Today’s healthcare leaders—in hospitals, health systems, physician practices and medical professional associations—face unprecedented shifts in how care will be delivered and financed in the future. For many, this is a time of living in two worlds—optimizing for success in a volume-based, fee-for-service environment while simultaneously preparing for how to thrive in an era of value-based, population health management and all it entails. CFAR is committed to helping our clients make sense of and manage the transition to 21st century healthcare by building and sustaining organizations that accelerate performance in the face of continuous change.
Below are a few examples of our work.
Sharpening the Strategy and Transforming the Business
A multi-billion-dollar health system operating in three states was working toward changing its identity from what was largely an acute care hospital company to a fully integrated “health” system that could take risk for managing the health of patient populations. The new entity announced that it would embrace a regionally focused operating model across three very diverse regions, each with their own geographic and competitive challenges. This change would require a clear and compelling strategic narrative, along with a shared set of strategic commitments that the entire system could both understand and contribute to. They asked CFAR to support this important work.
CFAR worked closely with leaders at the system office, local hospitals, and newly formed region-specific working groups to articulate a strategy that made sense for the system as a whole, but that could also be adapted locally to meet the unique needs of the organizations’ diverse markets. We engaged hundreds of administrative and clinical leaders throughout the system in a highly participatory strategic planning process that included CFAR’s proprietary Strategic Options tool (a customized online social media forum for ongoing input and feedback to the strategy) and a series of meetings that culminated in a Board of Trustees retreat where trustees from every hospital in the system came together to approve the plan. The result was a well-founded system strategy with goals that people understood and believed in, a platform for physician partnership across the new regional model, a set of regional planning teams, and preparation for early implementation.
Rescuing a Joint Venture Before It Unraveled
A joint venture formed between a respected academic medical center and a small post-acute care system was slowly unraveling. Its purpose had been to create a comprehensive continuum of care that expanded the reach of the post-acute care system and filled a strategic gap in rehabilitative services for the academic medical center. However, CFAR discovered that the joint venture was working with outmoded assumptions about the market and that the partners had developed serious misperceptions about each other. For example, many of the academic physicians believed that the joint venture did not value the education mission, while leaders of the post-acute system saw rehabilitation education as a key strategic goal. By revisiting the assumptions on which the joint venture had been built three years earlier, CFAR helped the board separate fact from fiction and affirm collective interest in continuing the relationship. With each party holding a shared view of the current state of the relationship and a joint agreement to move forward, they were able to accelerate plans to deliver on the joint venture’s promise for each party and for the joint venture as a whole.
Aligning Organizational Structure for Learning and Development with Health System Strategy
A major regional health system had made significant investments in award-winning learning and organizational development functions, but they were fragmented across the enterprise—making them challenging to access and understand for health system staff. The new CEO was concerned about the lack of functional integration across key departments and about unrecognized gaps and overlaps in learning resources. She sought to: assess the current quality of learning and organizational development capabilities, increase their impact, and align them to support strategic priorities of the health system. CFAR was asked to conduct a comprehensive assessment and develop structural, process, and content recommendations. Our recommendations included consolidating development, training and technological resources for learning, expanding the role of change management and organizational development, and strengthening the approach to succession planning. This study paved the way for the creation of a learning institute within the health system that explicitly supported delivering on the mission and strategy of the organization.
We recently wrote about a new approach to Executive Coaching and Team Development with our strategic partners at Richard Levin Associates. Click here to learn more about Coaching 2.0 for healthcare organizations.view case study »
The three intertwined missions of academic medical centers—education, research and clinical care—create complex challenges for leaders of these institutions. They must strive to sustain the energy and excitement that drive their organizations forward and nurture their most talented contributors, despite declining funding from current sources of revenue. The dilemmas are many: balancing integrated care in tertiary and quaternary care environments, providing excellent education across all disciplines as research agendas become more focused, and moving competing expert physicians to standardized protocols. CFAR offers well-honed approaches to developing precision solutions to help these complex organizations thrive.
