Cartoon – No Wonder Leaders Listen
Monthly Archives: March 2018
50 largest US medical group parents
https://www.beckershospitalreview.com/rankings-and-ratings/50-largest-u-s-medical-group-parents.html
Oakland, Calif.-based Permanente Medical Groups ranked No. 1 in the nation’s 50 largest medical group parents, with over three times the number of unique physicians as the second ranked Veterans Health Administration, according to an annual report published by IQVIA.
The report uses data from OneKey, a database from IQVIA that includes nine million U.S. healthcare professionals and 680,000 organizations.
The report ranked these parent companies by total physician affiliations, unique physicians and medical group count. Total physician affiliations are defined as the number of physician bridges between providers and sites, unique physicians are defined as the number of unique physicians affiliated to an integrated delivery network and medical group count is defined as the number of physicians at the IDN’s outpatient center(s), which may be a single specialty or multispecialty business. Imaging centers and surgery centers are not included in this report.
Here are the 50 largest U.S. medical group parents, ranked according to total physician affiliations, unique physicians and medical group count.
No. 1 — Permanente Medical Groups (Oakland, Calif.)
- Total physician affiliations: 19,179
- Unique physicians: 14,757
- Medical group count: 578
No. 2 — Veterans Health Administration (Washington, D.C.)
- Total physician affiliations: 4,909
- Unique physicians: 4,798
- Medical group count: 690
No. 3 — Mayo Clinic (Rochester, Minn.)
- Total physician affiliations: 5,137
- Unique physicians: 4,733
- Medical group count: 128
No. 4 — Ascension Health (St. Louis)
- Total physician affiliations: 5,035
- Unique physicians: 4,218
- Medical group count: 1,136
No. 5 — UC Health (Oakland, Calif.)
- Total physician affiliations: 4,797
- Unique physicians: 4,124
- Medical group count: 397
No. 6 — Fresenius Medical Care Holdings (Waltham, Mass.)
- Total physician affiliations: 5,875
- Unique physicians: 3,229
- Medical group count: 2,479
No. 7 — Providence Saint Joseph Health (Renton, Wash.)
- Total physician affiliations: 3,507
- Unique physicians: 3,054
- Medical group count: 573
No. 8 — DaVita (Denver)
- Total physician affiliations: 3,676
- Unique physicians: 2,737
- Medical group count: 2,813
No. 9 — Trinity Health (Livonia, Mich.)
- Total physician affiliations: 2,864
- Unique physicians: 2,551
- Medical group count: 607
No. 10 — Catholic Health Initiatives (Englewood, Colo.)
- Total physician affiliations: 2,961
- Unique physicians: 2,473
- Medical group count: 766
No. 11 — Sutter Health (Sacramento, Calif.)
- Total physician affiliations: 3,131
- Unique physicians: 2,468
- Medical group count: 436
No. 12 — HCA Healthcare (Nashville, Tenn.)
- Total physician affiliations: 2,838
- Unique physicians: 2,457
- Medical group count: 641
No. 13 — Partners HealthCare System (Boston)
- Total physician affiliations: 2,384
- Unique physicians: 2,178
- Medical group count: 218
No. 14 — UPMC (Pittsburgh)*
- Total physician affiliations: 2,955
- Unique physicians: 2,163
- Medical group count: 642
No. 15 — Carolinas HealthCare System — now Atrium Health (Charlotte, N.C.)
- Total physician affiliations: 2,235
- Unique physicians: 1,885
- Medical group count: 468
No. 16 — Cleveland Clinic
- Total physician affiliations: 1,873
- Unique physicians: 1,656
- Medical group count: 195
No. 17 — Aurora Health Care (Milwaukee)
- Total physician affiliations: 2,245
- Unique physicians: 1,623
- Medical group count: 258
No. 18 — Mercy Health (Chesterfield, Mo.)
