As the industry continues to move towards value-based care, health plans and provider organizations must collaborate and partner more closely than ever. But for partnerships to be successful, partners must conquer some deeply engrained cultural beliefs and embrace substantial change.
We recently sat down with Advisory Board's leading voices on organizational transformation, Matt Cornner and Micha'le Simmons, to discuss why change leadership is important for value-based care leaders—and how to get started.
Q: In value-based care partnerships, we often talk a lot about contract specifics and not enough about shared strategic goals. Do you have any advice for how partners can work together to set a meaningful shared goal?
Matt Cornner: No organization affects meaningful transformation without a clear internalized sense of shared purpose. Executives should be really clear about a partnership's shared purpose, develop language for talking about it, and then talk about it relentlessly—in ways that will allow each contributor to connect themselves to that purpose.
Micha'le Simmons: One of the hardest things to do is articulate a purpose that's meaningful to everyone in the organization—especially those outside of the executive team. The way leaders describe partnerships needs to go beyond contractual language to be meaningful on multiple levels. To create meaning, leaders should articulate how a partnership will impact their key stakeholders and identify the specific metrics they hope to inflect because of this partnership.
Q: That raises a good point – everyone within the organization needs to have that vision and trust, not just the C-suite. How can leaders ensure that most staff are bought in?
Simmons: Staff members often get frustrated when you involve them after you've made a change—so involve folks early. But you don't need to involve everyone. Instead, choose key influencers who can talk about these processes with their colleagues.
Second, give staff members the opportunity to voice the things that give them pause or anxiety. Sometimes you can't resolve their issue, but you can create space by acknowledging "Yes, we understand that some of these changes are burdensome. But here's what we gain by working together."
Third, set a high level of transparency around performance so that staff members understand the partnership's overall purpose.
Q: When we talk to industry leaders, something our team hears again and again is there's no such thing as win-win partnerships. How can leaders stay engaged in a partnership when they may not be seeing results right away?
Cornner: Whenever there is a large transformational change, organizations experience a loss of identity. In these instances, what makes these changes particularly hard are the deeply engrained beliefs between payers and providers. Throughout their careers, many leaders have learned to view providers or payers as "the other". When they partner in a new way, their beliefs about the world and their identity become threatened. So, organizations often get stuck because they can't or won't acknowledge those kinds of identity losses.
Leader must name the identity and cultural change again and again and again—because if they don't talk about the reality that our cultures are built around, they'll fall back on thinking of their partner in an antagonist way. It's grief management—needing to grieve the process of going through a change.
Simmons: I wonder about the power of storytelling and looking to the past to talk about what we've been able to accomplish. It's being willing to make some sacrifices upfront to get to our end goal. It's checking in along the way and having open conversations about how we're progressing against our agreements and outcomes.
Whenever you're looking at something ahead of you and thinking about the work required to make a change happen, it feels really daunting. Looking to the past and remembering how we navigated similar feelings and where we ended up on the other side can be helpful to ground yourself.
Q: VBC ultimately hopes to take some of the costs out of the system, which means that someone is going to be losing money. If you were talking to two organizations about this, how would you help them navigate that revenue loss?
Cornner: In these instances, organizations need to orient back to their purpose and know that they're making decisions that are true to their values despite revenue loss. This is where storytelling can be so valuable because you can start to see how you're differently impacting the patients and community you serve. Additionally, you need to be able to talk about early wins to see what's being done right. Like any investment, it's understanding how what's happening is in line with what we're trying to build together.
Q: If you had to give one piece of advice to health plans and providers looking to partner on value-based care initiatives, what would it be?
Simmons: Be explicit about what you can accomplish together that you can't on your own. You can't make an entire community healthier with just one health system. You need to recognize and accept the ways in which what you're doing may be falling short, which is a blow to the ego. Both partners need to recognize this reality.
Cornner: Look out for the adaptive challenges. Even though you can have interesting and innovative partnerships on paper, you need to understand technical challenges. It's bringing awareness to those hidden dimensions. Be willing and able to name them.
Leading change is never easy and physician leaders tell us they’re navigating more change and uncertainty than ever before. From consumerism to telehealth to care variation reduction, physician executives lead the physician enterprise through near-constant (and sometimes unpopular) change.
Use these tools and templates to keep physicians front and center as you roll out your next initiative—and increase the chances that it will stick.
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