JHC Sept 18

September 2018 • Vol.9 No.5

Primary Care at Home The Independence at Home Demonstration Project

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CONTENTS »» SEPTEMBER 2018

4 A New Wrinkle

Two IDNs acquire multistate LTC providers

8 Primary Care at Home The Independence at Home Demonstration Project

20 Health news and notes 24 Addressing Your Team’s Needs

How to galvanize your team when times are tough

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The Journal of Healthcare Contracting | September 2018

3

TRENDS

A New Wrinkle

health care begins and stops,” Randy Oos-

Two IDNs acquire multistate LTC providers

at the time. “This acquisition provides us

“The lines are blurring between where tra, ProMedica’s president and CEO, said the platform to think differently about health and aging.”

Perhaps it was bound to happen. In the past half-year,

Americans 65 and older are the fast-

two health systems have acquired large, multistate providers of

est growing segment of the population,

long-term care services. It’s too early to tell whether this could

meaning adequate post-acute care – and

mark a new trend in caring for patients with critical needs.

the ability for patients to transition effec-

In April, Toledo, Ohio-based ProMedica health system announced plans to acquire HCR ManorCare, also based in Toledo and the country’s second largest post-acute care provider, according to a press release announcing the merger.

4

tively between post-acute and hospital care – is in demand.

In June, Sioux Falls, South Dakotabased Sanford Health and the Evangelical September 2018 | The Journal of Healthcare Contracting

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PATIENT CARE

INTERVENTIONAL CARE

ENVIRONMENT OF CARE

TRENDS

in six states, will operate in

“ The lines are blurring between where health care begins and stops. This acquisition provides us the platform to think differently about health and aging.”

30 states and employ about 70,000 people once it acquires HCR ManorCare. The combined network’s projected annual revenue is $7 billion.

– Randy Oostra, ProMedica president and CEO

Sanford operates in nine states, and shares little overlap with Good Samaritan, which

Lutheran Good Samaritan Society announced a similar merger,

operates in 27 states. The merger could

to be completed by the beginning of next year.

potentially add 19,000 Good Samaritan

Sanford “never had a very specific approach to long-term

employees to the 28,000 Sanford already

care,” Grant Tribble, Good Samaritan’s chief financial officer,

has. At the time, the question was raised

told Skilled Nursing News at the time. The merger could allow

as to whether this would mean down-

the combined organizations to deliver a broader range of care,

sizing for Good Samaritan’s skilled nurs-

Tribble said.

ing facilities – it currently has about 80

Each acquisition means a significant expansion for the health systems involved. ProMedica, which currently operates

– though at press time that question remained unanswered.

For more information on the mergers and their potential implications: • ProMedica Health System to Acquire HCR ManorCare Redefining Care for Seniors (a ProMedica press release) • Good Samaritan, Sanford Target Continuum Control with Merger Deal (Skilled Nursing News) • NHI Sees Promise As Health Systems Move Into Skilled Nursing (Skilled Nursing News)

6

September 2018 | The Journal of Healthcare Contracting

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Primary Care at Home The Independence at Home Demonstration Project

In the next 20 years, the number of Americans who are 65 years old or older will nearly double to more than 72 million – one in five Americans, reports the National Association for Home Care &

Editor’s note: Demographics are changing. Venues of care are

Hospice, or NAHC. Many will live with dis-

changing. Reps’ call points and the products in their bags are

ability and multiple chronic illnesses.

changing too. With this issue, The Journal of Healthcare Contracting begins a series of articles on chronic care management.

8

Authorized by the Affordable Care Act, the Independence at Home Demonstra-

Chronic diseases and conditions – such as heart disease, stroke,

tion is designed to provide chronically ill

cancer, type 2 diabetes, chronic obstructive pulmonary disease, obesity

patients with a complete range of primary

and arthritis – are among the most common, costly, and preventable

care services at home. Medical practices led

of all health problems. As of 2012, about half of all adults – 117 million

by physicians or nurse practitioners provide

people – had one or more chronic health conditions. One in four adults

primary care home visits tailored to the

had two or more chronic health conditions. Seven of the top 10 causes

needs of beneficiaries with multiple chronic

of death in 2014 were chronic diseases.

conditions and functional limitations.

