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Delaware Valley ACO's Katherine Schneider uses population health to improve patients' lives, one at a time

By | May 16 th,  2017 | chief executive officer, Healthcare, Medecision, population health, accountable care organization, Main Line Health, Middlesex Health system, Modern Healthcare, president, Blog, CEO, clinical imformatics, clinical integration, clinician, community benefits, Delaware Valley ACO, Katherine Schneider, physician executive, AtlantiCare, family medicine, Jefferson Health, Top 25 Women in Healthcare | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2017. Furst Group and NuBrick Partners, which comprise the companies of MPI, sponsor the awards.

 

Katherine Schneider, MD, the president and CEO of the Delaware Valley ACO in the Philadelphia region—an accountable care organization owned by Main Line Health and Jefferson Health—has long been ahead of the game in whatever pursuit she has chosen.

 

She was part of the first group of U.S. physicians to earn subspecialty certification in clinical informatics. She led the implementation of value-based payment models at Middlesex Health System in central Connecticut, long before “value-based” was a common adjective in the healthcare lexicon. She was the senior vice president of health engagement at AtlantiCare, leading its pioneering move to accountable care and co-designing a value-based insurance benefit for 10,000 employees. She also served as executive vice president and chief medical officer for Medecision, which provided population health technology for health systems and health insurers.

 

That’s a lot of trailblazing but, to Schneider, it’s just a steady progression along the path of transforming care.

 

“Whether you call it community benefits, clinical integration, population health or accountable care, this concept of a health system being responsible for more than just transactional care is really what this is all about.”

 

Major achievements started early for Schneider, who skipped from sixth to ninth grade as an adolescent, ending up in college at 15 and in medical school four years later.

 

“When I was 11, we moved from New York City to Austria due to my father’s work,” she says. “I went from a very good private school in Manhattan to a very small, hands-on international school.

 

“I had the threat of ending up at an Austrian convent school hanging over me,” she jokes, “so I did really well.”

 

Though she was much younger than her medical-school classmates, she can’t resist some more self-deprecation.

 

“Yes, I was 19 when I went to medical school, but I made up for it because I spent nine years in medical and graduate school,” she says of the combination MD-PhD program she enrolled in. “To make a long story short, I became much more interested in public health and policy. So, I actually switched into the epidemiology program at Columbia University.”

 

She also chose family medicine, not one of the higher-paying specialties.

 

“Family medicine seemed to me a great fit for someone interested in population health and policy,” Schneider says. “It’s womb to tomb, broad clinical experience.”

 

That made giving up the practice of medicine difficult when she eventually had the opportunity to potentially impact more lives in a different kind of role. Not that she doesn’t have some regrets about not seeing patients anymore.

 

“I do miss it,” she admits. “But there are a lot of really good doctors out there. I was a good doctor too, but I have a skill set that not a lot of people have, which is a combination of the population-health aspects and the clinical experience. I’m seeing opportunities to transform the healthcare system to improve population health outcomes. That’s been my career niche since the day I finished my residency training.”

 

Schneider finds her role leading one of the nation’s leading ACOs to be inspiring, but also challenging at times.

 

“I was recently at a fireside chat featuring Michael Dowling, the CEO of Northwell Health, and he said that, to be in healthcare, you have to be an optimist but you almost have to be chronically unhappy with the status quo.”

 

Schneider says she wouldn’t describe herself as an optimist, but says she “is pretty resilient and determined,” traits she learned from her mother who fought—and beat—tuberculosis as a young woman. “What I learned from my mom is the power of perseverance against the odds.”

 

The perseverance these days comes from battling that persistent status quo—part of the marching orders for an ACO—where so many factions in healthcare have lobbyists to protect their interests, even when change can streamline care or bring about better outcomes.

 

“What one person calls waste is someone else’s lunch,” she says. “If you’re going to get waste out of the system—even through innovation—that’s still taking money away from someone and they’re going to fight it tooth and nail. We’re not going to solve this problem unless we’re willing to admit that and take it on.”

 

Schneider, for one, is ready to wade into the fray.

 

“I truly believe that we can do better and that most of us want to do better to serve our community and our country.”

 

 

SIDEBAR: In a sea of data, the power of stories

 

Katherine Schneider is a national leader in clinical informatics, but she’s a big believer in the power of stories. That’s why she and her team at Delaware Valley ACO open their meetings with a value-based story of impacting the life of a patient or a provider.

 

“You can talk all you want about care management and Triple Aim but, ultimately, if you can tell the story of how you’ve changed a patient’s life or a physician’s practice, people get it,” she says.

