A new Definitive Healthcare survey polled healthcare leaders on the most important trends of the year.


Industry consolidation was listed as the most important trend of the year, leading the way with 25.2% of the votes, followed by consumerism at 14.4%.

Definitive tracked 803 mergers and acquisitions along with 858 affiliation and partnership announcements last year, a trend that is not expected to slow in 2019.

Thirty-five percent of healthcare M&A activity occurred in the long-term care field, according to CEO Jason Krantz.

Widespread industry consolidation as well as the growing influence of consumerism registered as the most important trends healthcare leaders are paying attention to in 2019, according to a Definitive Healthcare survey released Monday morning.

Industry consolidation was listed as the most important trend of the year, leading the way with 25.2% of the votes, followed by consumerism at 14.4%.

Other topics that received double-digit percentages of the vote were telehealth at 13.8%, AI and machine learning at 11.4%, and staffing shortages at 11.1%. Cybersecurity, EHR optimization, and wearables rounded out the list.

The top results are generally in-line with some of the top storylines from the past year in healthcare, including focus on several vertical megamergers and longstanding business models being redefined by consumer behavior.

Jason Krantz, CEO of Definitive Healthcare, told HealthLeaders that healthcare is becoming increasingly more complicated and leaders are looking at a host of business strategies to navigate industry challenges or emerging market conditions.

“Something that’s on the mind of all of the people that [Definitive Healthcare] has been talking to, whether they are pharma leaders, healthcare IT companies, or providers, is that they’re constantly grappling with all of these new regulations, consolidation, and new technologies,” Krantz said. “[They’re asking] ‘What does that mean for my business and how do I address my strategy as a result?'”

In 2018, Definitive tracked 803 mergers and acquisitions along with 858 affiliation and partnership announcements, a trend Krantz does not expect to slow in 2019.

While Krantz cited some of the major health system mergers from last year as examples, he said another area that is experiencing widespread M&A activity is the post-acute care side.

Thirty-five percent of healthcare M&A activity occurred in the long-term care field, according to Krantz, and this is indicative of hospitals seeking to control costs and drive down rising readmission rates.

It also relates to another issue likely to accelerate in the coming years, which are the staffing shortages facing providers.

The sector currently suffering the most are long-term care facilities, which struggle to maintain an adequate nursing workforce due to the advanced age of most doctors and nurses in the face of the rapidly aging baby boomer generation. Krantz warns that all providers are likely to face these issues going forward.

Krantz also expects consumerism to hold steady as a top issue facing healthcare, citing the growing popularity of urgent care centers and the interconnection of telehealth services to provide patients with care outside of the traditional delivery sites.

However, the growth of these are reliable business options are all dependent on figuring out an adequate reimbursement rates for telehealth services rendered, Krantz said, which has not been fully addressed.

“I think until [telehealth reimbursement rates] get completely figured out, it’s hard for the providers to invest heavily in it,” Krantz said. “This is why you see a lot of non-traditional providers getting into telehealth, but I think it is something that people are thinking about and they know they need to adjust to, though nobody’s stepping up and being first in [telehealth] right now.”

For AI, machine learning, wearables, and cybersecurity, though the responses are split into smaller amounts, Krantz emphasized their combined score, which encompasses more than 25% of total votes, as a sign that healthcare leaders are paying attention to the area despite market complexity.

He added that they are all interconnected issues that deal with technological changes health systems are aware they will have to address in the coming years.

One issue related to harnessing technological change is EHR optimization, which Krantz believes leaders on the provider side are finally starting to gain excitement around. He said most leaders who have waited years to set up a comprehensive EHR system and input data are in-line to now utilize the data in their respective system.

“There’s a lot of great data in there and people are starting to figure out how to utilize that and improve patient outcomes based on the sharing of data,” Krantz said. 




The costs hospitals can control: 7 insights from clinical leaders on talent turnover, recruitment and retention

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High levels of employee turnover is costly in any industry, but as the demand for talented medical staff increases, issues with employee retention and recruitment can be particularly problematic for hospitals and health systems.

Hospitals are labor-driven entities dependent on talented frontline providers for fiscal success. In order to keep operations cost-effective, administrators must successfully recruit and retain highly skilled staff members or shoulder the financial burden of high turnover. The cost of turnover for just one experienced registered nurse can reach $88,000, according to a 2017 study published in SAGE Open Nursing. When factoring in the cost of recruitment, onboarding and lost revenue, the cost of physician turnover can reach as much as $1 million per physician, according to a 2012 study published in Recruiting Physicians Today.

High costs associated with turnover are likely to become even more palpable for many hospitals as the percentage of Americans over age 65 continues to increase, driving up provider demand. According to a 2017 projection from the Association of American Medical Colleges, the United States may face a physician shortage as high as 104,900 by 2030.

“The demand for talent, particularly for clinical executive talent, has never been greater,” Gail Wurtz, MSN, MBA, RN, vice president and account relationship executive with healthcare leadership solutions company B.E. Smith, told a room of more than 20 clinical healthcare leaders during a May 11 executive roundtable discussion at Becker’s Hospital Review Health IT + Clinical Leadership in Chicago. “You and the clinical staff you lead are the key to providing superior patient care, which supports your organization’s future success and services.”