September 2018 | The Journal of Healthcare Contracting

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CHRONIC CARE MANAGEMENT

The Demonstration also tests whether home-based

“The individuals we’re really looking for are the sickest

care can reduce the need for hospitalization, improve

of the sick, homebound patients, who are at risk of going

patient and caregiver satisfaction, and lead to better

into the hospital or suffering a poor outcome because

health for beneficiaries and lower costs to Medicare.

they don’t want to go to the hospital, or because going to the hospital may present its own risks,” says Karen Abrash-

Primary care team

kin, M.D., medical director of Northwell Health House

“I do think we are a nice option for office-based pro-

Calls, an Independence at Home participating practice.

viders to know that there is a team of primary care providers who will see patients in the home,” says Ina

CMS program

Li, M.D., program director for Christiana Care Health

The demonstration project began in 2012 and was origi-

System’s Independence at Home Demonstration

nally authorized for three years. It was subsequently extended for two additional years

“ Going into someone’s home allows you to get a real insight into their life and allows you to realize that, as a medical provider, your care is only one slice of what is going on in a person’s life and influencing his or her health outcomes.”

– Karen Abrashkin, M.D.

through September 30, 2017, by the Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015. The Bipartisan Budget Act of 2018, enacted Feb. 9, 2018, extended the demonstration for an additional two years through Sept. 30, 2019.

To qualify for an incentive payment, participating practices must meet the performance thresholds

Program and director of clinical geriatrics for Christiana Care in Wilmington, Delaware.

A typical referral is a patient who has had a stroke, chronic obstructive pulmonary disease and severe arthritis, she says. “This patient is no longer able to walk

• Follow-up contact within 48 hours of a hospital admission, hospital discharge, and emergency department visit.

• Medication reconciliation in the home within 48

down her front steps and can no longer make it in to

hours of a hospital discharge and emergency

see her primary doctor. The doctor who sees the patient

department visit.

may not have seen them in a year. Due to this situation,

• Annual documentation of patient preferences.

the doctor makes a referral to my practice for our team

• All-cause hospital readmissions within 30 days.

to see the patient and take over their care. We are then

• Hospital admissions for ambulatory care

able to provide timely care to the patient and, hopefully, maintain and improve their quality of life and reduce their burden of illness and symptoms.”

10

for at least three of six quality measures:

sensitive conditions.

• Emergency department visits for ambulatory care sensitive conditions.

September 2018 | The Journal of Healthcare Contracting

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CHRONIC CARE MANAGEMENT

In the second performance year of the demon-

a primary care provider is on call 24/7 to answer

stration – the most recent year for which data was

questions and get patients the care they need, says

available at press time – 10,484 beneficiaries were

Abrashkin. “We are able to take care of many diag-

enrolled in 15 participating practices. The data shows

nostics in the home, such as X-ray, lab work, EKG,

that all 15 practices improved performance from the

ultrasound, sleep studies and occupational and

first performance year in at least two of the six qual-

speech therapy. We deliver care in the home through

ity measures. Four practices met the performance

primary care, nurse and social work care-manager

thresholds for all six quality mea-

visits, and interventions, such as

sures. All together, the 15 practic-

IV medications.” Specially trained

es saved $10.6 million, and seven

emergency triage nurses are

participating practices earned in-

available telephonically 24/7.

centive payments of $5.7 million.

The House Calls team includes community paramedics, that is,

Northwell Health

specially trained paramedics who

Northwell Health’s demonstra-

can, under the orders of a physi-

tion program is directed by phy-

cian, evaluate and provide treat-

sicians and nurse practitioners,

ment in the home around the

with the aid of an entire team, in-

clock. The average response time

cluding technicians, social workers and others, says Abrashkin.

“By providing home-based primary care and a reliable alternative to receiving care through the emergency room and hospital (which many of our patients do not want), we were able to show savings in the total cost of care while honoring our patients’ wishes for where and how they receive medical interventions.

“Our home visits are just like office visits, but with a lot more behind them, including more frequent regular checkups as well as sick/urgent visits when necessary,” she says.

