Set a strong course

Choose the right executive director for your CI network

Topics: Care Transformation, Performance Improvement, Leadership, Workforce, Clinical Integration, Hospital-Physician Alignment, Physician Issues

August 18, 2011

The following excerpt was adapted from the  Network Advantage, the Advisory Board's dedicated blog for the Clinical Integration Project.

CI program executive director bridges administrative and clinical leaders
The program executive director (ED), also sometimes called the CEO, is ultimately responsible for coordinating both the administrative and physician stakeholder groups. The administrative and clinician leadership can be organized in a variety of ways. It is the job of the ED to coordinate efforts between the CI program groups and the appropriate hospital leaders.

Typically a full-time position, the ED oversees day-to-day program operations and helps set strategic course for the program. Therefore, a working knowledge of innovative care models, new payment models, and clinical quality/performance improvement opportunities is critical. In addition, the director serves as the CI program advocate both internally (to the hospital board and administration) and externally (to physicians, payers, legal counsel, and the broader community) and must be able to communicate effectively and work collaboratively with each of these groups. As the central liaison between the program and other entities, the executive director must be able to secure physician trust and stakeholder buy-in. The director is ultimately responsible for ensuring that the appropriate clinical care initiatives, physician alignment mechanisms, and payer contracts are in place to ensure financial success.

Executive director coordinates with physician-led committees and hospital administration
Aiding the ED in these responsibilities are several physician and non-physician teams. The ED acts as the central liaison between these bodies, which include the following:

  • Physician committees: Physician leadership is important both for engaging rank-and-file clinicians in program operations and, more broadly, demonstrating physicians’ “sweat equity” commitment to quality and efficiency improvement. Although governance structures may vary, every CI network should include dedicated physician committees to oversee the activities that define a legal CI program, such as clinical quality improvement, finance/contracting, IT coordination, and physician performance management. 
  • Non-physician staff: While physician governance is crucial to CI program operations, practicing physicians likely will not have time to oversee the day-to-day aspects of network operations. As a result, successful CI programs also employ a team of administrative staff members to support care management, data exchange, payer relations and other key program functions.
  • Hospital administrators: CI programs that are affiliated with a hospital or health system secure support from administrative leaders on the hospital side of the CI program, in order to provide continuity between the two entities and ensure that clinical approach, data tracking, and performance goals are consistent across sites of care.

Attributes of CI program executive director
In order to manage these disparate responsibilities and team relationships, CI program EDs should possess a variety of attributes, which can be grouped into a few key areas:  organizational experience, business acumen, communication, and relationship management. EDs should have several years of experience in health care management and/or oversight, including administrative management, physician relationships, and organizational/operational management.

Leaders should also be well-versed in the business elements of health care delivery systems, such as accounting, finance, risk-based contracting, physician compensation, EMR implementation/function, medical records management, and human capital management. In addition, the ED should have a conceptual and basic understanding of the legal environment around CI as defined by the Federal Trade Commission and Justice Department.

Beyond job experience, the ideal candidate should have integrity, a motivational spirit, strong verbal and written communication skills, a collaborative attitude, and an ability to secure credibility with physicians, payers and hospital executives. To build strong relationships both within and outside the CI program, the ED should be a team player, support a culture of accountability, understand the nuances of hospital-physician relations, be well-versed in payer contracting, and have an unblemished reputation. Programs that secure EDs with strengths in these defined areas are on track to succeed in the complex environment of clinical integration.

Learn more
Health Care Advisory Board members may join the Clinical Integration Project to receive notices of new CI resources, events, and research.
Daily Briefing readers may access The Network Advantage blog for more information on clinical integration.