Tag Archives: Recruiting. Talent Management

The Hidden Dangers of Leading Change

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

http://johngself.com/self-perspective/2017/09/hidden-dangers-leading-change/?utm_source=Self+Perspective+from+JohnGSelf+%2B+Partners%2C+Inc.&utm_campaign=3b361ba89c-RSS_EMAIL_CAMPAIGN&utm_medium=email&utm_term=0_70effc545f-3b361ba89c-88600789#.Wbge8ciGMdU

 

People hate change. They dislike it so much that otherwise nice people will resort to some uncharacteristic behaviors — gossiping, lying and personal defamation against the person leading the change. This is a real threat to senior executives, especially those involved in organizational turnarounds.

Important progress can be slowed or derailed. Executive careers can be tarnished if not ruined.

This negative phenomenon is not new. In fact, evidence can be found in the Old Testament of the Bible. What is new is that we live in a digital age where malicious rumors and gossip can be spread, sometimes anonymously, over the Internet like wind-fed wildfire. It can blow up so fast that an unsuspecting, perhaps naive, executive can be tried and convicted before they are aware that the malignant campaign to discredit them even exists. Their attention, after all, is focused on more pressing issues.

Everyone has strengths and weaknesses, including the opponents of change, those who typically use a leader’s weaknesses to stop that which they distrust and makes them uncomfortable. Now here is where I think executives can and must do a better job in protecting themselves against repetitional attacks — they must become more self aware and to begin using the digital tools and modern communications strategies to their advantage. Unfortunately, far too many CEOs, especially those who engage in challenging business turnarounds, are so focused on their plan that they fail to insulate themselves from the inevitable pushback. In fact, it is surprising how many CEOs reject any involvement in social media activities until they have lost their job and are looking for a new one.

Years ago, during the course of a major CEO search, an extraordinarily qualified candidate disclosed a background issue that was potentially problematic. He was such a superb candidate that I refused to eliminate this individual from the field. I disclosed it to the board of directors and, with an open mind and the recognition of this person’s outsized talent, they asked me to vet the issue more thoroughly. In the end, he got the job. Ultimately we made the decision to disclose the background issue, no longer material to leadership performance, because we knew that those who would most certainly oppose the changes that had to be made — some entrenched employee groups — would use it against the executive when it inevitably surfaced. They would have attacked the leader using the information as a blunt weapon to slow or halt changes and they would most certainly have accused the board of an unconscionable cover-up. We neutralized that issue and this executive went on to lead a highly successful turnaround.

The advantage in this situation is that we knew about the issue and took action. Far too often executives are the last to learn that they are the targets of a smear campaign. They frequently find themselves in a reactive mode and that alone can aggravate the bad optics even more.

California’s Health Care Workforce

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , , , , • Leave a comment

http://www.chcf.org/publications/2017/08/california-workforce

Image result for California's Health Care Workforce

California’s health care industry employed more than 1.4 million people in 2015. Five Almanac guides provide data on wages, education, and workplaces for selected health professions.

California’s health care industry employed more than 1.4 million people in 2015. Among these workers, nearly 55% were employed in ambulatory settings, about 25% in hospitals, and 20% in nursing or residential care facilities. An aging population, population growth, and federal health reform will likely contribute to increased demand.

This series of Quick Reference Guides from the CHCF California Health Care Almanac examines specific segments of the state’s health care workforce, focusing on pharmacists and pharmacy technicians, physician assistants, health diagnostic and treatment therapists, clinical laboratory scientists and technicians, and imaging professionals.

Among the trends:

  • California’s supply of pharmacists grew 17% between 2012 and 2015, while the supply of pharmacy technicians increased by 8%. About half of the state’s pharmacists were trained in California.
  • The number of physician assistants (PAs) in California grew 37% between 2012 and 2015. The Northern and Sierra region had more licensed PAs per capita than the rest of the state.
  • The supply of occupational and physical therapists increased between 2012 and 2015, while the supply of speech-language pathologists decreased slightly.
  • Between 2012 and 2015, California’s supply of clinical laboratory scientists remained stable while the number of medical/clinical lab technicians rose 11%.

The complete guides, as well as the 2014 editions, are available as Document Downloads.

When ‘gigging’ healthcare, providers must balance risk with cost

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , • Leave a comment

http://www.healthcaredive.com/news/when-gigging-healthcare-providers-must-balance-risk-with-cost/448756/

An explosion of innovative tech is disrupting the care-delivery model, aiming for both cost savings and better outcomes. Uber’s partnership with MedStar Health to reduce patient no-shows, a huge cost-sink, and the expansive potential of drones to fill healthcare infrastructure gaps in remote areas are just two examples of ways in which healthcare providers are setting out to provide better care at lower cost.

