ACHE report: High healthcare CEO turnover rates now the norm

http://www.fiercehealthcare.com/healthcare/ache-reports-continued-high-turnover-among-healthcare-ceos?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiT0RGaE9USTFOR1F4T0dGbSIsInQiOiJsMHdQVHhVK1pcL0c4S0JpV21SZXJxaVFNU3M5TWFHWWRJSU1XWnp1Szl0VkJlT29xdkFzNWJqdE9YMURvUTJYVjl4NVB3RHlBcVpZMEJVUEVVMVZNakFnUUVPNWV4SzU5amdCeGNWTURDdllzYzhrQWwxdFJHdHlxMDZidnlYN3MifQ%3D%3D

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The high healthcare CEO turnover rates seen over the past several years continued in 2016, according to the American College of Healthcare Executives (ACHE).

The turnover rate was 18% for healthcare CEOs in 2016, down from the record high of 20% in 2013, ACHE announced. Still, this level was approximately equivalent to those seen over the past few years, which the association notes are among the highest in the past 20 years.

Structural changes in the industry appear to be among the main drivers of this trend, according to ACHE President and CEO Deborah J. Bowen. “The ongoing consolidation of healthcare organizations, continuing movement toward new models of care and retiring leaders from the baby boomer era,” she said in the announcement, are likely influences behind the high turnover rates.

These results align with other recent reports of unprecedented turnover throughout hospitals, which are on pace to turn over half their overall staff every five years, according to previous reporting byFierceHealthcare. High turnover rates in the C-suite present organizations with problems beyond recruitment and retention, however, since changes to top leadership can have a ripple effect throughout the leadership pipeline.

RELATED: Hospitals nationwide face unprecedented turnover, report says

With the multiyear trend continuing unabated, Bowen urges healthcare organizations to ensure they have developed succession plans and that they keep them up to date. “Succession planning should include not only naming and preparing immediate successors to C-suite positions, but more broadly an emphasis on developing the pipeline of future leaders,” she said.

ACHE found the highest rate of turnover in the District of Columbia, which came in at a whopping 67%. That result appears to be an outlier, as the second- and third-highest states of New Hampshire and Washington came in at 38% and 30%, respectively. All other states showed adjusted turnover percentages under 30. Alaska, North Dakota and Delaware showed the most stable trends, all three in single digits.

Trump budget proposal cuts billions and would ‘devastate’ healthcare programs

http://www.fiercehealthcare.com/healthcare/trump-budget-proposal-cuts-billions-and-would-devastate-healthcare-programs?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiT0RGaE9USTFOR1F4T0dGbSIsInQiOiJsMHdQVHhVK1pcL0c4S0JpV21SZXJxaVFNU3M5TWFHWWRJSU1XWnp1Szl0VkJlT29xdkFzNWJqdE9YMURvUTJYVjl4NVB3RHlBcVpZMEJVUEVVMVZNakFnUUVPNWV4SzU5amdCeGNWTURDdllzYzhrQWwxdFJHdHlxMDZidnlYN3MifQ%3D%3D

Despite criticism over his initial proposal in March that included huge cuts to the Department of Health and Human Services, National Institutes of Health and Centers for Disease Control and Prevention, President Trump’s fleshed-out 2018 budget will slash billions from those health programs in order to spend more on the military and cover planned tax cuts.

The full budget plan is due to be released this morning at 11 a.m., but the White House administration inadvertently posted the section (PDF) that dealt with cuts to the HHS late Monday before it quickly took it offline.

In addition to a proposal to eliminate $800 billion from Medicaid, the Trump administration wants to make deep cuts to other health programs, including:

  • $5.8 billion from the overall NIH budget, including $1 billion from the National Cancer Institute, $838 million from the National Institute of Allergy and Infectious Diseases and $575 million from the National Heart, Lung and Blood Institute
  • $1.2 billion from the CDC
  • $403 million from health workforce programs, including diversity training, mental and behavioral programs, and select nursing and physician training programs
  • $22 million from the Office of the National Coordinator for Health IT.

Divisions emerge in the Senate on pre-existing conditions

Divisions emerge in the Senate on pre-existing conditions

Divisions emerge in the Senate on pre-existing conditions

Senate Republicans are showing early divisions over what to do about ObamaCare’s protections for people with pre-existing conditions.

Some conservatives, including Sen. Mike Lee (R-Utah), want to simply repeal those provisions and other ObamaCare regulations and leave them up to the states.

But advocates of a more centrist approach, like Sen. Bill Cassidy (R-La.), are speaking out in favor of pre-existing condition protections and endorsing a “Jimmy Kimmel test” for the bill, where no one can be denied coverage.

Other senators are exploring a middle ground where states would have to automatically enroll people in health insurance before they could get a waiver for the regulations, though conservatives object to that idea as Washington overreach.

The disagreements over what to do about preexisting conditions point to the larger difficulty facing Senate Republicans as they seek to find consensus on a host of contentious issues in the healthcare bill.

