Executive Education Program
April 21–24, 2009
**Please Note**
The following information is currently being updated. The program below reflects information from 2008 and is subject to change.
Session Descriptions
Framing the Forces of Change
Tuesday, April 21, 3:00–5:00 pm
David A. Shore, PhD
Director, Forces of Change Program
Director, Trust Initiative
Harvard School of Public Health
Health care greatly exceeds most other markets in its complexity and vulnerability. The sources, directions, and implications of change are nearly endless. For many participants in this volatile undertaking, the evolution of the health care market is an unending source of anxiety and confusion. We begin with a topographical sketch of the dominant challenges and questions, and with one clarion call: succeeding in the evolving marketplace demands that we think differently. Are you ready?
Stakeholder Conflicts and the Tragedy of the Commons:
Moving Beyond Winners and Losers (Includes Participant Reactor Panel)
Wednesday, April 22, 8:00–9:45 am
David A. Shore, PhD
The system of health care in the United States is anything but systematic. In contrast to other more efficient markets that feature clearly defined buyers and sellers, U.S. health care comprises a disorganized aggregate of diverse parties and groups, each of which relentlessly pursue their interests without coordination or regard for the interests of other stakeholders. Moreover, traditional market mechanisms rarely operate in this arena. Governments account for nearly half of the nation’s health care, while the interaction between purchasers and patients is mediated by payers, and hospitals and providers occasionally operate as near monopolies.
Consequently, stakeholders view health care as a competitive enterprise, where gains by one imply losses by another. Following the retreat of managed care, we have witnessed increasingly hostile interactions between providers and payers, between health plans and employers, between employees and payers, and many other conflicts. Stakeholder groups rush toward merger agreements in order to gain “leverage” over other groups. The resulting waste and market inefficiencies threaten the very limited resources available to all groups. Fortunately, alternatives to this “Tragedy of the Commons” are available. Stakeholder relations can be reconfigured to feature periodic collaborations and tacit accommodations. This transformation requires that stakeholders rethink their relations and identify areas in which their interests and expertise converge, rather than simply focusing on where they compete.
Balancing the Forces of Change to Achieve Organizational Strategic Objectives
Wednesday, April 22, 10:15–12 Noon
Tom Lee, MD
Chief Medical Officer
Partners HealthCare
Allen Smith, MD
President and CEO
Brigham and Women’s Physician Organization
Andy Whittemore, MD
Chief Medical Officer
Brigham and Women’s Hospital
Panel participants from the Partners Health System, the Brigham and Women’s/Faulkner Hospitals, and the Brigham and Women’s Physician Organization families will present their perspectives on balancing the forces of change impacting facets and functions of their organizations. The discussants will address the many stakeholder issues which present opportunities for collaboration and/or competition, as well as threats. Particular emphasis will be placed upon health care reform, especially within the Commonwealth of Massachusetts; governmental relations/political issues; high performance medicine and pay-for-performance; physician and hospital networks; quality and patient safety; and payer relationships. The panel will welcome questions and discussion from their colleagues who are attending the session.
Breaking Down Silos:
Merging and Managing Diverse Stakeholder Interests in Hospitals and Health Systems
Wednesday, April 22, 1:00–2:15 pm
Michael J. Dowling
President and CEO
North Shore-LIJ Health System
Successfully leading complex organizations involves the management of constituent politics — the bringing together of the various stakeholder groups and guiding them toward a common mission. This is of particular import in health care where many of your collaborators can also be your competitors. This session will discuss these issues and suggest some strategies on how best to resolve these inherent conflicts. Handling constituent politics is not just the province of government. It is key to organizational success.
The Changing Market in Health Care
Wednesday, April 22, 2:45–4:00 pm
David M. Cutler, PhD
Otto Eckstein Professor of Applied Economics and Dean for the Social Sciences
Faculty of Arts and Sciences
Harvard University
Change dominates the current health care market. Rising costs, falling insurance coverage, uneven patterns of quality improvement and regression, and growing commercialization have wrought profound transformations. This session will explore how two fundamental factors have driven the medical sector to where it is today: technological innovations in treatment methods and a reimbursement system that rewards quantity over quality. The session will illustrate how these factors lead to high cost and uneven quality, and how these conditions increase pressure on the uninsured and fuel commercialization of care. The session concludes by outlining different frameworks for harnessing market forces to promote productivity.
Socratic Dialogue
Wednesday, April 22, 4:00–5:00 pm
Moderator:
Marc J. Roberts, PhD
Professor of Political Economy
Department of Health Policy and Management
Harvard School of Public Health
Roberts draws upon the time-tested Socratic method in enticing participants to share their reflections on the program’s initial sessions, and the implications for the future of the health care industry. Participants will explore the central issues and debate the relative merits of available strategic options.
Making Health Care Safer and More Humane
Thursday, April 23, 8:15–9:15 am
Lucian L. Leape, MD
Adjunct Professor of Health Policy
Harvard School of Public Health
Despite the publicity garnered by the patient safety movement following the Institute of Medicine’s reports in 2000 and 2001, progress in the nation’s hospitals and other health care institutions has been agonizingly slow. Apologists note that moving to safe health care demands a change in culture comparable to that undergone by the aviation industry several decades ago. According to this view, effective change will take time. Others note that there are structural impediments that need to be resolved before significant change can take place. We will examine several of these structural barriers.
