3 Opportunities to Improve the Health Care System and the 5 Traits Industry Leaders Need to Seize Them

Challenges and opportunities for the U.S. health care system were on the examination table during a 24 March Leadership Unscripted event hosted by the University of Virginia Darden School of Business with Dr. Patrick Conway, CEO of Care Solutions at Optum, in conversation with Vivian Riefberg, Professor of Practice and David C. Walentas Jefferson Scholars Foundation Chair at Darden.

But so were more personal issues, such as the leadership traits health care industry executives will need to improve a system in desperate need of change and Conway’s own personal challenges and journey.

Caring for the Health Care System

Conway identified three primary challenges for the U.S. health care system today: the costs are unsustainably high and only getting worse; the quality of care is uneven, with some specialties drawing people from around the world while routine care like diabetes lags behind; and the consumer experience is poor. Riefberg noted that these challenges and widespread disparities in the access to care and quality of care have been laid bare by the COVID-19 pandemic.

The good news, Conway said, is that there are practical opportunities to address the challenges, including:

1. A move to values-based care, in which the system fixes incentives and other drivers to align the cost of care, quality and experience
2. The rise of home care, including virtual delivery, which will drive a shift to providing physical, social and mental health care for people in their homes for whatever their need might be, thereby preventing costly hospital stays and emergency room visits
3. The emergence of addressing mental and behavioral care

On the topic of behavioral care, Riefberg said the COVID-19 pandemic increased the incidence level and made clear that this area of health care in the U.S. is fundamentally broken. Conway agreed and said Optum has ramped up virtual and mental health care delivery, which became more than half of the company’s care delivery over the course of a few weeks because of the pandemic.

Looking ahead, Conway predicted short-, mid- and long-term changes in the health care system as the industry seeks to address its challenges.

Due to the pandemic, he said to expect a continued dramatic shift toward increased care at home (including virtual health) in the next one to two years. He said virtual care probably won’t remain at the high levels driven by the pandemic, but it won’t return to the pre-pandemic level again. In addition, Conway thought expanded support for mental and behavioral health will also be growing in the near term.

In the three- to five-year range, Conway predicted a significant “policy reckoning” to help shore-up Medicare funding and important policy debates on financing mechanisms bearing fruit. Though, given the history of health care policy struggles at the state and federal levels, he said that could easily slip to the four- to 10-year range.

On one pessimistic note, Conway said he would love to tell event attendees that the health care system will reinvent itself as a consumer-oriented system in the next four to 10 years, but the reality is that there is an immense amount of work to be done to make the system simpler and easier to navigate. On the bright side, though, he added that there is a record amount of capital and entrepreneurial activity flowing into health care, which will lead to meaningful innovation that could drive progress faster than expected. Consumer-driven, digitally enabled care will continue to grow.

Caring for Yourself

Riefberg asked Conway to address setbacks in one’s personal career, and Conway was candid about his own challenges with alcohol, which led to a conviction of driving while impaired and cost him his job as CEO of Blue Cross Blue Shield of North Carolina.

“I’ve had lots of failures. The most dramatic was 21 months ago. I made a decision on June 22, 2019, to drive after drinking,” Conway said. He believes he reached that low point because of poor self-care, over-reliance on alcohol and a hard-charging “I’ll sleep when I die” attitude about work.

Following the accident and loss of his job, Conway said he battled many expected emotions ranging from grief to denial to anger, but that he ultimately made a decision that he needed to learn from the mistakes that led to that failure and use the learning to move forward.  He said he has made several life changes including sobriety, daily meditation, better work habits with more reasonable work hours, regular exercise, and a better diet. The results, he said, have improved his relationship with his family and his own personal health immensely.

“My advice to prevent that kind of failure is to have discussions with people who you trust and self-reflect honestly. Listen to the warning signals,” Conway said. “My post-failure advice: move forward! Go through your period of deep emotions and adjustment, but then move forward with your learning and focus on personal growth. Resiliency is key.”

Dealing with failure and personal setbacks is a meaningful part of leadership, he said. Conway offered the five most important leadership characteristics health care industry leaders display when driving needed change:

1. They are bold and transformative in the change they seek. It’s tempting for leaders to seek incremental change, but leaders who really have impact pursue bold ideas.
2. They are willing to take risks, both personal and organizational. The risks won’t all succeed, but the best leaders learn and move forward.
3. They are resilient and persistent.
4. They combine strategic acumen, or vision, with a relentless pursuit of daily execution.
5. They are mission-driven servant leaders who connect organizational goals personally to individual employees and their families.

Beyond leadership traits, Riefberg noted studies show that hiring a diverse team of leaders is not only the right thing to do in principal, it is also good for business. Conway said diversity across all measures has been an imperative for success in the organizations he’s led. He said he’s worked intently at organizations that were falling short in terms of diverse leadership when he arrived because diverse leaders “have a different life experience that is incredibly helpful.”

Listen to the podcast of the event.