Category Archives: Leadership Implementation

In need of a new lens on demographic trends

Posted on by • Posted in Demographics, Disruption, Health System, Hospital, Hospital Industry, Leadership, Leadership Implementation, Strategic Alignment, Strategic Leadership, Strategy • Leave a comment

As we’ve discussed before, our view is the healthcare system faces two fundamental demographic challenges across the next decade.

The first is how to sustainably accommodate 80M Baby Boomers—all of whom will be over 65 within the next ten years and in the Medicare program. This will entail providers learning to care for seniors in a much lower cost, lower intensity way, and payers (the federal government and insurers) to design benefits, networks and reimbursement approaches that support a more appropriate model of care delivery.

The second, often less discussed, is how to adapt traditional delivery approaches for the (even larger) Millennial generation, who will enter their “fix me” years within the next decade, and bring their high-demand, high-information, digitally-oriented consumption behaviors to an industry that has been built for older consumers more accustomed to the “hurry up and wait” model.
 
Our concern for incumbents, as the graphic suggests, is that they view these two demographic challenges through the lens of their current business models and seek to protect their legacy economics.

We commonly hear provider executives talk about “taking a wait and see attitude” and having a bias toward “no-regrets moves”. Why should we embrace price transparency, destroy demand for our own services, or disrupt ourselves, while we’re still making so much money on fee-for-service medicine?

But self-disruption is becoming an urgent priority as newly-emboldened outsiders look to upend the traditional model. Players like CVS, UnitedHealth Group and others view now as the time to assemble low-cost delivery assets and redesign network and benefit structures to capture the loyalty of those Boomers in Medicare Advantage plans for the next decade or more. And technology companies from Amazon to Google see an immediate opportunity to build new models around consumer loyalty as well, moving at Internet speed.

The sooner incumbents wake up to the reality that these unprecedented demographic forces demand a new approach to doing business, the better their chance of avoiding being outflanked by these kinds of disruptors.

 

Trump craves big action on drug prices to take to the campaign trail

Posted on by • Posted in 2020 Election Issues, Food and Drug Administration (FDA), Health Insurance Coverage Adequacy, Health Policy, High Deductible Health Plans, High Drug Prices, Indecision, Leadership Implementation, Out of Pocket Expenses • Leave a comment

https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2019/07/03/the-health-202-trump-craves-big-action-on-drug-prices-to-take-to-the-campaign-trail/5d1b9aa21ad2e552a21d5228/?utm_term=.e49cb9f99e60

Image result for high drug prices

There may be a modest slowdown this year in the growth of drug prices, but it’s nowhere near the seismic shift President Trump has called for. And that seems to be irking the president to no end.

Much of the president’s frustration has been borne by Health and Human Services Secretary Alex Azar, a former drug executive who until very recently pushed back on proposals to allow the importation of lower-cost drugs from Canada and give the government the tools to directly negotiate lower drug prices in the Medicare program, my Washington Post colleagues Yasmeen Abutaleb, Josh Dawsey and Laurie McGinley report.

But now, under intense pressure, Azar has reversed his long-standing opposition to at least one of those ideas: drug importation, an idea typically embraced by Democrats and dismissed by Republicans and the drug industry.

“Inspired by the president’s passion, Secretary Azar has been pushing FDA to go even bigger and broader on importation,” a senior administration official told my colleagues, although the official declined to detail specific policy changes.

It’s been a little more than a year since Trump promised Americans, in a speech from the Rose Garden, he would slash the price of prescription drugs in the United States. In that time, his administration has proposed some bold new regulations that could help move the needle, but only one has so far been finalized — a new requirement that went into effect this month for drugmakers to list prices in television ads.

While Azar has championed a proposal to eliminate the secretive rebates drug manufacturers pay to insurers, opposition to the idea from Domestic Policy Council head Joe Grogan is hamstringing the effort, my colleagues report. Grogan dislikes its estimated $180 billion price tag and doesn’t view the measure as central to the administration’s drug-pricing effort, they write.

There’s another proposal under review at the Office of Management and Budget to tie some Medicare drug prices to those paid by other countries, but it’s opposed by key Senate Republicans and the drug industry.

A senior administration official downplayed talk of tension between Azar and Grogan, saying the two, along with White House legislative affairs director Eric Ueland, speak three times a week about what is happening on Capitol Hill.

And on Monday, the New York Post published a joint op-ed by Azar and Grogan praising a recent executive order from Trump aimed at more transparency around the prices negotiated between hospitals and insurers.

“President Trump has promised a better vision: a health care system that treats you like a person, not a number,” Azar and Grogan write. “He wants to hold providers and Big Pharma accountable to transparency and reasonable prices.”