- Total physician affiliations: 1,840
- Unique physicians: 1,570
- Medical group count: 515
No. 19 —New York Presbyterian Healthcare System (New York City)
- Total physician affiliations: 1,617
- Unique physicians: 1,506
- Medical group count: 168
No. 20 — NYU Langone Health (New York City)
- Total physician affiliations: 1,743
- Unique physicians: 1,500
- Medical group count: 221
No. 21 — Indiana University Health (Indianapolis)
- Total physician affiliations: 1,671
- Unique physicians: 1,462
- Medical group count: 244
No. 22 — SSM Health (Saint Louis)
- Total physician affiliations: 1,824
- Unique physicians: 1,455
- Medical group count: 274
No. 23 — Penn Medicine (Philadelphia)
- Total physician affiliations: 1,746
- Unique physicians: 1,443
- Medical group count: 210
No. 24 — Advocate Health Care (Downers Grove, Ill.)
- Total physician affiliations: 1,777
- Unique physicians: 1,398
- Medical group count: 284
No. 25 — Baylor Scott & White Health (Dallas)
- Total physician affiliations: 1,596
- Unique physicians: 1,362
- Medical group count: 290
No. 26 — Dignity Health (San Francisco)
- Total physician affiliations: 1,519
- Unique physicians: 1,342
- Medical group count: 396
No. 27 — Northwell Health (New Hyde Park, N.Y.)*
- Total physician affiliations: 1,528
- Unique physicians: 1,337
- Medical group count: 308
No. 28 — Mount Sinai Health System (New York City)
- Total physician affiliations: 1,522
- Unique physicians: 1,326
- Medical group count: 215
No. 29 — Community Health Systems (Franklin, Tenn.)
- Total physician affiliations: 1,497
- Unique physicians: 1,312
- Medical group count: 586
No. 30 — Yale New Haven (Conn.) Health System
- Total physician affiliations: 1,516
- Unique physicians: 1,311
- Medical group count: 202
No. 31 — Emory Healthcare (Atlanta)
- Total physician affiliations: 1,523
- Unique physicians: 1,282
- Medical group count: 119
No. 32 — Stanford (Calif.) Health Care
- Total physician affiliations: 1,403
- Unique physicians: 1,254
- Medical group count: 110
No. 33 — HealthPartners (Minneapolis)
- Total physician affiliations: 1,508
- Unique physicians: 1,254
- Medical group count: 117
No. 34 — Johns Hopkins Health System (Baltimore)
- Total physician affiliations: 1,515
- Unique physicians: 1,251
- Medical group count: 166
No. 35 — Vanderbilt University Medical Center (Nashville, Tenn.)
- Total physician affiliations: 1,655
- Unique physicians: 1,248
- Medical group count: 109
No. 36 — Duke University Health System (Durham, N.C.)
- Total physician affiliations: 1,549
- Unique physicians: 1,229
- Medical group count: 231
No. 37 — Intermountain Healthcare (Salt Lake City)
- Total physician affiliations: 1,452
- Unique physicians: 1,197
- Medical group count: 241
No. 38 — Jefferson Health (Radnor, Pa.)
- Total physician affiliations: 1,372
- Unique physicians: 1,153
- Medical group count: 173
No. 39 — UW Medicine (Seattle)
- Total physician affiliations: 1,459
- Unique physicians: 1,093
- Medical group count: 178
No. 40 — Northwestern Medicine (Chicago)
- Total physician affiliations: 1,370
- Unique physicians: 1,083
- Medical group count: 135
No. 41 — Fairview Health Services (Minneapolis)
- Total physician affiliations: 1,291
- Unique physicians: 1,070
- Medical group count: 139
No. 42 — Novant Health (Winston-Salem, N.C.)
- Total physician affiliations: 1,324
- Unique physicians: 1,063
- Medical group count: 305
No. 43 — Tenet Healthcare (Dallas)
- Total physician affiliations: 1,161
- Unique physicians: 1,052
- Medical group count: 347
No. 44 — Banner Health (Phoenix)
- Total physician affiliations: 1,303
- Unique physicians: 1,043
- Medical group count: 239
No. 45 — University of Michigan Health System (Ann Arbor)
- Total physician affiliations: 1,285
- Unique physicians: 1,039
- Medical group count: 84
No. 46 — Adventist Health System (Altamonte Springs, Fla.)
- Total physician affiliations: 1,180
- Unique physicians: 1,033
- Medical group count: 312
No. 47 — UNC Health Care System (Chapel Hill, N.C.)
