Inveniaspartners The Evolving Heathcare C Suite

The Evolving
Healthcare C-Suite:
Trends, Predictions and

Strategic Advice
A Report from InveniasPartners

Healthcare Executive Search,
Assessment and Talent Management
InveniasPartners: Delivering Leadership Excellence
Copyright Statement
Copyright, 2015, InveniasPartners
No part of this white paper may be distributed, reproduced or

posted without the written permission of InveniasPartners.
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Table of contents
4 A Letter from Curt Lucas, President and CEO, InveniasPartners
6 The Changing Healthcare Landscape

9 • Integration/Accountable Care
11 • Consolidation
12 • Population Health Management
14 • Retail Competition and the Consumer
16 • What Healthcare Trends Mean to C-Suites and Boards
18 From Trends to Strategic Action

18 • Strategy A: Find and Develop the Right C-Suite and
Board Talent—A Six-Step Process
19 • Strategy B: Recruit Top C-Suite and Board Talent
22 • Strategy C: Build Structures for C-Suite and Board Success
26 • Strategy D: Assess and Develop C-Suite Executives
and Board Members
28 • Strategy E: Create a Model for C-Suite and Board Transformation
37 Forward to the Future: Predictions for C-Suite and Board Members

37 • Industry Trends
38 • C-Suite and Board Trends
43 Conclusion
44 Resources
2
3
A Letter from Curt Lucas

President and CEO, InveniasPartners
Healthcare C-Suites and Boards

Confront a New Landscape
The healthcare C-Suite faces unprecedented change brought about by healthcare reform,
accountable care, increased consolidation and the economic realities of declining Medicare
reimbursement, deteriorated payer mix and pressures to contain costs.
Shifts in the healthcare landscape call for a new brand of healthcare leaders. Healthcare
organizations (HCOs), including hospitals, health systems, and payers, increasingly seek
out executives from industries as diverse as insurance, e-commerce, technology, retail and
consumer products.
There’s little doubt that healthcare C-Suites and boards will need skills, competencies and
knowledge as listed below:
Innovator Change leader

Risk taker People mobilizer
Transformer Communicator
Collaborator
Developed by InveniasPartners, a Chicago-based healthcare executive search, talent

management and assessment firm with six offices across the United States, this report
documents the challenges faced by healthcare C-Suite and board members. I would like to
personally thank the following executives featured in this report:
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Barry Ostrowsky, President and CEO, CEO, Baylor Scott & White Health, Louis, Missouri
Barnabas Health, West Orange, Dallas, Texas Victor V. Buzachero, Corporate
New Jersey John J. Finan, Jr. President and CEO, Senior Vice President for Innovation,
Deborah Proctor, President and CEO, St. Franciscan Missionaries of Our Lady Human Resources and Performance
Joseph Health, Irvine, California Health System, Baton Rouge, Louisiana Management, Scripps Health, San Diego,
Joel T. Allison, FACHE, President and and Board Member, Mercy Health, St. California
I would also like to thank the many Chicago, Illinois Ralph Muller, President & CEO,
others who provided insightful thoughts Jim Skogsbergh, President & CEO, University of Pennsylvania Health
and opinions for our report. They Advocate Health Care, Downers Grove, System, Philadelphia
include the following individuals: Illinois Lloyd Dean, President & CEO, Dignity
Mark Stauder, President & COO, Inova Health, San Francisco, California
Donna Katen-Bahensky, former Health System, Falls Church, Virginia Sam Moskowitz, Senior Vice President,
President & CEO, University of Steve Lipstein, President & CEO, BJC MedStar Health, Baltimore, Maryland
Wisconsin Hospital and Clinics, HealthCare, St. Louis, Missouri
Madison, Wisconsin Mitch Wasden, President & CEO,
Scott Serota, President & CEO, University of Missouri Health System,
Blue Cross Blue Shield Association, Columbia, Missouri
This report also offers predictions on the future of the C-Suite and guidance on how organizations,
executives and board members can prepare for healthcare’s bright but turbulent future.
The complete version of this report appears on the InveniasPartners (http://www.inveniaspartners.com)

Web site. We plan to update the report with fresh interviews, statistics and examples from news reports,
studies and white papers.
We welcome your input on this report and look forward to providing you with ongoing insights on
healthcare executive and board search, assessment and talent management.
Please connect with us on the InveniasPartners Web site (www.inveniaspartners.com),

Twitter (www.twitter.com/inveniaspartner) and LinkedIn (www.linkedin.com/inveniaspartners).
For more information on how InveniasPartners can help meet your healthcare executive search,
assessment and talent management needs, call Madeline Lazarz at 312-283-8184 or e-mail
Madeline Lazarz at [email protected]
Curt Lucas
Curt Lucas
President and CEO InveniasPartners
The Changing Healthcare Landscape

The healthcare landscape is changing. The American Hospital
Association’s Environmental Scan 2015 points to a future
dominated by the following trends:
Care transformation: Stand-alone hospitals will continue to disappear as providers,
payers and policymakers focus on value—defined as the best possible health outcomes
for a given cost or price. Providers will compete on outcomes.
Consumers and patients: As healthcare organizations (HCOs) transition to value-

based contracts, they will promote the notion that individual behavior is, by far, the most
powerful contributor to prevention, wellness and chronic disease management.
Economy and finance: While fewer uninsured patients will decrease the bad debt of
hospitals and health systems, volume is likely to remain weak.
Information technology and e-health: HCOs will continue to rely on data and data
analytics to deliver evidence-based care, manage population health and predict health
outcomes.
Insurance and coverage: While payers may continue to exclude higher cost hospitals,
payers are still willing to collaborate with hospitals interested in accepting lower
reimbursement.
Physicians: HCOs will continue to acquire physician practices at a rapid pace creating
enhanced management and financial challenges.
Political issues: Payment models will continue to evolve as accountable care

organizations and patient-centered medical homes grow in popularity. Access to care for
adults may deteriorate as performance disparities among hospitals and health systems
persist.
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Provider organizations: Brand loyalty will grow in importance as HCOs

differentiate themselves based on consumer and patient experience. Advances
in technology will continue to improve HCO performance through 2020.
Quality and patient safety: HCOs will focus on care partnerships with patients,
competition based on value, realignment of services with payment systems and
individual accountability for improvement.
Science and technology: Healthcare will continue to evolve toward precision-

based or personalized medicine as technology mobilizes healthcare and fulfills
the demands of an increasingly tech-savvy workforce.
Workforce: The C-Suite will continue to build workforces that are capable
of meeting the requirements of new and emerging markets, using programs
like workplace wellness and prevention to reduce healthcare costs and boost
productivity.
Chief executive officers (CEOs) are feeling the pressure. “State and federal
governments that pay the majority of the bills are running out of money, while
the private sector is unable to absorb added cost shifting,” says John Finan,
President and CEO of Franciscan Missionaries of Our Lady Health System
(FMOLHS), Baton Rouge, Louisiana. “And everything is playing itself out through
a complex, troublesome piece of legislation that carries both benefits and
challenges.”
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While the healthcare industry has always grappled with change, never before has
the change been so profound or broad based. Among the most challenging trends
witnessed by InveniasPartners in its work with hospitals, health systems and payer
organizations are the following:
• Continued consolidation, leading to challenges with operational and

cultural integration
• Financial constraints requiring cost containment initiatives and the

implementation of performance and continuous performance programs
such as the Lean Management System
• Partnerships with other providers or payers, both of which were once

considered direct competitors
• Population health and accountable care
• Retail healthcare competition
• Consumers’ increased involvement in their own healthcare delivery

