The evolving leadership role in healthcare

Our Discovery Expert Perspectives series brings you thoughts, advice, and opinions from experts across the healthcare ecosystem. Discovery maintains an ongoing partnership with these experts to enrich our understanding of the industry and shape solutions that deliver profound value to our clients. We are proud to share these experts’ unique perspectives with you.


We’re all well aware of the many challenges facing our industry and our country right now. A perfect storm of a pandemic, political turmoil, economic stress, and current events have people feeling under siege. Add to that a healthcare industry that is continually under fire and buffeted by changes. Sheltering in place, working remotely while balancing both family and work commitments, and an extremely polarized country have created some truly stressful times.

But out of this chaos comes an opportunity to rethink how we in the healthcare industry do business. It’s an opportunity to create an inclusive corporate culture where people feel they’re doing something important. It’s also the perfect time to rethink how we bring people into the workforce who can work well remotely and independently, yet still add to the sense of community we want to maintain.

The impact on the workforce

I personally know many people who are feeling disconnected, stressed, and overwhelmed right now. It’s the job of the leadership team to make people feel good about where they are and confident that the company can navigate through the chaos. That’s a pretty challenging assignment for leadership!

Leading in the new normal

Evolving leadership in the healthcare industry is more than just being reactive. This could be the moment for companies to get it right, to turn the box upside down and try to put the puzzle back together in a different way. An opportunity for companies to become compelling places for people to work and add value. Recognizing that something like the coronavirus could happen again—how do we prepare for it in the future? The legacy of COVID isn’t going away in a month or two—we could be looking at a year or two.

We need to rethink our formula for success both short- and long-term.

Some things leadership needs to consider

  • How do we need to change talent recruitment and development to prepare for the future?
  • How do we recruit people who can work well remotely and independently, but who still want to be part of a group?
  • Are we spending our money on our employees in the right places?
  • What’s the profile of someone who can adjust to this new environment and thrive in it?
  • How do our systems support adaptability and flexibility of individuals?
  • How do we create a pipeline of diversity and make inclusion part of the corporate culture?

We need a plan B

Healthcare companies are beginning to grapple with the issue of how to create a sense of community and identification in a fragmented world. And that’s going to take some thought in terms of what is it that people treasure, what is it that they really value, and what is it about your company that they identify with. And if there isn’t anything they identify with, why not?

Corporate cultures have typically tended to minimize creativity and innovation individually and in teams. Going forward, I think the only way corporate cultures are going to survive is if they are committed to having the best ideas and developing new responses.

To understand the answers to these questions, we must listen to what our employees say. The new model has to give employees the tools they need and recognize their capacity for individual thinking and creativity.

Leadership needs to rethink what you need to accomplish as an organization—5 years or longer. Rather than look at efficiency—the most results with the fewest people—you will have to think about how to improve community productivity.

For example, in the past, you would have had people come to a meeting and work on a project together. You assumed everyone knew each other. But in this world, you will have to make a real effort to help them.

It’s the perfect opportunity for companies to reinvent how they get work done.

My personal trainer was forced to rethink his company because no one wanted to go to the gym. He now makes most of his money doing virtual training. He has scheduled a lot more people because now he doesn’t have to go back and forth to clients. He’s making more money than before.

He rethought how he did the work—which is what’s needed in companies large and small across the country.

We may be looking at several years of change. It’s no doubt a chaotic environment—but it could be a creative one if we rigorously review what works and what doesn’t and rapidly eliminate the latter.


Two books I recommend: Leadership in Turbulent Times by Doris Kearns Goodwin and The Splendid and the Vile by Erik Larson.


Get inspired by leaders who led through difficult times

True leaders offer people a sense of security and a sense of focus. They serve as a beacon for people. In The Splendid and the Vile by Erik Larson, you see how Churchill allowed the British people to feel that they would get through this, that they were moving forward. He never lost courage and his courage bolstered the entire nation.

Another great read, Leadership in Turbulent Times by Doris Kearns Goodwin takes a look at four inspirational presidents who steered our country during chaotic and turbulent times. Lincoln had to deal with a civil war and social injustice that threatened to destroy a nation not yet 100 years old.

Both Churchill and Lincoln shared a quality of exceptional leaders—that sense of identification and connectedness with their people. Both of these leaders stayed close to their people. They also provided their people with a clear vision of the future as well as a realistic vision of failure.

People don’t look to leaders for specific answers, but they do expect and value integrity, principles, commitment, and courage. A frazzled employee who is balancing work and home schooling wants to know the person leading the company appreciates them and will be flexible enough to allow them to solve problems without unnecessary restrictions.

Amanda FoxThe evolving leadership role in healthcare
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The known unknowns of healthcare and health policy

It seems like eons ago that we were all out and about—mask-less and mingling with others. But things have certainly changed in the months since the pandemic struck. We’ve had to make some major shifts in our lives, and phrases like social distancing, virtual learning, and Zoom calls have become part of our everyday vocabulary.

