New Mandates, New Roles: Understanding Emerging Leadership Positions in the Rapidly Changing Health Care Market

Roadmap for The Discussion

A New World (Again)

New and Emerging

Leadership Roles

Taking Action

Objective: Ensure optimal care to as

many people as possible

Focus: Pay-for-Performance Population-Oriented Prevention Aspirations: Better Patient Outcomes Holistic Care Lower Costs (Better

Quality)

Objective: Help as many people as

possible Focus: “Heads in beds” Fee-for-Service The Individual

Reality Inefficient Reactive Care Unnecessary and More

Expensive Treatments

Medical Exchanges Fee-based

reimbursement Medical Homes

Population Health

Management Risk-Based Payment

Healthcare Reform

Volume Value

Healthcare reform is driving a shift from “volume-based” to “value-based” care.

A number of factors stand in the way of moving towards a value-based care model.

Incentives based on volume not quality Paper-based processes Complex regulations Need to fully engage physicians Uncertainty about magnitude of change VBP would bring Belief that VBP may be a fad Uncertainty (e.g., about exchanges)

Volume Value STOP

Though not the only answer, digital technologies offer a key means for transforming healthcare organizations to a value-based model.

Volume Value Digital Technologies

Big Data

Population management Innovation

Process improvement

Cost efficiency

Social Patient chat rooms

Patient-Patient support

Idea-sharing/medical research

Mobile Rapid, point-of-care

information sharing Clinician/Patient connectivity

Remote medical advice

Wireless tracking

Case Examples

Geisinger: XG Health Solutions Geisinger’s traditional focus on IT

leads the organization to identify new applications/opportunities for information and technology Goal is to assist provider

organizations in becoming high-performing population health management systems using data capture, analytics and dissemination

Excellus Excellus has identified new

opportunities in customer sales/service as result of healthcare reform Goal is to use technology to market

directly to customers through online and retail channels

Digital transformation is not about implementing IT projects, it’s about wholesale organizational change.

New equipment

Systems upgrade

Information security

New payment models

Remote treatment

Data-driven decision making

IT Projects Fundamental Change

Roadmap for The Discussion

A New World (Again)

New and Emerging

Leadership Roles

Taking Action

While many new titles are emerging, three primary responsibilities sit at their core.

1. Strategy/Innovation

2. Driving Change

3. Digital Expertise

Chief Innovation Officer

Vice President, Digital Ventures

Chief Accountable Care Officer

Chief Digital Officer

Chief Analytics Officer

Chief Transformation Officer

Emerging Titles New Core Responsibilities

Core Responsibility #1: Innovation

Common Titles Chief Innovation Officer – externally focused Chief Strategy Officer

Required Competencies:

Superior interpersonal /communication skills

Highly developed political skills

Continuous Quality Improvement – safest patient centered care

Knowledge of population health management and pay for performance

Background Experiences: MD/PhD, RN, CMIO, CIO Thorough knowledge of

trends, forces shaping HC delivery – patient centered medical homes, chronic disease optimization

Effective leadership/ management in complex system

Commercializing or research - IP

Accountabilities: Setting Strategic Vision -

developing a new care model Transforming HC services Improving quality, efficiency

and safety Identifying, assessing new,

emerging HC technologies Developing ACO /Population

Health strategy/products Delivering HC at lower cost Generate non-traditional

business opportunities that result in innovative HC solutions

Role: CHIEF INFORMATION OFFICER/CHIEF INNOVATION OFFICER

Objective: To re-conceive the method by which D-H makes and supports its core clinical and administrative systems. To identify and implement innovations that provide optimal platforms and opportunities for new business creation and commercialization.

Requirements: •Knowledge of medical informatics, clinical use of data and telecommunications •Knowledge of value-based care delivery and population health management. •Lead new business innovations

Role: VICE PRESIDENT DIGITAL VENTURES

Objective: Develop a digital strategy that is focused on innovation, research,

technology development and new product introduction. Improve patient care, reduce costs and position the company to

better meet the needs of its clients.

Requirements: • Strategic vision, innovation and managing change • Analytical thinking and business planning • Versed in analytics and outcomes • Customer Focus

Core Responsibility #2: Driving Change

Required Competencies: Exceptional

Interpersonal skills Change management -

success persuading stakeholders to adopt changes

Track Adoption, utilization

Effectively leads in a cross functional, matrix reporting structure

Background Experiences: Most often a physician

or nurse leader – MD, MSN, RN, MBA or MHA

Long tenure within organization

Health Plan and provider

Care Management/primary care

Familiar with clinical IT

Common Titles Chief Transformation Officer – internally focused Vice President, Population Health

Accountabilities: Operationalize process

improvements to increase quality, efficiency and patient sat

Identify and close gaps in population management capability

- Implement change that minimizes resistance and maximizes employee engagement

Role: CHIEF TRANSFORMATION OFFICER

Objective: Drives internal transformation agenda (elimination of preventable harm and delays) Assures Innovation is the collaborative engine that drives transformational improvements Effectively translates innovations into operations Ensures the collaboration and coordination of results and methodologies and / or best practices to and from the consulting practice. Requirements: Lead and manage significant change activities Think strategically as related to organizational effectiveness competencies Project management and data analysis skills

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Role: CHIEF TRANSFORMATION OFFICER

Objective: To accelerate Vanguard’s transformation to compete more successfully in the rapidly changing healthcare delivery environment To lead the rollout of efforts including new ventures.