strategy
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Integration/Accountable Care
C-Suite executives and board members must decide if an HCO can emerge as an in-
tegrated delivery system (IDS) that would ultimately evolve into an accountable care
organization (ACO), according to Jay Eckersley, partner in the Salt Lake City, Utah
office of InveniasPartners. The strategy: Reap the rewards of market share growth
through covered lives, premiums and payments based on quality and outcomes.
Unfortunately, integration remains challenging. It typically involves bringing together

physicians, hospitals and health plans and crafting budgets for governance, planning
and management. Partnering with 600 to 800 physicians, for example, can translate
into the recruitment of hundreds of physician extenders, acquisition of physician
practices and alignment of physicians with HCO strategy and goals.
Still, some hospitals and health systems are joining ACOs, helping to usher in the
prediction that more than 200 million Americans will be covered by ACOs by 2016,
says a report from ReportsonReports.com. Other hospitals and health systems are
seeking relationships with public and private payers for shared savings and bundled
payments, according to a 2014 report from ITG Market Research.
For example, DaVita HealthCare Partners has joined forces with Englewood,
Colorado-based Centura Health to create relationships that incorporate “financial
incentives to manage healthcare costs and quality, including accountable care and
capitation contracts,” according to Modern Healthcare. Meanwhile, Anthem Blue
Cross has created a health plan where seven rival hospitals, including Cedars-Sinai,
UCLA Health and MemorialCare Health System, will share in profits and losses.
ACO success is evident throughout the country. Neptune, New Jersey-based Me-
State and federal governments that pay the majority of the

bills are running out of money, while the private sector is
unable to absorb added cost shifting.
John Finan,
President and CEO, Franciscan Missionaries of Our Lady Health System (FMLOHS),
Baton Rouge, Louisiana.
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ridian Health System created an ACO through a partnership with Meridian hospitals,
partner companies, and more than 800 physicians and allied health professionals. The
ACO, which now serves some 50,000 patients, promotes evidence-based medicine,
patient engagement, and an infrastructure that allows providers to report on quality
and cost metrics.
Under CEO Joel Allison, FACHE, Baylor Scott & White Health, Dallas, Texas, has
advanced population health through an ACO called the Baylor Scott & White Quality
Alliance. Hospital admissions for the ACO’s 34,000 members have already declined
more than 4 percent, while 30-day readmissions are down 18 percent with a 7 percent
cost savings.
Others such as Baton Rouge-based Franciscan Missionaries of Our Lady Health

System (FMOLHS) have opted not to enter the insurance business. Instead, FMOLHS
plans to partner with insurance companies and sustain care management compe-
tencies acquired through its Healthy Lives population health initiative, according to
FMOLHS’ President and CEO, John Finan.
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Consolidation
Just as troubling to C-Suite and board members is the surge in mergers and acquisitions, a
trend that will continue throughout 2015, according to a report from Moody’s Investors Service.
The implications and results of consolidation may vary by provider size.
Struggling smaller hospitals are likely to gain from being acquired by larger, stronger systems,
predicts Moody’s. However, hospital and health system consolidation may emerge as a “credit
negative” for acquirers due to “high financial leverage associated with acquisitions and the risks
that come with acquired assets.”
According to Curt Lucas, President and CEO, InveniasPartners, consolidation deals typically
involve the following:
• Appointment of a single system CEO or C-Suite

• Integration of corporate, business and clinical functions
• Rebranding
• Development of separate budgets for hospitals, physician clinics and provider-
sponsored health plans
• Integration of cultures
Because loose affiliations often fall apart against managed care pressures, HCOs often
“merge up to avoid scrambling the egg,” says Eckersley. C-Suite search assignments typically
emerge immediately after a merger or before an HCO enters into its next merger discussion.
This is followed by pre and post-merger talent management in anticipation of a newly created
integrated delivery system and re-engineering of the C-Suite to include a specific number of
executives—often no more than 8–10.
Formed through the 2013 merger between Baylor Health Care System and Scott & White
Healthcare, Baylor Scott & White Health is now the largest not-for-profit health system in Texas
with 43 hospitals, some $9 billion in net revenue and a patient population larger than the state of
Virginia. The goal: Increase efficiency to combat shrinking margins brought about by healthcare
reform and the Affordable Care Act.
“Combining two systems offered us the opportunity to develop new models of care that
support individual patient care and population health management,” says Joel T. Allison,
FACHE, President and CEO, Baylor Scott & White Health. “By using our size and strength to
zero in on the health and well-being of patients, families and communities, we can continue
to offer high-quality care at an affordable cost.”
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Population Health Management

The population health market is still in its infancy, according to a report from Chilmark
Research, as HCOs struggle to both link outcomes with performance and leverage
data—clinical, claims and demographics—to improve care delivery.
“Healthcare has always taken care of the sick, but the emerging measure of success
is how well HCOs can manage and ensure the health of a population,” says George
Popko, partner, InveniasPartners. “It’s no longer about how to run a hospital, but how
to engage physicians and sustain population health.”
Fortunately, population health management programs are already paying off, according
to a survey of healthcare executives by KPMG LLP. More than half expect to recoup
investments in three to four years and view population health management as a
strategy to reduce avoidable medical costs and care variability.
Population health demands that C-Suites and boards align or reposition every care
entity—from hospitals, nursing homes, and imaging centers, to pharmacies, labs and
physician practices—along the expanding continuum of care, according to Popko.
Equally important, C-Suites and boards must secure and control premium dollars to
keep people healthy and manage care delivery.
As President and CEO of Irvine, California-based St. Joseph Health, Deborah Proctor
illustrates the challenges of managing a complex health system of 16 hospitals,
physician organizations, home health agencies, hospice care, outpatient services,
skilled nursing facilities and community outreach programs in Northern and Southern
California, Texas and New Mexico.
“St. Joseph Health’s emerging approach to population health management will vary
by region,” says Proctor. Texas, for example will become an insurance partner, while
Southern California will house population management within a medical foundation.
The only commonality among regions: physician leadership of population health
management.
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The definition of population is also shifting; Proctor, for example, recently formed a
partnership with a residential complex equipped with a grocery store, restaurant and
fitness club, in addition to a St. Joseph Wellness Center. Within the St. Joseph Health
Wellness Corner Village, residents have access to exercise equipment, as well as
personal coaching and health and medical services available through a St. Joseph
Health medical group. Wellness Corner Village has already offered triathlon training and
a more aggressive form of yoga, along with weekly consults with plastic surgeons and
sports medicine physicians.
The project is a winner for St. Joseph Health and the residential complex. Revenues
for the medical group will continue to climb as St. Joseph Health delivers its health
and wellness services through Wellness Corner Village. More specifically, St. Joseph
Health and the complex will share data on factors like resident age, income, education,
employment, activities and preferences for evening and weekend appointments.
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Retail competition and the consumer

Healthcare providers and payers are witnessing the “retailization” of healthcare. Walmart,
for example, launched Healthcare Begins Here with plans to create primary care retail
clinics available through Wal-Mart’s Centers of Excellence. With a Wal-Mart located within
five miles of 95 percent of the U.S. population, providers and payers may falter without a
retail-focused mindset.
“Ensuring that patients and consumers get the care they need means honing in on the
retail and consumer experience—specifically how people shop,” says Baylor, Scott &
White’s Joel Allison. “How, for example, can HCOs engage young invincibles in prevention
and wellness while taking on the retailers that just migrated into the healthcare space?”
The transition calls for a massive change in culture. “It may be a challenge to think
in terms of consumers and customers instead of patients,” says Allison. “Healthcare
executives and providers have devoted their lives to patients, so it’s not in our DNA to
carry on discussions about retail, shoppers and shopping. But we need to do it.”
The shift to consumers and a retail environment may also require HCOs to open their
doors to outsiders. “HCOs need to diversify their portfolio of outsiders and identify how
these professionals could contribute to the C-Suite,” says Allison. “Healthcare needs
people who will challenge traditional thinking, but still understand healthcare’s culture,
mission, vision and values.”
“HCOs must define what they hope to become and where they’ll fit, and then pinpoint
specific areas of expertise,” adds Allison. That, in turn, calls for leaders “to run a marathon
as well as a sprint” and meet consumers’ needs in an ever-changing environment.
“Executives must be as proactive as they are reactive, accepting that some ventures will
be home runs and others will be foul balls,” he says.
The healthcare C-Suite and board are especially concerned about the evolution of retail
clinics that have surfaced within supermarkets, chain drug stores and retailers like Wal-
Mart and Target. RAND Health counsels providers to track their answers to the following
questions:
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• Who uses retail clinics and why?