 

One example: A 92-year-old woman has been to the emergency room numerous times because she can’t get out of her bathtub. She calls her friends from the tub, who call 911. Over and over. Delaware Valley steps in and, within 24 hours, has connected her to free services in her community that come in and install grab bars and railings and retrofit her home. She doesn’t need to call for help anymore.

 

“Not everything we do is that simple,” Schneider cautions. “We also work with some extremely overwhelming, complex patients and make some small wins for them. A win is not like a cell in a spreadsheet. It’s not a graph on a PowerPoint. It’s really in the stories.”

 

 

2016 Top 25 Minority Executives in Healthcare--Trent Haywood: Clinical leaders essential in move to value-based care

By | December 6 th,  2016 | Blue Cross Blue Shield Association, chief medical officer, Community Health Management, population health, Top 25 Minority Executives in Healthcare, Trent Haywood, Modern Healthcare, Blog, Centers for Medicare and Medicaid Services, health disparities, healthcare costs, leadership, physician executive, Lawton, VHA | Add A Comment

 

Classic content: One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Trent Haywood has multiple titles after his name – an MD as well as a JD. But to find respect and cohesion among his leadership-team peers as he moved into a role as a physician executive, he says his biggest lesson was to check his degrees at the door.

 

“Someone gave me advice early on that, if you’re going to transition away from the bedside, you have to become comfortable no longer being called ‘Dr. Haywood’ but just ‘Trent,’ ” says the chief medical officer of the Blue Cross Blue Shield Association. “Being viewed as ‘the doctor’ has great social capital, but it prevents other executives from really getting to know you and sharing with you as a peer.”

 

But make no mistake – Haywood says he believes that more clinician executives are needed precisely because of their unique qualifications to bring the value to value-based care and to balance patients’ needs and concerns with healthcare finances.

 

“The business is evolving,” he says. “The model used to be ‘the suits and the scrubs.’ The suits did their thing, and the rest of us in scrubs did our thing. It was very siloed, and as long as you stayed on your side of the fence, it worked well.

 

“The model is changing. You have a new generation of clinicians who are going back and getting additional degrees. I think it’s going to continue to be the norm where you’re going to have many more clinicians in leadership roles.”

 

 

Haywood says his experience was easier than a lot of physician executives because he was able to wear both hats on a weekly basis for a seven-year period while he worked at the Centers for Medicare and Medicaid Services.

 

“On the weekends, all I was doing was focusing on individual patients as they came through the door of the ER. Then, during the week, I would be back at CMS flying all around the country trying to make a difference on a national level. My situation was unique; I was fortunate.”

 

Haywood’s own influences in leadership included his parents. His father Stanley, who recently passed away, had the longest tenure on the Lawton, Okla., city council in history. His mother Charlotte led the young people’s program for many years at the church the family attended.

 

“I learned early on from my mother that if you want maximum output, you have to take the time to invest in people,” he says. “You also have to delineate which people you are going to invest your time in.”

 

Haywood’s father coached him in athletics and impressed upon him the importance of teamwork over individual accolades. “If everyone showed up for practice, they were going to get into the ballgame, regardless of ability,” he remembers. “He put the onus on the team to think beyond ourselves and how we were going to approach the game in a team-based manner.”

 

In the same way, Haywood notes, payers and providers are going to need to work together as a team to help renovate the U.S. healthcare system. As someone who has worked as the deputy chief medical officer for the government (CMS), and chief medical officer for a major provider association (VHA) before coming to BCBSA, he thinks the convergence can’t happen soon enough.

 

“You’re going to see more and more collaboration across the board within a population-based framework,” Haywood says. “If I want to manage a population, then I need to understand more acutely where that population is going in terms of specialists and which ones are performing better for my population.”

 

But the talk between payers and providers needs to evolve beyond healthcare delivery, he says. Affordability is critical when many families live paycheck to paycheck with little savings, and that is reflected in BCBSA’s push for transparency in healthcare costs, Haywood adds.

 

“We don’t want families paying for waste in the system, and so that’s led to the issue of transparency. And the purpose is affordability – how can we make healthcare affordable for a family?”
Haywood has been using BCBSA’s new Community Health Management hub tool to take a deep dive into the data that affects healthcare consumers at the ZIP code level. For example, he recently dug into the statistics to show how something that many people take for granted – access to a car – affects population health, with many people in struggling neighborhoods unable to maintain nutritional health because they lack transportation.

 

“We need to get into the communities and do a better job of population health at the community level,” he says. “We need to find answers to questions like: What are the characteristics of a population? What are the environments in which we find those populations? And what are the behavior patterns of those communities?”

 

Like his father, the city councilman, Haywood hopes to make a difference on the local level – by guiding BCBSA policy on a national scale.

