THE 'EDGE REPORT BLOG

Calling all Innovative Health Plan Leaders

The challenges in U.S. healthcare are considerable. Improve patient outcomes, reduce costs and bridge the great divide between payers and providers. Meeting these challenges requires leadership. But what is leadership? True leaders, we suggest, reimagine three main resources: people, processes and technology.

People

In his bestseller, Ogilvy on Advertising, David Ogilvy shared his thoughts on talent acquisition. “When someone is made the head of an office in the Ogilvy & Mather chain, I send him a Matrioshka doll from Gorky,” he wrote. “If he has the curiosity to open it to the inside of the smallest doll, he finds this message: ‘If each of us hires people who are smaller than we are, we shall become a company of dwarfs. But if each of us hires people who are bigger than we are, we shall become a company of giants.’”

Our problem is this: Although true leaders hire the best, average managers, feeling insecure, hire the average. Average hands, however, will only grope for, not grasp, excellence in healthcare. We need the “crazy one”, the ones who are not afraid to challenge the status quo and are ready to lead. We need the disruptors who are willing to tackle new challenges in new ways. This is the only way we can stay ahead of the ever-changing healthcare landscape. 

Processes

Dale Carnegie told the story about two woodsmen who spent the day chopping wood. One took frequent breaks, while the other worked all day, stopping only for lunch. At day’s end, the woodsman who’d taken several breaks had chopped nearly twice as much wood. His secret? During each break he sharpened his axe.

Like this woodsman, the real leaders in U.S. healthcare use their time more productively. They reimagine processes. They are daring and disruptive. They’re lions undaunted by the lambs who cling comfortably to the status quo.

Two such lions are Patrick Conway, M.D., President and CEO of Blue Cross and Blue Shield of North Carolina (BCBSNC), and Adam Boehler, Deputy Administrator for Innovation & Quality, Center for Medicare and Medicaid Innovation (CMMI). Dr. Conway came to the carrier from the Centers for Medicare and Medicaid Services, where he reimagined care delivery to help drive our nation’s evolution to value-based healthcare. He continues this evolution at the helm of BCBSNC, in collaboration with the payer’s provider network. And while many talk about “social determinants of health,” Conway invests in them. BCBSNC is spending $50 million to combat the opioid crisis, support early childhood development and abuse prevention, and provide legal and social aid to North Carolinians in need. Mr. Boehler has taken a decisive stance at CMMI and is pushing the organization to fully support alternative payment models, noting that CMMI can and should play a role in finding providers to take on more risk. He is on record as saying, “I’ll tell you a lot of what I do in my role running CMMI as senior advisor to secretary Azar is to blow up fee for service”.

Technology

For too long, too many of us have turned to technology solely to cut costs and save time. Payers, for example, purchase enterprise systems to automate processes, lower costs and ensure compliance. But like chopping wood, investing in technology can benefit us in multiple ways. True health plan leaders leverage the best, next generation technology to achieve additional aims: flexibly configure new products for promising new markets, nimbly embrace new benefit and care delivery models, and collaborate more effectively with providers and members.

Yes, leadership is about reimagining people, processes and technology. As we do this, surely millions more Americans will enjoy better health and America will seize the leadership mantle in healthcare worldwide.

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