• What services do retail clinics provide?
• Are there valid concerns about retail clinics?
• What’s next for retail clinics?
The influence of retail is also being felt in Southern California where Deborah Proctor sees
value in a community wellness or customer engagement strategy that functions like a retail
business and relies on executives to take charge of wellness, accountable care, population
health and insurance. The focus: Manage at-risk lives through population health and deliver
care within an integrated system that addresses both wellness and acute patient care.
Proctor believes that HCOs must re-engineer how they interact and engage with patients,
consumers and members. While health systems may implement consistent approaches to
care delivery, she believes the way systems approach population health management can
vary by region, community, or patient population.
Proctor has already moved forward with a customer engagement digital strategy, reflecting
a nationwide trend to engage consumers, patients and families via digital media. Hospitals
already rely on digital media to acquire and retain patients, according to experts from
BerylHealth.
St. Joseph Health’s digital platform allows customers to become partners, even if they
never sought sick care or joined an insurance plan. Community residents obtain access
to a hub, which puts them in touch with St. Joseph’s digital platform. They can load their
health data into the hub, request that a hospital interact with a wellness center or allow a
physician to see their fitness data.
For example, residents who are expecting a baby can access specialized pregnancy
content, network with communities of mothers, parents and hospital-based labor and
delivery services or locate stores selling baby supplies.
Proctor believes that St. Joseph Health’s new digital platform will give consumers access
to health information and healthcare delivery in the way they want it, where they want and
when they want it. Going forward she believes that HCOs will need fewer customer service
professionals who staff call centers and will instead need more executives who can design
and implement multiple channels for community residents to engage with a health system.
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What Healthcare Industry Trends

Mean to C-Suites and Boards
“The trends of accountable care, consolidation, population heath management and retail
competition and the consumer suggest that C-Suite and board members must rethink
healthcare’s business model,” says FMOLHS’ Finan. Among his recommended questions:
• Models: Where are the new and emerging business models

for achieving clinical, financial and operational goals?
• Performance: How well have these models already

performed? How likely is it they will perform well in the years
ahead?
• Assets: How can C-Suite and board members leverage

organizational assets and strengths to reposition the HCO
along the expanding continuum of care?
• Gaps: How can the HCO bridge performance gaps through

partnerships, alliances and talent management systems while
still sustaining mission, vision and values?
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Beyond asking Finan’s questions, InveniasPartners advises healthcare C-Suite and

board members to also focus on these strategies:
• Develop leader skill, competence and experience

• Provide patient and family-centered care
• Coordinate and collaborate on care delivery
• Manage the health of populations
• Insist on continuous value and performance improvement
• Deliver care across the continuum
• Evolve into a learning organization
• Engage the workforce and community in the healthcare journey
“Moving forward means securing full agreement on what

you want to be when you grow up,” says Popko. “The
big questions for C-Suite and board members are: Who
are we and what do we want to do? Smaller hospitals
may not have a CTO, CIO or a chief population officer,
but they can partner with other organizations to tap
resources, support and expertise.”
George Popko,
InveniasPartners, Princeton, New Jersey
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From Trends to Strategic Action

Once healthcare c-suite and board members analyze, evaluate and synthesize the trends
dominating the healthcare landscape, they’re ready to outline strategies, goals and objectives
for executive search, assessment and talent management. InveniasPartners advises HCOs to
adopt the following strategies:
Strategy A: Find and Develop the Right C-Suite

and Board Talent: A Six-Step Process
Finding and retaining the talent capable of handling the demands of
accountable care, consolidation, population health management and retail
competition and the consumer demands a disciplined process:
Step 1: Leadership assessment: C-Suite and/or board members may choose to partner
with an executive search, assessment and talent advisory firm to assess executive
needs and create position specifications consistent with culture and preferred executive
performance.
Step 2: Executive selection: Executives, board members and consultants explore how
the right talent will drive clinical, financial and operational performance. Consultants brief
hiring executives and board members on interview standards, best practices, process, and
anticipated results.
Step 3: Strategic onboarding and coaching: Consultants work with hiring executives and
board members to ensure fulfillment of the four Cs: compliance, clarification, culture and
connection, all of which prevent executive derailing and enhance executives’ contributions
to strategic goals.
Step 4: Executive engagement: Consultants work with C-Suite and board members to
reinforce the HCO’s value proposition, mission, values and culture. By promoting external
and internal involvement and participation, the C-Suite and board enhance executive
engagement, performance and retention.
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Step 5: Executive development: Consultants join forces with C-Suite and board members
to create an enterprise-wide leadership development program. The goals: Identify and assess
high-potential leaders. Then educate executives on how they can champion and live HCO
values.
Step 6: Succession planning: Consultants help craft a succession plan complete with
roles, responsibilities, timeframes and resources that support C-Suite and board investment
in high-potential executives, clinicians, managers and other professionals. The process
includes developing objectives that come under review every six months. The goal: leadership
continuity.
Strategy B: Recruit Top C-Suite and Board Talent

Given the environment of unprecedented change, recruiting top talent in
the healthcare provider industry is more important than ever.
Health systems continue to evolve from cultures based on hierarchy, fragmentation and
expert-centeredness to cultures rooted in integration, collaboration, teaming, matrix structure,
and patient/family centeredness. These changes demand leaders who think strategically,
embrace change, learn quickly, move with agility and manage horizontally throughout the
enterprise.
“One thing is sure: HCOs should avoid a do-it-yourself approach. Identifying the appropriate
mix of skill, knowledge and experience requires enterprise-wide assessment,” says Jay
Eckersley, partner, InveniasPartners.
“Search, assessment and talent management firms evaluate an HCO’s mission, vision, values,
strategy and culture to identify candidates who will fit within that culture and fulfill strategic
goals,” says Lucas. “Only then can board and C-Suite members think in terms of specific
positions or clusters of positions.”
This includes merging titles like chief incentive officer, chief experience officer, chief
engagement officer, chief safety officer, chief population health officer and chief technology
officer.
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The best executive search, assessment and talent management firms challenge the
“specs” for positions—especially if a C-Suite and board identifies its ideal candidate
as a white male under the age of 40.
“The key,” says George Popko, “is motivating C-Suite and board members to examine
how candidates complement the HCO’s workforce, patient population and surrounding
community and service area.”
“All too often, employees, patients, families and clinicians can’t imagine how members
of a C-Suite or board could relate to their lifestyle, concerns and priorities,” counsels
Lucas. “If HCOs want to serve patients/consumers in an increasing diverse community
and nation, they must add diversity to their leadership team.”
Among the other search and talent management criteria recommended by

