Heard Around the C-Suite: CEO Insights on the Future of Healthcare

In today’s rapidly evolving healthcare landscape, health system CEOs have dozens of priorities on their plate—often simultaneously. While strategy leaders often work closely with their own CEOs, we wanted to bring you in the room to hear what CEOs from around the country are talking about and how they are grappling with their top priorities. Our inaugural audio episode of Heard Around the C-Suite dives into these challenges, recapping key insights from recent CEO discussions at The Health Management Academy’s CEO Forum and Horizon 2030 CEO Summit.

Listen in as Jerome Pagani, Executive Director of Strategy Catalyst, and Anika Rasheed, Strategy Catalyst Analyst, break down key themes from conversations with our resident experts and event attendees Robin Brand, Vice President of Member Insights, and Rebecca Akabas, Senior Director of Member Development.

Key Takeaways

• Epic and Innovation Constraints: CEOs recognize Epic’s importance but also voice frustration over the slow pace of updates, which limits agility. CEOs are exploring ways to adapt without overburdening their teams or compromising patient care by finding solutions that can be easily integrated and show immediate financial returns.
• AI’s Impact on Workforce Efficiency and Care Delivery Gaps: AI applications, like those demonstrated by Hippocratic AI, show promise in managing routine tasks, freeing clinical staff for more complex patient care. Still, there’s recognition that the human touch remains important.
• Value-Based Care and Physician Compensation Models: While some health systems are advancing in value-based care, others remain heavily tied to fee-for-service models. Leaders are continuing to discuss how to realign physician incentives in either model to drive meaningful change.
• Addressing Burnout with Technology: CEOs are focused on solutions that deliver immediate ROI without further straining already exhausted teams. The focus is on “plug-and-play” tools that integrate seamlessly into existing workflows.
• Learning from Consumer-Driven Industries: Health systems can gain valuable insights from consumer-driven sectors. Leaders at WellSpan and CLEAR demonstrated how establishing specialized teams and building adaptable platforms enable health systems to manage risks, drive innovation, and scale successful solutions organization-wide.

Transcript

Jerome: 0:01

Welcome to the health management academies, inaugural edition of hurt around the C suite. I'm your host the executive director of strategy catalysts, Jerome Pagani and with We have

Anika: 0:14

My name is Anika Rashid, and I'm an analyst on Strategy Catalyst.

Jerome: 0:18

heard around the C suite is a collection of insights from various forums that the health management Academy hosts every fall and spring These insights include what's top of mind for health executives peers. today, we're to pulling insights from our CEO and our horizon 2030 summit. We're going to talk about epic and technology integration really how executives are looking for tech solutions that enhance efficiency without overwhelming their workforce Talk a little bit about. AI applications in healthcare we're starting to see it move into clinical applications, and it's freeing clinical staff to focus on patient care, We talk a little bit about value based care and the importance of being able to talk to patients about what the shift means for them We also dive into lessons that healthcare can learn from other industries, and how those industries have been able to create flexibility needed for sustainable growth. Anika, one of the first things that we wanted to talk about was what for most health systems is their single biggest technology investment. And that's the EHR. A lot of times the EHR roadmap does not align to the speed with which health systems want to innovate. And so the urgency of those strategic goals particularly with rising demands around cost reduction, workforce challenges just don't align to those strategic roadmaps that the EHR vendors are putting out.

Anika: 1:41

yeah, that was a huge theme that we heard especially talked about at CEO forum. just these ongoing frustrations with Epic. We're hearing about friction on how that dominance affects health systems ability to innovate and integrate new tools at the pace that they want to without, you know, a complete overhaul of their systems. So, Robin Brand V P of Member Insights, attended C E O Forum this year. So let's listen to her describe some of the conversations that That she heard around EPIC and the technological limitations