Our world has changed a fair bit—especially so in healthcare

At Discovery Health Partners, we have transitioned to a fully remote workforce—as many of you have—and we are getting pretty good at navigating this new normal.

In our ever-evolving landscape, we’re thinking about what the next 12 to 18 months may look like and what unknowns we face. Here are some of the trends we’re watching and the implications they may have:

  • Reduced elective procedures during the pandemic—and how it affects member acuity
  • Increase in the telehealth adoption—and payment integrity issues surrounding appropriate telehealth billing patterns and coding
  • Reduced motor vehicle traffic during the pandemic and potential long-term reduction in motor vehicle traffic from a shift to working from home—and how this affects subrogation activity

We recently hosted a virtual client council meeting to discuss the future of healthcare and payment integrity with healthcare policy analyst Susan Dentzer as our keynote speaker.

In her “Health policy and the 2020 elections: what’s ahead?” keynote, Susan shared her fascinating perspectives with us about the “known unknowns” we can expect to encounter in this highly uncertain time.

Expected changes in health insurance coverage

According to Susan, we’ve never seen anything like our current set of circumstances any time before in modern history:

  • Known knowns: COVID-19, a weakened economy, ~30 million jobless, more uninsured
  • Known unknowns: the course of the pandemic this fall and winter, the outcomes of presidential and congressional elections, the course of economic recovery
  • More known unknowns: depending on the outcomes of all the above, what health policies will be on the table? What will or can be enacted?
  • Unknown unknowns: how will 2021 overall look in relation to 2020—in almost every respect?

She shared her insights about the impact of the coronavirus on the economy (“covidomics”) and what we could possibly expect to be the future of healthcare.

One of the biggest changes we can expect to see, according to Susan, is the rise in the uninsured rate. Even before COVID hit, she says, there were forces underway that would affect health law changes.


Projections show 3.3 million of those people will regain employer-sponsored insurance by being added to a family member’s policy, 2.8 million people will enroll in Medicaid, and 600,000 people will enroll in the individual market, mainly via the Affordable Care Act’s marketplace. Still, 3.5 million people will become uninsured.


“In a fair number of states,” Susan commented, “we’ve had at least modest rises in the uninsured rate. We knew that we were going to have this uninsured problem even before the pandemic, and then the pandemic hit.”


An estimated 48 million nonelderly people in the United States will be part of a household in which someone loses a job due to COVID-19, based on an assessment of pandemic-related job loss.


She pointed to Urban Institute research on coverage projections in the wake of pandemic-related job loss, in which 48 million people live in families with a worker who will have experienced COVID-related job loss in 2020.

“The Urban Institute estimates are, when you net all this out, about 3.5 million more people are likely to become uninsured as a consequence of the pandemic,” Susan said. “We had a big pool of uninsured, and now we’re adding potentially 3.5 million more people who are dreadfully uninsured as a consequence of this pandemic. The implication of this rise in uninsured population will likely be….???”

Rising Medicaid enrollment strains states’ budgets

Susan also discussed with us the impact of rising Medicaid enrollment on states’ budgets—already stretched too thin—and the toll that Medicaid providers are experiencing. “Medicaid enrollment has risen, and we have states in an enormous amount of fiscal difficulty at this point,” said Susan. “The degree to which that particular set of increments to Medicaid can be sustained is really in doubt. In some cases, the states’ revenues are so damaged that the state has compensated by cutting payments to providers.” This is not a sustainable solution by any stretch—some providers will stop accepting Medicaid, while others may continue to accept Medicaid but provide less care. Ultimately, this could create an inability to access quality care for a large segment of the country’s population.

And the challenge to state Medicaid programs will not get any easier in the near term. According to the Center on Budget Policy and Priorities, the unemployment rate will average 10.6 percent over 2020 and still be at 7.6 percent by the end of 2021. That would be the highest annual unemployment rate since the 1930s. Coupled with that, the U.S. economy is declining more sharply compared to the Great Recession of 2008. Certainly, Medicaid will be a key central issue over the coming months as states devise strategies to provide healthcare coverage to more people, control the pandemic’s impact on individuals’ health coverage, financially support providers’ viability, and balance their budgets.

What’s ahead

As we all know, a host of other healthcare issues remain—affordability, regulation of pharmaceutical prices, value-based payments, data sharing, and price transparency. Amid these multiple uncertainties, we will continue to monitor how the pandemic has transformed the healthcare policy landscape and share our insights with you.


About Susan Dentzer

Susan DentzerSusan Dentzer is one of the nation’s most respected health and health policy thought leaders, top healthcare keynote speaker, a frequent commentator on television and radio, including PBS and NPR, and an author of commentaries and analyses in Modern Healthcare, the Annals of Internal Medicine, and the New England Journal of Medicine. She is also the editor and lead author of the book Health Care Without Walls: A Roadmap for Reinventing U.S. Health Care.

Jason BrownThe known unknowns of healthcare and health policy
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