Bridging the information gap
For Chris Godfrey, senior vice president at Dallas-based venture capital firm HealthCap Partners, market signals are often missing in healthcare,
resulting in more uncertainty and less efficiency in the deployment of human and capital assets. His project revolves around
Bloodbuy, a small start-up enterprise he founded to create a more transparent and structurally cohesive process for the exchange
of price information and supply of blood products between distributors and hospitals.
"If you want to improve the market," Godfrey says, "the best place to start is with the core commodity of healthcare, which
is blood. Essential services literally cannot be provided without it, so I see it as a critical pathway into the health system—and,
unfortunately, the logistics of pricing and supply devised by blood center distributors are often non-transparent and lack
much accountability to the hospitals that depend on predictability in the supply chain. Godfrey notes that the FDA mandates
uniform standardization in the composition of blood products, which means there should be little differentiation in pricing—the
product itself is the same. Yet a strong spot market exists in many parts of the country for blood products, with the result
that hospitals face wide gaps in what they have to pay for blood, making it harder to accurately account for their needs.
To remedy this, Bloodbuy has developed data technology to help hospitals overcome the fragmented supply chain and lack of
transparency in pricing by broadcasting their blood needs to a broader audience, avoiding the traditional dependence on a
few local outlets. "It's essentially about diversifying risk, so that as a hospital I am going to have a better chance of
getting the blood products I need, when I need them, at the optimal price point." It also works for the blood centers, which
face a strategic dilemma as reform slows acute care utilization, which leads to less demand for their commodity. "Bloodbuy's
technology enables them to address this slowdown by helping them penetrate new geographies and acquire new customers." It's
a precision response to a gap unmasked by the drive toward system reform, helping customers out of their silo to connect to
a relevant area of unmet need, with greater efficiency at each end of the market as the intended result.
Star power: Enlisting the sales force
Debbie McKee, general manager for upstate New York and Connecticut at United Healthcare's Medicare and Retirement unit, works on the front
line of the insurance industry's efforts to adapt to new mandates under the ACA on cost-efficiencies in the delivery of health
services to seniors. Her Critical Challenge project is based on United Healthcare's commitment to accelerate the number of
star ratings it receives for quality of services provided to enrollees in the company's Medicare Advantage beneficiary plans.
This is important financially to all insurers because the ACA now conditions reimbursement and bonus payments through Medicare
on the quality star rating achieved by each plan, with CMS evaluating plan performance across 53 specific quality measures.
"My project confronts an important silo that can impede our progress against this goal, which is the failure to mobilize United
Healthcare sales agents to help win those higher ratings. We have hundreds of colleagues engaged in selling a plan and helping
to service the contract with the member, yet having no input around the execution of the company's star rating strategy."
With management support, McKee and her team have initiated a pilot program covering eight markets in United Healthcare's Northeast
service area. It gives sales agents assignments to ensure that members in their territories are on target in implementing
preventive care programs, especially the wellness checks that patients often fail to utilize. "So far, I have been surprised
by the number of people in sales who see this as evidence they are part of the wider solution to the cost of healthcare. Her
training at EMHL is helping McKee take the pilot to the next step, which is aligning individual pay and bonuses around this
broadened service orientation. "We have to provide a firm response to the root question of economic incentive: what's in it
The learning organization: Testing old boundaries
Jun Sutherland, worldwide director, education and learning for J&J's Infection Prevention Practice, has built his career helping life science
organizations keep pace with the heady pace of scientific discovery and the obligations it places on key functions ranging
from regulatory compliance to ethics and reputation management. His Critical Challenge project is arguably the most ambitious
in the group, given its scope: bridging what he calls the "learning gap" as big Pharma copes with trends like globalization
and high-cost drug development, where the common thread is seeding "the will to cooperate" as a cultural imperative. Says
Sutherland, "the way we educate our own workforces is very siloed. Technical training always tends to relate to specific job
roles and leadership development is driven largely by internal issues rather than relating to the wider world of healthcare,
especially that 'trifecta' of patient/customer expectations around cost, quality, and access."
To address this challenge, Sutherland has secured financial and leadership support for a pilot project in his Infection Prevention
Practice, to launch in the first quarter of 2015. The centerpiece is a core healthcare learning curriculum for new employees
and managers in three departments of the Practice: sales, marketing, and clinical/provider education. Six to eight course
modules are being planned, including an introduction to the ACA and J&J's corporate response to its key provisions; how the
innovation process works internally, outlining the distinction between invention and innovation; and what each function can
do to engage more productively with the external stakeholder environment.
J&J, as a highly decentralized organization with some 250 separate operating units, might seem averse to any overarching approach
to educating employees. But Sutherland was able to address this by securing approval from the company's Global Management
Board, and the Board member representing the Infection Prevention Practice authorized the budget to fund the pilot. The Board
will decide later next year whether to make the pilot permanent and to roll the concept out to other parts of the company.
Says Sutherland, "this is a change management initiative, so it's not unusual that in a large organization like J&J we have
to try this out to see how it flies. Where I am going with this is to get our top executives to understand that change in
this industry is permanent—organizational learning ultimately can't be applied piecemeal. And we have to be in it for the