Pay for Performance, at the Tipping Point. Will it Get Us Where We Want to Go?
Thursday, April 23, 9:15–10:15 am
Arnold M. Epstein, MD
John H. Foster Professor and Chairman,
Department of Health Policy and Management
Harvard School of Public Health
Quality of health care in the United States remains far from ideal. The expectation that efforts by health care providers in quality improvement would transform the delivery system has not been realized. In response, we have growing efforts in both the private and public sectors to better align payment with quality of care. It seems likely that use of financial incentives to improve quality will continue in coming years and become even more widespread. This session describes the developments in the delivery system that gave rise to “pay-for-performance,” the nature of prototype payment systems to encourage greater quality of care, the evolution of these systems as they have matured, the response by providers to date in terms of improving quality, and the challenges that confront us as we look to these approaches. The session concludes with a discussion of the policies most likely to improve the quality of care.
Redefining Health Care:
Creating Positive-Sum Competition to Deliver Value
(Includes Participant Reactor Panel)
Thursday, April 23, 12:45–2:15 pm
Michael E. Porter, PhD
Bishop William Lawrence University Professor
Harvard Business School, Harvard University
The U.S. health care system is in crisis. The quality of care and financial well-being for millions of individuals and employers are at stake. Skyrocketing premiums and the instability of federal and state government budgets threaten American health care. This session outlines a central and largely overlooked origin of the crisis: the zero-sum competition that encourages health plans, networks, and hospitals to accumulate power and restrict services, rather than to create value for patients. The session directs attention to encouraging competition where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Strong evidence suggests that the promotion of positive-sum competition will produce dramatic improvements in health care quality and efficiency.
How Emerging Science Will Change the Future of Medicine and the Delivery of Healthcare
Thursday, April 23, 2:15–3:45 pm
Harvey V. Fineberg, MD, PhD
President
Institute of Medicine
Rapid advances in technical capacities often outpace individual and collective capacity for judgment about the use of technology. New advances in genetics, for example, raise questions about the integrity and identity of persons and introduce opportunities for wrongful discrimination and other adverse consequences. Dr. Fineberg will discuss how new technology will transform the health care system, and offer insight for those seeking to avoid the pitfalls and maximize the potentials of these innovations.
Turning Soft Assets into Hard Power:
Leveraging the Tangible Power of Your Most Enduring Intangible Assets
Thursday, April 23, 4:15–6:00 pm
David A. Shore, PhD
Of the many factors contributing to individual and organizational success, none is more important than reputation. A highly valued reputation allows a brand to stand out from the crowd, comprising a “competitive moat” in your market. In the health care field, there is compelling data to suggest that the organization that owns a reputation for trust owns its marketplace. A trusted reputation for high quality programs, products, and services is good medicine, good business, and great leadership — it is both a mission-driver and a margin-driver. This practical session moves beyond simply documenting the value of brand, reputation, and trust-building. We will focus on how to build your organization’s capacity for trust and trustworthiness, and how your organization can translate that capacity into a trusted reputation and brand.
Reframing the Human Capital Debate:
Aligning Business, People and Engagement Strategies to Sustain High Performance
Friday, April 24, 8:00–9:30 am
Roselyn Feinsod, F.S.A.; Debra A. Canales
Employee engagement “powers” the employee-customer-performance chain. Organizations have far more ability and control to raise engagement levels than they typically assume. For hospital leadership, the message is clear: You have enormous untapped potential to engage your workforce in behavior that adds value and delivers on your strategic goals.
Using insights, analytic tools, and real-world experiences, we’ll examine how to tap into this potential, taking into account how the unique aspects of each organization’s strategy and culture need to come together to create a truly differentiated high-performance work environment.
We’ll also explore a rigorous method to translate business strategies into specific drivers of performance at the organizational and individual level and to use those drivers as the foundation for developing business, people, and reward practices and programs that yield the right kind of performance from all segments of today’s diverse workforce.
Capstone Workshop
Friday, April 24, 9:30–12:30 pm
David A. Shore, PhD
There is nothing more elemental to the work of leaders than producing results. Leaders are the force that ignite change. All too often, however, the desired results are not achieved and a new initiative falls flat. Walt Disney said, “If you can dream it, you can do it.” Not so fast, Walt. Many brilliant ideas have floundered or even died due to the lack of an activation-implementation strategy. Moreover, leaders get little credit for their brilliant ideas unless they can also bring them to market.
The Forces of Change model demonstrates the dominant market dynamics driving the future of health care. This interactive workshop will present the fourth phase of the Forces model, the Corporate Activation & Management Program (CAMP). CAMP offers a set of activation mechanisms for stakeholder groups to use both internally and externally. These mechanisms increase the likelihood of success for new initiatives. We will spotlight four prerequisites necessary to overcome pervasive inertia, resulting in greater organizational effectiveness and efficiency.
We conclude this workshop with an ending well exercise, prompting participants to draft a plan of action for bringing the lessons and strategies of the program to bear on their particular organization. We explore mechanisms for translating ideas into specific actions. We also draw upon our collective experiences to evaluate available techniques for enlisting the support and advice of colleagues.
We look forward to your active participation in CAMP.
For fees, payment policies, and registration, click HERE.