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Top 25 Minority Executives in Healthcare–Delvecchio Finley: Leaders understand that medical care is only part of the solution to disparities

By | December 29 th,  2016 | Healthcare, public policy, Top 25 Minority Executives in Healthcare, Modern Healthcare, safety net, Atlanta, Blog, CEO, diversity, Duke University, Harbor-UCLA Medical Center, health disparities, leadership, public housing, safety, Alameda Health System, quality | Add A Comment

 

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

 

Delvecchio Finley doesn’t shrink back from a challenge.

 

That’s one of the reasons his last two jobs have been leading California public health organizations with different but significant issues. But as he surveys the changes needed not only within his own health system but throughout the nation as a whole, he is adamant that healthcare is only part of the solution for what ails the U.S.

 

“Even though access to care and the quality of care is important, access to stable housing, food sources, education and jobs play a greater influence collectively on our overall health,” says Finley, CEO of the Alameda Health System. “I think the evolving research in the field is making it a lot more evident to all of us that those issues are significant social determinants of health.”

 

The interconnectedness of all those factors makes health disparities harder to eradicate, Finley says, but one way to begin is to address the lack of diversity in healthcare leadership and the healthcare workforce as a whole.

 

“Making sure that our workforce is representative of the community we serve – that people who are coming to us for care aren’t just the recipients of that care but can also play a major role in providing or facilitating that care – is what starts to provide access to good jobs and stable housing, and in turn begins to build a good economic engine for the community.

 

“Thus, you’re reinvesting in the community, and that’s how we start to get at the root of this and not just through the delivery of the services.”

 

Finley has some life experience along those lines. He grew up in public housing in Atlanta, where access to healthcare was poor even though the actual care was excellent when he and his family received it. In his neighborhood, he says, the three fields of employment that offered paths to upward mobility were healthcare, education and law enforcement. He was a strong student, and enjoyed helping people, so he was eyeing a future as a physician during his undergraduate years at Emory University, where he earned his degree in chemistry.

 

“Upon finishing my degree, I realized that I loved science but wasn’t necessarily as strong in it as I needed to be to become a doctor,” he says. “But I still loved healthcare and wanted that to be something I pursued.”

 

He explored other avenues and ended up earning his master’s in public policy at Duke University. Finley was the first member of his family to graduate from college and to get a graduate degree as well, but not the last, he is quick to point out.

 

“The thing that I’m most proud of is that, while I was the first to graduate from college, that achievement has set a path for my cousins, nieces and nephews, who have continued to shatter that ceiling for our family.”

 

He says it was also within his family – and within public housing – where he first began learning leadership skills that would result in him becoming one of the youngest hospital CEOs in the country.

 

“I spent a fair amount of my childhood being raised by my aunt, and she was a force of nature,” Finley says with a laugh. “She served as president of the tenant association and she used that position to strongly advocate for reasonable services and humane treatment for people who were in a very challenging circumstance. I learned from her that we have a responsibility to use our gifts – and to use our voice and our station in life – to help people.”

 

That was certainly the impetus for taking the helm at both Alameda and his previous post as CEO of Harbor-UCLA Medical Center.

 

“Both of them are safety-net organizations that serve a disproportionately underserved community,” Finley says. “That resonates with me from both a personal and professional standpoint. They have both provided a chance to work with a team to get our hands around some of these issues because of the very important work and role that these organizations play in their communities.”

 

At Harbor, the bigger challenges were regulatory, not having good, documentable evidence of the quality and safety of the care that was being provided, “which we were able to fortunately surmount and proceed from there,” he says.

 

The difficulties that Finley and his team at Alameda have had to address are different, he says. “A lot of it was short-term economic hardship combined with the growing pains of going from a historical health system that had grown exponentially through recent acquisitions of two community hospitals. We’re just beginning to stabilize and right-size the ship.”

 

The elements for achieving lasting change, both for the health system and the community, are within reach, he says. Alameda’s skilled nursing facilities recently outperformed a lot of private organizations in earning a 5-star rating from CMS, something Finley hopes can be replicated systemwide with a new strategic plan that promotes greater “systemness” and a focus on access, quality, patient experience, and innovative approaches to care delivery.