Cost-saving innovations have also begun to extend to the healthcare employment model — something notably risky when it comes to compliance. One program offers a solution to staffing issues that connects freelance nurses with open positions using an entirely digital platform in an attempt to modernize the business. Others have opted for more ad hoc hiring processes for IT and transcription talent.

Either way, the “gig economy” has reached healthcare — and it looks like it’s here to stay.

What does gig work in the healthcare space look like right now?

Healthcare providers have to manage an employee population with vastly different skill sets. But even in the diverse healthcare workplace, where special rules run rampant, some general guidance still applies.

Typically, the more specialized and trained the worker, the less likely they can be hired on as an independent contractor, Matt Stevenson, partner at Mercer, told HR Dive. And right now, most gig workers are on the lower end of the skill scale — especially in healthcare.

“Because of the way healthcare has been restructured, there’s been an explosion of employment at the low end,” Stevenson said. Increased calls for low-acuity care, like physical therapy and daily caregiving, have heralded the growth of contracted work. Convenience for both patient and provider also plays a part. Telehealth (while not specifically contract work, usually) allows doctors to sign up for specific hours to treat patients via phone or video, while digitization lets those doctors keep all records securely online. It brings a flexibility few office jobs can compete with.

Another bonus: cost.

“Incentives are changing,” Stevenson said. “You are now paying for results instead of the hospital getting paid more for you being in the hospital longer.”

As providers seek better outcomes for a lower price, contract work plays a pivotal role in improving care but keeping barriers low for patients. Caregivers can visit homes and encourage patient compliance, such as taking medicine and completing physical therapy, and hospitals can hire those workers on a job-to-job basis, which is cheaper overall.

Providers must keep liability in mind when hiring out independent gig work, however. Hospitals in need of on-demand talent often retain nursing agencies that take on liability, employee background checks and other major risk issues in exchange for hefty fees. Independent workers tend to be cheaper, but come with much higher risk.

Managing liability and questions of quality

Classification is a perpetual headache for employers in many industries. Simply calling someone an independent contractor doesn’t cut it, Shanna Wall, labor law attorney at ComplyRight, said. Nationally, employers have to satisfy a slew of tests under regulations from the IRS, the U.S. Department of Labor and individual states meant to protect workers from exploitation. Courts have been in on the action, too.

Most tests balance on one key question: How much independence does an individual worker have? More specifically, does an employer focus on a result alone or the job itself? Is the worker using their own equipment and deciding their own hours, or is an employer dictating that? The more control an employer has, the riskier independent contractor classification can be.

But that’s not all. Medical personnel have to deal with strict laws on private health information, such as the Health Insurance Portability and Accountability Act (HIPAA). Contractors must be trained on what those and other rules require.

“How do you ensure the quality of care provided by the gig person is okay?” Stevenson said. “How do you keep costs down but ensure quality? You may pay $15 an hour, but that is low for healthcare.”

Worse, if something goes wrong, the provider is on the hook. By giving jobs to outside workers, providers risk losing strict control over the quality of care and, in the long term, their brand. Employers already struggle to gather data on full-time employees. Gathering data on the success of gig workers is even tougher, since the very nature of the relationship is fairly low-touch.

That’s partly why the agency model has lasted for so long, as they take on most of those risks and give hospitals the ability to up- or downsize when needed. But the costs are real.

In the future: Outsourcing some jobs but not all

For that reason, employers may want to consider their needs on a sliding scale of risk versus efficiency. Joint employer cases are still working their way through the courts. Uncertainty remains the rule of the day. “It’s always best practice to err on the side of an abundance of caution,” Wall said.

As far as the future goes, that uncertainty renders predictions suspect. Digitization has encouraged the contracting out of some support services, including diagnostic work such as radiology. As long as a radiologist has an internet connection, they can read a scan and send their analysis from anywhere.

Innovation continues in the on-demand non-emergency medical transportation space, too. Circulation, a Boston-based provider of medical transportation, recently raised $10.5 million in a funding round that included participation from leading names in healthcare such as the Boston Children’s Hospital, Humana and NextGen Venture Partners. Experts believe that ride-share partnerships could save billions of dollars usually spent by Medicaid.

But as more employers focus on ways to engage employees, contract workers will largely remain outside those efforts, Stevenson said. Gig workers usually seek independence for a reason, be it the flexibility of hours or ability to set their own pay. They prefer autonomy, and don’t want to be bogged down in HR processes.

“If I really cared about engagement, I would bring them in-house,” Stevenson said.  But as long as demand is high, treatment of contract workers will have to remain top notch to keep a steady flow of candidates in the pipeline.

The influx of independent work has enabled unprecedented flexibility for workers and access to talent for employers. But above all, employers must be wary of the risks to truly enjoy the perks of independent contracting.

“You think you are safe from compliance because they are gig workers, but really, it’s the opposite,” Wall said.

