Accountable Care Organizations Need Solid Leadership DNA

So what will make a difference—-this time? Many of you can remember the days of utilization review, capitation, and all the strong arm techniques that failed. The failure was not only driven by poor design and bad information. Additionally,  a lack of clinical expertise at the helm, combined with some of the most ineffective organizational and individual leadership most of us have ever experienced certainly caused failures. Those with dark blue suits and with white coats did not engage positively in a new model or with one another.

As a very smart former colleague and friend of mine (Thanks Mark!) notes, “ACOs are simply one example of value-based care delivery models, whether ACOs will succeed or not remains to be seen.  In the meantime, I’d be hesitant to hitch my buggy to the ACO craze“. Certainly there are many questions that remain to be answered, don’t get hung up on those. Just know that the sun is about to rise on the day when organizations, caregivers and leaders will be HELD ACCOUNTABLE FOR HEALTHCARE OUTCOMES.

Are you up for this? So, of you are thinking about an ACO, look in the mirror. If you see much of the following, then step up. If not, get out of the way and make room for the next generation of leaders.

  1. Understanding of self and organization: The ability to recognize one’s strengths, weaknesses and opportunities for development, as well as those of the organization as a whole.  An appreciation of the importance of how others experience behavior may indeed be different from one’s intent.
  2. Judgement: The ability to integrate information in a systemic manner to understand a problem or opportunity from the inside out, vertically, laterally, at the detail level, and the aerial view. A deep appreciation for the complex dependencies associated with financial, clinical and cultural drivers of value creation.
  3. Motivation and ability to learn: The ability to develop and play with ideas and viewpoints to stretch them, bend them, reconstruct them into solutions that fit and work perfectly in specific situations and connect with those whose support is essential. As a leader, one must model this capability as the entire value-based health organization must have learning DNA embedded in all corners.
  4. Fluency and clarity with ideas: The ability to describe many versions of one answer and many solutions to one problem set and to explain the impact or outcome of each both orally and in writing in ways that others can understand.
  5. Vision: The ability to create and communicate a clear and compelling vision of accountable care inclusive of the destination, the strategy to get there, the measure of incremental success and the behavior that must be the foundation for change. This must be sufficiently detailed and supported to bring key stakeholders along.
  6. Situational leadership: The ability to quickly and accurately assess the organizational and individual readiness and meet individual and parts of the organization where they are as the starting place for dialogue.
  7. Authenticity of contributions: The ability to offer a value-added difference that would not be there were another person in the same role and have this be experienced as for the good of the organization over one’s personal interests.
  8. A bias toward opportunity and action: The ability to estimate and verbalize the loss to be taken by standing still and missed opportunities that occur by choosing one avenue over another, in spite of the fact that there is incomplete information available.
  9. Passion, enthusiasm, and positivity about decision making:The ability to bring the appropriate mindset to the decision-making process in order to lead oneself or a team to a positive decision-making experience; one more likely to result in commitment to action.
  10. Coaching and organizational development: Supporting the development of others to see and act in a manner that leverages strengths, manages weaknesses before they become organizational or personal derailers, as well as initiates opportunities for professional and and organizational learning and continuous collaborative improvement

Some would suggest these thoughts represent leadership attributes that are critical to any major change. Yes, they certainly do, however in the past these capabilities were not always evident in initiatives intended to create more accountability for value creation in healthcare.