InveniasPartners and healthcare CEOs are the following:
Transitional and transformative: Recruit C-Suite and board leaders with the skill,
knowledge and experience to take on the transition to value-based accountable care,
population health management, collaborative care across the continuum and fulfillment
of meaningful use.
“C-Suite and board members sometimes chase after the best talent without seeking
skill sets that complement HCO strategy,” says Barry Ostrowsky, President and CEO,
Barnabas Health, West Orange, New Jersey. “But healthcare is less about managing
health services and more about the delivery of care, prevention and wellness in a
retail-based, consumer-oriented environment.”
“Ostrowsky is recruiting a chief population health officer and is in the process of

re-engineering a chief medical officer position. If Barnabas assumes added risk for
clinical services, Ostrowsky may tweak finance and strategic positions or look for data
professionals who can interface with sources of big data analytics.”
Back-to-basics: Seek out C-Suite and board leaders who can focus on patient
satisfaction, quality improvement and financial performance, and who can reach past
the “bigger is better” merger and acquisition mania of past years. Lucas advises HCOs
to search for leaders who are willing to work with incentives that respond to long-term
financial, clinical and operational performance rather than quick fixes and fast wins.
Inspirational: The best executives understand how to forge bonds between C-Suite
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and board members, employees, managers and clinicians. “Technology isolates

people, compromising the interpersonal relationships that accelerate productivity,”
says Ostrowsky. “The C-Suite must counter the migration to non-interpersonal
communication because we’re in the people business and you can’t manage people
via Twitter.”
Ostrowsky also champions a culture of transparency and simplicity. “Healthcare is

a business where we can’t keep secrets,” he says. “The C-Suite of the future must
communicate with every constituency in the enterprise.”
People focus: “Seek C-Suite and board leaders who can implement enterprise-wide
human capital management and align employee performance with HCO strategy,”
counsels Popko.
Ostrowsky recommends that HCOs recruit a visionary chief human resources officer
(CHRO)—possibly someone from outside of healthcare. As a stop gap measure,
he advises HCOs to build a team of executive vice-presidents to oversee talent
management.
Openness: “Seek C-Suite leaders who won’t endlessly meet and collaborate but will
lead and act decisively,” advises Popko. Equally important, uncover leaders who are
willing to combat healthcare myopia and look for inspiration and ideas from outside
the industry.
Ostrowsky, for example, meets regularly with small groups of less experienced
professionals to discuss new and emerging trends, implications, strategies and “what
Barnabas needs to achieve success.” He also challenges professionals “not to wait for
me to explain something” but to master trends on their own.
Tech savvy: The best executives know how to leverage new and emerging
technologies. While information systems have allowed HCOs to use data more
effectively, Popko believes that it’s up to C-Suite and board members to transform
data into information, information into meaning, meaning into knowledge and
knowledge into wisdom, as first described in The Knowledge Pyramid.
Diversity: HCOs need executives who will bring diversity—in age, gender or
ethnicity—to the C-Suite and board room. “HCOs should ensure that newly developed
or recruited executives and board members complement the HCO’s patient population
and workforce,” says Lucas. “That, in turn, means working with executive search firms
that make diversity a priority.”
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Strategy C: Build Structures for

C-Suite and Board Success
What kinds of structures allow C-Suite
and board members to achieve top performance?
Jay Eckersley, former President and CEO of Springfield, Missouri-based St.

John’s Health System and now a partner with InveniasPartners, recommends an
organizational structure that incorporates approximately twelve senior management
positions visualized through a series of concentric circles.
The goal, according to Eckersley, is to “integrate hospital, physician and health

quality and economic interests at all levels of a health system, including governance,
senior management, business operations and clinical service lines of excellence.”
Eckersley recommends CEO, line and support staff leadership development for
hospitals, health plans and clinics. He envisions each system hospital being led by
a CEO, as well as a chief medical officer elected by medical staff and a chief nursing
officer. Each member of a C-Suite can share the same incentive-based goals linked to
the system’s strategic goals.
Just as vital to a health system’s success is appointing line managers to functions

such as mission services, information technology, legal, customer service, finance,
human resources, strategic planning and marketing. A foundation can oversee fund
development and community involvement.
Eckersley recommends that hospitals and health systems develop multiple strategic
service lines around mission, vision and values. Physician and executive teams
can take charge of service lines that could include women and children, oncology,
neuroscience, cardiovascular, seniors, sports medicine and emergency, trauma and
burn care.
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However, not all services may qualify as strategic service lines. To evaluate the prospects of
service lines, Eckersley suggests applying the following criteria:
• Grows market share through covered lives

• Is led by a physician and executive management team
• Accepts managed care risk
• Focuses on utilization and global cost per case
• Offers excellent customer service
• Publishes quality metrics
• Serves the poor
• Reinforces system image and identity
• Develops disease management protocols
• Benchmarks with other centers of excellence
• Focuses on health and wellness programs
“Hospitals and health systems increasingly abandon the belief that a physician will magically
morph into a manager and run a service line alone,” says Eckersley. “Instead, a physician
and manager should partner to build market share and assume insurance risk on a carve-
out if a contract demands it.”
Other organizations like Scripps Health have taken a different tack. When Scripps’ COO
moved up to become CEO some 14 years ago, he chose not to replace himself with
a traditional COO. Instead, COO roles and responsibilities are shared among several
executives, including the CEO, chief financial officer (CFO), and Victor Buzachero, who
handles workforce and talent management as Corporate Senior Vice-President for
Innovation, Human Resources and Performance Management. The executives also support
each other on board committees.
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The executive team realized that Scripps had “grown up by picking up facilities,” says
Buzachero. What it lacked, however, was a consistent strategy for addressing the
needs of diverse functions like human resources, information technology, purchasing
and clinical care. Buzachero responded with a succession planning and benchmark
development program. The goal: Create horizontal operations leaders who assume
responsibilities across the organization that complement their vertical responsibilities.
The program produced multiple horizontal vice-presidents who work in collaboration

with hospital CEOs to eliminate variation across the enterprise. By monitoring
elements as diverse as operating room and service line performance, the executives
ensure consistent implementation of standards and squeeze out costs.
“Our horizontal VPs are the best operations executives because they understand how
to collaborate with other operations executives,” says Buzachero. “Professionals who
might have defended their silos or turf are now committed members of a team.”
“Making the transition from management of business units to management across

organizational entities is vital as Scripps works to deliver accountable care, population
health and positive health outcomes at a reasonable cost to patients and payers,” says
Buzachero.
Managing across Scripps has already created the need for senior executive talent in
medical management, population health and business development. For example, a
senior vice-president of corporate development now promotes dialogue on potential
partnerships and affiliations.
24
25
Strategy D: Assess and Develop C-Suite