Wanted: Leaders for tomorrow’s emergency room

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , , , , • Leave a comment

http://www.healthcaredive.com/news/wanted-leaders-for-tomorrows-emergency-room/448757/

A conversation with Bill Haylon, CEO of Leaders For Today

Economic anxieties need not correlate with a high unemployment rate. Take it from business leaders across multiple U.S. industries: Their biggest challenge is not a lack of job openings for thousands of qualified candidates — it’s a lack of candidates for thousands of openings.

HR professionals are used to hearing about skill shortages in manufacturingand other blue-collar work, but perhaps more understated are gaps in the STEM fields.

Careers in nursing and medicine, which often require years of additional, specialized education are hard to fill. Physician assistant openings were one of the most in-demand fields near the end of 2016, according to the American Staffing Association. But hospitals aren’t just struggling to find people to staff operating rooms. They face a much bigger challenge in a lack of leadership skills.

HR Dive/Healthcare Dive spoke with staffing firm Leaders For Today’s CEO Bill Haylon about the root of leadership gaps in healthcare, and how hospital HR departments can confront the problem. Our conversation has been lightly edited for length and clarity.

HR Dive: When hospitals come to a healthcare staffing firm like Leaders For Today, what are they asking for?

Bill Haylon: What we’re really doing is helping them find people who have particular sets of skills. We provide staffing on an interim basis. A hospital or healthcare system comes to us and says, “we really need somebody who can fix and lead our case management department,” “we need somebody who’s got certain technical skills and leadership skills.” We’re not actually training individuals, we’re finding people who fill those slots.

We’re going out and finding people, who they can either hire full time or on an interim basis. We’ll look for, on average, a little more than six spots, and we’ll start from a pool of people that we have that we’ve worked with before.

We’re not really doing training, but training is one of the problems in the healthcare world.

HR Dive: When you look for potential staffers, what kind of skills do they have? What stands out the most to the healthcare systems you work with?

Haylon: There are certain skills that go across all positions, and there are certain skills that are specific to a position because we can hire for. For example, we have a team that focuses on OR people, while others focus on case management, hospital finance, physician management, practice management, etc.

Across the board, what we focus on is, first and foremost, trying to find people who have been steady with or who have stayed with an organization for some period of time and developed within that. In other words, we try and stay away from what we call “jumpers” — people that have a job for a year, two years, and then try and go on their next role.

Unfortunately, that’s counter to what occurs in the industry. People in the hospital industry jump all the time.

We try and get some stability in their job, because we believe they learn more that way [when it comes to] both the technical skills and leadership skills. Of course, you look for the basic things: education, undergraduate work, master’s degree and other certifications.

You’re trying to vet the person along, so a lot of time you’re talking about different situations, different experiences, how they’ve handled them in the past or how they might handle them in the future. It could be a difficult position to deal with, a union situation, a quality situation, a safety situation. And you try to understand what their thought-making process is.

HR Dive: What skills are hardest to come by in the medical world, given that a lot of industries are seeing skills shortages?

Haylon: There’s an enormous shortage of talent within the hospital industry in all key levels. It was going on before Obamacare, and now with Obamacare and more people being covered, each organization is seeing a big uptick in the number of patients they see. It’s really gotten to be a very critical moment.

The most difficult job category is the O.R., the second hardest is case management and the third hardest is physician practice management.

From a skill set perspective, it’s leadership. Most of those in leadership positions are people who were nurses or doctors. When you go to school, you do not learn about financial statements, management skills or leadership. You’re learning how to suture, avoid infections and open up rib cages.

You take a person who has been a staff nurse for [a certain number] of years, and they decide they want to go into a leadership role. Because there’s a shortage of people, they are put in those spots well before they’re ready. They don’t have any training; hospitals do not train people for career development or leadership, and so you’re just kind of winging it. You get people who are very quickly over their head in their positions.

HR Dive: What can hospitals change about the way they operate to help develop those skills, or is that simply not possible given their bandwidth?

Haylon: They make it harder than it is. The reality is that hospitals consolidate, so they’re parts of bigger systems. You have a director in the O.R. who could be managing 440 people. That’s a lot of people. This was the case for one hospital we worked with, and the person running that OR had been a staff nurse and morphed to this role. But her [previous] role had been running a small hospital where she had 30 people, and now she’s up to 440 people, and it’s over her head.

So the reality is that they need to start thinking about different skill sets, and the obvious one is an MBA. When you’re the director of a 440-person O.R., you’re not seeing patients anymore. You’re doing hiring and scheduling. You’re developing quality programs and safety programs. You’re trying to get the surgeons on board. You’re never seeing a patient; that’s a different set of skills.

You don’t need to be clinical, you need to be a manager and a leader. It could be an MBA, it could be a master’s in health. But you need more than clinical training.

So what hospitals do [by recruiting for a certain skillset] is totally reactive as opposed to being proactive and developing people.

