Bridging the Provider-Payer Divide: Leadership Lessons from Kenyokee Crowell, MBA

<p>hello everyone this is Cole from the American Journal of healthc care strategy I'm joined by a very special guest kenoki kenoki please introduce yourself hi good afternoon thanks for having me Cole um my name is kenoi croll and I am a senior Healthcare leader um I have sign significant experience working on both the provider and payer side uh based in the Pittsburgh area um for the last uh seven years of my career I spent at a very large Healthcare organization uh in the Pittsburgh area and since last uh summer I uh took an intentional intermission from my career uh to pursue some personal interests and travel extensively which has been really great and I'm also staying uh you know professionally active and I um serve as an executive leadership coach and have had the opportunity and privilege to coach uh some folks and um also the opportunity to do a little bit of Consulting on customer engagement and customer uh collaboration during this little bit of an intermission that I'm taking so thanks for having me [Music] today so happy to have you you've been in this field for it looks like 24 25 years right yes yes yes um a long time time um and kind of getting to the point where sometimes you don't want to put all the years of experience you have in an industry because it's been uh many many years but it's been um amazing and I've had the opportunity over those years to work in just about every area of healthc care um which has been fantastic and um it's a industry I'm passionate about um and it's a very customer Centric in uh industry which I'm also passionate about so it's been an amazing amazing career so far looking at kind of your LinkedIn resume here you worked in kind of operations at Cleveland Clinic um and then you did physician integration clinical access at High Mark uh Clinical Services and then a clinical organization and so you you've gotten both leadership of teams at Cleveland Clinic like you mentioned on the the healthc care side and then at High Mark on the insurance side of things what benefit did it give you to know both the hospital you know Health provider end and the insurance side of things that's a great question and I will tell you um having the opportunity to work and learn both sides I would say that's probably one of the most beneficial uh things that I've done in my career and I think for so many of us we work in one lane or the other and as you know uh working in healthc care yourself um there are a lot of disconnects sometimes that can exist between those two sides um in terms of how we understand each other the language that we speak um which is often different um and how we collaborate and problem solve um so for me I think to be able to work in that lane as well and learn that and impact meaningful work um it really just expanded my language um and my fluency in healthc care as an industry and it really gave me deeper insights and more robust insights into the problem solving finding common ground um and really aligning uh different parties around common goals so for me it was an excellent choice to take that leap um and really have learned a lot of things that I think will carry me um uh well through the rest of my career I agree I agree I I mean looking at at the resume and already talking with you briefly it's you know you can tell that you're you're knowledgeable about kind of the 360 degrees of healthare one of the areas that I'm particularly interested in right now with all these mergers and Acquisitions physician shortages is the four years that you spent as a kind of doing physician integration at Cleveland Clinic what were your outcomes there for that what are some of the challenges you faced and how did you overcome them sure sure so without kind of sharing anything confidential on the organizational strategy I would say that um aligning Physicians I think um just as an industry industry practice is a is an important um thing to do and I think um when you're looking at doing that whether you are a healthc care organization that is acquiring facilities meaning hospitals or clinics or cancer centers or acquiring practices or just looking at new and unique ways to align um uh providers with your organizations I think the outcomes that you are going to desire is number one you want to be able to have greater continuity of care for the patients that you are serving um which should improve outcomes and quality of of care um you also want to enhance the partnership levels that you have with those providers and when I say partnership I don't necessarily mean signing a contract saying you will do this for me but really kind of being and living in the same space together um and that can have impacts on um making sure patients get the care that they need when they need it Greater collaboration between referring providers greater collaboration and cooperation when it comes to things like uh throughput and making sure patients are discharged timely um and have the resources that they need it just kind of elevates the communication game um is in a lot of different ways and it can improve outcomes for patients I I really feel strongly about that and I I agree and here's one of the problems that I see though is that you know we we have physician leaders who still practice they go in and they work with their fellow Physicians but you're not a physician yourself neither am I how can we be involved with them as non-physicians how could we get that you said that shared space that is um that's an excellent question and it's I think a million-dollar question and um I will say my entire career I've worked with f Physicians and clinicians and have an extraordinary amount of respect uh for the skill and commitment that they have and I think for me um I really once I truly understood in a very robust way that um doctors want to be able to do what they do best which is caring for patients and typically in my career when I've seen that you've got a mismatch of understandings or some conflict with the provider that you're trying to collaborate or work with it usually goes back down to that principle and the fact that maybe we as non-clinical leaders and administrators in health care we may be doing something that is interrupting or making uh that charge to care for patients more more challenging or more difficult or um we are trying to move fast and Implement change but we haven't done a great job at making sure one we have all the right voices at the table in terms of if we're creating new things or changing things and moving cheese for lack of a better term that's going to affect um how provider see and care for patients we should bring them to the table and we should ask them their opinion and we should engage them in a meaningful way in that and then I think also too have we as administrative leaders and non-clinical leaders have we created a compelling value proposition and actually help them understand how what we are trying to accomplish is actually a mutually beneficial thing um so I think we have to um as non-clinical Leaders we have got to meet our clinical colleagues where they're at and understand um what they are trying to accomplish and at the end of the day in healthc care we are all here to serve the patient period I don't care what role you have we are all here to serve the patient improve the health of the population and we've got to understand and respect that providers um and and any clinician for that matter they are the closest to that um and we need to respect that we need to try to understand it and we need to try to collaborate in a more effective way and um I feel in my career I've been able to successfully do that um that doesn't mean that I have not had providers and Physicians during my career that were not happy with me or that I was dealing with conflict and that's expected um because I think honestly if you go through your career as a administrative leader working with clinical leaders and everybody that you work with that's a clinical person is like oh that's fantastic that's great