Below are a few examples of our work.
Leadership Transition and Development
CFAR was engaged by the incoming Chancellor to support his transition as the leader of a public academic health system. Responsible for all aspects of campus administration—the $1B-plus clinical enterprise, other system level leadership, and operational and governance duties—the Chancellor needed to build his leadership team, enhance effective administrative office support, and understand the cultural and strategic landscape of his new institution. We gathered 360-degree feedback for the Chancellor and provided a detailed analysis of essential opportunities and risks to help him shape his early leadership and strategic agenda. We assessed his leadership team and meeting structure, to ensure the optimal use of individual and collective time and resources, as well as the administrative structure, recommending role and organizational structure changes designed to enhance the administrative team’s ability to best support the Chancellor and his team. We continue to periodically provide the Chancellor with key leadership, top team, and organizational support.
Creating a Culture of Value—in High-end Surgery
CFAR’s charge was to support a high-end surgery program in moving from high growth and high volume toward a program that focused on quality and value. This represented a deep cultural shift for everyone in the program—from the division chief and the physicians to the advanced practice providers, the nurses, and all of the ancillary personnel a successful program needs to thrive. To facilitate this shift, CFAR focused on the day-to-day practices in both the program and the infrastructure needed to support its practices. Over the course of the work, CFAR worked with the division chief to create a cross-entity leadership team to help him identify the right patients for the program, the procedures that reached across the system, and to develop a new focus on interprofessional collaboration. Within six months of completing the work, the quality scores improved visibly and, eighteen months later, they continue to improve.
Tapping the Creativity of Faculty—Quickly!
CFAR was asked to serve as a trusted and objective outsider after a medical college’s curricular redesign effort became stuck. The college needed to fully design a new curriculum in time for admissions deadlines, but the faculty had put on the brakes when they felt the process ignored their input. After an intensive listening phase, CFAR developed a redesign process that honored faculty expertise and their need for participation. With a transparent process in place, and acknowledgment of roles across the medical college, the work moved forward—in time for the admissions deadline. Faculty were enthusiastic about what they had designed, and were able to extend its reach to newly developed community medical school programs.
We recently presented a seminar entitled "Making Change Happen: Skills to Lead and Manage Change in Academic Health Systems" at the American Association of Medical College’s 2017 Learn, Serve, Lead Conference.view case study »
Biomedical Research Centers are poised to play an increasingly important role in our health sciences research ecology, especially as the pharmaceutical industry looks towards academia and these research centers to partner with in the development of translational medicine, genomics, and drug development. At the same time, research centers face significant operational and organizational challenges, as government funding of research declines, and competition heats up for philanthropic dollars. Research centers must think creatively about how to sustain their operations and remain at the cutting edge of science. CFAR can offer our experience in strategic planning, organizational change, and development to help Biomedical Research Centers work more effectively within their organizations and collaborate more productively in the complex partnerships and alliances on which they increasingly rely.
Family enterprises are the lifeblood of today’s economy. They also face myriad challenges: businesses in their second or older generations face different competitive as well as familial challenges than their founders faced; increasing numbers of family members have an economic stake; families seek to make a difference through philanthropy; and new financial instruments create liquidity that families can chose to manage together. The proliferation of family offices in this world is a strong indicator of the growing complexity of this work. Little is straightforward in a family enterprise, where the natural interaction of family dynamics and economics together create exceedingly high stakes. Since the early 1980's, CFAR has been a pioneer in advising family organizations of all types, across industries. We help clients locate the will and skill resident in their organizations to make choices and propel themselves into their chosen future.
Family philanthropies have unique needs. Like any business, they require a clear-headed exploration of goals, methods, resources and results. But they also need an understanding of how the philanthropy fits into the larger family enterprise and the values, history, culture and network of relationships that make that enterprise unique. Challenges for family foundations range from their initial creation, to how they create and measure impact, to generational succession and transition. CFAR helps these organizations institutionalize a founder’s passion for a cause into a systematic approach to making a difference, integrate the inspiration of other family members with new perspectives on the mission, and build a structure that allows family members to have differential and meaningful roles and work.