Executives and Board Members
Growing numbers of HCOs realize the importance of a single executive
development program implemented throughout a hospital, health
system or payer organization.
These programs identify and focus investment in “high-potential” executives while

showing newly hired executives how to live and share HCO values.
HCA, for example, sponsors an executive development program “that ensures the
management pipeline necessary to ensure leadership today and in the future.”
Candidates can choose from two-to-three year programs focused on COO, CNO or
controller positions with promotion based on “individual development, leadership skill
assessments completed by (a) mentor and executive development leadership.”
Executive assessment at FMOLHS, where John Finan serves as CEO, is a structured

process that relies on the following questions:
Assessment: Who are the real leaders in this organization? What types of leaders
does FMOLHS need in terms of skill, experience, expertise and cultural fit?
Expectations: What are the behaviors required for success? FMOLHS focuses on
mission, quality, satisfaction (team member, patient, physician), and financial results.
What kind of performance is expected?
Goals and objectives: How do we create a clear line of sight from organizational
performance requirements to individual leader personal goals and contributions to
success?
Support: How can FMOLHS provide the resources—human, financial and structural—
that executives need to support performance excellence?
26
At Scripps, Buzachero compares assessments with the actual performance of high-potential

executives, while involving supervisors and managers in employee and team performance
evaluation. The process removes what Buzachero calls “the Lake Wobegon effect” and
ensures robust assessment of every Scripps worker.
Scripps evaluates its executives based on outcomes, including employee morale, financial
performance, quality and patient satisfaction. By feeding performance data into an
algorithm, Buzachero can rank executives and executive performance from highest to
lowest.
Executives in the top quartile tend to perform well in every category: budget, turnover,
patient satisfaction and quality. However, executives in the lowest quartile miss on almost
every measure, while those in the middle quartile demonstrate mixed results. The actionable
data and intelligence allow Scripps to validate and invest in high-potential executives.
“Scripps no longer relies on performance reviews, just concrete statistics,” says Buzachero,
who compares the process to the narrative of the 2011 film “Money Ball.” By securing
data on how well executives perform under pressure in a variety of settings, Scripps can
formulate individualized plans for improvement. Or the system can transform the highest-
performing executives into mentors, coaches or heroes that up-and-coming executives
might want to emulate.
And what about executives who rank near the bottom? Buzachero and his colleagues work
to find these executives less complex, more realistic positions. However, if the executives
fail to perform after a period of three years, they invariably leave the organization.
Executives who rank in the middle typically qualify for coaching and possible placement
within Scripps.
Scripps always leaves the door open to new executives who might head up massive
development, construction or redesign projects. Buzachero already sees the need for an
executive who could re-engineer some of Scripps’ clinical areas. However, he insists that
the executive be someone “with a transformational mindset, lean experience and the talent
to teach Scripps new skill sets.”
27
Buzachero’s passion for executive development is shared by Allison of Baylor Scott &
White. Allison advises HCOs to pinpoint emerging leaders and perform regular assessments
of professionals who are likely to occupy executive positions in one-to-three years. For
example, Baylor requires each emerging executive to prepare a performance development
plan complete with goals for improvement.
“Developing leadership talent is the best way for an HCO to get ready for situations that
call for someone to step in to develop or run a program,” says Allison. “And the premium
strategy for doing that is to assess and develop talent faster than your competitors.”
Executive assessment and development are vital to succession planning and management,
according to Lucas. These programs typically start with a succession management plan that
delineates targeted roles and assessment and development of high-potential executives.
By relying on succession planning, HCOs can ensure leadership continuity and avoid
disruptions that come with crisis and turnover.
Experts agree. Succession planning ensures the survival of any business, according to a
2014 Harvard Business Review blog. The author recommends that C-Suites and boards
sustain their focus on succession planning—even when a CEO’s retirement is two-to-three
years out. Equally important: Observe how candidates interact with the outgoing CEO and
set clear expectations on the new CEO’s roles and responsibilities.
Strategy E: Create a Model for

C-Suite and Board Transformation
InveniasPartners’ model for C-Suite and board transformation focuses on
development and alignment of collaborative, interdisciplinary teams
and ongoing assessment and talent management of c-suite executives and board
members. Just as vital, says InveniasPartners, is integration of fresh, diverse points of
view and creation of an environment that supports innovation and change.
28
Teams: Implement collaborative teams

aligned on common goals.
“Care delivery calls for clinical, financial and operational expertise, which demands full
collaboration and goal alignment by clinicians, executives, managers and employees,”
says Lucas. “C-Suites and boards must leverage technology to enhance clinical
performance balanced by financial and operational performance.”
HCO success hinges on the ability of C-Suite and board members to engage and align
clinicians, employees and managers with strategic objectives and goals, not on the
ability to recruit, hire and reward people for competency or tenure.
Adds Lucas: “We need to recognize executives who are willing to move the bar on
performance outcomes in measurable areas like patient satisfaction, quality, safety,
efficiency and cost, not just those who stick with the organization for years.”
Industry changes have sold Baylor, Scott and White’s Allison on the concept of team-
based care and a team-based C-Suite and board development. “Surround yourself
with people who can develop and execute on new ideas and sustain a spirit of
innovation and entrepreneurship that surges throughout the enterprise,” he says. “If
you’re committed to team-based collaboration, the last thing you want is a C-Suite or
board controlled by one or two executives.”
FMOLHS’ Finan leads interactive dialogues on assumptions that underlie FMOLHS’

plans for care delivery. “If these are the reigning assumptions, what’s the strategy?”
he asks. “How do we develop a clinical network and delivery system that gets us
predictable cost and quality? And where do we find the talent to lead the surge?”
29
Talent: Transform the HCO via talent management for

C-Suite and board members.
Will hospitals and health systems identify leaders from within or continue to rely on
executive search? The answer depends on how much HCOs are willing to invest in
ongoing executive development and succession planning programs.
HCOs that commit to developing existing executives for higher, more expansive
roles may be less likely to conduct exhaustive searches of external candidates. The
answers will surface in research that evaluates the following:
• Pre-employment assessment: What’s the impact of pre-employment

assessment on executive performance and tenure? What types of pre-
employment assessment work best?
• Evidence-based selection: How does evidence-based search and

selection contribute to clinical, operational and financial performance—for
C-Suite executives and HCOs?
• Executive on-boarding: What are the functions, features and advantages

of executive on-boarding?
• Executive development: Which types of executive development

programs generate the highest levels of individual and organizational
performance? How are executive development programs implemented,
managed and evaluated over time?
• Succession planning: How does succession planning contribute to

leadership continuity within HCOs? How does lack of succession planning
generate disruption and crisis within HCOs?
Finan has introduced an assessment process to confirm the quality of existing talent
and identify executives who would participate in accelerated development programs
and then serve in expanded or emerging executive roles.
30
Adds Finan: “FMOLHS will go outside of healthcare or our organization if we have to,
but we believe that we build a stronger organization by promoting executives within
the organization. The key is developing a strong mix of executives who complement
each other’s strengths, while compensating for areas that need enhancement.”
31
“HCOs need professionals with the knowledge, skill and experience to envision the
next wave of innovation and forge a path to enterprise-wide transformation,” says
Lucas. As an alternative to quick termination and turnover, he advises C-Suite and
board members to work with search, assessment and talent management firms to
evaluate the performance of existing executives along with the HCO’s overarching
needs for fresh skill sets, knowledge, experience and competencies.
HCOs can then develop position specifications based on clinical, financial and
operational needs, including demographic needs, rather than on the popularity or
trendiness of a specific C-Suite position.
Equally important is revamping incentive programs. “While almost all HCOs now offer
incentive and bonus programs for senior executives, the programs often typically
aren’t strong enough to incentivize or differentiate between short or long term
leadership performance,” says Lucas.
Short-term incentives, which typically come in the form of an annual bonus, reward
executives for “moving the needle” on variables like patient satisfaction, reduced
morality or healthcare-associated infections. However, few programs hone in on the
clinical outcomes goals, strategic organizational priorities and long-term financial
performance.
Another priority is physician development. “The majority of physicians who completed

medical school focused on solving clinical problems, not on business management,”
says Popko. Other executives who never went to medical school missed the clinical
perspective but grew up on business, finance and operations. “The key”, he says, “is
to build dual competencies within clinicians and executives and integrate and share
expertise via team-based collaboration.”
FMOLHS’ Finan believes that many physicians falsely assume that completion of
an MBA program is a fast track to the C-Suite. He counsels physicians to consider
alternatives such as serving as examiners for the Baldrige program or attending
programs similar to those offered by the Harvard School of Public Health or the
American Association of Physician Leadership.
32
Ostrowsky’s approach also surfaces in his interactions with members of the medical
staff, who typically want an inside track on strategy, implementation, results, benefits
and roadblocks. Among the questions Ostrowsky prepares to answer: Where is
Barnabas headed? How can physicians participate? How can we better align
physicians with Barnabas’ strategic goals and objectives?
“Do everything you can to see that the C-Suite is an extension of the enterprise,” says
Ostrowsky. “It’s a mistake to connect the enterprise to a C-Suite that no longer fits the
HCO’s strategy.”
Integration: Remove boundaries; reach out.