 

Alameda Health System is also a benefactor of the a state Medicaid Waiver called Medi-2020, which is a partnership between CMS and the State of California that aims to promote continued transformation of the safety-net delivery system for Medi-Cal recipients. And, internally, Finley plans to bring more Lean management processes to Alameda in the next fiscal year.

 

He had begun to explore Lean several years ago when he was at Harbor-UCLA. He and leaders from a number of systems – including Alameda – took trips to watch Lean in operation at ThedaCare in Wisconsin, Virginia Mason in Washington, and Denver Health in Colorado.

 

“I appreciated that Lean wasn’t just a performance improvement methodology and the flavor of the day, but it was an operating system,” he says. “I think my other takeaway from the trip was that Lean is very hard to do. You’re going to have fits and starts, but if you commit to it, it can lead to some very transformative outcomes for your organization and for the community you serve.”

 

Transformative outcomes? Finley personally knows a thing or two about that.

 

 

2016 Top 25 Minority Executives in Healthcare--Bruce Siegel: Diverse leadership is a must on the road to equity of care

By | December 14 th,  2016 | America's Essential Hospitals, Center for Health Care Quality, Equity, population health, Top 25 Minority Executives in Healthcare, C-suite, healthcare disparities, Modern Healthcare, president, risk adjustment, safety net, Blog, boards, CEO, diversity, Johns Hopkins, academic medical centers | Add A Comment

 

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

 

Thirty years ago, Bruce Siegel had what he calls “a rude awakening,” running headlong into the perplexing spider web of health disparities as a young MD. It’s been something that he’s spent his entire career trying to solve, albeit not with a stethoscope.

 

“I went off to medical school and started my internship, and I was stunned by what I encountered,” says Siegel, now president and CEO of America’s Essential Hospitals. “I worked in the clinic at our hospital, and it was just a tidal wave of diabetes, heart disease and lung cancer. Most of it was preventable. And the other thing I noticed was that it was mostly affecting communities of color.”

 

It was a frustrating experience, one that led Siegel to pursue a master’s in public health at Johns Hopkins University and try to find public-policy solutions to the nagging issues he saw as a physician. “I felt like I was running an assembly line that never ended. I’d see 200 people with these problems. I’d send them back out and they’d be back a month later.”

 

The New Jersey Department of Health helped pay for Siegel’s education at Hopkins, so he owed them some time when he graduated. He did so well that he eventually became a very young state commissioner of health, then parlayed that experience into running New York City’s health system and a Tampa, Fla., hospital. His early years in leadership after being a clinician were rocky, he admits.

 

“It was a crucible in many ways,” he says. “Sometimes, it was very uncomfortable and I was probably in over my head at points. But it’s where I began to learn that leadership is about giving people space. I really think a leader’s job is to create a safe space for talented people and tools to help them move forward. If I’m giving orders, then I’m failing.”

 

Siegel joined America’s Essential Hospitals in 2010 after eight years as a professor and the director of the Center for Health Care Quality at George Washington University. But at each step of the way, his thoughts went back to those diverse patients in the clinic who found little hope in healthcare. “I had so many patients of color for whom the system simply wasn’t working, but I didn’t understand why.”

 

In recent years, Siegel has begun to see a change as he leads the nation’s essential hospitals, his association’s term for public and other non-profit hospitals with a safety-net role. The association’s members often are a driving force, he says.

 

“It’s great to be in the company of change agents,” he says. “Our members have leaders who care about these problems and are working to fix them. Equity is now front and center in the American agenda. We’re not there yet, but at least today we have the tools.”

 

At times, it’s still a tough slog, he notes. One of the must-haves on the road to equity is diverse leadership, and the effort to improve that is stalled. Medical schools are failing to enroll minority communities, and boards have been far too quiet on the lack of diversity, Siegel says.