- Total physician affiliations: 1,162
- Unique physicians: 1,013
- Medical group count: 211
No. 48 — PeaceHealth (Vancouver, Wash.)
- Total physician affiliations: 1,137
- Unique physicians: 1,006
- Medical group count: 165
No. 49 — Allina Health System (Minneapolis)
- Total physician affiliations: 1,259
- Unique physicians: 999
- Medical group count: 120
No. 50 — Sanford Health (Sioux Falls, S.D.)
- Total physician affiliations: 1,212
- Unique physicians: 964
- Medical group count: 198
To download IQVIA’s full report, click here.
How a sudden departure can affect your job prospects — & what to do about it
So far in 2018, approximately 12 hospital and health system executives have suddenly left their roles. While there are myriad reasons for the departures — ranging from being ousted to personal issues — most of them occurred with little or no notice. Whatever the reason, the question remains: How can executives mitigate the potential fallout?
According to Cody Burch, executive vice president at healthcare executive consulting and search firm B.E. Smith, any potential fallout from a sudden departure can be mitigated if executives remain positive and transparent.
“It doesn’t necessarily have to have a negative impact on [a] healthcare executive’s chances of landing another job,” he says.
There are several reasons behind a healthcare executive suddenly stepping down from their role. Common ones include burnout, termination for cause, personal issues and structural changes in the organization, says Mr. Burch. More recent reasons include consolidation, facility closures and demand for new skill sets. An executive may find they are not the right fit for the role anymore as the demands of the role or organization have changed.
An executive who has suddenly left an organization may find they have fewer opportunities in the job market. Mr. Burch says sometimes organizations looking to fill positions may only consider candidates who are currently employed, so executives who have recently left their roles may see a narrower job market than before.
Job seekers with a sudden departure on their resume may have to navigate challenging waters as they look for new opportunities. Here are five key considerations for these executives:
1. Remember honesty is key. Healthcare is very well connected. Healthcare executives and recruiters know each other, often having crossed paths over several years working in the same industry. The best strategy for executives who are looking for a new job after an abrupt departure is to be honest about their past circumstances.
“It is easy for people to find out the real story in an industry like healthcare,” says Mr. Burch. “Communicate about it honestly.”
2. Proactively address the one question every recruiter will ask. Most recruiters will ask the inevitable question, namely some version of, “Why did you leave your previous role?” Mr. Burch suggests healthcare executives expect that question and address it before the recruiter can even ask it. This gives the executive control over the messaging and narrative.
Mr. Burch says executives need to prepare their response to the question carefully. As much as possible:
• Try to disconnect the reason you are no longer in your previous role from the future.
• Communicate what you learned from your previous experience.
• Keep your answer short and focused on the positives.
• Reiterate your qualifications for the current opportunity.
• Explain why you are great fit for the new organization.
3. Stay positive. Although an abrupt departure can be a negative experience, it is important not to lose your positivity and perspective. “I think there is something to be said for either [the executive] or the employer identifying that the fit just isn’t there in the current organization,” says Mr. Burch. “Being able to come to a conclusion and reflect, truly reflect, on why it didn’t work.”
Finding an organization that is a better fit for the executive is a good thing for both the executive and the organization. It is important not to become bitter or emotional. Take the high road regardless of how things ended with the previous employer.
4. Keep networking. Keep your CV up to date and leverage your relationships within the industry, Mr. Burch says. Networking is always critical, but especially so at times of sudden change. Don’t be afraid to ask for help with your CV and partner with a recruiting firm if needed, he adds.
5. Leverage interim leadership. Executives looking to get back into the industry after a sudden departure can look for interim leadership roles. Use these roles to build confidence and demonstrate their value, says Mr. Burch. This will also help connect you to new people within the industry and potentially, new advocates for your leadership expertise.
“If you handle that transition well and get into a good opportunity for your career, the transition no longer matters,” says Mr. Burch. “People aren’t going to look back at that situation unless it happens commonly and frequently [in your career].”
Health Care Spending in the United States and Other High-Income Countries
Synopsis
A study of why the United States spends so much more on health care than in other high-income countries concludes that higher prices — particularly for doctors and pharmaceuticals — and higher administration expenses are predominantly to blame. U.S. policy must focus on reducing these costs in order to close its spending gap with other countries.
