When times are good, it is easier to lead.  When times are tough, good leaders are the ones who build and retain the strongest teams.

Earlier Sunday, as I sat in the lobby of the Chicago Hilton where the American College of Healthcare Executives will commence their annual congress on Monday, I had a chance to visit with several old friends, CEOs, regarding the challenges they face in running health systems and hospitals.

Here is a sampling of what these accomplished CEOs think, the articles in Modern Healthcare and other healthcare periodicals notwithstanding:

  1. Finding a bigger strategic partner – Look before you leap.  Some of the potential bigger partners have their own set of serious financial problems that they are able to conceal.  The conventional wisdom is that bigger will afford more flexibility in resolving core, structural problems.  It won’t.  Moreover, a merger is like a marriage – it should not be entered into too quickly. You need to carefully assess the motives – and the “needs” of the suitor.  Nor should a governing board allow itself to be stampeded by a retiring CEO.  If you engage a strategic adviser, pay them for the quality of their advice, the ability to offer well-reasoned options, not a self-serving solution.
  2. Get ahead of the curve – Medicare, Medicaid and commercial payers will all reduce reimbursements over the next seven years just as the number of Medicare beneficiaries will explode.  Health systems, hospitals and other providers need to redesign their care systems NOW as a cost reduction strategy that will enhance quality, reduce risks and protect financial margins.  Changing the way you deliver care flies in the face of existing culture and physician patterns of practice.  This type of change will not happen overnight. 
  3. Affordable Care Act is here to stay — The Fox News Kool-Aid notwithstanding, CB 2030 – aka Obamacare — will not be repealed; tweaked, but not eliminated.  Now is the time for healthcare CEOs to do what they do best:  become adept adapters.  We are not an industry that enjoys getting out in front with innovative ideas.  We tend to punish innovators. Adapting is not to be confused with innovating.
  4. The future of healthcare is now — It is easy to smugly dismiss futurists with claims of reductions in payments from Medicare, Medicaid and commercial payers.  We are entering a new era in healthcare – the new normal – where innovators will shine and their ideas will redirect the delivery of healthcare services.

© 2012 John Gregory Self