Robin: 2:20

There's just a lot of, I'd say, talk around Epic because it was coming on the heels of EPIC's UGM. But there's a palpable frustration I would say with folks in the room around EPIC maybe not moving fast enough I think we know that a lot of CSOs are really frustrated in terms of how hamstrung they feel by EPIC and EPIC's progress or lack thereof in terms of certain capabilities and certain applications. And they feel more like we need to lead the charge. I didn't feel that strong of a, of a. Push, from the CEOs. I think they're thinking about things, with their organizations a little bit more holistically and if Epic's going to be the one that sets the pace of when we adopt things, then so be it. For now If it's not able to integrate, if it's expensive, there's just not a lot of tolerance for that. So that was interesting. I haven't felt that much. I guess I would say tension around how Epic kind of dictates the timeline of, you know, technological progress in the healthcare system. I think there's just candidly some exhaustion and recognition from CEOs that their staff are exhausted in terms of epic implementations. We're still in this post pandemic world. We're still focused on taking costs out of the systems. it's almost like we're just going to look for solutions that are easily integrable into our tech stack That was kind of the attitude I got.

Anika: 3:40

so after listening to the clip from Robin, I mean, we already knew that epic is foundational but that's also kind of a double edged sword. yes, it's foundational, but that can also restrict agility.

Jerome: 3:54

that as well as this sort of tension between the CEO perspective on epics pace. Since this is the single biggest investment that most health systems make in technology, CEOs are really sort of resigned to maximizing the return on the investment that they get from their EHR. And that means being in many cases wedded to this low pace

Anika: 4:16

yeah, I think something else that came out in that clip Is that CEOs know that they can't push their workforce through more massive overhauls. They really need those practical solutions that are going to integrate quickly, easily with their existing solutions. even if that means relying on Epic's timeline,

Jerome: 4:39

and there's a balancing act because CSOs obviously want sure that whatever technologies they're investing in, given the very limited resources they have are maximizing the impact for the clinical staff, as well as financial and clinical outcomes. Usually that means being able to work within the workflow. so even those that we're seeing innovate around the EHR are really looking for things that have plug and play kinds of integration. you're not pulling out into some other application, and it really seems like, only things that are going to move the needle on a really specific KPI or where CSOs are willing to invest. I think that's where we get tension between CSOs who are sort of pushing for the innovation trying to do it in ways that focus on very particular KPIs and maybe the CEO's more cautious approach of, leaning into that investment that they've already made.

Anika: 5:28

Think that's why we're hearing this push to Explore some alternatives that really complement epic rather than necessarily Wait for epic to deliver, but it it's just this, as you said, balancing act. Post pandemic cEOs are really focusing on stabilizing operations, safeguarding their workforce, reducing costs. And major changes just aren't feasible without a clear ROI.

Jerome: 5:57

One of the other themes we heard at the forum and horizon 2030 was, the pressure that CEOs are facing to improve patient access. And one of the clear problems there are related to workforce. Workforce has already stretched thin hiring more providers is not, you know, Always available. particularly in very highly competitive markets. so CEOs are trying to think creatively about expanding capacity.

Anika: 6:24

Yeah, so instead of trying to solve the problem purely through staffing or the, experience piece or scheduling necessarily, they are looking at ways to really optimize the resources that they already have and through capacity, I think this is where AI really comes in, especially for handling those nonclinical tasks. Thanks. If AI can manage patient interactions, like appointment reminders and follow ups, then clinical staff can focus on only they can do. so we're seeing a lot of really promising applications, particularly around AI's role in supporting team based care and just managing broader panels of patients,

Jerome: 7:10

So I think that's exactly right. The priority then becomes looking for technology they can help change care models and the way care is delivered. And I think this is a place where AI can step in and help folks really operate at the top of their license, reduce some of the workforce burden, and improve the patient experience by enhancing communication with patients and also the burden on the care staff

Anika: 7:30

yeah. So Robin saw, Hippocratic A. I. S. Demo of some of their patient engagement technology. Let's listen to what she had to say about that.