Meanwhile, drugmakers have continued hiking prices, albeit a bit more slowly on average. List prices for branded drugs grew 3.3 percent in this year’s first quarter, compared with 6.3 percent in the first quarter of 2018, according to SSR Health pharmaceutical analysts. Bernstein analysts told Politico that drug prices jumped 10.5 percent over the past six months, less than over the same period last year but still four times the rate of inflation.

Trump has frequently referenced some encouraging data from the consumer price index, where the index for prescription drugs fell by 0.6 percent for the 12 months ending in December, according to the Bureau of Labor Statistics. The index also dropped in January, February, March and May — a string of monthly declines not seen since 1973, my Post fact-checking colleagues recently noted.

Yet these data are a far cry from the drastic price reductions Trump would love to tout on the campaign trail as he seeks reelection in 2020.

“By all accounts, drug prices are a fixation for Trump, who frequently sends advisers news clippings and summons them to the White House to rant about the issue,” Yasmeen, Josh and Laurie write. “The guy likes to make money, and he thinks they make too much money,” said one former senior administration official.

A senior administration official told my colleagues there was frustration at a lack of executive branch tools to lower drug prices and that some of Trump’s ideas were ambitious but unworkable.

“Disagreements over how to proceed have created a policy free-for-all as different advisers — and the president himself — pursue what appear to be ad hoc and sometimes dueling approaches,” they write. “Trump entertains proposals usually pushed by progressive Democrats one moment and free-market GOP ideas the next.”

 

6 DEFINING VALUES OF A LEADERSHIP CULTURE

Posted on by • Posted in Culture, Employee Engagement, Employee Surveys, Implementation, Leadership, Leadership Alignment, Leadership Cares, Leadership Commitment, Leadership Culture, Leadership Flexibility, Leadership Implementation, Leadership Listens • Leave a comment

http://www.leadershipdigital.com/edition/daily-innovation-leadership-2019-06-16?open-article-id=10712652&article-title=6-defining-values-of-a-leadership-culture&blog-domain=n2growth.com&blog-title=n2growth-blog

Twelve years after launching culture change consulting services, I am finally sitting down to write about six defining values of a leadership culture. These are factors I’ve learned that define whether an organization can improve their Culture or not. No surprise that all six values rise and fall on leadership.

Before I unpack the six values, let me paint the backdrop of how it all began. In 2006, one of my CEO clients in Sarasota, FL shared with me his annual employee engagement survey. Most Type A leaders are charming, demanding, and unlovable, but not Steve. He had a caring heart just below the surface of his Type A layer. Even in his frustration, he oozed care and concern for people. We sat in his office while he shared his most recent employee engagement survey, and because he cared so much, he was frustrated. He didn’t like the pre-formulated questions, and he didn’t know what to do with the report results. He was delivered a canned report with no clear direction. “David,” he asked, “can you build me an employee engagement survey that we can customize around the kind of culture I want to create?” Like all good consultants, I said, “probably, let me do a little research and get back to you.” After I flew home from my monthly trip to sunny Sarasota, I did as I said and began to research and evaluate his request. As I dug around the internet, three data points came to light.

The first data point revealed that most employee engagement surveys were un-customizable. Surveys were built for mass production, not carefully and strategically customized for unique cultures. Why should the 8-year old, first generation, 88-person software development company in San Diego expect to have the same desired culture as the 48-year old, 3rd generation, 268-person manufacturing company in Rochester, NY? To me, that made no sense for the client, but all the sense to the vendors who mass-produced their expertise to increase profit over quality. Their research determined that one of the most important questions that define a good corporate culture is “Do you have a best friend at work.” Really? How does that define one’s culture? I am quite blessed to have had many best friends over the years, but none of them worked with me. Whether my best friend worked in Chicago or with me in Allentown never impacted my like or dislike of corporate culture.

The second data point was that most employee engagement surveys and the firms that employed them were extremely heavy on reporting data overload, but weak on meaningful implementation. Before starting Walton Consulting, Inc. in 2001, I worked for a boutique strategy consulting firm out of Princeton, NJ that developed and delivered high-cost elaborate strategic plans. The client would outwardly applaud the mountain-sized strategic planning document full of analysis, logic, and recommendations. However, inside I am sure they were asking themselves, “what the hell do I do now, and why did I pay so much for something I don’t know what to do with…maybe I should hide it on the bookshelf and refer to it in ‘name’ whenever I want to drive a random point home to my employees.” It is the same way with employee engagement surveys. The client gets a pretty report, but without the creator of the report, the expert on the topic to help with implementation, the report becomes an article of affection or dissatisfaction (depending on the results of course). As with many consultants, the implementation phase becomes an afterthought, a monumental chore that gets swept under the carpet and ignored.