“No single executive or board member can address healthcare’s looming challenges,”
says Lucas. “HCOs need external expertise and the perspectives of multiple
stakeholders.”
He believes reaching out embraces the recruitment of board members who are
prepared to enforce C-Suite accountability, represent or reflect other industries and
ensure clinical, financial and operational performance.
“C-Suite and executive team members also need to get out from behind their desks to
conduct rounds throughout the enterprise,” counsels Lucas. “They should listen and
seek answers to core questions: What’s working? What isn’t working? What should be
changed—now and in the short-term future? Which innovations should be introduced
and launched?”
“CEOs need a truthful evaluation of facts, opinions and implications of new and
emerging trends,” says Ostrowsky. He recommends using panels of experts to deliver
advice on diverse enterprise functions, including talent management and human
resources, as well as emerging healthcare trends.
Lucas advises C-Suite and board members to pursue standard professional

development opportunities, including relevant reading, continuing education, seminars
and conferences, while also deriving insights from slightly offbeat media sources like
Wired, Mashable and VentureBeat.
33
“Network with C-Suite executives and board members within the provider, payer,
government and retail healthcare communities, but also reach for inspiration from
entertainment, sports, technology, retail and consumer products,” says Lucas. “If you
insist on staying in your own back yard, you may get fenced in.”
Innovation: Orchestrate innovation; manage change.

Our mission is to deliver care to the next person who comes through the door or
across our computer or phone,” says FMOLHS’ Finan. “The challenge for HCOs is to
assess community and patient needs and then connect individuals to the resources
that can meet those needs.”
He recommends that C-Suite and board members move through these steps:
• Define the business.

• Ensure accountability for determination and implementation of strategy.
• Transform everyone and everything else into a supportive resource.
For example, FMOLHS’ e-health technology group is identifying patient
care systems that support clinicians in their efforts to deliver, and
improves care for patients.
And what happens if an HCO responds to the call for accountable care and
integrates enough to assume insurance risk? It should at least consider going at risk
and sponsoring a health plan. “Providers need not allow insurance companies to do
what they could do themselves: wholesale or group contract services to self-insured
employers,” advises Popko.
HCOs should also select service lines to grow market share or covered lives. They
might, for example, market an at-risk product for orthopedics to employers or
insurance companies, or sell services such as vascular grafts for a specific price.
“The key,” says Eckersley, “is acting on the assumption that large employers will use
health plan products to improve quality and outcomes.”
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“Innovation flourishes when clinicians, executives, managers and employees are aligned
and collaborate across the enterprise,” says Lucas. “Collaboration should reach beyond
the enterprise to embrace think tanks, associations, vendors, government and media.”
Hospitals and health systems are already involved in community-wide partnerships that
“bring a wide range of stakeholders—healthcare providers, educators, business leaders,
social service providers, community organizations, and clergy—together to promote
healthy behavior, improve access to primary and preventive care, and reduce health
disparities,” according to the Commonwealth Fund.
Funded by the Robert Wood Johnson Foundation (RWJF) and the Kresge Foundation,
the Hilltop Institute’s Community Benefit Programs foster collaboration between multiple
hospitals and local health agencies, according to Partnerships for Community Health.
Change also beckons executives and board members to broaden the concept of
engagement to include former competitors and diverse fields and disciplines like sports,
entertainment, politics, media and religion.
• St. Joseph Health teamed up with the Los Angeles Angels to mark Cancer
Survivorship Day, while recognizing community heroes through its St Joseph
Health Heroes campaign and Halo Moments Web site.
• Boston Children’s Hospital joined forces with television personality and

producer Ryan Seacrest to launch Seacrest Studios. The studios operate
under the closed-circuit hospital television station channel, broadcast
entertainment programming throughout the hospital and complement the
hospital’s commitment to clinical innovation and pediatric health.
• Massachusetts General Hospital has partnered with the Boston Red Sox to
establish Home Base, a provider of healthcare services to deliver care for Iraq
and Afghanistan veterans who have combat or deployment-related stress or
traumatic brain injury (TBI). Home Base also provides counseling and support
for veteran’s families and those who are closest to the veteran.
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Executives must also take a fresh look at former competitors that could easily morph
into partners. St. Joseph Health, which once competed with Hoag Memorial Hospital,
is now part of an alliance called St. Joseph Hoag Health. In 2014, St Joseph joined with
Children’s Hospital of Orange County (CHOC) to form an accountable care organization.
“As HCOs become larger and more complex, C-Suites and boards must also change,”
says Lucas. For example, one hospital CEO who managed 150 employees for five
years faced an organization that grew to 1,500 employees in just one year. While the
CEO struggled to maintain his existing C-Suite team, he eventually realized that he
needed a new team to meet changing requirements in human resources, marketing and
information systems.
“C-Suite executives often fall into a pattern of passivity and the mentality of don’t rock
the boat,” says Popko. “The search for collaboration can easily evolve into a relentless
pursuit of consensus. The CEO and members of the board and C-Suite must lead and
take ownership.”
36
Forward to the Future: Predictions

for C-Suite and Board Members
Industry Trends
Health industry trends C-Suites and board members can look forward to in the coming
years include the following:
Physicians will increase their influence. “Hospitals, not physicians or insurance

companies, will drive physician partnerships thanks to their retained capital and
interdependence with physicians,” predicts Popko. “HCOs can never control or employ
every entity, but they can function as partners and integrate to the degree that they’re able
to assume insurance risk.”
Small independent hospitals may continue to falter without integration: Mergers and
acquisitions could lead to nothing more than a collection of hospitals that operate under
a single umbrella. “What’s needed,” says Lucas, “is integration and alignment driven by
C-Suite and board leaders who envision the HCO’s evolution over the next three-to-five
years and forge strategies around margin, revenue, quality of care and satisfaction.”
The future will hinge on care management, making physician and nurse leadership
indispensable, Healthcare’s future is about improving the management of care and the
best people to lead that change are often clinicians,” says Finan. “The CEO must view the
HCO through the lens of what is needed to provide complete care of the patient.”
That means the HCO must evaluate clinical process and improve care teams to deliver
predictable outcomes and costs. For example, one FMOLHS organization established
a joint program in which physicians, nurse leaders and team members redesigned
orthopedics processes that start with an office visit for knee pain and conclude with the
final visit following a surgical procedure and rehab.
37
Consumers will come into their own. Baylor Scott & White’s Allison is convinced
that healthcare will reach beyond conversations about patients to conversations about
consumers as the industry expands population health management and embraces
the evolving continuum of care. Authentic population health management will blend
prevention, wellness and patient management in the best, most appropriate settings
across the continuum, he predicts.
C-Suite and Board Trends