HR Dive: Do you see a shift in terms of the skills that physicians and other professionals are being taught in school?

Haylon: You’re being taught technical skills, clinical skills, whatever your specialty is. You go to medical school, do your residency, maybe followed by a fellowship, and it’s all technical skills. Physicians [are also] getting way more specialized than they used to be.

Typically the people who have jobs [in healthcare leadership] have gone and gotten additional training and education on their own.

Physicians and nurses are not trained in school to run big organizations. Plus, they’re doing research, and they’ve got to handle anybody that comes into the OR and the ER. It’s hard enough to get training for it, and it’s beyond belief if you don’t have training.

HR Dive: What else should hospital systems be mindful of when looking for leadership in the medical workforce?

Haylon: When you look at survey data from across the hospital industry, you see that people are staying in positions for incredibly short periods of time. Forty percent of people right now in key positions in hospitals have been in their position two years or less. Another 40% expect to leave in the next two years. What happens is that hospitals have a hole, and they need better leaders, so they poach from somebody else.

So the director of a surgical department will be a manager at a small hospital, then become a manager at a bigger hospital, then a manager at a bigger hospital, then a director at a small hospital, then a director at a bigger hospital, and finally a director at a bigger hospital. They just keep poaching from each other.

The problem is it’s the same people who are circling through. The people you’re hiring never had the time to put in place good, quality programs, [including] safety programs and productivity programs, because they’re not there long enough. They can’t make it stick in just two years; these are very complicated things.

And so that’s the result of what you’re talking about. The lack of training and development shows itself in this poaching and job hopping in the hospital world. It is like no industry you have ever seen before.

In other industries, an enormous amount of resources are put into training, so people stay in those industries and move up. You take up greater responsibilities, but they invest a lot in you as a developing person. The hospitals invest almost nothing. It’s up to the individual to go and figure it out on your own. Get your MBA, take this class, get a certification from the hospital association. But you’re not developing your own people.

Other organizations develop their own people because they want to be the best at what they do — they want to differentiate themselves. The only way they can do that is to develop their own people. Because hospitals don’t do that, there really is no differentiation, and hence, they struggle.

So this lack of training and the lack of development ends up creating an industry where everybody knows they’re going to jump all the time. You’ve got hospitals that have hired their sixth CEO in seven years. So the question is: If you’re a patient and you have knowledge of this, would you want to go to that hospital?

If you have that sort of instability at the top spot, then it’s going to trickle all the way down. Healthcare is complicated; it takes a while to figure out orders in place that are going to work. If they have quality problems, or safety problems, you can’t fix them that quickly. You’ve got to have someone who understands the lay of the land and can make a difference.

A snapshot into why some providers are eliminating positions

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , , , , , , • Leave a comment

http://www.healthcaredive.com/news/healthcare-workforce-growth-cuts/446182/

Employment in the healthcare industry has risen since the ACA was passed, but many health systems have been trimming their workforce under financial pressure.

It’s clear there have been a fair amount of hospital and provider layoffs in 2017.

In the past few months, hospitals of all sizes, and in all parts of the country, have said they are cutting jobs or eliminating open positions. Major providers affected have included Memorial Hermann, Brigham and Women’s Hospital, NYC Health + Hospitals, Summa Health and Hallmark Health. In May, Becker’s Hospital Review listed 48 layoffs across the industry the publication had reported on in 2017.

The layoffs come in contrast with the sharp rise in hiring in the healthcare sector ever since the Affordable Care Act (ACA) was enacted. While the hiring growth is a long-term trend — though it’s yet to be determined at what rate in 2017 — these layoffs are due in part to the short-term trends of softening admissions and flattening reimbursements. Many providers cited similar problems: declining reimbursements, lower admissions and shrinking operating incomes. Layoffs aren’t the only play for struggling organizations, but hospital expenses are rising on multiple fronts, and executives have to make some hard choices.

Big drivers of the growth are the aging population and the pending retirement of many registered nurses. It’s unclear how or when the layoff and healthcare job growth trends will change, but the underlying themes are not going away. The Bureau of Labor Statistics (BLS) is scheduled to release 2016-2026 occupational projections in October, while layoffs will continue to be tracked throughout the year.

Then there’s the elephant in the room over the buzzword of 2017: Uncertainty. Whether it be in Congress or in the executive branch, uncertainty over U.S. healthcare policy is making providers nervous as the insurance open enrollment period nears with no clear ACA reform or repeal in sight.

Healthcare hiring still on the rise, but the pace may be slowing

To date, the healthcare employment bubble hasn’t burst. Healthcare jobs, including hospital jobs, still are on the rise. While job growth is a different metric than layoffs and require different considerations, both underscore the themes affecting the industry’s workforce.

