer

AHA Center for Health Innovation

November 7, 2019

Disclosure of Relevant Financial Relationships

The following faculty of this continuing education

activity has no relevant financial relationships with

commercial interests to disclose:

Andy Shin

Redefining the healthcare ENVIRONMENT

Cultivating new MINDSETS

Reimagining the PRACTICE of healthcare

Collaborating through an ECOSYSTEM approach

Leading with COMPASSION

Transformational healthcare leadership looks like…

AHA Agenda for Innovation And Transformation

• Public PolicyLong-term policy planning

• Center for InnovationThe Value InitiativeMarket intelligenceEducation and learningBuilding innovation

capacityTools, data and products

• Field EngagementNew methods of

engagementEngaging other

stakeholders

• Best-in-Class Operations

Developed to enhance assistance and value to our members in this rapidly changing environment.

Encourages fluidity between the areas of public policy, innovation and field engagement to leverage all aspects of the AHA.

All areas of the AHA are working together through the One AHA approach to advance members’ priority issues at the center of our work.

The goal: To assist members in a seamless and simplified way, getting the field the tools and resources they need to achieve optimal health in their communities.

AHA Agenda for Innovation And Transformation

Innovation [in-uh-vey-shuh n]

noun, verb

One possible definition:

• The process of taking new

‘ideas from inception to

impact’

• An ‘idea’ is the match

between a problem and a

solution

• The process is critical, not

products or services

Services are aligned to assist members in 3 areas

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Redefining the Healthcare

Environment

“The two things you don’t want to be running, for the next ten

years are… academics and healthcare”

-Austin Goolsbee (The Forbes Napa Conference), August 2013

IS BEING “SIMPLY THE BEST” ENOUGH ANYMORE?

…OR DO YOU HAVE TO BE UNIQUE?

…and make trade-offs!

When your smartphone replaces the entire store

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We don’t decide who our

competition is…

THE CONSUMER DOES.

2018: A Year of

New Entrants

2019: The

“potential”

disruptors

have a name

Healthcare is Prime for Disruption

Patient Expectations

Consumers of health care expect an

experience similar to other industries where

access to services and information is easy,

convenient and on their terms

Changing Incentives

The shift from fee-for-service to value-

based-care is changing the roles the

various sectors in health care play as

well as how they interact with one

another.

Complex Care

Advances in science and medicine are

increasing the complexity of care delivery.

Meanwhile, changing lifestyles and

increasing life expectancies are leading to

further complicated diseases and conditions.

Rising Costs

With health care expenditures

representing nearly 20% of GDP, there

is opportunity to capture revenue as

well as reduce costs.

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Hospital & Health System Disruptor Framework

Hospitals

and Health

Systems

1. Technology-based

Innovation

3. Market Structure

Transformation

Big Tech:Amazon, Google, Apple, Microsoft,

Epic, IBM, etc.

Startup Tech-enabled Services:Babylon, Virta, Omada, Cricket,

Livongo, Pear, etc.

Virtual Care Providers:Teladoc, American Well, MDLive,

InTouch, Doctor on Demand,

SOC Telemed, etc.Vertical Integrators:

CVS/Aetna, United/Optum,

Walmart, Cigna/Express Scripts

Payer Organizations:Oscar Health, Devoted Health,

Clover Health, Bright Health, etc.

2. New Model Organizations

Provider Organizations:One Medical, Cityblock, Landmark,

ChenMed, Contessa, etc.

Source: AHA Center for Health Innovation Market Insights

https://www.aha.org/center/emerging-issues/market-insights/year-in-review

THE NEW HEALTHCARE STRATEGY

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Cultivating New Mindsets

“If every instinct you have is wrong, doing the exact opposite must be right”

- [Paraphrasing] George Costanza (Seinfeld)

““

In the word question,

there is a beautiful word – quest.

I love that word.

Elie Wiesel

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A Quest for Catalytic Questions…

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DISCOVERY

SKILLS

4 Year Olds- 95%

Novelty Rate

Adults- 5% Novelty

Rate

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If failing is so

great…

should we aim

to fail?

““

- Ed Catmull, President of Pixar and

Disney Animation Studios

To be wrong as fast as you can is

to sign up for aggressive, rapid

learning.

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Reimagining the Practice of

Healthcare

"We're delivering, perhaps, 'Star Wars' solutions into a 'Flintstones'

health care system,"

- Dr. Freda Lewis-Hall, Chief Medical Officer, Pfizer

Digital Health

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Digital Solutions Make for Good Headlines

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Digital as a New Asset Class

Source: AHA Center for Health Innovation Market Insights

https://www.aha.org/center/emerging-issues/market-insights/telehealth

Virtual Care is

Critical to

Transformation

Age dictates what patients value in their

healthcare consumption which closely relates

to attitudes towards AI

Retirees Millennials

Lack a Primary

Care Doctor15% 33%

Desire for Greater

Physician Attention71% 41%

Positive View of AI 82% 72%

Source: AHA Center for Health Innovation Market Insights

https://www.aha.org/center/emerging-issues/market-insights/ai

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Don’t forget

about low tech-

high value!