The “ideal” C-Suite executive will evolve: “The ideal C-Suite executive is someone
who can integrate an agenda that embraces quality of care, patient satisfaction and
financial management,” says Lucas. While some executives assumed that mergers
and larger systems of care would build scale and slash overhead, these initiatives
sometimes failed to address quality, safety, efficiency, cost and value-based
reimbursement.
Innovation superstars will stay on HCOs’ radar. Healthcare C-Suites and boards
will likely search for colleagues with characteristics often found among increasingly
popular chief innovation officers (CINOs). Many organizations struggle to innovate
because they don’t know how to lead the process, according to Collective Genius: The
Art and Practice of Leading Innovation. Top-notch innovators can unleash and harness
the “collective genius” of everyone in the organization, says the book’s author.
Equally important, healthcare C-Suites and boards are likely to

diversify their portfolio of candidates to include professionals who have
already pushed the envelope on innovation. Innovation superstars are
increasingly likely to come from service industries like retail, financial
services or consulting. Or they might emerge through sharing of talent
management best practices at companies like Medisafe, Foundation
Medicine, SetPoint Medical, Ginger.io or Medivation.
38
Accountability will increase: “HCOs will increasingly insist on board performance and
accountability,” forecasts Popko. Board members, in turn, will hold C-Suites accountable,
insisting that executives adhere to strategic goals and priorities. The trend could mean
recruitment of board members with fresh, outside-the-industry perspectives and extensive
business experience.
Talent management will surge. HCOs will need internal and external performance
management expertise to evaluate and enhance leadership capabilities that improve care
processes. That, in turn, requires measuring how well clinicians, employees and executives
fulfill enterprise goals and objectives. Adds Eckersley; “Human capital management is
the selection, development, management and alignment of talent and human capital with
business and clinical strategies and tactics.”
C-Suite turnover and retooling will continue: “As healthcare shifts from fee-for-service
to accountable care, C-Suite turnover may be inevitable,” predicts Lucas. “Half of C-Suite
executives will need to re-learn healthcare, re-tool skills and operate within new and
emerging clinical and business models.” That could mean ongoing turnover within the
C-Suite as documented within American College of Healthcare Executives (ACHE) turnover
studies and the growing emphasis on investment in enterprise-wide assessment and talent
management.
New positions will surface on C-Suites and boards. Not every new and emerging C-Suite
position will survive or become commonplace. That being said, Lucas envisions growing
roles for population health managers within hospitals, health plans and medical groups,
as well as accountable care managers within hospitals and health plans. Also gaining in
popularity is the chief ambulatory care officer—especially within hospitals that rely on an
expanded care continuum for revenues.
39
Other areas with new development include the following:
• Quality and innovation: “HCOs will continue to rely on chief

quality officers, while adding chief transformation or innovation
officers,” says Popko. “These executives will guide the C-Suite
on how to function under previous models while evolving new
models based on ambulatory care, disruptive technologies,
consumer engagement and the continuum of care.”
• Medicine: “Chief medical officers (CMOs) and chief medical

information officers (CMIOs) will continue to focus more closely
on operations,” says Lucas. “The CMO, in particular, will
work to ensure compliance with clinical protocols and quality
guidelines.”
• Technology: Chief technology officers (CTOs) will review the

capacity of new and emerging technologies to improve care
quality, efficiency, safety, cost management, engagement and
service: Among the issues identified by Lucas: “How could
enterprise robots measure blood pressure? And how might GPS
technologies aid in tracking patients in nursing homes?”
Baylor Scott & White’s Allison envisions a healthcare C-Suite composed of physician and
nurse executives, along with chief officers devoted to population health, integration and
experience and physicians and nurse executives who lead clinical enterprises. Baylor’s
Office of Patient Centeredness, which aims to create positive experiences for providers,
patients and family members, relies on the expertise of a chief safety officer, chief
information officer and chief patient experience officer.
“The key,” says Allison, “is to embrace trends like consolidation, value-based payment and
population health while sustaining a focus on patient experience, engagement and care.”
St. Joseph Health’s Proctor envisions a strategy and business development executive with
customer engagement experience who could come from outside of healthcare. She’s already
staffed senior marketing positions with professionals from other industries, following the
lead of C-Suite and boards that increasingly recruit talent from hospitality, financial services
and other consumer-facing sectors.
40
Adds Proctor: “As we move from acute care to care across an ever-expanding continuum,
we need C-Suite executives who understand customers—who they are, how they behave,
why they get sick and what they’re willing to do to stay healthy.”
“The key,” she says, “is making the transition from selling sick healthcare to selling
partnerships in enhanced health and well-being” through “an open model where people can
go anywhere they want for a healthcare experience.”
Patient experience will grow as a C-Suite function. Fewer than 100 hospitals have chief
experience officers (CXOs), according to Catalyst Healthcare Research. However, analysts
like the Beryl Institute view the CXO as an emerging role “that encompasses and leads a
broad portfolio of resources and services fundamental to the patient and family experience—
from advocacy to service and, in some cases, broadening to lead or significantly influence
people, quality and safety issues.”
The next round of CEOs will likely be physician executives. Insurance companies that
employ physician executives have already set a precedent for recruiting executives to head
up healthcare systems that will either function like insurance companies or act in partnership
with insurance companies.
“Physicians understand hospital and health system culture and the intersection of clinical,
financial and operational strategy, along with population health, insurance and technology,”
says Eckersley. “With backgrounds in insurance and clinical care, they know how to manage
large groups, analyze data, strike premiums and manage costs.”
“HCOs will embrace physicians, nurses and other clinicians as future C-Suite and board
members,” predicts Lucas. “Candidates will include nurses who evolved into human
resources, technology or operational positions or became presidents of hospitals. Or, board
members will emerge from the ranks of physicians with specialized expertise in technology,
government, public policy, clinical management or insurance.”
41
Physicians, including a growing number of hospitalists, represent 14 percent of C-Suite

