There is an old cook’s adage — you have to break eggs to make an omelette.
As healthcare providers begin their uncertain journey from a sick care/pay-for-procedures business model, this phrase will become an immutable truth for healthcare leaders as they navigate the challenges of making transformative changes to how they deliver and staff the care to their customers.
How an organization responds to this oncoming freight train — we can see its light at the other end of the tunnel — is dependent, in large part, on how the Chief Executive Officer prepares their teams emotionally and intellectually.
Making these sweeping changes will require that we break some eggs. We will have to change things we are comfortable with. We will have to recognize that hospitals may not be our core business in just eight to 10 very short years. We will have to do more with less because we are going to be paid a lot less.
Lets start by saying that the Patient Protection and Affordable Care Act, also known as ACA or Obamacare, for all of its benefits, has some serious flaws that should be addressed. Now, this post is not intended as a camouflaged endorsement of, or an attack on, ACA.
There has rarely been a perfect piece of legislation voted on, much less approved, by the Congress that did not have flaws/issues, even silliness, that needed to be addressed when someone finally got around to reading what the law actually said. That was certainly the case with the GOP sponsored Medicare pharmacy legislation, also known as the Medicare Modernization Act, which passed in 2003 during a highly unusual three-hour roll call vote in the middle of the night, and went into effect in 2006. In fact, one of the last tweaks to that bill was contained in the aforementioned ACA, revising the dreaded, so-called Do-Nut hole covering beneficiary deductibles.
Even if the GOP wins the Senate and the House, unless they gain a veto-proof majority, or the Supreme Court mortally wounds it on their second bite of the appellate apple in a year or two, ACA is probably here to stay, the threats of Rush Limbaugh to leave the country notwithstanding.
So it behooves all senior leaders, their political point of view aside, to educate their employees, physicians and other community stakeholders with a matter-of-fact review of the various elements of this rather large bill, the even larger set of regulations, and the litany of potential and perceived unintended consequences. Trashing healthcare reform in management and medical staff meetings and in community forums, as I recently witnessed, may make you feel better if you are opposed to the bill, but it will not serve you well when you have to begin adjusting your operating culture to make the new business model work.
Leaders need to be mindful of this key human law: the vast majority of people, and employees, are reluctant to change.
When leaders rant endlessly to their managers against a piece of legislation they do not like (ACA), when they regularly voice gloom and doom over a virtual certainty — that we will have to change the way we do business because we cannot afford not to — it will just make it harder to succeed when the time comes. Not succeeding may mean that our patients are placed at greater risk or that a community which depends on their healthcare system to ensure a better quality of life, is poorly served.
We should be able to break eggs, improve our system and do a better job for our patients/clients.
© 2022 John Gregory Self