SAN DIEGO — Monday’s proceedings at the Leadership Summit could be summed up by one word: urgency.
From best-selling author Malcolm Gladwell to superstar quarterback Peyton Manning to executives from major employers, health care leaders were told in no uncertain terms that they need to accelerate their efforts to innovate, redefine their business models and embrace value.
Gladwell, speaking to a standing-room only crowd, noted eloquently — and humorously — how innovators such as oncologist Emil J. Freireich, M.D., and Apple founder Steve Jobs viewed the world differently from the rest of us and pursued radical solutions, often in the face of heady opposition, while others hemmed and hawed.
It wasn’t that Jobs, for instance, was necessarily smarter than his peers elsewhere in the computer industry; rather, he had an urgency to bring something new to the marketplace, Gladwell said.
Offering life lessons learned on the gridiron, Manning, a future NFL Hall of Famer, suggested that strong leadership also comes from those who are able to build trust among their teammates. Much like what he had to do following neck surgery and switching teams, Manning suggested that hospital leaders need to “draw a new baseline” for their operations. “As leaders, we can’t let change drag us down,” he said. Instead, change should stimulate innovation.
Executives from Disney, CalPERS and Walmart, however, delivered the most concrete call for urgency. Each detailed how their organizations are using the power of the purse to drive change in health care and, importantly, how they are ready to reward hospitals that deliver on value.
“You should be afraid of them. Purchasers are not happy,” moderator Ian Morrison joked — sort of — in introducing the panel. “They’re on their own mission for value and they’ll be more in your face. They want partners on this journey.”
Sally Wellborn, vice president of benefits for Walmart, explained how the retailer is contracting with a dozen centers of excellence to incent employees to go to high-value providers. While the arrangements will pay for employees (and a loved one) to go to the Cleveland Clinic or Virginia Mason Medical Center for a procedure, it is also designed to avoid unnecessary care.
“The reason we developed these arrangements is for the hospitals to evaluate the appropriateness of care,” Wellborn said, adding that sometimes surgery isn’t the only or best option.
With a diverse workforce that includes entertainers and hotel housekeepers, Disney is facing a situation of trying to develop benefits that cover a wide range of care. The company spends $1 billion annually on health care and, like Walmart, wants to increase the value for that spending.
Looking two years out, Barbara Wachsman, Disney senior executive of employee health benefits and chair of the Pacific Business Group on Health, says that the company does not want to pay the ACA’s excise tax, which penalizes plans that exceed certain limits. She also noted that for some Disney employees, nearly one-third of their salary goes to cover health care costs.
To bring costs into alignment, Disney is modifying its benefits structure, including expanding narrow networks. Doing so will “disrupt” the lives of employees, Wachsman says. “We need to figure out a way to communicate this to employees. We have to have them walk away and see value in this network; that it is high-quality and high-efficiency.”
And that is ultimately what’s at stake: proving that the care you provide is high-quality and high-efficiency.
“I hope the field hears what was said here and doesn’t give up the opportunity to really partner with purchasers,” said Jim Hinton, president and CEO, Presbyterian Healthcare Services and AHA chair. Hinton joined the panel discussion to explain how Presbyterian is partnering with Intel to, among other things, deliver care at work-site clinics. He emphasized that if hospitals don’t engage in these partnerships, other disruptive forces are on the fringes and ready to pounce.