The House Calls team makes visits Monday through Friday, and 12

is 21 minutes, and they can perKaren Abrashkin MD

“What you might discuss over lunch with your colleagues now has to be communicated deliberately to a group who is driving across Queens and Long Island.”

– Karen Abrashkin, M.D.

form EKGs, blood glucose monitoring and CO2 tests; administer more than 20 medications (either through an IV, inhalation or orally), and more.

“There are very few things in life that physicians and patients love, and that also save money,” says Abrashkin. “But the patient satisfaction rating for our community paramedicine program is through the roof, and we’re offering a new career option to paramedics. By building this team and this program, we are able to give patients safe and reliable ways to receive care at home, where most of our patients prefer to remain.”

September 2018 | The Journal of Healthcare Contracting

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CHRONIC CARE MANAGEMENT

During the second year of the

offices refer their homebound pa-

Independence at Home dem-

tients to our program for us to take

onstration project, Northwell’s

care of in a longitudinal fashion. The

House Calls practice provided care

office-based primary care providers

to 357 patients in Nassau and Suf-

relinquish control of their patients

folk counties as well as Queens in

once they enter our program.

New York City. In addition to im-

“We work closely with Christiana

proving health outcomes, North-

Care’s Visiting Nurse Association, as

well’s clinicians reduced costs that

they are another referral source for

year by $6,816 per patient per

us,” adds Li. “As many of our home-

year, for total savings to Medicare

bound patients require in-home skilled nursing and physical, occu-

“ The individuals we’re really looking for are the sickest of the sick, homebound patients, who are at risk of going into the hospital or suffering a poor outcome because they don’t want to go to the hospital, or because going to the hospital may present its own risks.”

– Karen Abrashkin, M.D.

pational and speech therapies, we often refer to our Visiting Nurse Association for assistance.

“In terms of outcomes, we have worked hard to reduce our inpatient hospital and skilled nursing facility admissions,” she says. “By focusing on these two specific measures, we have reduced the average Medicare payment per beneficiary per month by 22 percent in the last five years. We are in the process of designing a tool for

of $1,641,825. This was the second highest savings

patient experience to better understand how we can

performance among the demonstration sites. After

most effectively serve the needs of our patients.”

accounting for Medicare withholds, Northwell earned $874,151 in incentive payments.

learning experience, says Li. “We have found that high utilization of skilled nurs-

Christiana Care Health System

ing facilities and care for dialysis patients were big

Christiana Care began participating in the Indepen-

factors in [our] expenditures,” she says. “Compared to

dence at Home Demonstration Project in 2012.

other Independence at Home programs, we had high-

“The Independence at Home program is a delivery model where we are the primary care providers for homebound patients,” explains Li. “We provide primary care in the patient’s home. Primary care providers who work in 14

Implementing Independence at Home has been a

er proportions of both. We are now modifying our program to better control these costs.”

That said, Li is convinced that the team-based approach of Independence at Home is a sound one.

September 2018 | The Journal of Healthcare Contracting

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CHRONIC CARE MANAGEMENT

“To manage homebound patients who have a high disease burden, including medical, psychological, and socio-economic issues, a team-based model of care is essential.”

– Ina Li, M.D.

“To manage homebound patients who have a high disease bur-

Participants

den, including medical, psychological, and socio-economic issues, a team-based model of care is essential,” she says. “Since these patients have complex issues, [they need] the support of many disciplines to ensure that they can receive their care at home and avoid having to be admitted to the hospital.”

Lessons learned Independence at Home has given Northwell Health House Calls a chance to transform its approach to home-based primary care by adopting some best practices, says Abrashkin, who served as a hospitalist before getting involved in House Calls

care at home. Independence at Home has helped provide fund-

The following organizations are participants in the Independence at Home Demonstration Project: • Boston Medical Center • Christiana Care Health System • Cleveland Clinic Home Care Services • Doctors Making Housecalls, LLC • Doctors on Call • House Call Doctors Inc. • Housecall Providers, Inc. • MD2U-KY, MD2U-IN • Mid-Atlantic Consortium • Northwell Health Care • VPA Dallas • VPA Flint • VPA Jacksonville • VPA Lansing • VPA Milwaukee

six years ago.