The third data point was an epiphany that corporate culture was the missing cog. At this juncture of Walton, I had been focused on delivering consulting services to CEOs and business owners to help them grow healthy organizations. I was already delivering strategic planning, sales and marketing strategy and leadership recruiting services, all of which helped grow organizations, but the culture cog was missing. As I pondered on the importance of corporate culture, I intuitively understood that the culture cog acted as a fuel valve that could either spur on growth or squelch it. I reflected on how much corporate culture was really the vineyard soil that determined the environment’s capability and capacity for growing good fruit and producing a rich yield.

Wow, I must build this tool for my client I thought. It is not only critical as a foundation for successful organizational growth, but it also fits neatly into my core service offerings focused on “healthy” growth. In 2006 I launched the Culture offering. Now, 13 years later, with over 3,000 employees surveyed, and a marketplace foaming at the mouth about culture with quotes like Peter Drucker’s, “Culture Eats Strategy for Breakfast,” I am ready to share six values that leadership needs to employ if they plan on truly Changing Culture. Check back next issue where I will reveal what they are and why they are so important to growing a healthy organization.

Here are six leadership values that impact culture:

  1. Leadership Cares
  2. Leadership Alignment
  3. Leadership Listens
  4. Leadership Commitment
  5. Leadership Implementation
  6. Leadership Flexibility

For the purposes of this article, leadership is defined as the CEO and his or her executive team. Let’s deep dive into each factor…

LEADERSHIP CARES

There are different reasons why leaders care.  I had one client who cared because he was experiencing an employee revolt.  He was truly concerned that if he did not get his arms wrapped around his dysfunctional corporate culture that he would have a mass exodus on his hands.  Some leaders care because they understand that improved culture leads to improved profitability.  Other leaders care because they want to enrich the lives of their employees.  Bottom line, the leadership needs to care.  A friend and colleague of mine who was the President of a mid-market global firm told me flat out; he just didn’t care.  The employees to him were a means to an end.  Another human resource colleague of mine cares deeply about changing their culture, but she isn’t the CEO, and without the CEO caring, it will never get the attention it needs.

LEADERSHIP ALIGNMENT

When beginning a culture change endeavor, the likelihood that the CEO and all of the executive team really cares, views culture impact with the same gravity, and has the same cultural values is rare.  For successful culture change to occur, leadership needs to be aligned.  This is not an easy task, but my pill for the cure is training.  With each culture change engagement I deliver, I interview and train the leadership team together.  We review how it impacts their business, and we talk about what kind of culture they have and want.  We even design the employee engagement survey together for aligned executive level buy-in.  People own what they help to create, so in this manner, the leadership team owns their culture and shifts into alignment.

LEADERSHIP LISTENS

One of the most important messages you can send to people that follow you is that you listen.  That means you ask for opinions and give others an opportunity to influence.  When you incorporate a strong feedback mechanism in your employee engagement survey, you create a pathway for communication that fuels employees’ personal value.  The key though is to listen.  The biggest mistake to corporate culture change is to ask and not act.  Essentially communicating that you are not listening.  I encourage my clients to respond to culture change feedback even if the ideas cannot be adopted—this reinforces that you have listened.

LEADERSHIP COMMITMENT

As a leader of your organization, if you are not ready to commit to the adventure of change, then don’t get off the porch.  I mean that—do not start unless you are committed to finish!  I have seen firsthand companies that have turned culture change into an organizational minefield.  The CEO will tell me it didn’t work, and unfortunately, I have to remind them that they weren’t committed to change and that the entire initiative turned into a hollow promise.  Yes, it will backfire if there is a lack of commitment.

LEADERSHIP IMPLEMENTATION

As a 20-year consultant veteran, I differentiate myself by emphasizing implementation.  When an organization begins culture change, the transformation will only occur through implementation.  I do not stop with a report and recommendations. I help my clients build actionable implementation plans.  I work with the leadership team to identify and select employees who can play a role in helping the execution of those plans.  This spreads the implementation buy-in throughout the company and ensures greater success of implementation.  Leadership’s role is to coach and facilitate implementation.

LEADERSHIP FLEXIBILITY

When a company embarks on transforming their corporate culture, they are embarking on a journey into the unknown.  Culture is fluid, ever-changing, impacted by the daily weather, disruptive, moody and explosive.  During culture change implementation, leaders need to be flexible, understanding that the environment will shift actions and initiative throughout the process.  Leaders need to use their corporate values as the compass, to ensure they are going in the right direction, yet be flexible to allow deviations.

The bottom line is simple. Culture change rises and falls on leadership, but a strong culture can make the difference between winning and losing, so I encourage leaders to embrace the challenge and lead their organizations toward a healthy corporate culture.