While leaders of founder- and owner-led businesses are not joined by the familial ties of a family business enterprise, they are often friends or close colleagues, with bonds to each other that often extend beyond business, and may even span generations. Especially in partnerships and professional service firms, creating cohesion in the leadership group can be challenging since individuals may have goals that don’t actually contribute to the business as a whole, they may volunteer for roles for which they aren’t qualified, or they decided to go into business together in the first place—as friends—without assessing whether the group has the necessary skills to accomplish the objectives of the business. In these firms governance and compensation can be hot topics: resentments about equality of compensation, for example, often simmer below the surface, but go unaddressed in favor of preserving friendships. And even in firms with formal governance structures, how decisions are actually made may not be at all consistent with by-laws or organizational charts. CFAR can help owner-led organizations surface the assumptions that may be creating barriers to effective execution of strategy and the growth of the business, and resolve them in ways that improve performance and maintain the integrity of relationships.
The Life Science industry faces significant challenges that impact research and innovation, organizational structure and profit. From pharma to biotech and device manufacturing, companies are working under unprecedented pressures on pricing and the costs of research and development, from diminished pipelines, and from competition from generics and biosimilars. New business models are needed, new ways of partnering with other companies, and new opportunities to remove costs and sustain profitability. CFAR offers a variety of research-based approaches to help life science companies speed innovation, improve collaboration within and between enterprises, sharpen strategy, and resolve complex business dilemmas.
Biotech organizations must navigate a complex and changing set of external conditions – decreasing sources of capital investment, increasing regulation, downward pressure on pricing, and a changing healthcare environment that prioritizes evidence and outcomes. All of these factors require biotech companies to be more strategic in their focus and efficient in their operations, particularly as they are increasingly drawn into collaborations with large pharma companies whose interests and timetables are different. CFAR can help biotech companies align strategy within the organization, increase their focus on execution, and build organizational capacity and leadership skill. We also offer our extensive experience in organizational collaboration to help biotech companies structure and maintain effective partnerships with large pharma companies and other partners.
Our leading institutions of higher education face challenges today that demand strategy and speed—strategy so that they can use more limited resources in ways that drive greater impact and speed so that they can act before opportunities disappear. This is particularly true in the context of leadership transitions within institutions, where the incoming vision of the new leader may be at odds with the outgoing legacy. But moving strategically and quickly isn’t easy in a world where divergence and autonomy are valued and the process of decision-making is as important as the outcome. CFAR supports institutions of higher education by engaging faculty and broader community in authentic participation that results in solutions that stick.
Associations are complex organizations, critical to the industries, professionals and publics they serve. Association leaders—in both executive and volunteer roles—must navigate an increasingly complex landscape of membership expectations, pressures on time and resources, and the need to continually adapt their governance structures to changing requirements. Association leaders need strong skills in strategic thinking, using influence and persuasion to get their ideas across, and in advocating for their members and multiple constituents. CFAR has deep experience working with medical societies and other professional associations to help them be more innovative in their programs and member relationships, improve the design and effectiveness of their organizations, and develop their skills as leaders.
In today's economy, foundations are at a crossroads. While the influx of private wealth into philanthropy continues to grow, the very nature of philanthropy is becoming increasingly multi-faceted and complex, requiring innovative organizational solutions that accelerate impact. And just as many foundations are searching for the next "stage" of their identity, they continue to face the challenges that have persevered throughout their history. They need to exercise creativity and sophisticated business strategies to amplify impact and, increasingly, they demand measurable return on their social investments. CFAR has a long history of consulting to many of the country’s largest and most prominent foundations. We understand what it takes to face a world that is simultaneously filled with opportunity and constraint and translate that into action on the ground. CFAR helps foundations refresh organizational strategy and structure to respond to changing market needs, develop more effective leadership teams, and amplify impact.