Ani Turner, co-director of Altarum Institute’s Center for Sustainable Health Spending, told Healthcare Dive there have been some clear trends in hospital job growth in recent years. In 2013, there was little job growth but the expanded coverage affect — where more individuals gained health insurance for the first time under the ACA — helped spur hospital job growth in 2014.

This expanded coverage helped hospitals experience new revenue opportunities thanks to more people entering the care delivery space, especially in states that expanded Medicaid. In addition, since the implementation of the ACA, the level of uncompensated care nationwide has gone down from $46.4 billion in 2013 to $35.7 billion in 2015.

Since that time, hospitals experienced great growth from a jobs perspective. In a 2015 Forbes article, Politico’s Dan Diamond noted that healthcare job growth surged at its fastest pace since 1991 starting in July 2014 up through May of 2015. In fact, healthcare practitioners and healthcare support positions are expected to be among the fastest growing jobs from 2014 to 2024. BLS notes the aging population and expanded insurance coverage will help fuel this growth as demand for healthcare services increases.

The recent surge is “somewhat unexpected,” Turner says. “One would think hospitals would be conservative in their hiring. Everything I’m seeing is flat or slightly declining volumes, especially on inpatient side.”

“The data don’t always cooperate with the story that makes sense,” Turner added.

Brian Augustian, principal at Deloitte, believes the job growth is going to continue to slow this year in part because there will be a push for greater automation and productivity. “As organizations are able to use machine learning, artificial intelligence and better utilize technology to get tasks done, it will not only result in…needing fewer people but also different types of people,” he told Healthcare Dive.

The rate of job growth will be an issue to watch throughout the year. As shown above, just two months worth of data changes the story from a narrative of “slowing growth” to “continuing to soar.” The looming retirement of registered nurses and the aging population do point to hospitals and providers arming themselves to smooth the transition of both the workforce as well as the pending flood of baby boomers entering into the care space.

Job growth doesn’t stop financial troubles for providers

However, as seen in the job cut announcements and recent quarterly earnings for hospital operators, providers are facing challenges that are affecting their bottom lines.

One of the biggest challenges for providers is declining or flattening admissions. In 2010, all hospital admissions totaled 36.9 million admissions. By 2013, admissions had dropped by 1.5 million; 35 million patients were admitted in 2015.

In the latest rounds of quarterly earnings, most for-profit hospital operators took a lashing, all acknowledging softening markets and weaker-than-expected patient volumes. Community Health Systems (CHS) reported it underperformed in Q2 2017 and is exploring more divestitures while HCA Healthcare reported it missed Q2 estimates due in part to higher expenses and lower-than-expected patient admissions. On Monday, Tenet Health reported a 4.5% decline in total admissions for the first six months of 2017.

Indiana University Health’s operating income suffered a 46% loss while seeing less individuals coming into the facilities, Modern Healthcare reported.

As seen in HCA Healthcare’s Q2 earnings call, lower acuity visits declined in the last quarter. At CHS, emergency department volume declined on the outpatient side, which Tim Hingtgen, president and COO of CHS, attributed to “industry dynamics, including urgent care growth, freestanding ED competition in select markets.” As Turner notes, the average person seeking a care setting visit is likely going to a physician’s office. This puts pressure on operators to rethink their lower acuity setting strategies and not rest on the strength of organic patient growth seen in previous years.

Another major issue for providers are expenses. More jobs equals more expenses, for example. Facility maintenance, equipment, electricity, telephone lines, internet, etc. all add up. According to the American Hospital Association, expenses for all U.S. registered hospitals are currently $936 billion, up from $859.4 billion in 2013. In addition to these changes, turning toward value-based care exposes providers more to risk-based contracts which can affect reimbursement formulas.

Hospitals know they need to lower cost structures, and personnel changes is one means

Ben Isgur, director of PricewaterhouseCoopers’ Health Research Institute, adds that squeezing costs isn’t a new concept for hospitals. There are many options for executives to manage out costs from its overhead. Supply chain, infrastructure and third party contracts are all go-to areas for such efforts. If two systems merge, departments can be streamlined or share services. In some cases, third-party contractors may be more beneficial to a provider than hiring for internal positions.

Igor Belokrinitsky, healthcare strategist at Strategy&, a member of the PwC network of firms, told Healthcare Dive in March many administrators faced with financial challenges tell their departments during the budgeting process to budget for zero cost increases or even for a reduction. “In the longer run, we are seeing and are working with health systems to take out pretty significant amounts of cost out of their operations, both clinical and nonclinical, and setting targets like 15-20%, which is a transformative change,” he said. “When talking about a 20% cost improvement, you’re questioning, ‘Do we need this facility? Do we need to provide this service at this location? Does this service need to be provided by a physician?'”

The current political landscape isn’t helping matters either

Isgur tells Healthcare Dive that healthcare industry layoffs should be watched closely and agrees with Turner that one of the biggest reasons is uncertainty in the industry.