 

“Most healthcare decisions happen outside the four walls of a clinical setting,” Haywood says. “I’m excited that we’re going to transition to more of a preventive healthcare model instead of a disease-based model.”

 

 

BCBSA's Trent Haywood: Clinical executives essential in move to value-based care

By | June 24 th,  2016 | Blue Cross Blue Shield Association, chief medical officer, Community Health Management, population health, Top 25 Minority Executives in Healthcare, Trent Haywood, Modern Healthcare, Blog, Centers for Medicare and Medicaid Services, health disparities, healthcare costs, leadership, physician executive, Lawton, VHA | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Trent Haywood has multiple titles after his name – an MD as well as a JD. But to find respect and cohesion among his leadership-team peers as he moved into a role as a physician executive, he says his biggest lesson was to check his degrees at the door.

 

“Someone gave me advice early on that, if you’re going to transition away from the bedside, you have to become comfortable no longer being called ‘Dr. Haywood’ but just ‘Trent,’ ” says the chief medical officer of the Blue Cross Blue Shield Association. “Being viewed as ‘the doctor’ has great social capital, but it prevents other executives from really getting to know you and sharing with you as a peer.”

 

But make no mistake – Haywood says he believes that more clinician executives are needed precisely because of their unique qualifications to bring the value to value-based care and to balance patients’ needs and concerns with healthcare finances.

 

“The business is evolving,” he says. “The model used to be ‘the suits and the scrubs.’ The suits did their thing, and the rest of us in scrubs did our thing. It was very siloed, and as long as you stayed on your side of the fence, it worked well.

 

“The model is changing. You have a new generation of clinicians who are going back and getting additional degrees. I think it’s going to continue to be the norm where you’re going to have many more clinicians in leadership roles.”

 

 

Haywood says his experience was easier than a lot of physician executives because he was able to wear both hats on a weekly basis for a seven-year period while he worked at the Centers for Medicare and Medicaid Services.

 

“On the weekends, all I was doing was focusing on individual patients as they came through the door of the ER. Then, during the week, I would be back at CMS flying all around the country trying to make a difference on a national level. My situation was unique; I was fortunate.”

 

Haywood’s own influences in leadership included his parents. His father Stanley, who recently passed away, had the longest tenure on the Lawton, Okla., city council in history. His mother Charlotte led the young people’s program for many years at the church the family attended.

 

“I learned early on from my mother that if you want maximum output, you have to take the time to invest in people,” he says. “You also have to delineate which people you are going to invest your time in.”

 

Haywood’s father coached him in athletics and impressed upon him the importance of teamwork over individual accolades. “If everyone showed up for practice, they were going to get into the ballgame, regardless of ability,” he remembers. “He put the onus on the team to think beyond ourselves and how we were going to approach the game in a team-based manner.”

 

In the same way, Haywood notes, payers and providers are going to need to work together as a team to help renovate the U.S. healthcare system. As someone who has worked as the deputy chief medical officer for the government (CMS), and chief medical officer for a major provider association (VHA) before coming to BCBSA, he thinks the convergence can’t happen soon enough.

 

“You’re going to see more and more collaboration across the board within a population-based framework,” Haywood says. “If I want to manage a population, then I need to understand more acutely where that population is going in terms of specialists and which ones are performing better for my population.”

 

But the talk between payers and providers needs to evolve beyond healthcare delivery, he says. Affordability is critical when many families live paycheck to paycheck with little savings, and that is reflected in BCBSA’s push for transparency in healthcare costs, Haywood adds.

 

“We don’t want families paying for waste in the system, and so that’s led to the issue of transparency. And the purpose is affordability – how can we make healthcare affordable for a family?”
Haywood has been using BCBSA’s new Community Health Management hub tool to take a deep dive into the data that affects healthcare consumers at the ZIP code level. For example, he recently dug into the statistics to show how something that many people take for granted – access to a car – affects population health, with many people in struggling neighborhoods unable to maintain nutritional health because they lack transportation.

 

“We need to get into the communities and do a better job of population health at the community level,” he says. “We need to find answers to questions like: What are the characteristics of a population? What are the environments in which we find those populations? And what are the behavior patterns of those communities?”

 

Like his father, the city councilman, Haywood hopes to make a difference on the local level – by guiding BCBSA policy on a national scale.

 

“Most healthcare decisions happen outside the four walls of a clinical setting,” Haywood says. “I’m excited that we’re going to transition to more of a preventive healthcare model instead of a disease-based model.”