16

portant to providing high-quality

ing for these services and also has allowed us to create a network across the country of other practices involved in IAH to share best practices.

“We have applied the quality markers of Independence at Home across our whole patient population – things like advanced care planning to really understand what our patients want for their care, having a provider on call by phone 24/7 to give a meaningful alternative to calling 911, and making an in-person visit within 48 hours of hospital discharge to check on the patient and reconcile medications if they do go into the hospital for treatment. We know that these are

“Independence at Home has provided financial

important to the outcomes of our patients, and have

support and a platform to support our care model,” she

applied them to all patients, whether they are enrolled

says. “There are many expenses in our program – such

in Independence at Home or not.

as care manager visits and community paramedics –

“This work is very meaningful, both to our staff and

that are not reimbursed by Medicare but that are im-

to our patients and their families, but also very difficult,” September 2018 | The Journal of Healthcare Contracting

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CHRONIC CARE MANAGEMENT

she continues. “Going into the home setting, where the

NAHC a big supporter

typical resources of a hospital or an outpatient facility

The National Association for Home Care and Hospice is a self-proclaimed strong supporter of the Independence at Home Demonstration project. IAH works because: • It is designed to provide appropriate levels of care for a carefully targeted group of the most complex, high-cost beneficiaries.

• It requires an interdisciplinary team to provide access to care 24 hours a day, seven days a week, and to offer in-home visits within 48 hours of hospital or emergency room discharge, including medication reconciliation.

• It prevents unnecessary hospitalizations and misuse of medications, and discourages overuse of services.

• It has rigorous quality standards that assure better patient and family experience, and better clinical outcomes.

• It is backed by a substantial body of evidence showing that home-based primary care, as applied in the IAH demonstration, enhances quality of care and reduces cost for seriously ill elderly Americans.

• It saves Medicare money.

box on a daily basis. Our staff encounters new and dif-

“The Independence at Home demonstration project is focused on very high-risk patients, generally, the top 5 percent high-risk Medicare patients, so it is appropriate that medical practice takes a predominant role,” says NAHC President William A. Dombi. “Will that change in the future? It certainly could, but probably not to the point of being driven by a non-medical focus. Home health could certainly become more involved in the future, thanks to technological improvements, but currently home health is more appropriate for the other 95 percent of Medicare patients.”

a physician or nurse into the home to retake the mea-

are not available, pushes our team to think outside the ferent situations and challenges every day. The people working in our program are doing this work because they are truly dedicated to their patients.

“We have also learned that regulations set for traditional office-based settings may hamper growth of programs delivering home-based primary care. For example, the oxygen saturation readings measured by our community paramedics cannot be used to certify a patient for home oxygen; instead, we need to send

“Our home visits are just like office visits, but with a lot more behind them, including more frequent regular checkups as well as sick/ urgent visits when necessary.”

– Karen Abrashkin, M.D.

surement. There is also a role for telemedicine that is not currently reimbursed, which could allow us to increase our footprint and provide more care across our area.

But without support for these services, it is very difficult to develop programs that could potentially be helpful.”

The Northwell Health team has also learned that organization and predictable workflows are essential to the success of a program such as Independence at Home.

“With a mobile workforce, communication can be more difficult than in an office or hospital,” says

18

September 2018 | The Journal of Healthcare Contracting

Abrashkin. “What you might discuss over lunch with your colleagues now has to be communicated deliberately to a group who is driving across Queens and Long Island. This also goes for collegial discussions amongst physicians or care managers about difficult cases and how to proceed. These discussions have to be built into the work week or else they won’t happen, and they are very important for holistic team-based care.

“Having a medical record that supports your work is very necessary for day-to-day work and communication as well as reporting.

This is a real challenge when working remotely.”

you to get a real insight into their life and allows you to

But the payoff makes the effort worthwhile.

realize that, as a medical provider, your care is only one

“A major lesson learned is just how meaningful this

slice of what is going on in a person’s life and influenc-

work is,” she says. “Going into someone’s home allows

ing his or her health outcomes.”