As an example, he points to the Congressional Budget Office’s figure that 15 million individuals could have lost health coverage in 2018 if the Senate ACA repeal bill had become law. “Providers look at that and have to be ready for an environment where they have potentially fewer paying patients,” Isgur told Healthcare Dive.

During the heady time when ACA repeal-and/or-replace was on Congress’ plate this summer, many projections showed healthcare jobs would’ve been affected. One analysis of the House ACA bill estimated 725,000 jobs across the entire industry would be lost by 2026 if it had become law. The primary cause of the job disappearances and state economic downturns would have been attributable to cuts to healthcare funding, such as more than $800 billion to Medicaid, and lower premium subsidies.

Moody’s Investor Services projected the Senate ACA repeal bill would have caused uncompensated care costs to rise at hospitals.

The fight over healthcare policy is likely now headed to the executive branch, as Congress has failed to pass a bill that repeals or replaces the ACA. President Donald Trump has cost-sharing reduction payments to insurers hanging in the balance, and hasn’t publicly stated if the White House will continue to make these payments.

If these payments are discontinued, Fitch Ratings found in a new report that premiums could increase to the point where customers won’t be able to pay for coverage, thus increasing the chance for uncompensated payments to rise.

In addition, state Medicaid waivers will have to be looked at. Some applications, such as the Maine’s, could include work requirements, mandatory premiums and asset testing. It would be one of the most conservative state programs, and some health policy experts warn that the restrictions would push out many low-income adults who would otherwise qualify.

“When you add uncertainty to what’s already been going on in the reimbursement environment around how many more uninsured there may be going forward, that’s not the cause of [layoffs] but it’s certainly going to accelerate the thinking of executive teams to make sure [their organizations] are efficient and ready for anything,” Isgur said.

Isgur does think the industry will see more layoff announcements this year, but that it is an important trend to watch, especially as more decisions come out of Washington.

 

Here’s why your attitude is more important than your intelligence

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

https://www.weforum.org/agenda/2017/08/heres-why-your-attitude-is-more-important-than-your-intelligence?utm_content=buffer0f9a5&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer

A worker arrives at his office in the Canary Wharf business district in London, Britain February 26, 2014. REUTERS/Eddie Keogh/File Photo GLOBAL BUSINESS WEEK AHEAD PACKAGE Ð SEARCH ÒBUSINESS WEEK AHEAD 5 SEPTEMBERÓ FOR ALL IMAGES - RTX2O4AU

When it comes to success, it’s easy to think that people blessed with brains are inevitably going to leave the rest of us in the dust. But new research from Stanford University will change your mind (and your attitude).

Psychologist Carol Dweck has spent her entire career studying attitude and performance, and her latest study shows that your attitude is a better predictor of your success than your IQ.

Dweck found that people’s core attitudes fall into one of two categories: a fixed mindset or a growth mindset.

With a fixed mindset, you believe you are who you are and you cannot change. This creates problems when you’re challenged because anything that appears to be more than you can handle is bound to make you feel hopeless and overwhelmed.

People with a growth mindset believe that they can improve with effort. They outperform those with a fixed mindset, even when they have a lower IQ, because they embrace challenges, treating them as opportunities to learn something new.

Common sense would suggest that having ability, like being smart, inspires confidence. It does, but only while the going is easy. The deciding factor in life is how you handle setbacks and challenges. People with a growth mindset welcome setbacks with open arms.

According to Dweck, success in life is all about how you deal with failure. She describes the approach to failure of people with the growth mindset this way,

“Failure is information—we label it failure, but it’s more like, ‘This didn’t work, and I’m a problem solver, so I’ll try something else.’”

Regardless of which side of the chart you fall on, you can make changes and develop a growth mindset. What follows are some strategies that will fine-tune your mindset and help you make certain it’s as growth oriented as possible.

Don’t stay helpless. We all hit moments when we feel helpless. The test is how we react to that feeling. We can either learn from it and move forward or let it drag us down. There are countless successful people who would have never made it if they had succumbed to feelings of helplessness: Walt Disney was fired from the Kansas City Star because he “lacked imagination and had no good ideas,” Oprah Winfrey was fired from her job as a TV anchor in Baltimore for being “too emotionally invested in her stories,” Henry Ford had two failed car companies prior to succeeding with Ford, and Steven Spielberg was rejected by USC’s Cinematic Arts School multiple times. Imagine what would have happened if any of these people had a fixed mindset. They would have succumbed to the rejection and given up hope. People with a growth mindset don’t feel helpless because they know that in order to be successful, you need to be willing to fail hard and then bounce right back.

Be passionate. Empowered people pursue their passions relentlessly. There’s always going to be someone who’s more naturally talented than you are, but what you lack in talent, you can make up for in passion. Empowered people’s passion is what drives their unrelenting pursuit of excellence. Warren Buffet recommends finding your truest passions using, what he calls, the 5/25 technique: Write down the 25 things that you care about the most. Then, cross out the bottom 20. The remaining 5 are your true passions. Everything else is merely a distraction.