hires, according to a Billian’s HealthDATA and Porter Research study of 384 executives from
January to July of 2014. Twenty-eight percent of new hires at the C-Suite or director level
were women, including 38 percent who were named CEOs, 26 percent who were named chief
nursing officers (CNOs) and 13 percent who were named COOs. CNOs accounted for 17
percent of the transitions to COOs.
“Physicians feel more confident and secure when they’re included in decisions that affect
them and have representation from physician leader,” says FMOLHS’ Finan. “Often a
physician leader can help physicians connect care decisions to quality, satisfaction, and cost
outcomes. It’s a different perspective and mindset that we need within C-Suites, boards and
throughout the enterprise.”
When FMOLHS launched its population health program, Finan found its leader in a pediatric
emergency physician who had been its chief medical information officer. When FMOLHS
created a clinical network to improve quality and assume financial risk, it turned to a
physician executive at its Baton Rouge hospital. Ultimately, the physician emerged as the
leader of a clinical network. A physician serving as FMOLHS’ Vice-President of Performance
Excellence and Technology was selected to unify multiple practices across the system.
42
Conclusion
Healthcare is changing. HCOs must act in the context of trends that include accountable
care, consolidation, population health management, retail competition and the burgeoning
role of consumers. The preferred approach is for C-Suite and board members to rely on
external expertise and a disciplined process to find and develop talent with the right mix of
knowledge, skill, experience and leadership insight. HCOs must also create structures that
ensure C-Suite and board success, including a process through which they can assess and
develop executives. HCOs can look forward to a future where C-Suite and board members
will need to demonstrate knowledge, skill and competence in diverse areas, including
innovation, accountable care, population health, consumer behavior, digital health, patient
engagement and experience, and predictive analytics.
43
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hospital-c-suite.html Arming the C-Suite for Organic Growth
http://www.forbes.com/sites/prospernow/2014/09/24/
Why Recruiters Are Looking to Amazon, Insurers to arming-the-c-suite-for-organic-growth/
Fill Hospital C-Suites
http://www.advisory.com/daily-briefing/2014/08/13/ The New Path to the C-Suite
why-recruiters-are-looking-to-insurers-amazon-to-fill- http://hbr.org/2011/12/courage-in-the-c-suite/ar/1
hospital-c-suites
45
IBM: Top Five Lessons for CIOS from the C-Suite New Anthem Blue Cross Plan Takes on Kaiser
Report http://www.latimes.com/business/la-fi-anthem-
http://www.forbes.com/sites/peterhigh/2014/06/24/ hospitals-deal-20140917-story.html#page=1
ibm-top-five-lessons-for-cios-from-c-suite-report/
Digital Patient Engagement & Hospital Marketing
Take a Look at How Market Forces Will Impact Health Strategies to Improve Patient Acquisition and
Care Retention
http://www.hhnmag.com/display/HHN-news- http://www.beckershospitalreview.com/healthcare-
article.dhtml?dcrPath=/templatedata/HF_Common/ information-technology/9-digital-patient-engagement-
NewsArticle/data/HHN/Magazine/2014/Sep/gate-aha- hospital-marketing-strategies-to-improve-patient-
environment-scan-2015 acquisition-and-retention.html
Accountable Care Organization (ACO) Exec’s Survey HCA Executive Development

and Outlook Report http://executive.careersathca.com
http://globenewswire.com/news-relea
se/2014/10/29/677728/10105116/en/129- Leadership for Physician Executives Seminar
Accountable-Care-Organization-ACO-Execs-Survey- http://levinsonandco.com/physician-exec-leadership
and-Outlook-Report.html
Leadership Development for Physicians in Academic
With Economy Stabilizing, Hospital Executives Focus Health Centers
on Big Data to Improve Cost Efficiencies and Quality https://ccpe.sph.harvard.edu/programs.
http://globenewswire.com/news-relea cfm?CSID=LDP1014
se/2014/06/17/644649/10085888/en/With-Economy-
Stabilizing-Hospital-Executives-Focus-on-Big-Data- American Association for Physician Leadership
to-Improve-Cost-Efficiencies-and-Quality.html http://www.physicianleaders.org/education
DaVita strikes joint venture with Centura hospital Quality Matters

System http://www.commonwealthfund.org/publications/
http://www.modernhealthcare.com/article/20141106/ newsletters/quality-matters/2012/february-march/in-
NEWS/311069955/davita-strikes-joint-venture-with- focus
centura-hospital-system
Hospital Community Benefits after the ACA
2014/15 Clinician Network Management Market http://www.rwjf.org/content/dam/farm/reports/issue_
Trends briefs/2012/rwjf72344
http://www.chilmarkresearch.com/research/reports
Health care in a hyper-connected world: Cisco’s
Retail Health Care Clinics Carlos Dominguez
http://www.rand.org/topics/retail-health-care-clinics. http://vectorblog.org/
html
46
Collective Genius Baylor Scott & White Center Office of Patient-

https://hbr.org/2014/06/collective-genius/ar/1 Centeredness
http://www.baylorhealth.edu/Quality/IHCRI/
Catalyst Healthcare Research OfficeofPatientCenteredness/Pages/default.aspx
http://catalysthcr.com Franciscan Missionaries of Our Lady Health System
https://fmolhs.org/Pages/Home.aspx
The Beryl Institute
http://www.theberylinstitute.org St. Joseph Health
https://www.stjhs.org
Hospital C-Suite Trends: Who’s Making it to the
Corner Office?
http://www.billianshealthdata.com/news/SiteNews/
news_items/2014/Hospital_C-Suite_Trends-Whos_
Making_it_to_the_Corner_Office
http://www.medisafeproject.com
Foundation Medicine
http://www.foundationmedicine.com
Smarter care starts with your smartphone

http://www.ginger.io
Organizations
American College of Healthcare Executives

http://www.ache.org
American College of Healthcare Executives

Healthcare Career Resource Center
Barnabas Health
http://www.barnabashealth.org/
Baylor Scott & White Health

http://baylorscottandwhite.com/
47
InveniasPartners
With decades of combined healthcare executive experience, InveniasPartners search

consultants have placed more than 750 professionals in top-tier executive and board
positions. We identify, assess, recruit and develop executives and board members for
America’s leading providers and payers—from Scripps Health, Mercy Health, St Joseph
Health and BJC HealthCare.
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The Evolving

Trends, Predictions and

A Report from InveniasPartners

Copyright, 2015, InveniasPartners

No part of this white paper may be distributed, reproduced or

233 South Wacker Drive,

4 A Letter from Curt Lucas, President and CEO, InveniasPartners

6 The Changing Healthcare Landscape

18 From Trends to Strategic Action

37 Forward to the Future: Predictions for C-Suite and Board Members

A Letter from Curt Lucas

Healthcare C-Suites and Boards

Innovator Change leader

Developed by InveniasPartners, a Chicago-based healthcare executive search, talent

The complete version of this report appears on the InveniasPartners (http://www.inveniaspartners.com)

Please connect with us on the InveniasPartners Web site (www.inveniaspartners.com),

The Changing Healthcare Landscape

Consumers and patients: As healthcare organizations (HCOs) transition to value-

Political issues: Payment models will continue to evolve as accountable care

Provider organizations: Brand loyalty will grow in importance as HCOs

Science and technology: Healthcare will continue to evolve toward precision-

• Continued consolidation, leading to challenges with operational and

• Financial constraints requiring cost containment initiatives and the

• Partnerships with other providers or payers, both of which were once

• Population health and accountable care

• Retail healthcare competition

• Consumers’ increased involvement in their own healthcare delivery

Unfortunately, integration remains challenging. It typically involves bringing together

State and federal governments that pay the majority of the

Others such as Baton Rouge-based Franciscan Missionaries of Our Lady Health

• Appointment of a single system CEO or C-Suite

Population Health Management

Retail competition and the consumer

• Who uses retail clinics and why?

What Healthcare Industry Trends

• Models: Where are the new and emerging business models

• Performance: How well have these models already

• Assets: How can C-Suite and board members leverage

• Gaps: How can the HCO bridge performance gaps through

Beyond asking Finan’s questions, InveniasPartners advises healthcare C-Suite and

• Develop leader skill, competence and experience

“Moving forward means securing full agreement on what

From Trends to Strategic Action

Strategy A: Find and Develop the Right C-Suite

Strategy B: Recruit Top C-Suite and Board Talent

Among the other search and talent management criteria recommended by

“Ostrowsky is recruiting a chief population health officer and is in the process of

and board members, employees, managers and clinicians. “Technology isolates

Ostrowsky also champions a culture of transparency and simplicity. “Healthcare is

Strategy C: Build Structures for

Jay Eckersley, former President and CEO of Springfield, Missouri-based St.

The goal, according to Eckersley, is to “integrate hospital, physician and health

Just as vital to a health system’s success is appointing line managers to functions

• Grows market share through covered lives

The program produced multiple horizontal vice-presidents who work in collaboration

“Making the transition from management of business units to management across

Strategy D: Assess and Develop C-Suite

These programs identify and focus investment in “high-potential” executives while

Executive assessment at FMOLHS, where John Finan serves as CEO, is a structured