Requirements: •Strategic business development and operations experience •Information technology with concentration in e-Commerce strategy •Use of mobile, social media and online platforms as convenient ways for customers to manage their health and access products

Core Responsibility #3: Digital Expertise

Common Titles Chief Digital Officer Chief Information Officer

Required Competencies: Strategic and Business

Acumen Relationships and

Influencing Ability to drive

innovation Technical Depth

Accountabilities: Assessing digital

opportunities and risks Use the data and

insight to improve care delivery

Use the data and insight to better position organization

Use the data to provide more consistent experience across digital platforms

Background Experiences: Strategic business

development & operations Information technology E-Commerce strategy Use of social media Consulting

Role: CHIEF DIGITAL OFFICER

Objective: Connecting current and future digital initiatives Ensuring that CVS Caremark continues to use the most innovative technology available to seamlessly meet customer needs Develop and lead teams driving CVS Caremark’s companywide digital innovation efforts Requirements:

•Experience leading digital innovation in an information intensive industry (Financial Services, Media, Transportation and Health care) •Building and deploying digital capabilities via disrupting the business from the inside •Leverage corporate information and platforms

Role: CHIEF INFORMATION OFFICER

Objective: Developing Master Information Technology Strategy and corresponding roadmap that works in concert with the Mayo Clinic Operating Plan Promote a greater “systemness” in Mayo Clinic’s IT strategy, ensuring organization maintains an interconnected network of care that is more readily accessible and more affordable.

Requirements •Generating, evaluating, integrating and managing knowledge and information. •Using analytics as a driver for successful planning, implementation and transformation •Working in a constantly changing, fluid and undefined environment

Strategy & Vision

World-Class Data & Analytics Capabilities

Insight & Impact – Leverage Data

Influence vs. Ownership

These new roles require new leadership skills.

Traditional Skills

Technical Expertise

Operational Excellence

Top-Down Management

Business Acumen

New Skills

Roadmap for The Discussion

A New World (Again)

New and Emerging

Leadership Roles

Taking Action

Healthcare Transformation Diagnostic Vision & Strategy Strategic Plan: We have a formal strategic plan that clearly outlines how the organization will move from volume-based

reimbursement to value-based reimbursement. Data and analytics: Data and analytics (“Big Data”) play a central role in our plan to effectively move to a volume-based

reimbursement model—e.g., by helping us better manage risk, predict patient behaviors, drive operational efficiency. Digital Technology: New digital technologies, such as mobile devices, cloud computing, and social media, play a central role in our

plan to effectively move to a value-based model. Leadership Team CEO: Our chief executive officer fully understands the obstacles preventing our transition to a value-based reimbursement model and

is actively working to overcome them. Leadership Team: Our executive leadership team fully understands the obstacles preventing our transition to a value-based

reimbursement model and is actively working to overcome them (within each of their respective functions and collectively across the business).

Board: Our board fully understands the obstacles preventing our transition to a value-based reimbursement model and is actively working to overcome them.

Transformational Leadership Roles: We have targeted transformational roles at the C-suite level with specific accountability for: strategy/innovation, change/transformation, data /analytics, and digital responsibilities.

Organization and Culture Awareness: Our employees across the organization fully understand the difference between volume- and value-based

reimbursement and are aware that we have a formal transformation strategy. Application: Our employees across the organization understand how our transformation strategy specifically impacts their day-to-day

work. Engagement: Our employees are engaged in and excited about our transformation to a value-based model. Systems & Processes: Our technology systems and internal/external processes fully support our transformation to a value-based

model. Measurement & Reward: Our performance, remuneration and recognition systems clearly reinforce our transformation to a value-

based model.

Emerging Positions

TITLES Chief Transformation Officer Chief Innovation Office Chief Analytics Officer Vice President, Digital Ventures Chief Digital officer Chief Accountable Care Officer

QUESTIONS How many of your organizations are ready to embrace the changes resulting from volume to value based care? What are some of greatest obstacles that you see? Mobile, Social, Big Data – are these digital technologies being implemented in your organizations? Are any of these roles being created within your organizations? What are the titles and responsibilities?