What's the top priority in the second half? What's the biggest challenge?
Those are likely two of the questions under discussion in C-suites as second-quarter results are disclosed and companies use their first-half performance to guide them through the rest of the year.
Modern Healthcare reporters posed those two questions to CEOs in all corners of the industry to see where healthcare is headed in the coming months. The responses have been edited for length and clarity.
We're growing state-by-state, which means doing the right things to invest and grow in those states while being really, really thoughtful about capital efficiency and the bottom line. That's our main area of focus in the next six months.
The biggest challenge is the change in the insurance landscape around obesity. It's broader than just medication coverage. Payers are constantly shifting which services they consider necessary for obesity, which includes, but is not limited to, medication. When you're an insurance-based services business, that matters a lot. There's really no way to know ahead of time.
We're implementing behavioral health services in our emergency department via telehealth. We are also going to be providing leadership training for all of our middle managers to build upon the cultural training that we have been doing for the last three years.
Staffing is the biggest challenge. Also, maintaining a positive operating margin is becoming a problem. So many of our patients now have Medicare Advantage coverage. That means that they are no longer on traditional Medicare, which provides cost-based reimbursement since we are a critical access hospital.
We plan to study the impact that Medicare Advantage is having on our organizational finances. Our operational income continues to decline, and we are wondering if this is the cause.
We are fighting to expand the collective bargaining rights of nurses and other clinicians who work in the Veterans Health Administration, through working to pass the VA Employee Fairness Act. We support the Protecting the Right to Organize Act, which protects workers’ rights to organize.
NNU has been a longtime supporter of Medicare for All and will keep fighting for a single-payer system so everyone can get the care they need when they need it.
We hope to keep growing in strength and numbers so nurses can have a say in patient care and working conditions. Staffing remains a key issue.
The biggest challenge is the hospital industry, which puts profits over patients and jeopardizes patient care. Nurses are also concerned about the use of technology. We are fighting to ensure that any new technology, including AI technologies, is subject to comprehensive scientific testing and regulation before it is implemented in any healthcare setting.
Our focus is on scaling and execution, which is not that easy. Scaling for us means getting new clients, enrolling new patients, and then delivering the results and maintaining outcomes. We don’t have to pull any more rabbits out of our hats. It’s just about scaling. And we have to show we can do it profitably. There’s no easy money.
The biggest challenge in the obesity world is the same as it was five years ago in diabetes, which is separating facts from fiction for potential buyers. You can go to five companies’ websites and they all say the same thing.
The primary focus is stabilizing our new acquisitions from the first half of the year, integrating them onto our medical record and electronic dashboard platforms, increasing clinical capabilities and technology tools, creating the culture that makes us successful, and continuing to integrate our operational groups together to find efficiencies.
We have some potential acquisitions on the horizon, and we want to be able to ensure stability across our portfolios as we grow.
As we navigate CMS’ new staffing rules, and learn what that means in each of our geographies, we’re focused on staffing. We already staff above the minimum CMS requirements, but recognize there are nuances we want to be more vigilant about such as the registered nursing components. We’re also focused on recruitment and sponsorship of staff from outside the U.S.
A continuation of quality service delivery is our first priority. We’re making investments to provide better clinical support, more streamlined home-based visits and better implementation of benefits for seniors.
The second thing is managing the growth we've achieved. We've had 50-some percent growth in the year.
Our challenge is scaling and ensuring the degree of service delivery we're providing to our members continues at current levels. The industry needs to think about Medicare Advantage from a different lens, not just a financial engineering profitability lens. If you put seniors first and think about them as your mom or dad, what would you want done for them?
We are going live with our pharmacy reimagined initiative on Jan. 1. We plan to nail that. There are also a couple of large accounts we need to implement well. CalPERS is moving 400,000 of its PPO members to us from Anthem. We are also taking on the TRICARE contract for the West in California, which is around 350,000 members.
