Transcription:
Strategic Planning in Health Care

Bill Klaproth (Host):  On this edition of the SHSMD Podcast, we visit with Jeffrey Kraut, Executive Vice President for Strategy and Analytics at Northwell Health and we talk about strategic planning and we get his seven key strategic themes which you are going to want to hear and we get what he thinks is the biggest emerging trend in healthcare. You don’t want to miss it, get ready for it. all of that and more coming up right now.

This is the SHSMD Podcast Rapid Insights for Healthcare Strategy Professionals in Planning, Business Development, Marketing, Communications and Public Relations. I’m Bill Klaproth. And in this episode, we’re going deep into strategic planning in healthcare with Jeffrey Kraut, Executive Vice President for Strategy and Analytics at Northwell Health and Jeff is also the Associate Dean for Strategy for the Zucker School of Medicine at Hofstra Northwell. Jeff, welcome to the SHSMD Podcast. Now as you know, we start every episode of the SHSMD Podcast with Rapid Insights, one quick tip someone can use to make their marketing communications better today. Jeff give us your Rapid Insight.

Jeff Kraut (Guest):  Let me just share with you one of the things that I think everybody tries to do in strategic planning is to constantly reinforce what’s your goal and objective of strategic planning. And for us, the key phrase is how do we become indispensable to the communities we serve and to the stakeholders, government, payors, employers, people that are responsible for making sure we’re delivering the highest quality healthcare. And for us, that’s a constant issue that we try to reinforce in all of our marketing and strategic communications.

Host:  And that’s your Rapid Insight. Well done Jeff. And I love that phrase, becoming indispensable. I think that’s really important. So, let me start with that. Because I think we all need to work on becoming indispensable to the communities that we serve. So, how can that fit into a strategic plan as we work to continually improve our efforts to serve the community?

Jeff:  So, if you kind of dissect your strategy, I think you come out with key strategic themes that the organization has to work on. One of them is the work that is never finished. It’s doing better tomorrow than you do today. Because if you don’t deliver high quality care; then what’s the point. What are you doing? You are not needed. And it’s a critical part of I think any strategy development; you are focusing on that continual improvement.

Host:  That’s a terrific phrase, doing better tomorrow than you do today. So, just go ahead and roll out the rest of your strategic themes that we should know about.

Jeff:  You have to become efficient. You have to be responsive to meeting the needs of the community. And for us, it’s becoming the hub of a targeted specialized services, be it serving the chronically ill, or dealing with specific healthcare issues that come out of our community health needs analysis. Because if you don’t respond to those community health needs; they are going to go somewhere else. And they are going to go to somebody else who is going to do it better.

Host:  Yeah, no question about that.

Jeff:  The other issue that I think all of us are dealing with is about the cost of care and the focus on affordability. It’s certainly driving a lot of the single payor discussions. It’s driving so much of the dissatisfaction with healthcare about out of pocket expenses. And if we don’t focus on affordability; if we don’t focus on being aware of what it’s going to cost an individual in out of pocket; we are going to risk becoming the problem. And somebody is going to come along and solve that problem better than we have and instead of trying to explain away why we can’t talk about charges or this; we’re focusing on making people understand how much do they have to pay, how much do they have to pay now, what their financial obligation is. We’re simplifying our bills. We’re explaining how you can pay your bill and we’re giving them choices in which to provide and access care. Some are lower cost settings. Some are more expensive and there’s trade off.

It's focusing on bringing quality information and financial and cost information to the patient.

Another issue is really tackling social determinants of care. Some people say moving upstream and downstream of medicine. Because if we don’t take into account the social issues that affect healthcare particularly for those of us who are serving the mentally ill or people that are substance users; we become less relevant and we become less valued and then less indispensable if you will to the communities we serve. But if we’re focusing on the most disadvantaged parts of our community and the ones with the more difficult problems; just think about how government and how community leaders and how civic leaders will view you and how important you are and to support your organization.

Host:  Yeah, I think sometimes we might lose sight of that. These are great Jeff. Please keep going.

Jeff:  The other issue and I think this is absolutely important in if we are embracing a consumer driven kind of strategy; you have to become – you have to have a digital front door and that digital front door has to take the hassle and the friction out of accessing and consuming healthcare. Not filling out forms. Having all your information available. I mean it goes well beyond Telehealth and Telemedicine. It’s allowing anybody to consume healthcare in any place that they want to. It could be their home, their office, their workplace. It could be community settings. It could be at 2 a.m. in the morning with an Apple phone. And one day we are going to stop calling it Telehealth just like we don’t call it telebanking anymore. It’s just how you consume healthcare.

Host:  Right, it’s just banking.

Jeff:  And this is – we consider this one of the biggest strategic challenges for an organization like us because we know the Amazons and Googles of the world are going to have the technology and the way to figure out how to do this and if we don’t do this; somebody else will.