 

 

Innovation keeps George Brown, Legacy ahead of the curve

By | October 20 th,  2014 | Furst Group, Top 25 Minority Executives in Healthcare, executive, Modern Healthcare, Blog, CEO, diversity, George Brown, healthcare reform, leadership, Legacy Health, physician executive, safety, Walter Reed, physician leadership, quality | 1 Comments

 

One in a series of profiles of Modern Healthcare’s Top 25 Minority Executives in Healthcare (sponsored by Furst Group)

 

George Brown, the CEO of Legacy Health System in Portland, Ore., has had a long and distinguished career as a physician and leader, but his talents in innovation help him keep his organization on the industry’s leading edge.

 

From collaboration and affordable care to medical homes and information technology, Brown and his team have been unafraid to adapt and take risks, providing an example to the northwest region and the country at large.
Legacy joined with a number of organizations to form an integrated delivery system, Health Share of Oregon. It’s partnering on the OHSU Knight-Legacy HealthCancer Collaborative. In an era bursting with mergers and acquisitions, the path Brown has charted is intriguing.

 

“I have accepted the need to change from a completely competitive mindset to a collaborative mindset,” he says. “Competition doesn’t help the economics of healthcare – it divides communities.”

 

The Affordable Care Act has prompted soul-searching on the part of many executives, and Brown applauds the arrival of reform.

 

“I believe healthcare is too large of an issue for this country not to have a thoughtful and near-universal solution,” he says. “The Affordable Care Act is a step in the right direction.”

 

Although Brown has a sterling history in healthcare, it’s clear he doesn’t waste time looking back. He is especially proud to be on the board of Cover Oregon, despite some of the hits that the exchange took in the media for its early problems.

 

“We’ve enrolled 400,000 people,” he says. “We are moving in the direction to have affordable healthcare for all Oregonians.”

 

The ACA, he says, mirrors some of the measures Legacy has already been working on for some time, foremost of which is quality.

 

“The number one project we have been working on is how to make our organization more efficient,” he says, “and what we’re driving efficiency to mean is quality. We believe if you do things right, you don’t have to do them all over again, and that means it’s also less expensive.”

 


Brown also has led Legacy as an early adopter of the patient-centered medical home, an area in which some other health systems are just getting started.

 

“It’s important for me to say that all of our primary care clinics are Tier 3 certified patient-centered medical homes, and they’re doing very well,” he says. “Patient satisfaction scores are going up and we think we’re making an impact. In fact, we were recently recognized by the Oregon Health Leadership Council as being one of the top performers, so we’re quite proud of that.”

 

It’s also been a learning experience, Brown says candidly. He says Legacy has three main takeaways from the experience thus far:

 

--Specialization is needed. “If you have a population that’s heavy with patients who have congestive heart failure, diabetes, hypertension and obesity, a lot of contact is required with patients.”

 

--The influx of Medicaid patients changes preconceived notions for providers and patients alike. “There are a significant number of people who have not had access to healthcare services. We are evaluating those people and their needs. Some of these people have never seen us before, so that’s going to be an area of revelation for us.”

 

--Mental health is a gaping need in the community. “We’re realizing that behavioral health, mental health and addiction issues are a lot more prevalent in the population than I think we realized, so we’re looking at how best to provide access to those services for our patients who are in medical homes.”

 

Legacy also earned kudos via a Stage 7 award from HIMSS last year. Brown has long been a proponent of how technology can improve care.

 

“I think the lesson we’ve learned – and we have to remind ourselves so we don’t get to learn it again – is that a lot of IT projects really are not IT projects. They are clinical projects that require IT expertise,” he says.
“If you get the clinicians involved early they can become champions of the initiative, where before there may have been some naysayers. It’s important to listen to the clinicians, particularly in their early experience and exposure with products, so that you can modify and incorporate those things that they think are essential.”

 

Listening to the clinicians, Brown adds, “has been the key element of our success.”

 

It surely helps that cause that Brown is a physician himself, a gastroenterologist and internist who rose to the rank of brigadier general in the U.S. Army and led several military healthcare installations, including Walter Reed Health Care System in Washington, D.C.

 

At one time, he found little interest among his colleagues for administrative work. Now, under reform, that has changed as clinicians see their input as essential to changing the industry.

 

“I think the old attitude of some of my colleagues was, ‘I just want to be a physician. I don’t want to be bothered with running an organization.’ Now, clinicians are more involved. They realize they need to help shape the future of healthcare if they want to see things change in a way that’s commensurate with their beliefs. You shouldn’t be passive about change.”

 

Working hard to achieve change, he says, is an attitude he inherited from his parents, who saw him become the first family member to graduate high school and were unwavering in their support of Brown and his two siblings, seeing education as the door to opportunity.

 

“They would tell me, ‘You have the ability. If you apply yourself, you’ll be able to achieve whatever you want.’ “

 

It’s a lesson he’s applying at Legacy, facing the future with resolve.

 

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