Take action. It’s not that people with a growth mindset are able to overcome their fears because they are braver than the rest of us; it’s just that they know fear and anxiety are paralyzing emotions and that the best way to overcome this paralysis is to take action. People with a growth mindset are empowered, and empowered people know that there’s no such thing as a truly perfect moment to move forward. So why wait for one? Taking action turns all your worry and concern about failure into positive, focused energy.

Then go the extra mile (or two). Empowered people give it their all, even on their worst days. They’re always pushing themselves to go the extra mile. One of Bruce Lee’s pupils ran three miles every day with him. One day, they were about to hit the three-mile mark when Bruce said, “Let’s do two more.” His pupil was tired and said, “I’ll die if I run two more.” Bruce’s response? “Then do it.” His pupil became so angry that he finished the full five miles. Exhausted and furious, he confronted Bruce about his comment, and Bruce explained it this way: “Quit and you might as well be dead. If you always put limits on what you can do, physical or anything else, it’ll spread over into the rest of your life. It’ll spread into your work, into your morality, into your entire being. There are no limits. There are plateaus, but you must not stay there; you must go beyond them. If it kills you, it kills you. A man must constantly exceed his level.”

If you aren’t getting a little bit better each day, then you’re most likely getting a little worse—and what kind of life is that?

Expect results. People with a growth mindset know that they’re going to fail from time to time, but they never let that keep them from expecting results. Expecting results keeps you motivated and feeds the cycle of empowerment. After all, if you don’t think you’re going to succeed, then why bother?

Be flexible. Everyone encounters unanticipated adversity. People with an empowered, growth-oriented mindset embrace adversity as a means for improvement, as opposed to something that holds them back. When an unexpected situation challenges an empowered person, they flex until they get results.

Don’t complain when things don’t go your way. Complaining is an obvious sign of a fixed mindset. A growth mindset looks for opportunity in everything, so there’s no room for complaints.

 

Hiring an Interim CFO

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

https://www.linkedin.com/pulse/hiring-interim-cfo-joe-zuyus?trk=mp-reader-card

Image result for interim leadership

Hospitals are seeing increasing amounts of management turnover, especially in the C-Suite. Skilled and experienced healthcare executives are in short supply mostly due to an industry-wide talent drain, lack of mentoring, and minimal succession planning.

Realistically, filling executive positions takes time, even with the assistance of search firms. Meanwhile, management voids can be damaging: communications suffer, initiatives lose pace, and disruptions occur. Even during a brief transition, some organizations cannot afford vacant leadership positions.

Is interim management a viable option to the risk of absent leaders? Is it better to hire quickly to avoid a vacant role? Many organizations consider interim management solutions as a transitional step to permanent replacement of vacant positions, often in conjunction with the use of a search firm. Others may see the talent and skills within and be able to move quickly. Still, others may hire hastily and lose valuable time in the long run to identify the best candidate.

What tact should your organization take when leadership vacancies occur?

ADVANTAGES OF INTERIM MANAGEMENT

When openings occur in the senior leadership structure, interim management offers advantages over traditional alternatives.

1. Prevents work overloads. Spreading assignments among others causes work overloads. Temporary assignments add extra responsibilities to an incumbent’s already “full plate,” which can lead to work overload and compromised performance. However, a capable interim executive can devote full time and attention to the responsibilities of the vacant management role. A temporary appointment is a welcomed contrast to assigning extra responsibilities to incumbents when a resignation occurs.

2. Adds objectivity. A new set of eyes is beneficial to organizations in transition. Interim leaders usually are less affected by the internal politics of an organization, especially those related to a promotion or a permanent placement into the vacant role. By removing the “vested interest” from the leadership paradigm, the interim executive holds a unique perspective often unavailable to others within the organization. Simply, the temporary status allows the interim position-holder to make decisions unencumbered by career-driven aspirations.

3. Enthusiasm generates optimism. Seasoned healthcare leaders enjoy serving as interim executives and they bring their gratification to the assignment. Their extensive experience and relevant knowledge enables the interim manager to serve as a short- or medium-term replacement for a vacant position as well as a valuable consultant. The organization benefits from the interim’s experience and ability to address the ongoing challenges. When a national search to fill the position is concurrent with an interim assignment, the interim leader and the search consultant can work together to identify a candidate with the right cultural fit. Nuances unique to the operation, culture, and strategic initiatives otherwise unnoted are minimized as the two executives work in tandem.

DISADVANTAGES OF INTERIM SOLUTIONS

An interim management solution may not be the best option for every organization or with every vacancy. Quickly hiring and filling the position may be more expedient, especially if an internal candidate with the necessary skill set and personal attributes to succeed is available. Interim solutions may convey misconceptions among the senior managers.