chances are you aren't challenging the system enough and bringing them to the table as partners or you're not being honest with them about what the change and the impacts really are which is not good either because we know you know I I like to be involved with a few physician groups and we know even amongst Physicians there is disagreement there is um struggle to try to push us in a better Direction right and that's something that even goes on in the groups do you think that maybe part of the problem isn't so much of that disagreement or that confrontation as you said but more so the avoidance that sometimes administrators can take out of fear right if we don't hear the problems if we don't talk to them if I could hide in my office or or work remote Etc then I don't have to deal with it um I I think part of it is um I think we in general Ro in the healthcare industry and we're probably not the only industry we have to do a better job at having difficult conversations in the right way and engaging in that courageous dialogue and I think that you're right if you're working remotely and um you're not willing to roll up your sleeves and get in it um it's easier in the short term but as boys are going to cause huge problems in the long term so I think um and I think that's something we have to work at too of course that sort of dialogue and engaging in that way um which can sometimes be tense but should always be professional and collegial um that that doesn't come as a natural ability to a lot of people um or um they don't have enough political Capital built up with that audience where they can navigate that successfully and I think that's when it goes back to if you're only engaging with the providers that you're working with when there's a problem or there's a change um you can't expect that they're going to always receive that well and I think um as you know it's all about building relationships with all those stakeholders and kind of investing in that throughout the process um which isn't going to make the conflicts and any issues ues or any disagreements on what direction to go and strategically go away but it's going to arm both parties to actually come to the table and have that dialogue and I think we got away from that a little bit I think in covid um because everybody kind of went to their own corners and did their own things um but I think whether you're still in a fully virtual environment a hybrid environment or an in-person environment you can still kind of cultivate those connections in a meaningful way but you have to make the effort in order to do that right no 100% I I love that and then and I I mean I've seen the rewards of doing that with a lot of my leaders who take tremendous time to connect with with Physicians or clinicians or just other members of their organization one of the struggles I want to ask you about is is at High Mark right you're transitioning to the insurance more towards the insurance realm do you feel like it requires even more effort because now you're one step further removed from the actual patient encounter compared to where you were at Cleveland Clinic um so for me and I will say this has been true throughout my career I would say um I've never been a clinical person which we've talked about before um but I think for me which what keeps me in healthc care is that whatever role I've had I want to understand what that customer experience is that that my team is impacting um in understanding that in a really meaningful way so I'll give you an an example so I have had um jobs throughout my career where I'm working in a clinical setting you're working in a hospital in a physician practice Etc I've also worked in revenue cycle or in coding or in Acquisitions as we talked about or on the insurance side but regardless of that at the end of the line there is a there is a patient or uh sometimes a customer that we are trying to impact and I think just to take insurance as an example um you are there for the customer you are there for whatever function you're doing you're trying to facilitate timely care for that individual your organization might not be delivering that care or employing the people that delivers that care but you are trying to facilitate it and you are also trying to advocate for that patient and that individual to make sure they're getting the appropriate care um and I think so many times um and this is something I don't I truly understood until I hit more exposure to that insurance side um in insurance plans regardless of where they are in the country they are not there to stop people from getting care they are there to help facilitate people getting care and they're there to make sure it's the appropriate care for the condition and it's evidence-based and all those sorts of things um so at the end of the day wherever you are in any Healthcare organization whether you you sit in the finance department you sit in operations you sit in a care delivery facility you are there to serve a function that in some way will impact that end customer which is your patient this episode of the strategy of Health was sponsored by modality Global advisors modality Global advisors optimizes Hospital Revenue enhances patient experience and delivers proven results visit modality Global advisors.com to learn more very well put and I think that what Amazon calls it right is this customer Obsession and that's what made Amazon better than the other retails um that they were competing against and I think that you see that in healthcare as well right uh you know institutions that focus on customer experience as a science and and put so much effort into all of their staff members having that seem to succeed um one of the things though is that at you're at the SVP level right now you're you were um that's higher up you're managing more and more people underneath you you you're now managing managers that manage people that that's challenging because you're you're now it's not just you making you know these decisions it's other people making more and more decisions it's a Cascade right how did you build these teams up the individuals who were underneath you so that they also had this customer Obsession this customer involvement that you did um it's it's all about um as the leader of that team whether that team you know as an SVP is 10 people or 10,000 people or something in between um it's about aligning your team around the priorities and what's important to the organization overall and what is our role within that department and within that team in order to support that that is entirely critical and I think um you have to outline those priorities um and a lot of time those priorities are coming from above Enterprise or organizational priorities but sometimes they're coming from within from the conversations you have with your team so I think aligning people around that priorities generating an enthusiasm um and I think as a senior executive it's critically important and this is something I've lived by and it's my advice for anyone is don't move too far away from all the great work that's happening in the ranks of the organization and I will tell you you know being a senior executive and having hundreds or a thousand people um indirectly in your organization clearly you're not going to be having conversations with all thousand or all 500 on a regular basis if you are you're probably not doing the job and moving the big boulders and and and motivating the team to success the way you need to but what you can do is create forums and opportunities to ensure that you're staying connected to that so some tactics that I've used is I have done whenever I've gone to a new job I do job shadowing so who are what are the Frontline roles in my organization and sitting for 30 minutes and understanding what that role is kind of interviewing that employee and I'm not doing hundreds of these but I'm doing you know a dozen or so whatever the roles are in the organization um you can also employ I did town halls with my team so quarterly meetings where I'm talking about my vision for the strategy of the...