 

“I don’t think our boards of directors are demanding this,” he says. “They need to be unequivocal that this is an expectation, not just a nice thing to do. But I don’t think our hospitals are going to look diverse in the C-suite if our boards don’t.”

 

Lack of diversity, Siegel says, is short-sighted because it is harmful to patients and harmful to an organization’s bottom line.

 

“The slow walk on diversity is just bad business,” he says. “We’re not going to succeed if our leaders don’t fully understand the lives of our community and their priorities.”

 

America’s Essential Hospitals is working with the Robert Wood Johnson Foundation on a population health project, and Siegel sees a disconnect between some healthcare executives and the communities they try to serve. “I’ve been in communities where, if you ask the CEO, he or she will talk about chronic disease management as their main concern on population health. But if you ask the people, they’ll say their most pressing need is a safe street for them to walk on, and safe playgrounds for their children. We’re not going to get to population health without addressing what people think of as health.”

 

In the same way, he adds, population health can’t be attained if you weaken the academic medical centers which comprise much of the association’s membership. The AMCs, with their three-legged stool of clinical care, education and research, sometimes feel the ACA is applied like a wildly swung ax, Siegel says.

 

“These are places in America that do what no one else does,” he says. “They attract the sickest people who have the greatest social and economic challenges. Home may be a homeless shelter. English may not be their first language. These patients may have a harder time navigating the healthcare system, and they may be readmitted through no fault of the hospital.”

 

Siegel’s association is pushing Congress for a risk adjustment for these hospitals, which, he notes, had an aggregate operating margin slightly in the red for 2014. Compare that to, say, the pharma industry, which banks about 20 percent profits each year.

 

“To me, the future of healthcare is that hospitals will be at risk for dollars they get. I accept that,” Siegel says. “We’ll do everything we can to make that better, but we also need the regulators and the payers to do their part.”

 

The challenges of America’s Essential Hospitals’ members are personal to Siegel. He and his sister were both born in a public hospital. Their mom emigrated to the U.S. from Haiti. “My family very much depended on a safety net when they came to America. So these issues are near and dear to me and my loved ones.”

 

 

Delvecchio Finley: Medical care only part of the solution to health disparities

By | August 24 th,  2016 | Healthcare, public policy, Top 25 Minority Executives in Healthcare, Modern Healthcare, safety net, Atlanta, Blog, CEO, diversity, Duke University, Harbor-UCLA Medical Center, health disparities, leadership, public housing, safety, Alameda Health System, quality | Add A Comment

 

Delvecchio Finley doesn’t shrink back from a challenge.

 

That’s one of the reasons his last two jobs have been leading California public health organizations with different but significant issues. But as he surveys the changes needed not only within his own health system but throughout the nation as a whole, he is adamant that healthcare is only part of the solution for what ails the U.S.

 

“Even though access to care and the quality of care is important, access to stable housing, food sources, education and jobs play a greater influence collectively on our overall health,” says Finley, CEO of the Alameda Health System. “I think the evolving research in the field is making it a lot more evident to all of us that those issues are significant social determinants of health.”

 

The interconnectedness of all those factors makes health disparities harder to eradicate, Finley says, but one way to begin is to address the lack of diversity in healthcare leadership and the healthcare workforce as a whole.

 

“Making sure that our workforce is representative of the community we serve – that people who are coming to us for care aren’t just the recipients of that care but can also play a major role in providing or facilitating that care – is what starts to provide access to good jobs and stable housing, and in turn begins to build a good economic engine for the community.

 

“Thus, you’re reinvesting in the community, and that’s how we start to get at the root of this and not just through the delivery of the services.”

 

Finley has some life experience along those lines. He grew up in public housing in Atlanta, where access to healthcare was poor even though the actual care was excellent when he and his family received it. In his neighborhood, he says, the three fields of employment that offered paths to upward mobility were healthcare, education and law enforcement. He was a strong student, and enjoyed helping people, so he was eyeing a future as a physician during his undergraduate years at Emory University, where he earned his degree in chemistry.