Robin: 7:40

The 1st use case was for instructions and procedures prior to screening colonoscopy. So they're not actually having nurses or ma's do that. the other use case was for, certain surgical procedures, post discharge, like calling and just checking up, you know, the patients were discharged with, some kind of RPM devices. So the bot is able to actually ask them, about the readings, whether they were able to get 1 or not seeing if they got their weight that day, just going through kind of those stats, essentially, and seeing how patients were adhering to their post discharge care. it was interesting how it can actually have a conversation. the 1 thing I think that they were pretty up front about in terms of not being able to do is if something comes, you know. out of the quote unquote blue. that throws it off. So, still some work to be done, but really fascinating. If you think about all the patient engagement work and patient touch points. that are needed under value and candidly under any type of pop health and even fee for service if we're thinking about pre and post discharge, of procedures,

Anika: 8:41

so Jerome is really fascinating to hear about how Hippocratic A. I. Demo is applying A. I. To some of those routine patient interactions. mean, these are critical touch points for keeping patients informed and engaged in their care

Jerome: 8:57

what's really exciting to me is that we've had a lot of examples of, AI or algorithms being used in the back office, now we're starting to see usage in actual care. on the clinical side. And so having the manage these sort of low risk, high frequency tasks really frees up clinical staff, time, mental effort, and as a practical way to expand capacity. This really isn't, about replacing the clinical workforce and any by any stretch of the imagination. It's really about that sort of augmentation to allow them to be able to do more of the things that technology is never going to be able to do.

Anika: 9:33

Mm hmm. But I think Robin also touched on a key limitation they still struggle with anything that is unexpected or out of the scope. So that's where the human touch Is still needed. It's still crucial, especially for patients with more complex or more nuanced needs or questions. And I think that also just raises the question in general about how patients and consumers feel about interacting with a bot for parts of their care. so Robin also had some comments About this as well, how CEOs are discussing the cultural dimension of AI and health care and how leaders are navigating those patient preferences.

Robin: 10:14

there was a recognition that some patients may not prefer that. and so there's the option to be able to opt into a real person, so to speak. I think there's a broader theme around as much as we want to be able to scale our providers. And again, going back to this, we just don't have enough and we're not going to have enough. We're not going to be able to grow enough to be able to meet the demand across the next 10, 20 years. Is there a concern around taking away any kind of human to human contact in certain cases, right? it is a little bizarre and strange. Some patients are not going to want to do that. but in as much as people are getting used to AI for, you know, paying bills, cable, utilities, shopping, all of that good stuff. I mean, airlines, I mean, I think it kind of comes to figure that they'll get more comfortable with it, especially if it's not actually a part of treatment. more about what surrounds the treatment episode.

Jerome: 11:06

Right. that sort of hybrid model really allows the technology and the human touch to coexist, which I think is the place where we as people are currently most comfortable,

Anika: 11:18

So we also had Rebecca. Uh, campus senior director of member development, attend horizon 2030 summit this year. And AI also came up there. So let's listen to her. Talk about that conversation.

rebecca-_1_10-28-2024_151437: 11:29

another key theme I would say was, of course, ai. that's inevitable, right these days in terms of how it's going to impact care delivery and what that looks like for health systems strategy, from a clinical care delivery perspective, a big focus of that conversation was around primary care, I think there's pretty strong consensus that primary care is the area that's most primed for early use cases on the clinical adoption side and has the potential to drive down costs. But again, the incentives kind of need to be aligned in a way that's encouraging providers, to make these changes and adopt those technologies. And frankly, we're not there right now. I still think there's a bit of an uphill battle here culturally intellectually, I think there was agreement in the room that this makes sense to do. and when we think about the intersection there, again, of cost, and driving adoption for solutions that are going to help with hypertension, weight management, those types of things which are the primary drivers of cost and connected to the primary care that could potentially be delivered through AI. everyone understands the value there. but I still think culturally speaking and in terms of the prioritization I'm not sure most of the room sees this at the very tip top of that list.