What is Our Goal?

Goal: Build a social movement so all care with older adults is

age-friendly care:

• Guided by an essential set of evidence-based practices (4Ms);

• Causes no harms; and

• Is consistent with What Matters to the older adult and their family.

Our first aim is to reach 20%: 1000 hospitals & 1000 primary care

practices by December 31, 2020

Age-Friendly Health Systems

The 4Ms Framework

4Ms Framework: Hospital

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The Dual Process Model

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Pattern Matching

Infrastructure

Culture

Strategy

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Collaborating through an

Ecosystem Approach

“When an industry with a reputation for difficult economics meets a

manager with a reputation for excellence, it is usually the industry that

keeps its reputation intact.”

— Warren Buffet

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• 71% will increase

collaboration with other

providers and payers on

population health

• 80% will increase

investments in behavioral

health services

• 74% say 10%+ of their

patients will be covered by

risk-based contractsSource: Society for Healthcare Strategy & Market Development. Futurescan 2018-

2023: Health Care Trends and Implications. American Hospital Association

9 out of 10 Americans have health insurance,

but out-of-pocket expenses for premiums and

deductibles are growing faster than overall

inflation and earnings

Individual Perspective

Source: Kaiser Family Foundation. 2017 Employer Health Benefits Survey.

The Average worker

spends almost $6,000

each year on health

insurance for a family

plan.

Insurance Expenditures Growing

Source: Kaiser/HRET Surveys of Employer-Sponsored Health Benefits

On The Rise

The number of Americans with chronic conditions is rapidly rising

Source: Robert Woods Johnson Foundation. Chronic care: making the case for ongoing care. February 2010.

Number in Millions

Impact of social determinants of health

The role for hospitals and health systems

Partnering with Other Stakeholders in

the Healthcare Ecosystem

FORMING A COMMON

IDENTITY + PURPOSE

Atrium Health and Novant HealthCharlotte, North Carolina

What: One-year demonstration project to

advance health equity through hospital and

community group partnerships for place-

based interventions

Who: 10 anchor hospitals across the

country

Support: technical assistance partners

The Hospital Community Cooperative

Moving to Value

55

Blue Premier is “Leap Forward” for Risk-Based Payment

Hospital Partners

• 2-sided risk arrangement, within 3 years

(shared savings model)

• Up to 2% increase in fee for service

payments

• In 5 years, all 4 million BCBS NC

members will be attributed to a risk-

based contract

Non-affiliated physician practices

• Practices join BCBS NC ACO

program

• Infrastructure (including data) support

from Aledade

• Goal of > 10% spend on primary care

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Leading with Compassion

“Compassion is not a virtue. It is a commitment. It’s not

something we have or don’t have. It’s something we

choose to practice.”

- Bren ƴe Brown

• 77% say workforce shortages likely

to be one of the 3 most significant

challenges facing their organization

• 88% likely to implement strategies

such as increasing staff engagement,

raising salaries or expanding their

recruitment budget to compete for

talent with emerging providers

• Approximately half of all physicians

who work in a care delivery setting,

report being burned out

Source: Society for Healthcare Strategy & Market Development. Futurescan 2019-2024: Health Care Trends and Implications. American Hospital Association

Sexton JB, Adair KC, Leonard MW, Frankel TC, Proulx J, Watson SR, Magnus B, Bogan B, Jamal M,

Schwendimann R, Frankel AS. “Providing feedback following Leadership WalkRounds is associated with

better patient safety culture, higher employee engagement, and lower burnout.” BMJ Quality & Safety. 9

Oct 2017.

WELLBEING ∝ SAFETY,

QUALITY, INNOVATION

CAPACITY…

Bohman, B. et. al. “Physician Well-Being: The Reciprocity of

Practice Efficiency, Culture of Wellness, and Personal

Resilience.” NEJM Catalyst. April 26, 2017.

https://catalyst.nejm.org/physician-well-being-efficiency-

wellness-resilience/

ADMINISTRATIVE CLINICALRelationships

Communication

VISIONMISSIONGOALS

Institutional Management Patient Management

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What Will Be Your Leadership

Legacy/Signature?

• Possible Self

• Storytelling

• Authenticity

What/Who Shaped Your

Leadership Identity?

• Family, Faith, Friends…

• Inter-personal

• Empathy

How do you Lead today?

• Crucibles of Leadership

• Diversity & Inclusion

• Leading on the Edge of

Uncertainty

“Anxious Eyes”

James Stanfield, 1987

“Anxious Eyes”

ashin@aha.org

@shinovation

www.aha.org/center

Thank You for Helping Us To Achieve Our

Highest Potential for Health