I believe the U.S. healthcare system would have a higher standing globally — and achieve better outcomes for patients — if it placed a stronger focus on wellness and prevention, on chronic disease management, and on more seamless care for patients to prevent Emergency Department use when that level and cost of care are not warranted….
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Scott Nordlund, Chief Strategy and Growth Officer for Banner Health, one of the nation’s largest nonprofit health systems. He has deep experience in healthcare, having previously served in increasingly senior positions at Select Medical, Trinity Health, Dignity Health, BJC Health System, and Baxter Healthcare. He holds two master’s degrees, in health and business administration, from the University of Michigan.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
Growing up, I always wanted to be a doctor, so I spent much of my educational life preparing for that. Then, when I was an undergraduate studying biology and preparing for the MCAT, a physician gave me some great advice. He told me that, given the way medicine and executive leadership were going, I could make just as great an impact as an executive leader as I could as a physician — and not to ignore that as an option in my career journey because I would be able to make a difference in healthcare in a completely different way. That advice made me want to understand more about healthcare administration. Eventually it led me to earn my MBA and MHA at the University of Michigan, and the rest is history.
Can you share the most interesting story that happened to you since you began leading your company?
I left Select Medical in 2018 to join Banner because I wanted to come back to the health system side of things, but I had developed great respect for Select as a post-acute care and rehab provider. Not long after I made that career move, Banner finalized a partnership with Select, and I am now a board member for their joint venture. It is great to know both organizations so well and to be able to help guide our success together.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
I started my career in healthcare consulting at Baxter. On my first project, I was learning how to prepare data analysis for presentation by senior leaders. I was asked to put together a presentation providing updates to an orthopedic study we were doing, so I tried to emulate other presentations in our project library. When we arrived at the client site, the project leader began the meeting and then said, Scott will be presenting our update today. I felt totally unprepared and had not devoted the time I would have if I had known in advance that I would be presenting. Great lesson: treat work for others with the same pride and ownership as if it is your work!
What do you think makes your company stand out? Can you share a story?
I believe Banner is the only health system in the United States that spans the entire continuum of healthcare, from digital health options to quaternary care and from urban environments to critical access delivery. We cover six states and have a huge community delivery arm: we’re the largest healthcare provider in Arizona, the only system with two medical schools (Banner — University Medical Center in Tucson and Phoenix), and Arizona’s largest employer. Our scope makes us a very different organization than anyone else out there. We are pretty heavily into managed care and managed care partnerships. We own a Medicaid managed care plan. We’re partners with Aetna in a large commercial plan. We are also partners in a Medicare Advantage plan. About 20 percent of our revenues comes through true risk-based, managed care-level business. That’s different than others. We have a little bit of everything that health systems are trying.
What advice would you give to other healthcare leaders to help their team to thrive?
I would encourage them to engage and inspire their team members. Banner is really invested in our people and in creating an engaging, appreciative work environment that enables everyone to be at their best. Critical elements of how we approach this at Banner include: setting and implementing high standards for performance and accountability; developing our people, grooming top talent to become future leaders; and focusing on a diverse, world-class talent pool that is truly customer-obsessed. The final thing I would encourage is to create an inclusive culture in order to improve employee engagement, performance, and retention. Engagement and retention are becoming a new battleground of sorts, because your staff will definitely have other options for employment. You want to keep your team engaged and feeling that they are an important part of your organization. Developing and retaining your team will boost your productivity and the results you are able to achieve.
Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
Rankings of various nations’ healthcare systems often focus on assessment of several areas. I see four key factors that contribute to the United States’ low ranking in these reports:
1) Our country does not have universal healthcare coverage, which is often a metric in global health system rankings. Moreover, the U.S. system broadly has very little focus on wellness. With this combination, ours is primarily a “sick” care system.
2) The American healthcare system does not place enough emphasis on managing chronic disease, which accounts for the vast majority of healthcare spending and much of the burden of disease and premature death in our country.
3) The U.S. has very high utilization of its hospital emergency departments (EDs), which results in part from a lack of seamless care. When patients receive care from a patchwork of doctors and clinics that don’t communicate, the odds increase that something will happen that leads those patients to the ED.
4) The U.S. has some of the highest healthcare costs in the industrialized world: prescription drug prices, administrative costs, and defensive medicine — ordering tests and procedures primarily to avoid the threat of lawsuits.
