Is your leadership team transformational?

If not, you may find yourselves wallflowers at the biggest dance since your high school prom. And we all remember what it felt like standing next to the punch bowl pretending to act cool as we mocked our buddies who, through the miracle of miracles, landed a date. Yet, secretly we were pretty envious, wishing we could be out there dancing the night away as the cover band ripped through one Journey song after another.

The reality is, all of your potential dance partners are being very picky these days. They are looking for organizations with visionary leadership teams that are committed to following through on the opportunities that lie ahead.

My colleague Mary Grayson, on Page 8, declares that this century has been "the era of CEO commitment." She notes that initiative after initiative would have withered on the vine without the "full and constant support of the CEO." Consider patient safety, which is a top agenda item around the executive table and in the boardroom. Now, as Grayson points out, that constant drumbeat from the C-suite has turned patient safety on its head with front-line staff taking ownership of the movement.

To survive in the next iteration of American health care, executives will need to embrace delivery system transformation with the same level of vigor. But don't take my word for it; listen to those who are already out there driving the change, like Charles Kennedy, CEO of Accountable Care Solutions at Aetna.

"We are selecting partners with executive leadership that sees the same type of change that we think is possible. Much like venture capitalists, we are investing in the leadership team," he says. "We are looking for leadership that is committed to following through."

I spoke with Kennedy in late July, shortly after KLAS issued a report evaluating insurers and their ACO strategies. In "Accountable Care Payers: Partners in a Changing Paradigm," KLAS ranked Aetna as "transformational" and described the company as "forward thinking." By comparison, Cigna ranked as more of an operational player and one that may be a "good learning opportunity for cautious providers."

But the evaluative process doesn't stop there. Financial firms and rating agencies also are putting leadership teams under more intense review. Last spring, the three major credit rating agencies each issued reports signaling that leadership commitment to transformation will weigh heavily in future assessments. As the Standard & Poor's report put it, "A larger percentage of time in Standard & Poor's management meetings is now devoted to health care reform and preparedness, and we expect management to adequately and articulately address their proposed strategies and their ability to execute them."

Just as they did with patient safety, hospital executives must become agents of change. As Stephen Covey wrote in his 1992 book, Principle-Centered Leadership, "The goal of transformational leadership is to 'transform' people and organizations in a literal sense — to change them in mind and heart; enlarge vision, insight, and understanding; clarify purposes; make behavior congruent with beliefs, principles, or values; and bring about changes that are permanent, self-perpetuating, and momentum building."

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