 

“Upon finishing my degree, I realized that I loved science but wasn’t necessarily as strong in it as I needed to be to become a doctor,” he says. “But I still loved healthcare and wanted that to be something I pursued.”

 

He explored other avenues and ended up earning his master’s in public policy at Duke University. Finley was the first member of his family to graduate from college and to get a graduate degree as well, but not the last, he is quick to point out.

 

“The thing that I’m most proud of is that, while I was the first to graduate from college, that achievement has set a path for my cousins, nieces and nephews, who have continued to shatter that ceiling for our family.”

 

He says it was also within his family – and within public housing – where he first began learning leadership skills that would result in him becoming one of the youngest hospital CEOs in the country.

 

“I spent a fair amount of my childhood being raised by my aunt, and she was a force of nature,” Finley says with a laugh. “She served as president of the tenant association and she used that position to strongly advocate for reasonable services and humane treatment for people who were in a very challenging circumstance. I learned from her that we have a responsibility to use our gifts – and to use our voice and our station in life – to help people.”

 

That was certainly the impetus for taking the helm at both Alameda and his previous post as CEO of Harbor-UCLA Medical Center.

 

“Both of them are safety-net organizations that serve a disproportionately underserved community,” Finley says. “That resonates with me from both a personal and professional standpoint. They have both provided a chance to work with a team to get our hands around some of these issues because of the very important work and role that these organizations play in their communities.”

 

At Harbor, the bigger challenges were regulatory, not having good, documentable evidence of the quality and safety of the care that was being provided, “which we were able to fortunately surmount and proceed from there,” he says.

 

The difficulties that Finley and his team at Alameda have had to address are different, he says. “A lot of it was short-term economic hardship combined with the growing pains of going from a historical health system that had grown exponentially through recent acquisitions of two community hospitals. We’re just beginning to stabilize and right-size the ship.”

 

The elements for achieving lasting change, both for the health system and the community, are within reach, he says. Alameda’s skilled nursing facilities recently outperformed a lot of private organizations in earning a 5-star rating from CMS, something Finley hopes can be replicated systemwide with a new strategic plan that promotes greater “systemness” and a focus on access, quality, patient experience, and innovative approaches to care delivery.

 

Alameda Health System is also a benefactor of the a state Medicaid Waiver called Medi-2020, which is a partnership between CMS and the State of California that aims to promote continued transformation of the safety-net delivery system for Medi-Cal recipients. And, internally, Finley plans to bring more Lean management processes to Alameda in the next fiscal year.

 

He had begun to explore Lean several years ago when he was at Harbor-UCLA. He and leaders from a number of systems – including Alameda – took trips to watch Lean in operation at ThedaCare in Wisconsin, Virginia Mason in Washington, and Denver Health in Colorado.

 

“I appreciated that Lean wasn’t just a performance improvement methodology and the flavor of the day, but it was an operating system,” he says. “I think my other takeaway from the trip was that Lean is very hard to do. You’re going to have fits and starts, but if you commit to it, it can lead to some very transformative outcomes for your organization and for the community you serve.”

 

Transformative outcomes? Finley personally knows a thing or two about that.

 

 

Bruce Siegel: Hospitals need to listen to their communities to tackle health disparities

By | July 18 th,  2016 | America's Essential Hospitals, Center for Health Care Quality, Equity, population health, Top 25 Minority Executives in Healthcare, C-suite, healthcare disparities, Modern Healthcare, president, risk adjustment, safety net, Blog, boards, CEO, diversity, Johns Hopkins, academic medical centers | Add A Comment

 

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

 

Thirty years ago, Bruce Siegel had what he calls “a rude awakening,” running headlong into the perplexing spider web of health disparities as a young MD. It’s been something that he’s spent his entire career trying to solve, albeit not with a stethoscope.

 

“I went off to medical school and started my internship, and I was stunned by what I encountered,” says Siegel, now president and CEO of America’s Essential Hospitals. “I worked in the clinic at our hospital, and it was just a tidal wave of diabetes, heart disease and lung cancer. Most of it was preventable. And the other thing I noticed was that it was mostly affecting communities of color.”