I believe the U.S. healthcare system would have a higher standing globally — and achieve better outcomes for patients — if it placed a stronger focus on wellness and prevention, on chronic disease management, and on more seamless care for patients to prevent ED use when that level and cost of care are not warranted. We must also do something to rein in rising costs. Health systems can do some of this work — and we are pursuing some of these goals at Banner — but other factors will require wise policymaking and a multi-sector approach at a national level.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
Perfect the customer experience. Give the customer an outstanding experience by providing convenient, affordable services. For instance, Banner is working to offer patients and customers a full continuum of care, from wellness and prevention to post-acute care, as well as a health plan, new partnerships, greater physician alignment, and best-in-class digital access for customers. We’re looking at clinical integration, employment, and partnership models, and tightly aligning our physicians and clinicians to our networks. All of these things are critical for the nation’s healthcare system because they ultimately lead to healthcare being more affordable and more convenient. They make customer service experiences better at each interaction, with better integration across sites and services. All of these things are truly important.
Improve our cost position and expense discipline. Our nation’s healthcare system must improve its cost position and expense discipline. Banner is spending a lot of time focusing on performance transformation strategies. By that, I mean enhancing our financial stability and ensuring that we’re prepared to provide services in a more efficient manner that ultimately may allow us to prosper at or below Medicare levels of reimbursement. To achieve this will require strategies like improving worker safety, because workers’ comp costs are a challenge, so that’s a win-win — keeping your employees safe and healthy. Other strategies in this area include looking at optimal performance across all facilities and functional areas; continuing to reduce supply chain purchase service expenditures and clinical variation; optimizing revenue cycle; and managing salary and benefit costs, which are around half of most health systems’ costs.
Help customers and populations become healthier. To achieve this, most health systems in the U.S. need to expand the areas they serve and the types of care and services they provide, in order to improve health for more people. This may mean expanding access and market share within existing service areas or entering new service areas, as well as significantly expanding community-based wellness offerings, ambulatory offerings, non-acute services, and their digital health footprint. We must continue to foster a high-performing academic medicine enterprise. To better support customers and health plan members, build an effective provider network that’s attractive to customers, grow membership through that network, diversify non-acute holdings, and expand digital business opportunities.
Provide connected care and service. The level of connected care and service must improve. An important part of this will be developing world-class levels of electronic connectivity — between physicians, nurses, patients, and frontline workers — so that customers have a great service experience and higher-quality outcomes and so the system delivers more efficient care. It will also involve successfully implementing connectivity of electronic medical records across multiple sites. It’s a difficult experience when a customer goes to a different facility within the same health system and is treated as if they’ve never visited that system before. We have to improve that experience.
Prioritize enterprise data strategies. For the above to happen, enterprise data strategies will be very important. Many health systems will find themselves facing data governance issues — how to manage data across a system in a way that is a competitive advantage. This will be a key component in improving population health.
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Thank you so much for these insights! This was so inspiring!
About the Author:
Originally from Israel, Limor Weinstein has been anorexic and bulimic, a “nanny spy” to the rich and famous and a Commander in the Israeli Army. Her personal recovery from an eating disorder led her to commit herself to a life of helping others, and along the way she picked up two Master’s Degrees in Psychology from Columbia University and City College as well as a Post-Graduate Certificate in Eating Disorder Treatment from the Institute for Contemporary Psychotherapy.
Upon settling in New York, Limor quickly became known as the “go to” person for families struggling with mental health issues, in part because her openness about her own mental health challenges paved the way for open exchanges. She understood the difficulties many have in finding the right treatment, as well as the stigma that remains so prevalent towards those who are struggling with mental health issues. She realized that most families are quietly struggling with a problem they’re not comfortable talking about, and that discomfort makes it much less likely that they will get the help they need for their loved ones. She discovered that being open and honest about her own mental health challenges took the fear out of the conversations. Her mission became to research and guide those families to the highest-quality treatment available. Helping others became part of her DNA, as has a commitment to supporting and assisting organizations that perform research and treatment in the mental health arena.
After years of helping families by helping connect them to the right treatment and wellness services, Limor realized that the only way to ensure that they are receiving appropriate, coordinated and evidence-based care would be to stay in control of the entire treatment process. That realization led her to create Bespoke Wellness Partners, which employs over 100 of the best clinicians and wellness providers in New York and provides confidential treatment and wellness services throughout the city. Bespoke has built its reputation on strong relationships, personalized, confidential service and a commitment to ensuring that all clients find the right treatment for their particular issues.
In addition to her role at Bespoke Wellness Partners, Limor is the Co-Chair of the Academy of Eating Disorders. She lives with her husband, three daughters and their dog Rex in Manhattan.
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