Health care version 1.0, run by physicians and other providers, did not work due to an unrestrained utilization of resources. Health care version 2.0, run by corporate forces, also has been a failure. For the past several decades the focus in health care has been about the business of health care. A model of corporate medicine has emerged and proliferated and it only works well for those whose job it is to manage the bottom line. Now we are told (finally) that the future of health care is value. And we are told that the numerator and denominator of value are quality and cost respectively. In theory this will be a transformational change in health care that will require a complete overhaul in operations. But unfortunately nothing is happening at the front lines. Most likely because those currently in charge know nothing about quality but rather are business people. A meaningful change in health care will begin with a substantive change in leadership.
- CCO: Chief Cultural Officer. The most important person in the C-Suite. The CCO will be the relentless agent of change. The CCO will establish the environment where quality care happens. A Donabedian disciple of quality who realizes that structure and process guarantees nothing. Care will always be patient focused. Care will always be evidence based. Sets the standards and acts as a role model for providers at every level of the organization.
- CAO: Chief Alignment Officer. The CAO will serve as the intermediary between quality and cost. Understands the importance of the bottom line which is second only to great care. Will interact with and align the providers with the payers and others whose job it is to maintain the bottom line. Will share information between the two sides on an ongoing basis so that the value equation is maximized.
- CPO: Chief Practice Officer. Possibly the most difficult job on the list. The CPO will be responsible for transforming the practice of medicine. The current model will be deconstructed and rebuilt. The medical staff will first and foremost be dedicated to evidence based practice and will be provided with all of the time and resources to do so. All unnecessary and ineffective processes will be eliminated so that providers can use that time for better purposes. It’s not about compliance anymore. The future will be about a medical staff that is self-motivated to be the best that they can be and doesn’t need high-priced babysitters to follow them around checking boxes on paper. The CPO will make sure that their medical staff is functioning at the highest possible level. The CPO will also assure that they medical staff will make every decision based upon the patient’s best interest. Always.
There will be additional new and innovative positions designed to completely change health care. These positions will all be held by physicians who have demonstrated a selfless commitment to patients and the profession. They must be innovators. Incremental change won’t work. Lastly, they must be courageous. For several decades health care has been shaped and managed by non-physician administrators who now will need to be displaced. Someone will need to help them see how little they actually contribute to the process of delivering health care. They won’t go quietly. There will be an incredible amount of self-preserving rhetoric. Keep the focus on patients, quality and care and the good guys will persevere.
The new C-Suite will meet regularly with community members to receive feedback and assure that the new model is meeting the needs of the people that they serve.
So hopefully a complete change at the leadership level will result in the transformational change in health care that is necessary: The transition from the emphasis being placed on volume to the emphasis being placed on quality with the result being value. This isn’t bad news for everyone currently in the C-Suite. Will keep the CFO. Someone needs to understand how to depreciate equipment 🙂