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February 07, 2018 11:00 PM

Guest commentary: Don't fear the disrupters or the disruption

Elliot Joseph
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    Elliot Joseph

    The healthcare industry has had its share of turmoil in recent years. But news of the Aetna/CVS Health merger in October set a new standard for disruption—and it signaled we'd see more nontraditional alliances.

    Sure enough, late last month came news of another high-powered partnership, this one a behemoth: Amazon, Berkshire Hathaway and JPMorgan Chase will be launching a company to provide better and lower-cost healthcare to their 1.2 million U.S. employees.

    The elephants are dancing.

    Many large players—both inside and outside the healthcare industry—are talking, collaborating and combining in order to enter healthcare or to strengthen their positions as national players.

    Because of their size and power, their movements will affect all of us in healthcare—and beyond. (Consider, among the mergers in healthcare alone, the reports of discussions between Ascension and Providence St. Joseph Health to create a $44.8 billion jumbo system with 191 hospitals. The Aetna/CVS deal brings together nearly 10,000 CVS pharmacies with 23 million Aetna medical members.)

    What the elephants see is a disconnected U.S. healthcare system that continues to be the most expensive in the developed world with way too much variability in results. I hope they also see heroic doctors, nurses, home health aides and many other nonclinical folks who perform daily miracles despite the silos and fragmentation.

    Amazon's role in this new venture is no surprise. It has wholesale pharmacy licenses in at least 12 states and is widely expected to enter that business. It has deep technological and logistical expertise and superb customer service. Berkshire Hathaway offers the legendary foresight of its leader, Warren Buffett, and JPMorgan Chase is truly a heavyweight as the nation's largest bank. What they bring to our industry in terms of innovation, new technology and best practices from their own fields will have lasting repercussions. When they dance, the ground will shake.

    But I'm not shaking, and neither should you. For those of us already pursuing better, more affordable care, this could be a dance of opportunity in which we compete—and partner—in ways that allow us to better serve our communities. But it takes tools to tango.

    At Hartford (Conn.) HealthCare, we have worked for a decade developing our "operating model," which includes personal behaviors, Lean-based daily management and the methodical use of the balanced scorecard. We're clear about our vision of coordinated, personalized care. Through our daily workplace huddles and leadership development, we inspire and sustain a sense of urgency about the work we do for our communities. As a result, we have a track record of organizational agility that has allowed us to thrive in Connecticut's uniquely challenging economic environment, stay ahead of industry trends and form innovative partnerships.

    Whatever you have in your leadership toolbox, I believe you must start with these three qualities: clarity, urgency and agility. Your people—at all levels of the organization—have to clearly understand your goals and what your organization is about. There has to be a sense of urgency. Employees have to see their work as a true vocation, not just a job. And these attributes lead to the third: agility. Clear thinking and a sense of mission—coupled with a responsive organizational structure—will allow everyone to move quickly as the tempo quickens.

    If you have these qualities, there is no reason to fear the elephants. You can dance with the best of them.

    Elliot Joseph is CEO of Hartford HealthCare in Connecticut.

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