During the roundtable event, clinical leaders split into groups to discuss issues related to turnover, recruitment and retention. After these mini-discussions, designated leaders relayed the most crucial elements of their group’s discourse to the larger group.

Here are seven insights from the roundtable.

“Location, location, location.”

1. During the discussion, an administrator from a 300-plus bed hospital in the Midwest described physician recruitment as all about “location, location, location.” While the leader’s hospital is located in a city of less than 30,000, it is located within driving distance of a major metropolitan area. The hospital tries to market its proximity to the big city when recruiting top talent.

2. The CMO of a Midwestern children’s hospital said his organization is not located in what is generally considered a “destination community.” The hospital’s location proves challenging for physician recruitment. The leader said his organization addresses these issues in a number of ways, including investment in medical residents.

“We’ve done some innovative things to tap into resident talent,” the CMO said. “We invest in them during their training with stipend programs and three-year [employment] guarantees upon residency completion, which have worked out pretty well for us.”

The CMO said the three-year mark is a critical turning point for his organization. “Within the first three years, we have a reasonably high turnover rate,” the CMO said. “Once they’re employed with us for three years, they get really engaged and they stay.”

3. Ms. Wurtz said a B.E. Smith survey of 800 hospital leaders published in January reflect executives’ comments about the importance of location when recruiting talent. In the survey, 33 percent of respondents identified location as their organization’s greatest challenge to staff recruitment, making it the most identified challenge in the survey. Twenty-four percent of respondents said access to high quality talent was their organization’s greatest challenge, making it the second-most identified challenge.

Prioritize retention to combat turnover

4. In the B.E. Smith survey, which participants completed in November and December of 2017, 35 percent of respondents said they were contemplating a job change in 2018. Ms. Wurtz said this finding highlights the importance of implementing retention programs within organizations to “foster a culture of continuity” and staff engagement.

5. During the discussion, a nurse leader who heads the intensive care unit at a medical center in the Southwest said her organization is piloting programs to hold onto top nurse talent. “There’s been more of an emphasis on new nurse hires at my organization rather than a focus on retaining top nursing talent,” the ICU leader said. “We’re looking to do more to hold onto leaders that are seasoned.”

6. The assistant director of clinical support for an academic health system based in the Midwest said her discussion group believes mentorship programs should receive more attention and resources to help develop leaders from within. Such programs could help mitigate potential overreliance on outside recruitment for leadership positions.

Focus on the nurse-physician relationship

7. During the roundtable, multiple leaders discussed the importance of creating an environment of inclusion and collaboration to facilitate positive relationships between providers — specifically nurses and physicians. As a nurse leader, the ICU director from the Southwest said strong nurse-physician relationships require both provider groups to keep the perspective of the other in mind.

“When we have good relationships, those can help retain talented employees,” the ICU director said. “For my part, I know I think very often about, ‘Do I like to work with this doctor?’ But I don’t often think, ‘Does this doctor like to work with me?’ To be successful, that kind of thinking has to go both ways.”

For more insights into hospital workforce recruitment and retention trends, click here.


A Looming Leadership Talent Crisis: Can you solve the Leadership gap?

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Editor’s Corner: Geisinger’s new-school/old-school approach to retain, recruit staff

“You can give out bonuses, trinkets, t-shirts and keychains. But at the end of the day people want to be listened to and feel valued, respected and cared for by their colleagues and the leadership team.”

Treat Employees Right So They Treat Customers Right

Isadore Sharp,  Founder And Chairman, Four Seasons Hotels And Resorts (Photographer: Bryan Mills for Four Seasons)

Isadore Sharp, Founder And Chairman, Four Seasons Hotels And Resorts

Starting from a modest offshoot of his family’s construction business (“The Four Seasons Motor Hotel,” if you can believe that), founder and chairman Isadore Sharp has built one of the great brands and organizations in the hospitality industry, the privately-held Four Seasons Hotels and Resorts, with 93 highly-rated luxury hotels and resorts under management worldwide.

Most impressive to me is that the Four Seasons organization  has been built in alignment with Mr. Sharp’s longstanding commitment to The Golden Rule, to applying this principle of fairness to all of the entities involved in creating their hospitality experience; to quote the Four Seasons corporate framework, “In all our interactions with our guests, customers, business associates and colleagues, we seek to deal with others as we would have them deal with us.”  The success of this approach in employee retention –Four Seasons has one of the lowest turnover rates in the industry–and engagement–Four Seasons has been ranked in the “100 Best Places To Work” for 18 years straight–is evident, and Mr. Sharp also credits this philosophy with allowing Four Seasons to provide what he says is the single most important factor in the success of his company: a superior level of customer service.

Healthcare Turnover – The Cost, the Causes, and a Sustainable Solution

While most organizations measure turnover and try to improve it, many don’t really understand its cost or causes, and fewer still take a holistic, effective approach to attracting and retaining the best talent, at every level of the organization.

This interactive panel discussion will explore turnover from multiple perspectives. HR leaders from two of the nation’s largest not-for-profit health systems and an expert in hiring, selection, and turnover will discuss the cost of turnover and the ROI of improving retention, the issues and variables that drive turnover, and their impact on broader organizational goals. After exploring what really goes into understanding turnover, the panel will share what they’ve learned about what works, what doesn’t, and an approach to the problem that can be tailored to your situation – and that can be sustained.