Searching for a new hospital chief executive in 2014 has to be quite a bit different task than it was 15, or even five years ago.

I know the mission on either side of that timeline has always been to care for patients in the best fashion possible. But health care reform — and its calls to deliver value to the health care consumer, avoid unnecessary care and focus on wellness — has thrown things a bit topsy-turvy in the business.

Texas Health Resources, a 25-hospital system based in Arlington, was recently forced to contemplate those themes in a more fundamental way with the announced departure of its longtime CEO, Doug Hawthorne. For the first time since the organization was formed in 1997, THR had to consider who its chief should be, and it didn’t waste much time, choosing internal candidate and COO Barclay Berdan (below) as the next captain last week.

Barclay Berdan-ceo-texas health resourcesBoard chair Ann Bass tells me that a grasp of the trends, and aggressiveness in addressing change, were traits they were seeking during the nationwide search.

“This is a very rapidly changing landscape, and in order to succeed and provide for the needs of patients and their families, the organization has to be responsive,” she says. “We can’t let grass grow under our feet because we would be doing a disservice to our patient population if we did.

“It’s a very interesting world that we live in with respect to health care. It’s really changing very rapidly, and so I think one of the things that executives these days needs to be able to do that maybe they didn’t before is be able to be conversive about the complicated, national governmental area.”

Medicare and Medicaid, of course, have been around for quite some time, but “aspects of those programs have not received as much attention as they have in the past,” she adds. As the mantra goes, which we keep hearing at conferences and roundtables, breaking even on Medicare is a critical strategy, with reimbursement on the more lucrative commercial side not what it was.

As for Berdan, he tells me that he isn’t concerned with trying to make his own personal mark on the system when he starts as CEO next month (don't forget he’s been there for years, and already has made a name for himself, points out Bass). Rather, THR is “still in the same race” under its new chief, and Berdan plans to focus on executing the last two and a half years of the organization’s 10-year strategic plan.

Getting acquainted with the new role will involve a lot of listening, to the health system’s providers and payers, but especially to the increasingly discerning and consumer-like patients.

“Patients are becoming much more educated and aware,” he says. “The systems are being designed where, from an economic point of view, they need to be more informed as incentives are put in place, and we need to get out and pay attention to how people perceive the system, where they think the strengths and weaknesses are, and how we can use information technology to get our message out to consumers so that they really continue to develop a broad and warm feeling for the brand Texas Health Resources.”

The system has already made a couple of consumer-oriented maneuvers, including announcing in April that it would start sharing quality data with the public “warts and all” to help foster accountability and speed up improvement. Plus, they announced last month an affiliation with CVS Caremark and 34 of its clinics in the Dallas-Fort Worth area, aiming to add access points for THR patients.

The organization isn’t far from creating its next 10-year strategic plan, and Berdan imagines that access, affordability, wellness, forging partnerships and providing team-based care in alignment with physicians will all likely play a factor in the next roadmap.

“We’re not the only ones thinking of these kinds of things,” he says. “There are a lot of companies investing in a variety of access points in north Texas. I sometimes worry that, when all is said and done, we’ll have as many freestanding emergency rooms on as many corners as there are Walgreens and CVS (stores), and I’m not sure that helps to attack access or cost in the marketplace. And, I’m not sure it really does anything to improve continuity of care. That’s a big piece of our strategy: How do we link the various points of delivery and access into a more coherent system for patients?”

What does your hospital or health system value in a chief executive in this uncertain environment? And what do you think your next strategic plan will look like while planning for the next decade? Share your thoughts in the comment section below.