1. Delay may cause unrest. Concerns about a delay should not lead to rushing to a decision or hurriedly identifying an individual to fill the vacated position. Other leaders and managers throughout the healthcare organization may become disillusioned when a vacancy is filled hastily with an internal interim solution.

2. Management perceived as indecisive. By engaging in a temporary solution, senior management may be perceived as indecisive and willing to “float along” for a period while the entity secures the right person with particular skills.

GUIDELINES FOR INTERIM MANAGEMENT

If you decide to engage an interim executive, follow proven guidelines to achieve success and to provide your organization with a value-added service beyond supplying a temporary workforce.

1. Use a reputable and qualified placement firm. Engage a reputable executive search firm to identify and vet candidates before placement. Using qualified professionals to fill interim assignments allows you to off-load the time-consuming, and often expensive, recruitment and screening process. Some firms have both a capable short-term bench and the capacity to conduct the search for the permanent placement. As a subject matter expert, the interim executive can collaborate with the search professional to produce the desired results.

2. Inform candidates of expectations. The candidates should be aware of the expectations that both the hiring organization and the placement firm will have for them. The acting executive needs to understand that their primary focus and allegiance is to the assigned organization. He or she should consider the provisional assignment as a full-time role and not just act as a placeholder. This ownership of the job responsibilities at hand will be a critical success factor for the interim executive. The placement firm should provide oversight to ensure the interim executive approaches the work in this manner, focusing on results. Other leaders within the organization must not perceive the interim as temporary, rather a part of their team.

3. Engage a multi-service search firm. The organization may be well-served by using executive search companies that have the bench strength to fill both short-term and permanent vacancies, as well as the resources to evaluate and even train interim executives in the leadership skills necessary to their new roles. Executive coaching of this type can be especially valuable with physician executives who may lack the management training and experience to succeed in their new non-clinical areas of responsibility.

4. Focus on alignment and avoid conflicts of interest. The organization and the placement firm should be transparent and focused on alignment to assure that the interim executive succeeds. They should identify any potential conflicts of interest and make all efforts to resolve these without involving the interim executive. The executive should be able to commit his or her full loyalty and attention to the hiring organization. He or she should not be in a position of having to choose between fidelity to the interim employer or their direct employer, i.e., the placement firm.

5. Compensate fairly. Executive search firms that know the market rate for high-level managers in healthcare organizations are best suited to handle interim placements. An acting role may demand a premium payment for travel expenses, dislocation of the candidate from his or her family, relocation to a geographically isolated facility or overseas location, and placement into an often chaotic and dysfunctional environment. However, the fees for the interim manager should be valued fairly, not exceeding the boundaries of fair-market-value or commercial reasonableness. This test is especially important when hiring physician executives into these roles, as Stark and anti-kickback laws may apply, especially if the physician continues to practice clinically.

CASE STUDY

In 2014, a large multi-specialty healthcare system engaged Coker Group to assist with the interim management of their Chief Financial Officer position. The assignment also included conducting a national search for filling the position permanently. Coker vetted several candidates and then agreed to place into the role a full-time Coker employee with extensive experience as a CFO and CEO of several healthcare organizations.

The interim CFO assignment was filled within a week of the discussions. The acting executive immediately faced several issues: declining revenues in several important service lines, and languishing growth and business development initiatives in critical service areas (cardiac services and orthopedics).

Over the next four months, the interim CFO was able to advance many of the stalled initiatives. By performing successfully as CFO, he was asked to assume the role of interim CEO for the system’s flagship hospital, upon the resignation of its CEO. Now, with the CFO position vacant, Coker provided another experienced interim candidate as CFO, again within a week.

Utilizing the skill set from many previous CFO and CEO assignments, the interim candidates quickly aligned with other members of the health system’s senior management team. They expeditiously identified and prioritized opportunities to align costs, increase reimbursement, challenge charge master assumptions, and analyze service line margin contributions. This engagement provided an example of collaboration to the other C-Suite members, as previously they had not worked with their peers and subordinates, creating a silo mentality regarding routine tasks and operational responsibilities.

This case denotes how interim executives can enter into an organization and guide it successfully through uncertain times. It also demonstrates how the right interim leader can take ownership of an acting role and consider it his or her full-time position. The successful leader is versatile and can work at many positions, often assuming greater responsibilities. Ultimately, the CFO and CEO positions were filled permanently as a result of the executive search, and the organization lost no momentum during its conduct.

CONCLUSION

Immediate replacement versus interim management is a consideration for every board and executive team that must fill a vacancy in its executive positions, with advantages and disadvantages for both options. Each vacancy in healthcare leadership offers a unique challenge. Consider the options, reflect on the personalities of the existing executive management, the political climate of the organization, and the skills and expertise needed before making a decision.