Host:  And they are removing the friction and the hassle.

Jeff:  That’s correct. Just look how much was purchased last a couple of weeks ago in Christmas time. It broke all kinds of records and even bricks and mortar like Target and Walmart sold more online than anytime in their history. Just shows you, you can teach an old horse new tricks, so to speak. And we have to embrace that and part of it leads to our next thing. We can’t do everything. We have to look for some partnerships. We have to partner with people, and we have to innovate. Now we’re looking at doing that to also diversify some of our revenue. So, we can support our not for profit mission. If we don’t partner, we might lose some of the upside. And we are going to be unable to fund our mission. So, we’re looking at inviting people in who could do some of these things better than we can or have the technical capabilities or the intellectual or some of the competencies and that leads me to the last thing.

If you are going to focus on quality, if you are going to do programs and focus on social determinants, affordability, reducing the cost of care and providing a frictionless kind of digital front door; you have to be able to have data. You have to have not only the right data, but you have to leverage your analytic capabilities because you are not going to be able to do everything I just described. It’s going to be a data driven, consumer focused strategy. And that’s the essence of what our organization is kind of fueling in some of the strategic areas that we’re focusing on.

Host:  That is a great list Jeff. Strategic themes as you call them. So, if I took notes properly, here’s what I wrote down. Quality of care, program growth, affordability, social determinants of care, make sure you have a digital front door, also innovations and partnerships, and leveraging analytic capabilities which then leads you to a data driven, consumer focused strategy. So, let’s talk about strategy now and strategic planning. So, taking all of those great touchpoints that you just gave us; how do we come up with a strategic plan to cover those strategic themes?

Jeff:  So, I think one of the first things, remember, when you are developing the strategic plan, you are doing a few things here. You are looking at thinking about the future and saying, there’s a future that happens to you and there’s a future you create. And you need to get a common understanding of the direction you need to move in. This is about managing change. So, how do you kind of get that common understanding of the future and the need to change? And that’s one of the issues I find with SHSMD, we have an enormous amount of resources. For those of you who are not familiar with it, your time will be extraordinarily well spent if you went online and looked at a copy of Bridging Worlds. Bridging Worlds is really – was designed for the strategist to help them understand and organize all these forces that are happening and what the potential impact might be to your organization.

And you have to take these macro forces and help translate them to your local service area or your marketplace. And that’s one of the great things that SHSMD does is give you those resources. We also have Futurescan which kind of goes through different scenarios and experts help you understand what areas you might take advantage of and of course, there are plenty of other resources that the Kaiser through think tanks, through policy activities, you can get a sense of the environment. At the same time, you have to kind of strategically look at kind of a checklist of what is the capabilities of the organization. What do you need to be successful in the future is something SHSMD helps you identify. Then you got to kind of compare it to what you are doing today and where those changes have to occur.

And I think again, through their planning documents, there is online courses that we give that helps individuals develop those skills that helps your organization. Remember planning is a team sport. It’s not done by a small group of people in a planning office. We are responsible and in fact I say I don’t produce the strategy, I’m not the key strategist. I help coordinate it. I’m more of a quarterback with my CEO who in many organizations is the Chief Strategist. And you have to have – my job is to bring those resources to the organization to help them think through that strategy and how to make it measurable, objective and it to create discreet activities that help you move forward.

Host:  Really well said Jeff on talking about the resources that you bring to the table and how to make them measurable, objective and to create discreet activities to help you move forward. Really important. So, then what is the danger of not having a strategic plan?

Jeff:  Yes. The danger of not having a strategic plan is I think you suffer from what I would call the shiny penny syndrome. Any little opportunity, you kind of get along, you start doing things, you go ready, aim and you go, oh my God, we better start doing stuff with employers and you start moving there and then you kind of the newest thing comes out or Amazon is doing something. Oh we got to put Alexa on the floors and people – you can’t jump around. I think the importance of a strategic plan is you need to create a framework to manage change. And if you don’t have that framework; what are you telling your organization? What direction are you rowing in? What’s important? And you got to align that strategy not only with your management team but everybody in the organization has to be incented to try to accomplish those goals that you’ve set for the organization.

Host:  Right. I love what you said earlier. There’s the future that happens to you and the future the you create. So with the strategic plan, you’re helping to create that future that you want to see.

Jeff:  That’s correct. There’s so much going on in Washington and probably in many of our state capitols. Certainly the federal election will change it. What we have found and what we have been consistent, we have – we go into the bond market periodically to raise capital to fuel this strategy. One of the things the bond rating agencies have discussed about Northwell in particular, is we’ve had a consistency of strategy that is able to adapt and pivot to the circumstances, the policy circumstances; so our strategy has been more or less consistent. Our tactics may have to change because circumstances change. But the overall strategy of growth, of value, of operational efficiency, affordability; has been consistent for many, many years.