The Issue
Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries.
Health care spending in the United States greatly exceeds that in other wealthy countries, but the U.S. does not achieve better health outcomes. Policymakers commonly attribute this spending disparity to overuse of medical services and underinvestment in social services in the U.S. However, there has been relatively little data analysis performed to confirm that assumption. Writing in JAMA, researchers led by former Commonwealth Fund Harkness Fellow Irene Papanicolas and mentor Ashish Jha, M.D., report findings from their study comparing the U.S. with 10 other high-income countries to better understand why health care spending in the U.S. is so much greater.
Key Findings
- The U.S. continues to spend more on health care. In 2016, the U.S. spent 17.8 percent of its gross domestic product (GDP) on health care, while the average spending level among all high-income countries was 11.5 percent of GDP.
- The U.S. has lower rates of insurance coverage. While health coverage in the U.S. has risen to 90 percent since enactment of the Affordable Care Act, every other high-income country has achieved coverage for at least 99 percent of its population.
- The U.S. has mixed levels of population health. While Americans smoke less than people in other wealthy countries do, they have higher rates of obesity and infant mortality. Life expectancy in the U.S. is 78.8 years, nearly three years less than the average life expectancy in high-income countries.
- Except for diagnostic tests, the U.S. uses health care services at rates similar to those of other countries. Numbers of hospital visits and surgeries performed in the U.S. are similar to those in other countries. However, the U.S. performs 118 MRI scans per 1,000 people, compared to an average of 82 MRIs per 1,000 people among all high-income countries. The U.S. also performs a higher rate of CT scans: 245 per 1,000 people, compared to 151 per 1,000 people among all high-income countries.
- The U.S. pays more for . . .
- Doctors. The average salary for a general practitioner in the U.S. is $218,173, nearly double the average salary across all high-income countries. Specialists and nurses in the U.S. also earn significantly more than elsewhere.
- Pharmaceuticals. The U.S. spends $1,443 per person on pharmaceuticals, compared to the average of $749.
- Health care administration. The U.S. spends 8 percent of total national health expenditures on activities related to planning, regulating, and managing health systems and services, compared to an average 3 percent spent among all high-income countries.
The Big Picture
The study demonstrates that overall health system performance in the United States does not compare well with that in other wealthy nations, particularly given high U.S. spending — a finding consistent with the Commonwealth Fund’s most recent health system rankings. The health care spending gap with other countries appears to be driven by the high prices the U.S. pays for health care services — particularly doctors, pharmaceuticals, and administration. Compared to its peers, the U.S. has similar levels of spending for social services (including both public and private spending) and similar health care use, neither of which appear to be major causes of the spending gap. To reduce spending, the authors say that U.S. policymakers should focus on lowering prices and administrative costs, rather than just reducing use of health care services.
About the Study
The researchers analyzed data on health care spending, performance, and utilization made available by the Organisation for Economic Co-operation and Development and the Commonwealth Fund from 11 high-income countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, Sweden, Switzerland, the United Kingdom, and the U.S.
The Bottom Line
The United States spends more on health care than other countries do because it pays more for health care services and administration.
THREE C’S FOR LISTENING LIKE A LEADER
THREE C’S FOR LISTENING LIKE A LEADER
Listening is a vast ocean surrounded by empty beaches.
I’ve been paying attention to listening, both my own and others. You’re more likely to meet a red-crested tree rat* than to meet someone who actually listens.
5 reasons shallow listening is normal:
- Desire. Listening is such a bother.
- Ignorance. You might listen if you knew how.
- Time. Hurry up. The clock’s ticking.
- Energy. You don’t have energy to listen deeply.
- Discipline. On a list of “hard things to do,” listening is near the top.
Set the stage for deep listening:
Unfocused conversations feel like chasing chickens.
Establish conversational direction or you’ll end up exhausted and disappointed.
- What’s on your agenda today?
- What good thing might come from our conversation?
- What would you like to accomplish during this conversation?
- What’s important for you to bring up during this conversation? What’s important to you about that?
Three C’s for listening like a leader:
#1. Character.
#2. Calmness.