Jerome: 12:51

What I love about this side by side is that we're really, and this is near and dear to my heart, talking about how to design for health, which is really put the clinical care team and the patient's perspective together and really design around that. And Robin's talking about the emphasis of giving patients options, bot or the human, based on their comfort level and workflows around that And Rebecca adds that focus on the potential in primary care and some of the cultural hurdles that we need to get through, And CSOs need to be thinking about how to introduce innovations like this in a way that fits within the organizational culture. this isn't just an implementation, right? Where it's not just about rolling out a piece of technology. It's got to align with the broader priorities, and it needs to be able to fit within the cultural context of the specific organization. There needs to be ongoing support as the clinical team figures out how to use this, what's working, and what's not.

Anika: 13:48

I think those are all really great points. It's not enough to just deploy a I in a way that supports cost goals. they also have to create an environment where both patients and providers also see its value. So that might mean targeted training, incentives for early adopters, really making sure you have those physician champions on board, just constant evaluation and transparency about how these tools are affecting clinical outcomes and patient satisfaction.

Jerome: 14:21

so Anika, I think this gets us to another theme that we heard, which is really around how cost pressures and managing burnout influence strategic choices that CSOs have to make. they're really under pressure to control costs, but they have to weigh potential savings against, being able to support and bolster the workforce.

Anika: 14:38

and just this conversation about what is going to show an immediate impact. On margins without overburdening and already strained staff. let's listen to what Robin had to say about that

robin-brand_1_10-25-2024_142259: 14:51

CEOs are still focused on just workforce and overall impact. They're still very cognizant of the post pandemic world that they live in. they're really, really focused on that. And again, their margins overall, so not eager to push toward, any more investment or anything that's going to not, you know, Immediately show returns that was something that a lot of the industry members in the room were saying to that they're hearing, it's just this huge pressure to show returns on their solutions. not instantaneously, but pretty darn quickly. there's just not a lot of patience for waiting six months, a year. before seeing any type of, hard R. O. I. especially again, this goes back to workforce status today and burnout. they're not going to screw with somebody's workflow. They're not going to make somebody implement something unless there's going to be some serious dollars attached. And I don't know that that conversation is happening at the CSO level. there's definitely like a recognition that workforce is burnt out, but CEOs seem pretty clear to connect kind of the tech and workforce pieces and making sure that they're not pushing further and farther than they need to be.

Anika: 15:57

Okay. So we know health system CEOs want to see immediate ROI and building on the theme of balancing short-term financial pressures with longterm strategic goals. We're also hearing from CEOs that they're under constant pressure to improve patient access and manage costs. Yeah. When it comes to areas like Medicare advantage where health systems are underperforming, financially CFOs are still opting to invest. So let's listen to Robin, as she talks about this phenomenon a little bit more.

robin-brand_1_10-25-2024_142259: 16:26

We have some data from a survey of CFOs across the summer where we asked them, what's performing well, what service lines and business lines are performing well, what's underperforming, what's meeting expectations? They all say MA is underperforming. And yet the next question is, um, For MA, are you increasing spend this year, keeping it the same or decreasing? And they're all increasing. And so it's, it's like, we know that we're losing, but we're still going down this path because of all the reasons I mean, one, is it right for the patients to, are we getting, a bump on our other contracts with those particular payers? Like, are we able to use it as a negotiating lever? Can we make it up with a higher commercial rate? So pretty interesting to see. but I am curious as to how many are just going to kind of ride this out.

Anika: 17:10

So that's really interesting to hear, even with M a underperforming, financially CFOs are still doubling down on the investment. and seeing it as part of a bigger strategy to support patient care and maintain, leverage in negotiations. it's about positioning the organization for long-term gains. that connects us directly to another really important topic of conversation. Value based care.