Host:  I really like what you said there. The strategy is consistent, but the tactics may change, and I think that’s something for all of us to remember. So, when you said in your role, you don’t necessarily write the strategic plan, you help come up with parts of it and organize it. For someone listening, how can they approach their position in that same way? What should they be doing to help the CEO come up with that strategic plan?

Jeff:  Well, I think one of the most important things you do with to help your CEO and let’s just recognize, every organization is different. They have a different culture. And let’s just be clear, culture will eat strategy all the time. It will just destroy any strategy. If you don’t have a culture of strategic thinking; this is like you are wasting your time. So, presuming you have a CEO that is very focused, I think the most important thing you can do is help simplify the strategy so the communication can be effective. It’s not only communicating it in the C suite, it’s making the people in housekeeping and dietary and the back of the house, on the floor, the nurses, the doctors, both your voluntary and employed staff understand what you are trying to do. So, I think, I’m a big believer in the language of strategy and understanding data driven strategic planning. So, you help your CEO, make sure they have the data and information which supports the need to change and you talk in terms of what I kind of said at the beginning a little.

The strategic themes and then you always take a specific objective and relate it back to a theme or an environmental force that compels you why you have to change. If people don’t believe affordability is a problem and we could charge whatever we want, and nobody is going to ask us about pricing; I think you’re looking at an organization that’s not long for this earth. It’s not going to be sustainable in many markets. If you are in the Upper Eastside of Manhattan maybe and we are. I would even say even there that’s not sustainable. We are in some of the wealthiest, but we are also in some of the poorest zip codes in New York.

Host:  So, some really interesting thoughts there Jeff on affordability which is one of your strategic themes which were again as you outlined, quality of care, program growth, affordability, social determinants of care, making sure you have a digital front door, innovations and partnerships and leveraging analytic capabilities. So, as you were talking about affordability, I was thinking, I’m going to pick Jeff’s brain here for a minute. And I’m going to ask you to look into your crystal ball. Give us another emerging trend in healthcare that you feel we need to pay attention to as we talk about strategic planning and map out the future.

Jeff:  I think it’s the most important thing at some level is essentially the transformation of our business model. Our business model is fundamentally changing. I think the way we’re – we’ve been moving pretty slow from fee for service to value based. I just think we might have over estimated the speed of change on that. But we’ve underestimated it’s impact in the long term. I think a lot of us kind of drag a foot and want to stay in fee for service healthcare as long as they possibly can. But the reality is we’re going to have to move into more value based settings. I think we’re going to strategically develop different relationships with insurance companies.

You can’t tell the difference sometimes between an insurer and a provider and a lot of providers are insurers. I think we’ll see more blending of that and that will be forced by the employer and the government because of the affordability issue.

Host:  Yeah, that’s really interesting. So, you see the biggest emerging trend in healthcare is the transformation of our business model going from a fee for service model and moving into a more value based system. That’s really, really interesting.

Jeff:  Yeah, we haven’t seen the speed, hasn’t moved as quickly in a lot of markets but I think it’s a matter of time because you – and it’s not a Democratic issue and it’s not a Republican issue. It’s a frustration issue.

Host:  Right and then as far as strategic planning as we wrap up, you mentioned all of the great tools that SHSMD offers such as Bridging Worlds. So, is somebody really wants to get into strategic planning and really flesh this out; that’s where you would start is at Bridging Worlds, is that correct?

Jeff:  I think so but go to our website. We have plenty of resources there. We have documents and books on planning that you can use. We have a lot of case studies and we offer some wonderful online experiences. Some of it is on demand, some of it is you pay a small fee to access a class. But I would tell you, it should be the first place you stop for those of us who practice this profession.

Host:  Yeah, that’s really good advice. Just go to www.shsmd.org, click on the resources tab and under that, you’ll see Bridging Worlds. Great advice Jeff. And thanks for your time. I’ve really enjoyed talking with you.

Jeff:  I appreciate it and I enjoyed it and look forward to the follow up. Let’s see in a year or two if I am right.

Host:  All right. I’m going to hold you to that. I’m going to book it right now. Get ready, January 2021.

Jeff:  Fair enough.

Host:  All right, thanks again Jeff. That is Jeffrey Kraut, although I call him Jeff. We’re kind of on a first name basis. I got that going for me. You know. He is the Vice President for Strategy and Analytics at Northwell Health. I get a little loopy at the end of these podcasts. And please join us for SHSMD Connections 2020 where you can learn more about healthcare strategy, specific to marketing, digital engagement, communications, public relations, strategic planning, business development, as well as career and leadership development this year. It’s going to be September 13^th through the 16^th, 2020 in Chicago. And to learn more about SHSMD, please visit www.shsmd.org, that’s SHSMD.org and you can subscribe to this very podcast and check out upcoming SHSMD education events by heading to www.shsmd.org/education. This has been a production of Dr. Podcasting. I’m Bill Klaproth. See ya.