Breathe deeply.
Although listening takes energy, it requires a calm spirit.
Inner agitation blocks listening.
#3. Compartmentalization.
Set a fence around your listening space. You don’t have anything else to do except attend to the person speaking.
Explain time limits before you begin. Because listening requires rigor, you might need to set short-time limits.
After explaining limits, attend fully.
The character of a listening leader:
#1. Courage.
Churchill put it this way, “Courage is what it takes to stand up and speak; courage is also what it takes to sit down and listen.”
#2. Compassion.
“Compassion is the quality of having positive intentions for others. … It’s the ability to understand others and use that as a catalyst for supportive action.”**
#3. Confidence.
Insecurity seems to loosen tongues and close ears.
#4. Openness.
A closed mind lies behind closed ears.
Poor listening is a character issue.
What’s one thing you could do that would make you a better listener?
Which one of these 19 websites are on your must-read list as a healthcare executive member?
https://www.linkedin.com/pulse/which-one-19-your-must-read-list-healthcare-executive-fontenot-iii/
We recently asked some of our healthcare executives which sites were ‘must-reads’ in their weekly schedule.
- Do any of these make your list?
- What would you add?
- Which are the top 3?
Publication | Websites:
- Advisory Board Daily Briefing
- Becker’s Hospital Review
- Daily News
- DRG’s Digital Marketing Daily
- FiercePharma
- Harvard Business Review Strategy + Business, Healthcare Management Science
- Healthcare Dive
- HealthLeaders Media
- IT Weekly & Daily News
- MedCity
- Media Post
- Modern Healthcare
- Politico’s Pulse Check Podcast
- Rock Health
- Skimm
- The Incidental Economist
- Ticadoc
- Univadis Professional Essentials for Practice of Medicine
- Vox
- Leaders in Healthcare
Americans’ Views on Health Insurance at the End of a Turbulent Year
The Affordable Care Act’s 2018 open enrollment period came at the end of a turbulent year in health care. The Trump administration took several steps to weaken the ACA’s insurance marketplaces. Meanwhile, congressional Republicans engaged in a nine-month effort to repeal and replace the law’s coverage expansions and roll back Medicaid.
Nevertheless, 11.8 million people had selected plans through the marketplaces by the end of January, about 3.7 percent fewer than the prior year.1 There was an overall increase in enrollment this year in states that run their own marketplaces and a decrease in those states that rely on the federal marketplace.
To gauge the perspectives of Americans on the marketplaces, Medicaid, and other health insurance issues, the Commonwealth Fund Affordable Care Act Tracking Survey interviewed a random, nationally representative sample of 2,410 adults ages 19 to 64 between November 2 and December 27, 2017, including 541 people who have marketplace or Medicaid coverage. The findings are compared to prior ACA tracking surveys, the most recent of which was fielded between March and June 2017. The survey research firm SSRS conducted the survey, which has an overall margin of error is +/– 2.7 percentage points at the 95 percent confidence level. See How We Conducted This Study to learn more about the survey methods.
HIGHLIGHTS
Adults were asked about:
- INSURANCE COVERAGE 14 percent of working age adults were uninsured at the end of 2017, unchanged from March–June 2017.
- AWARENESS OF THE MARKETPLACES 35 percent of uninsured adults were not aware of the marketplaces.
- REASONS FOR NOT GETTING COVERED Among uninsured adults who were aware of the marketplaces but did not plan to visit them, 71 percent said they didn’t think they could afford health insurance, while 23 percent thought the ACA was going to be repealed.
- CONFIDENCE ABOUT STAYING COVERED About three in 10 people with marketplace coverage or Medicaid said they were not confident they would be able to keep their coverage in the future. Of those, 47 percent said they felt this way because either the Trump administration would not carry out the law (32%) or Congress would repeal it (15%).
- SHOULD AFFORDABLE HEALTH CARE BE A RIGHT? 92 percent of working-age adults think that all Americans should have the right to affordable health care, including 99 percent of Democrats, 82 percent of Republicans, and 92 percent of independents.
The More Things Change, the More They Stay the Same
Cartoon – Expert Opinions
Cartoon – My Best Cognitive Distortions
HENRY KOTULA 