HOW TO SUCCEED WITH MULES IN A BEAUTY PAGENT

How to Succeed with Mules in a Beauty Pageant

Mules come in many forms. Some are loud, opinionated, and adversarial.

A pleasant mule is stubborn in a beauty queen’s skin.

Beauty queen mules are more dangerous than conspicuous resistance. You end up tolerating negative behaviors and poor results because you falsely believe performance will improve.

Beauty queen mules seem humble, even as they kick back.

3 qualities of beauty queen mules:

  1. Subtle forms of blame are normal and pervasive. Beauty queen mules can’t accept the thought that they’re responsible.
  2. Suggestions or ideas that might improve performance are seldom, if ever, good enough.
  3. Justification for poor choices is normal. They don’t say, “I was wrong.”

Hope is destructive when disappointment becomes a pattern.

Things mules say:

  1. “I don’t really have time to work on this right now.”
  2. “The reason Betty’s projects come in under budget is she has a better team than I have.”
  3. “That’s a great idea.” (But in the end, nothing changes.)

5 things to do with beauty queen mules:

#1. Stop defending your ideas. Beauty queen mules love explaining why your ideas won’t work. Input isn’t good enough to cause them to actually change their behavior.

#2. Stop offering advice. The moment you realize that suggestions are never good enough, stop offering suggestions. Stiff-necks don’t want to change. They want others to change.

#3. Let them be right. “You know, you’re right. My suggestion was off base. Your way is probably better.”

#4. Establish consequences. “This is what’s going to happen if things don’t improve.” The only thing that might help a stiff-neck is suffering.

#5. Set a deadline and remove them if performance or relationships don’t improve. Don’t let hope be the reason you tolerate a mule while others suffer.

Shielding mules from consequences rewards stubbornness, prolongs irresponsibility, and discourages teams.

How might leaders identify and deal with beauty queen mules?

Taking the Nuclear Option Off the Table

Taking the Nuclear Option Off the Table

Image result for nuclear explosion

Last Thursday, fifteen states and the District of Columbia moved to intervene in House v. Price, the case about the ACA’s cost-sharing reductions. At the same time, they asked the court to hear the case promptly.

This is a bigger deal than it may seem, and could offer some comfort to insurers that are in desperate need of it. Apologies for the long post, but the law here is complex and uncertain.

* * *

When the House of Representatives sued the Obama administration a few years back, it argued that Congress never appropriated the money to make cost-sharing payments. The district court sided with the House and entered an injunction prohibiting the payments. The court, however, puts its injunction on hold to allow for an appeal.

The Trump administration has now inherited the lawsuit, and the health-care industry is waiting on tenterhooks to see what it will do. For now, the case has been put on hold. But if Trump drops the appeal, which he has threatened to do, the injunction would spring into effect and the cost-sharing payments would cease immediately, destabilizing insurance markets across the country. It’s the nuclear option.

If the states are allowed to intervene, however, they could pursue the appeal even if Trump decides to drop it. With the appeal in place, the injunction couldn’t take effect until the case is heard and decided.

What’s more, the states are very likely to prevail. Not on the merits: as I’ve written before, the House is right that there’s no appropriation to make the cost-sharing payments. But the D.C. Circuit is likely to be skeptical of the district court’s conclusion that the House of Representatives has standing to sue. That’s why the states want to court to decide the case quickly: they hope to get rid of the lawsuit once and for all.

Allowing the states to intervene would not eliminate uncertainty. The D.C. Circuit could always surprise us and affirm the district court’s decision. Premiums for 2018 would still have to rise in response to the risk that payments might stop sometime next year. And even if the House loses, the Trump administration might be tempted to stop making the payments anyhow—although it’s not clear that it has the legal authority to do so without going through the cumbersome process of withdrawing an Obama-era rule.

Still, insurers could breathe a bit easier. If the states are allowed to intervene, Trump couldn’t blow up the individual markets in a fit of pique.

65 financial benchmarks for hospital executives

http://www.beckershospitalreview.com/finance/65-financial-benchmarks-for-hospital-executives-022117.html

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Hospitals leaders across the nation use benchmarking as a way to determine the areas of their business that need improvement. The continuous process of benchmarking allows hospital executives to see how their organizations stack up against local and regional competitors as well as national leaders.

Here are 65 benchmarks related to one of the most important day-to-day areas hospital executives oversee — finance.

Key ratios
Source: Moody’s Investors Service, “U.S. Not-for-Profit Hospital 2015 Medians” report, September 2016.

The medians are based on an analysis of audited 2015 financial statements for 340 freestanding hospitals, single-state health systems and multi-state health systems, representing 81 percent of all Moody’s-rated healthcare entities. Children’s hospitals, hospitals for which five years of data are not available and certain specialty hospitals were not eligible for inclusion in the medians.