Jerome: 17:35

We know that one of the things that health executives need to do is be able to align their messaging with current industry trends So that they are telling their story to the market in a way that makes sense. Patients understand their value. Where they're making investments, where they're making cuts. and how all of those things impact the care they can expect to receive. so what some of that messaging really revolves around the current strategy and then sort of the big macro trends, like the shift towards value based care. and right now we're seeing some markets push heavily towards value based care, where others are still more on the balance fee for service. And what we're seeing is that CSOs have to balance VBC adoption and align messaging with some of their health system's longer term goals

Anika: 18:19

I think that's a great point Jerome, really about right environment for either model to succeed. And as health systems. transition to value based care, one of the internal changes that they really need to think about is how they are engaging with their workforce. And we're hearing a lot of discussions about the need to shift physician compensation to align with value based care let's hear Robin discuss that a little bit more.

robin-brand_1_10-25-2024_142259: 18:51

there was also, a session just around the state of value based care. people are split here, right? I mean, in terms of whether this is necessary or not, it feels like a conversation I might have heard 10 years ago in terms of, who's pursuing what. and it just feels like there's some kind of entrenched sides in terms of, yeah, we're still on this path. We're still going to go forward. but. Others that are like, no, we're going to ride this fee for service wave. Like, we just, we don't think that we need to be investing there. Our market has not turned if it does, We have, you know, certain things in place. Obviously there are things, the no regret strategies, things that are going to drive patient engagement, population health strategy, but, it's interesting. There's also just this realization that unless you can actually change physician comp models, to actually align with value based care, there's not a lot of point. I mean, you just absolutely have to change behavior. But there is some, for folks that are continuing down the path, they do feel like when you change the incentives for physicians, like I heard this, physicians are smart, they're gonna figure it out. Right? And so they really do feel like that's the critical lever, there's definitely several conversations I heard, not necessarily front of room, but just, throughout the days around having the challenges and the opportunities that a split medical group model would present. Like, do you have, you know, half your physician practices kind of fee for service and based upon eat what you kill RVUs, do you have the other half kind of more focused on, Fully cap ideally, I guess, and, more on kind of the value piece. but I also think that there's this resignation that, if I think about back to, the, and I think about the birth, I would say of, like, and when bundled payments really kind of reemerged. There was always this idea that we were going to have two feet in two boats, right? But it was only going to be temporary. And now I feel like people are a little bit more willing to be like, we might be here for 20 years. We might be here for 30 years. we're just going to have to be able to balance the. the. feet, I guess they're going to be in the splits as the canoes drift away from one another.

Anika: 20:46

that's a really important point for CSOs to consider as well. If they are pursuing value based care, they just need to consider that the incentive structures need to support it. It, no longer about this big picture decision to go after value-based care. It's also about setting up those enterprise wide changes that drive provider engagement

Jerome: 21:07

and then on the health care consumer side, we know that most people don't really understand what value based care means. and when they do, they're really sort of honing in on the value part right? They are thinking a little bit on the quality, but a lot of what's driving their thinking is around cost.

Anika: 21:25

I mean, I think it's really interesting that, you know, we're having these discussions about having one foot in two boats with fee for service and value based care, but on top of that something that came up at CEO Forum was that we're still even discussing the terminology of value based care. And what kind of connotations that sends to consumers, which is just a really, think, interesting discussion to be having at this point in the transition. So let's take a listen to hear more about that conversation.

robin-brand_1_10-25-2024_142259: 21:53

there was a little bit of conversation around the word value. for some consumers, some CEOs had shared that they don't like the word they maybe have done some user group testing. Value can sound cheap, or does it connote that the rest of the care that they've been delivering isn't valuable? And so nobody has a great answer. Answer, right? but it is interesting that's even rising to the top in terms of what do we even call this thing that we're trying to do?

Jerome: 22:21

So I think health executives have a chance to sort of lean into the narrative in the market and begin to shape people's perception so that they understand what the principles are and the benefits. I think in particular, there's a lot that can be done to combat some of the perception that value based care approaches Maybe more limiting to consumers choices and really to lean into this narrative that we're talking about enhanced care coordination and outcomes, so that people can see the benefits of shifting to this kind of care model.