Health plan waives cost for chronic-care meds A health plan in Massachusetts has begun offering a program that waives co-pays for 11 common prescription medications that treat chronic conditions, such as high cholesterol, high blood pressure, heart disease and depression. The program will be offered by Neighborhood Health Plan on a selection of commercial plan designs for large employer customers. Neighborhood Health Plan is a member of Partners HealthCare.

“Care Complement” also gives members access to prevention services, such as diabetic education and nutritional counseling, at no additional cost. Costsharing is waived for certain pain treatments offered

The Journal of Healthcare Contracting | September 2018

in place of opioid prescriptions, as well as for cardiac rehabilitation services to speed recovery after a heart attack.

“Care Complement improves adherence and management of chronic disease, and offers affordable alternatives to opioids for the treatment of pain,” Dr. Anton B. Dodek, chief medical officer for Neighborhood Health Plan, was quoted as saying. “By eliminating cost sharing, this benefit design encourages members to work with their doctors and optimally manage their conditions, which results in healthier outcomes and improved patient satisfaction.”

19

HEALTH NEWS

Health news and notes Addressing PTSD

20

Posttraumatic stress disorder (PTSD) affects an estimated 6

Putting menopause on pause

percent of adults in the United States at some point in their

A study from the United Kingdom sug-

lives. It can cause flashbacks of upsetting events and difficul-

gests that eating a high intake of oily

ty sleeping, among other symptoms. With funding from the

fish delayed onset of menopause by 3.3

Patient-Centered Outcomes Research Institute, the Agency

years per portion per day, and a high

for Healthcare Research and Quality reviewed PTSD treatment

intake of legumes delayed onset by 0.9

studies published since 2012 and found strong support for the

years per portion per day. In addition,

effectiveness of certain types of cognitive behavioral therapy

higher intake of two micronutrients – vi-

in treating patients with PTSD. Cognitive behavioral therapy

tamin B6 and zinc – delayed onset by 0.6

is a type of talk therapy that focuses on helping patients be-

and 0.3 years, respectively. The research

come aware of negative thought patterns and beliefs, and

also found that higher intakes of refined

develop constructive ways of thinking. It also found moder-

pasta and rice led to earlier menopause

ate evidence that the antidepressant medications fluoxetine

by 1½ years. A team from the University

(Prozac), paroxetine (Paxil), and venlafaxine (Effexor) can help

of Leeds followed 914 women for four

reduce PTSD-related symptoms.

years, examining their food and nutrient September 2018 | The Journal of Healthcare Contracting

intake related to age of natural meno-

weight, the most commonly reported methods were ex-

pause, reports the Washington Post.

ercising (62.9 percent) and eating less food (62.9 percent),

Legumes, vitamin B6 and zinc all have

followed by consuming more fruits, vegetables, and salads

antioxidant properties, and oily fish are

(50.4 percent).

associated with potentially improving antioxidant capacity. So, the results, and

The company you keep

data from other studies, suggest that an

Do the people you surround yourself with influence a health-

antioxidant-rich diet can potentially de-

ier lifestyle or bring you down? “Researchers have found that

lay onset of menopause, which is associ-

certain health behaviors appear to be contagious and that

ated with greater life expectancy and re-

our social networks – in person

duced risk of cardiovascular disease and osteoporosis. More established research suggests that consuming heart-healthy and bone-strengthening foods, exercising and avoiding weight gain are good strategies for avoiding the cardiovascular disease and osteoporosis that so often are associated with menopause.

The ‘in’ crowd Dieting? You’re not alone. According to the Centers for Disease Control and Prevention: • In 2013–2016, 49.1 percent of U.S. adults tried to lose weight within the past 12 months.

• A higher percentage of women (56.4 percent) than men (41.7 percent) tried to lose weight.

• A lower percentage of non-Hispanic

Between 10 to 15 percent of women experience hypertensive complications during pregnancy, and evidence shows that these women are more likely to have a heart attack or stroke later in life, even if their blood pressure returns to normal immediately following pregnancy.

and online – can influence obesity, anxiety and overall happiness,” Tara Parker-Pope writes in the New York Times. “A recent report found that a person’s exercise routine was strongly influenced by his or her social network.” Parker-Pope describes the “moai,” a social network concept from Japan, where a group of five friends are connected for life as a source of social, logistic, emotional and financial support.

