ACHE discussions range from trust to crisis as 'the new normal'

Attendees of the American College of Healthcare Executives annual meeting did not limit their discussions to the marketplace and health policy. Top executives at the event also had a few words to say about how to run—or not—the nation's multimillion- and multibillion-dollar hospitals and health systems.

“I don't know how to deliver a baby,” said Teri Fontenot, president and CEO of Woman's Hospital in Baton Rouge, La. “I don't know how to process a lab test.” Her skill instead lies with managing resources so that health professionals “can do their jobs,” she said in remarks delivered during the ACHE's 2014 Congress on Healthcare Leadership.

Healthcare management increasingly demands executives who are able to withstand volatility, Fontenot said. Leaders need to be both near-sighted and far-sighted and able to quickly shift between the two. Top management should also be prepared to operate under extreme pressure, she said, suggesting that organizations stress test top executives. “Crisis seems to be the new normal,” she said.

As if to prove the point, Congress dropped a bombshell as the meeting closed with a proposed one-year delay to the deadline for implementing ICD-10 diagnostic and procedural codes, which the House of Representatives swiftly passed. The bill ties the ICD-10 delay to a temporary fix for deep scheduled cuts to Medicare physician pay. The legislation ignited outrage among doctors, and mixed reactions from hospital executives, whose responses ranged from relief to frustration. A Senate vote is expected Monday.

The ICD-10 news capped off the annual meeting, which brought together nearly 4,000 executives and healthcare professionals from across the country to discuss ICD-10 and healthcare's other major issues. New payment models such as accountable care and bundled payments were popular topics, perhaps for good reason. Joseph Swedish, CEO of WellPoint, one of the nation's largest health insurers, told attendees that half of the company's commercial reimbursement would be tied to performance incentives by the end of the year.

Fairview Health Services, Minneapolis, underwent its own leadership and operating crisis in 2012 when its billing contractor, Accretive Health, settled allegations of aggressive emergency room collections with the state's attorney general. The Chicago-based company did not admit wrongdoing, but agreed not to do business in Minnesota for at least two years. Fairview's board of directors opted not to renew CEO Mark Eustis' contract that year.

Rulon Stacey, the chief executive named to succeed Eustis at Fairview, told ACHE attendees that organizations must ask CEOs and managers to address their deficiencies. Stacey has asked his board to solicit his performance review from Fairview's employees, physicians, management and community members. Executives are accountable, he said. “Leaders provide a service and the service we provide is management, and the customer of that service is employees.”

Stacey rejected the philosophy that successful managers don't need to be liked by employees, just effective at producing results. Leaders need to motivate employees to unite around a common goal, he said.

“They do have to like you,” he said. “You do that by earning their trust and there's an amount of 'like' in there.”

Follow Melanie Evans on Twitter: @MHmevans