Anika: 22:53

Yeah, Jerome agreed. So I want to pivot to our next theme there is a lot of interest and learning from out of industry companies on how they build more agile platforms to adapt to shifting market needs and consumer demands, and just having the infrastructure in place to support. Innovation and flexibility. Let's let Rebecca tell us about the conversations at horizon 2030 about this.

rebecca-_1_10-28-2024_151437: 23:22

we're in health care but there's so much That they can learn and appreciate from other companies, I would say the overarching theme was just the importance of building a health care platform, and the flexibility that this platform versus having multiple point solutions enables when you have to pivot or want to expand how you're partnering. Clear the company that we know from the airline industry, shared how as they built and expanded across their platform, they've learned to kind of like start small and not out Into all places all markets everything all at once being able to like prove their concept and scale from there WellSpan is an interesting example there as well because in order to allow for the flexibility and the innovation to succeed in the consumer space, they've stood up a separate team, a separate entity, essentially, to allow for that growth and flexibility, and I know that, again, in other conversations with the strategy officers, some other health systems have taken a similar approach, because I think there is an appreciation from the CEO perspective that, you know, our health system isn't always the most agile, and it isn't always the, easiest to, allow folks to innovate and take risks and so having a dedicated space to do that is really critical

Jerome: 24:39

I really like WellSpan's idea of having a separate innovation team.

Anika: 24:43

WellSpanis really great example. so as we listened, they've set up this separate team specifically to drive innovation, which has allowed them to be more flexible and nimble in the consumer space. This approach really recognizes that large health systems aren't always built for rapid change. You know, they're typically more conservative, so creating a dedicated space. Where the main focus is innovation can be really key to adapting to consumer demands. And I think both of these examples really highlight the importance of not seeing healthcare as a special snowflake and more that we are able to import best practices from other industries. I think the other really important thing is that both of these examples seem to really focus on building platforms over point solutions.

Jerome: 25:34

the cohesiveness that comes from that approach really helps to prevent some of the fragmentation that we're already seeing in health care. I think the takeaway here for CSOs is that. Really thinking about strategies that improve adaptability and flexibility, but also focused on solutions that span multiple domains. and I think this is really an opportunity to also be thinking about how partnerships can help drive innovation in a really competitive market

Anika: 26:02

those are all great points, Jerome. And to round us out, I just want to touch again on the topic of health system identity. CEOs at Horizon 2030. They also spend some time discussing what that really means for them. And when they're trying to balance innovation and care delivery and trust and just how it impacts them as leaders and how they really rely on their teams.

rebecca-_1_10-28-2024_151437: 26:25

There was definitely some back and forth about, you know, how they're negotiating their core identity with the need to wanna be at the cutting edge of technology especially when it comes to clinical care delivery, but recognizing scaling that, and also continuing to deliver the day in and day out basics of care that are needed for the majority of the populations are sometimes at odds, there was some great conversation around um, The seasons of being a CEO, what it takes to manage through the day in and day out and the long term of this role that is so demanding. We talked a little bit about, personal balance, of course, but also just how important it is to the team around you that you can rely on, to make these difficult decisions and then also to execute them talking about the challenges of just working in the health care market, 1 of the speakers made a comment, about how there are more break pedal people than gas pedal people in health systems often. And that when it comes to innovation and transformation and identifying partners, it's really critical to figure out, you know, who are your gas pedal people within the organization to be able to help drive change forward, and that's something that, you know, I think was an offhanded comment, but really stuck with a number of members that I've had follow up conversations with,

Jerome: 27:50

And I think that's an important part of the innovation, right? health executives really need people on their team that are gas pedal individuals who are eager to drive change and push innovation and have the sort of brake pedal people that helps maintain sort of that conservative, appropriate level of change.

Anika: 28:07

And I think for CSOs, it's really essential to identify who fits into each role to ensure that they've got a balance for an effective strategy that they can drive forward, but also manage risks.

Jerome: 28:22

Thanks for joining the health management academies heard around the C suite. I've been your host, Jerome Pagani.

Anika: 28:28

and I've been your co host Anika Rasheed

Jerome: 28:30

and we'll see you next time