Hypertension in pregnancy Women with pregnancies complicated by high blood pressure

may benefit from cardiovascular screening throughout their

Asian adults (41.4 percent) than

lives. That’s because those with a history of preeclampsia or

non-Hispanic white (49.4 percent),

gestational hypertension in pregnancy developed chronic hy-

non-Hispanic black (48.0 percent),

pertension at a two-to-three-fold higher rate and had 70 per-

and Hispanic (49.1 percent) adults

cent and 30 percent higher rates of type 2 diabetes and high

tried to lose weight.

cholesterol, respectively, than women who had normal blood

• The percentage of adults who tried to

pressure in pregnancy, according to a study published in the

lose weight increased with family in-

Annals of Internal Medicine. Between 10 to 15 percent of women

come and with weight status category.

experience hypertensive complications during pregnancy, and

• Among adults who tried to lose The Journal of Healthcare Contracting | September 2018

evidence shows that these women are more likely to have a 21

HEALTH NEWS

heart attack or stroke later in life, even if their blood pressure

less fiber, which makes you feel full. Be-

returns to normal immediately following pregnancy.

cause juice can be consumed quickly, it

When games are no longer fun

is more likely than whole fruit to contribute to excess carbohydrate intake.

“Gaming disorder,” with its online and offline variants, has been included in the draft of the 11th edition of the International Clas-

A walk in the park

sification of Diseases (ICD-11) as a clinically recognizable and

What does it mean to take a “brisk walk?”

clinically significant syndrome, when the pattern of behavior is

About 100 steps per minute, of 2.7 miles

of such a nature and intensity that it results in marked distress

per hour, according to a study published

or significant impairment in personal, family, social, educational

in the British Journal of Sports Medicine.

or occupational functioning, re-

Just count how many steps you take in

ports the World Health Organi-

10 seconds and multiply that number

zation. (ICD-11 was scheduled to be released in June 2018.)

Health concerns associated with gaming behavior include other aspects of health (e.g. insufficient physical activity, unhealthy diet, problems with eyesight or hearing, musculoskeletal problems, sleep deprivation, aggressive behavior and depression) and psychosocial functioning.

Turn off the juice Soda pop and sports drinks are a major source of added sugar

22

While eating certain fruits like apples and grapes is associated with a reduced risk of diabetes, drinking fruit juice is associated with the opposite, according to the researchers.

by six, advises Dr. Catrine Tudor-Locke, a professor of kinesiology at the University of Massachusetts Amherst. “The good news is that this pace will probably not feel strenuous to most healthy people,” she says.

Rising form of hepatitis Liver specialists say there’s a form of hepatitis that is sneaking up on about 12 percent of the U.S. population, or an estimated 25 million Americans, reports the Sacramento Bee. Called nonalcoholic steatohepatitis, or NASH for short, it does not result from drug use, alcoholism, sex-

for Americans, and they con-

ual contact, water contaminants or virus-

tribute 145 calories a day to

es. Rather, it occurs when too much fat

our diets, report researchers in a New York Times article. How

is stored in liver cells. Primary care pro-

about juice? Despite all the marketing and government sup-

viders are urged to look for risk factors

port, fruit juices contain limited nutrients and tons of sugar.

among patients, including high blood

In fact, one 12-ounce glass of orange juice contains 10 tea-

pressure, high cholesterol, diabetes, and

spoons of sugar, which is roughly what’s in a can of Coke.

a body mass index of 30 or higher. De-

Worse, juice isn’t the same as eating whole fruit. While eating

finitive diagnosis requires a noninvasive

certain fruits like apples and grapes is associated with a re-

liver ultrasound called a FibroScan. Early

duced risk of diabetes, drinking fruit juice is associated with

detection can lead to management of

the opposite, according to the researchers. Juices also have

the disease.

September 2018 | The Journal of Healthcare Contracting

Same people.

Same company.

Now, with a renewed focus.