There's this financial temptation to treat the patient like an ATM machine. We need to tie pay to value. Our biggest challenge is getting the players in the system to embrace that as a serious objective.
We're not going to sign a contract with a provider unless it moves the needle on the structure of pay and the way we work together so we're confident it moves toward affordability and accountability on care. If it doesn't, then there may be a lot more contract terminations that may be more prolonged and painful.
We're about to launch a recognition program for hospitals following the IHI's National Action Plan to advance patient safety. We believe it will really reflect the spirit of the new patient safety structural measure from CMS.
In addition, we're increasingly participating in discussions with academic organizations, government agencies and the private sector on how to build AI and technology tools to help improve quality and patient safety overall.
There's a very distracting political situation. The two candidates at the top of the ticket represent pretty different futures for the government and significant potential for deregulation or maybe changes in regulation. That is certainly complicating forecasting and prediction.
Marshall has really focused on investing in our employees. We rolled out a program last year that focuses on being mindful of your impact as an employee and what we can do as an employer to help improve your work and work experience.
We started a medical assisting school about a year ago. In collaboration with the El Dorado County [California] Office of Education, we provide space in one of our offsite campuses for the school. We are looking to expand our pipeline for those kinds of jobs for the local residents of El Dorado County.
We have a significant number of resources just fighting denials. All we want is when we sign a contract, just pay us based on the contract we signed. I have hospitalists who are spending many hours on the phone doing peer-to-peer authorization referrals, and it is just a complete waste of time. We win less than 1% of them, but if we don’t fight, we won’t win any of them.
We are focusing on a new malicious threat vector in healthcare. Patients are being directly extorted and blackmailed by hackers after their sensitive medical data has been exfiltrated during a breach. Unfortunately, hackers have uncovered yet another revenue stream in healthcare.
The challenge is educating resource-limited organizations overwhelmed by the sheer amount of existing cybersecurity technology complexity, debt and associated organizational politics. We find educating and navigating organizational cybersecurity politics on "the basics” quite challenging.
Our top priority has been, and will continue to be, to ensure that our clinicians and caregivers have the resources and support they need.
We are a people-centric business and attracting and retaining great talent is a challenge I think most everyone in healthcare is facing. Our focus is firmly on building a strong workplace culture that is innovative and, most importantly, collaborative.
A key part of this has been to evaluate our systems and technology to identify where improvements can be made to improve the workflows for our teams.
To address a regional shortage of outpatient care, we will expand ambulatory services including primary care, obstetrics, cardiovascular, neurosciences and ambulatory surgery centers. We are growing our primary care network with an integrated advanced practice provider-supported, team-based care model.
The biggest challenge we see is having the workforce to meet our community’s healthcare needs. Our workforce strategic plan, modeled after the American Hospital Association's work in this area, includes initiatives to address affordable housing, child care, transportation, care model redesign, and partnerships with regional colleges and universities to expand the pipeline of clinical and nonclinical healthcare workers.
We are focused on completing and igniting our new strategic vision, REWIRE 2030. Healthcare is at an inflection point, necessitating a complete redesign of how care is delivered to patients. We are creating an innovation district in Charlotte called the Pearl, working with industry-leading partners to leverage the latest technological advances.
The nation's largest provider of hospital-at-home, we are expanding our programs to transform the care experience and tackle chronic access challenges. We are integrating AI into enterprise-wide clinical protocols and research across our 69 hospitals and 1,000 ambulatory care sites. We are taking big swings.
Workforce remains our greatest asset and our No. 1 challenge. We are embracing virtual care and AI solutions that reduce burdens on clinicians and enable them to spend more time with their patients. We are building training and development programs in partnership with public schools and universities, while leveraging our own nursing and medical school campuses to build talent pipelines and career development pathways.
Lauren Berryman, Mari Devereaux, Diane Eastabrook, Caroline Hudson, Alex Kacik, Gabriel Perna and Brock E.W. Turner contributed to this story.
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