 

Anatomy of a post-acute care partnership

http://www.beckershospitalreview.com/hospital-transactions-and-valuation/anatomy-of-a-post-acute-care-partnership-a-guide-to-finding-the-right-partner-and-forming-a-successful-joint-venture.html

Image result for post acute partnership

In communities across America — large and small — local hospitals serve a purpose that goes beyond being a center for on-demand emergency care. Our nation’s healthcare facilities have a legacy and responsibility as leaders and guardians for the health of individuals in the communities they serve.

As such, it is imperative that local hospitals continue to take the lead in community patient care and avoid being relegated to the position of bystander through managed care or government mandate.

In addition to providing quality patient care, hospitals also have a responsibility to remain financially healthy. And in today’s environment of uncertain and changing regulation, government-mandated penalties, and shifting payment models, hospital leaders are being reminded that financial health and quality patient outcomes go hand-in-hand.

Balancing these two responsibilities is an increasingly tough task. Avoidable readmissions are a cost no organization can afford to ignore, and many of America’s best healthcare facilities are struggling to find an effective solution to their patients’ post-acute needs.

For many hospitals and health systems seeking an answer, partnering with an experienced and proven post-acute care provider has been the solution.

In a value-based world, the ability to manage the total cost of care — from admittance, through acute care, to the post-acute environment — is a strategic advantage for sustaining organizational health and getting patients the right care at the right time, obtaining efficient outcome and attracting and retaining the best and brightest of professional caregivers.

But how do executives and hospital leaders find the right partner, and how can they determine competence and compatibility for their needs?

William F. “Bud” Barrow II, the recently retired president and CEO of Our Lady of Lourdes Regional Medical Center in Lafayette, La., developed what he calls his “Four-Way Test” for evaluating prospective  post-acute care partners.

“There are many players in the sub-acute space, and a lot of them are not in it for the right reasons,” Mr. Barrow says. “There are many small companies formed not to advance care AND make a profit, but to make a profit and flip the company for even more profit.”

“It’s important to partner with a large capital healthcare provider that has demonstrated long-term commitment to patients, to profitability and to doing the right thing at the right time — every time,” adds Mr. Barrow.

The four “C’s” in Mr. Barrow’s test include:

  • Character: Examine the cultural history of the organization and the character of key individuals.
  • Competence: Can they demonstrate long-term, systemic success and expertise in their field?
  • Capital: Is there a financial model in place that suggests sustainability in a profitable way?
  • Creativity: Does the organization demonstrate nimbleness and the ability to rethink and adjust on-the-go based on the uncertainties inherent in healthcare reimbursement and the overall healthcare landscape?

Once a suitable partner is found, Mr. Barrow further identifies three “must-haves” for forming a successful and sustainable joint venture.

  • Organization-wide support

    Support must come from all areas of the organization. Everyone — from board members to medical staff — must understand and support the goal of the enterprise and fully endorse what is a time-consuming process and significant investment.

  • A critical eye

    You must be willing and able to employ a critical eye when viewing your own organization and make a clear and unbiased assessment of what you do well versus what you wish you did well. “Most people are unable to make this critical internal evaluation,” Barrow says. “As a result, they continue to try and do things on their own, often times leading to long-term failure.”

  • Assemble the right team

    The right people must be in place to evaluate various alternatives and possible solutions as you go through the process and fill in the deficit gaps determined in the critical assessment.

Poor evaluation of organizational readiness, Mr. Barrow adds, is one of the most common pitfalls — particularly when it comes to the vital mutual commitment from administration and medical staff.

“There has to be alignment between the business of medicine and the practice of medicine — it’s paramount,” he says. “The prevailing attitude must be that failure is not an option. This is not something where you put your toe in the water, see what happens, and then back out the first time you hit a bump in the road. Everyone must be on board with an all-in focus on clinical networks, evidenced-based best practices, shared accountability and a singular focus on best patient outcomes.”

Nearly two decades ago, LHC Group pioneered a model of post-acute care partnership that has since earned a reputation for enhancing patient outcomes and financial performance in cities and towns across the country. Since then, the company has pursued a mission to build stronger healthcare delivery systems in the communities it serves.

Quality outcomes — for patients and partners — are the driving force behind everything LHC Group does. Quality metrics are now the preferred standard for evaluating post-acute providers, and with more than 60 percent of its home health locations named among the 2016 HomeCare Elite®, and with the highest CMS Star Ratings compared to home health national averages, LHC Group continues to enhance its reputation as one of the top quality home health providers in the country.

“I can think of no other post-acute provider that demonstrates all of the ‘Four C’s’ at the level of LHC Group,” says Mr. Barrow, who formed his first joint-venture partnership with the company in 2007. “Their overwhelming commitment to character, competence and creativity has allowed them to develop the strong capital to deliver on what they promise.”

LHC Group’s record of designing and growing successful post-acute care partnerships throughout the country is the result of years of dedication, tireless work and experience. Their team is accustomed to rising to the challenge of succeeding in the constantly shifting landscape that is the healthcare industry, and they know how to provide value for partners and improved outcomes for their patients.

The conclusion is clear: Choose the right partner. The health of your community and your organization is at stake.