Better care doesn’t happen by chance—it happens by design. Design that takes into account not just the space, but the people working in it. Because at Midmark, we believe that who’s using our technology is every bit as important as how and why it’s being used. It’s this attention to the patient-caregiver experience that has enabled us to transform the clinical care environment—and our brand.

midmark.com/JHCsep

© 2018 Midmark Corporation, Dayton, OH

LEADERSHIP

By Lisa Earle McLeod

Addressing Your Team’s Needs How to galvanize your team when times are tough

24

Given the climate, how can well-intended leaders galvanize their teams? It’s simple, but not easy. You must go beyond the traditional transactional approach to work and address three core human needs:

No 1. Connection: Get emotional

Welcome to the new normal. We’re adding jobs daily,

Discussing emotions at work can make

but most people are still miserable at work. Workplace study

people queasy. But have you ever noticed

data confirms what leaders are experiencing: work is harder,

that you never hear managers saying,

over half of all employees are disengaged and many people ac-

“Please don’t get so excited?” Emotions are

tively hate their jobs.

at the center of every human endeavor.

In the old days leaders could rally the troops by painting

What would happen if you walked in

a picture of a glorious, prosperous future, garlanded with

one day, looked one of your employees

bonuses, perks and advancement. Today, people want both

in the eye and told him or her, “I’m so

money and meaning. They’re also less trusting of senior lead-

grateful you’re on our team, and it’s not

ership promises having seen evidence that a merger, acqui-

just about the work; it’s also about how

sition, economic downturn, or CEO change makes all past

much you as a person add to this place.

promises null and void.

I love having you here”?

September 2018 | The Journal of Healthcare Contracting

Visit Ventyv.com/JHC for more information Hello@Ventyv.com • 5401 West Kennedy Boulevard, Suite 760, Tampa, FL 33609-2447 • 1.888.4Ventyv

LEADERSHIP

It sounds hokey, but every time I suggest this in a presenta-

don’t care, it’s often because leadership

tion, people’s eyes fill with tears. Human connection isn’t a nice

hasn’t given them anything important to

thing to have; it’s a must-have. Meaningful connections provide

care about. Revenue objectives, market

people with the internal fortitude they need to stay productive

share targets and productivity numbers

during tough times.

are worthy goals. But the secret of true

No 2. Meaning: Provide context

emotional engagement is to get beyond the numbers and make it personal.

We all want to know our lives – and work – actually count for some-

People who are connected to each

thing. A person who makes widgets may do a good job of qual-

other and have a sense of purpose

ity control. But if his boss holds a team meeting every Monday

about their work will push through

morning and shares stories about people who bought the widgets and how their lives were made better, more fun, more interesting, safer or easier as a result, that imagery is going to stick. The person responsible for stamping out part 357A will know his work counts for something more than a production number. He has a purpose.

No. 3. Leadership: Apply daily It would be nice if we all went through our days feeling beloved

One of the essential roles of a leader is to remind your team why their work matters.

When employees seem like they don’t care, it’s often because leadership hasn’t given them anything important to care about.

Revenue objectives, market share targets and productivity numbers are worthy goals. But the secret of true emotional engagement is to get beyond the numbers and make it personal.

by our families and co-workers secure in the knowledge our work makes a real difference. Sadly,

tough conditions to get things done. If

angst and worry are the typical default setting for the human brain.

your team is facing a challenge, or they

Left to the mercy of our own perceptions, our jobs can descend

seem to be disengaged, ask yourself: Do

into an endless series of meaningless tasks. That’s why we need

they know why their work matters? And

leaders who can reset us in times of uncertainty and challenge.

most importantly, do I as a leader rein-

In fact, one of the essential roles of a leader is to remind your team why their work matters. When employees seem like they

force meaning and connection every single day?

Lisa is a sales leadership consultant, and author of Selling with Noble Purpose. Companies like Apple, Kimberly-Clark and Pfizer hire her to help them create passionate, purpose-driven sales forces. She has appeared on The Today Show, and has been featured in Forbes, Fortune and The Wall Street Journal. She provides executive coaching sessions, strategy workshops, and keynote speeches. Visit www.LisaEarleMcLeod.com 26

September 2018 | The Journal of Healthcare Contracting

At HealthTrust, we use science supported by data. Others may claim big data. But they can’t duplicate our experience and insight in guiding informed decision-making that supports improved care and lowered cost. Let us help you amplify your voice and turn data into action.

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