4 retiring health system CEOs share their advice for successors

Kelly Gooch - Monday, March 29th, 2021

As CEOs prepare to retire, they are telling their successors to prepare for uncertainties and decision-making challenges.

Below is their advice.

Ed Bruff. President and CEO of Covenant HealthCare (Saginaw, Mich.): Expect the unexpected. Things change in all organizations, but do your best to anticipate it. The organization is built on a strong foundation of values. Staying in line with our culture, focusing on what's in the best interest of the patient and employees, will always lead you in the right direction.

Mark Laret. President and CEO of UCSF Health (San Francisco): There is a long list of potential opportunities and risks to prepare for, but the primary issue I believe every health system executive needs to prepare for is a significant reduction in payments for the services we provide.

The ability of private industry to continue to cover increased healthcare costs — exacerbated by the growing cost-shift from public payers — has diminished and will continue to do so. Private industry will find alternatives to absorbing higher costs, including through transferring risk to employees/patients (higher deductibles or copayments, or providing lump sums and letting employees/patients shop for health insurance themselves). After COVID, the federal government will inevitably return its attention to deficit reduction, and every health system should prepare for actions like Medicaid block grants, or Medicare payment reductions or risk transfer to providers. These de facto payment reductions will be especially difficult for health systems to absorb when payments from Medicaid and Medicare already fail to cover the costs of care.

All of this will put a premium on organizations operating at the highest levels of efficiency, innovating to provide less labor intense and less costly models for caring for specific patient populations, and prioritizing among many important nonpatient care services the health system currently subsidizes.

Mel McNea. CEO of Great Plains Health (North Platte, Neb.): You have to have courage to work in the healthcare industry and even more so to be the CEO of a health system. Daily, you will be challenged with making decisions about direct patient care, new equipment, technology, process changes and so on. How do you manage the growing revenue commitments, such as constant monitoring of patient information, the explosion of software and the associated costs? These are just some of the uncomfortable decisions you will face as a health system CEO. You may never get comfortable, and that's OK. Change is constant in healthcare, and the demand to find balance in protecting the bottom line and providing the highest quality patient care is a challenge you will face. However, it is also inspiring. We are doing some amazing things in healthcare, and it has truly been a privilege to be a part of it.

Mary Starmann-Harrison. President and CEO of Hospital Sisters Health System (Springfield, Ill.): My advice to my successor is to be sensitive to the impact of COVID-19 on our colleagues and organization — the need for healing, the resilience of our colleagues and our organization adapting to the increased pace of change in healthcare. At the same time, a focus on strategy for future growth is key.

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