 

It was a frustrating experience, one that led Siegel to pursue a master’s in public health at Johns Hopkins University and try to find public-policy solutions to the nagging issues he saw as a physician. “I felt like I was running an assembly line that never ended. I’d see 200 people with these problems. I’d send them back out and they’d be back a month later.”

 

The New Jersey Department of Health helped pay for Siegel’s education at Hopkins, so he owed them some time when he graduated. He did so well that he eventually became a very young state commissioner of health, then parlayed that experience into running New York City’s health system and a Tampa, Fla., hospital. His early years in leadership after being a clinician were rocky, he admits.

 

“It was a crucible in many ways,” he says. “Sometimes, it was very uncomfortable and I was probably in over my head at points. But it’s where I began to learn that leadership is about giving people space. I really think a leader’s job is to create a safe space for talented people and tools to help them move forward. If I’m giving orders, then I’m failing.”

 

Siegel joined America’s Essential Hospitals in 2010 after eight years as a professor and the director of the Center for Health Care Quality at George Washington University. But at each step of the way, his thoughts went back to those diverse patients in the clinic who found little hope in healthcare. “I had so many patients of color for whom the system simply wasn’t working, but I didn’t understand why.”

 

In recent years, Siegel has begun to see a change as he leads the nation’s essential hospitals, his association’s term for public and other non-profit hospitals with a safety-net role. The association’s members often are a driving force, he says.

 

“It’s great to be in the company of change agents,” he says. “Our members have leaders who care about these problems and are working to fix them. Equity is now front and center in the American agenda. We’re not there yet, but at least today we have the tools.”

 

At times, it’s still a tough slog, he notes. One of the must-haves on the road to equity is diverse leadership, and the effort to improve that is stalled. Medical schools are failing to enroll minority communities, and boards have been far too quiet on the lack of diversity, Siegel says.

 

“I don’t think our boards of directors are demanding this,” he says. “They need to be unequivocal that this is an expectation, not just a nice thing to do. But I don’t think our hospitals are going to look diverse in the C-suite if our boards don’t.”

 

Lack of diversity, Siegel says, is short-sighted because it is harmful to patients and harmful to an organization’s bottom line.

 

“The slow walk on diversity is just bad business,” he says. “We’re not going to succeed if our leaders don’t fully understand the lives of our community and their priorities.”

 

America’s Essential Hospitals is working with the Robert Wood Johnson Foundation on a population health project, and Siegel sees a disconnect between some healthcare executives and the communities they try to serve. “I’ve been in communities where, if you ask the CEO, he or she will talk about chronic disease management as their main concern on population health. But if you ask the people, they’ll say their most pressing need is a safe street for them to walk on, and safe playgrounds for their children. We’re not going to get to population health without addressing what people think of as health.”

 

In the same way, he adds, population health can’t be attained if you weaken the academic medical centers which comprise much of the association’s membership. The AMCs, with their three-legged stool of clinical care, education and research, sometimes feel the ACA is applied like a wildly swung ax, Siegel says.

 

“These are places in America that do what no one else does,” he says. “They attract the sickest people who have the greatest social and economic challenges. Home may be a homeless shelter. English may not be their first language. These patients may have a harder time navigating the healthcare system, and they may be readmitted through no fault of the hospital.”

 

Siegel’s association is pushing Congress for a risk adjustment for these hospitals, which, he notes, had an aggregate operating margin slightly in the red for 2014. Compare that to, say, the pharma industry, which banks about 20 percent profits each year.

 

“To me, the future of healthcare is that hospitals will be at risk for dollars they get. I accept that,” Siegel says. “We’ll do everything we can to make that better, but we also need the regulators and the payers to do their part.”

 

The challenges of America’s Essential Hospitals’ members are personal to Siegel. He and his sister were both born in a public hospital. Their mom emigrated to the U.S. from Haiti. “My family very much depended on a safety net when they came to America. So these issues are near and dear to me and my loved ones.”

 

 

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