Higher Ed and Healthcare: The Common Parallels

​Emme Deland is Senior Vice President for Strategy at NewYork-Presbyterian Hospital (NYPH), and is responsible for developing the overall strategic plan for NYPH including both clinical and corporate plans. Emme will present the closing keynote address at the AIR 2015 Forum in Denver, Colorado.

Interveiw by Lisa Gwaltney and Elaine Cappellino 

eAIR: Initially, it seems a little unusual that a senior VP of a hospital would address institutional researchers in higher education. Can you speak to how your work relates to higher education?

There are actually a lot of similarities between healthcare and education, beyond the fact that education is one of the core missions of an academic medical center such as NewYork-Presbyterian. In both of our fields, people are our core resource—and by far our largest expense. Additionally, our workforces are both highly dependent upon experts—physicians in health care, and professors in higher education—and administrators need to balance their demands with the overall mission and goals of the organization. We are facing disruptive innovations—whether precision medicine or massive online open courses—that will likely transform our industries. We also are heavily regulated sectors with many unfunded mandates. And finally, our cost growths have significantly outpaced inflation.

Consequently, while the day-to-day work might be different, and though healthcare reform means that we might be a little further down the road than higher education, the challenges we face and the expectations placed on leadership are actually quite similar.

eAIR: What do you see as the common problems faced by both higher education and the healthcare industry?

There are a large number of common problems between healthcare and higher education. As I mentioned, probably the biggest challenge we both face is the fact that what we charge has far outpaced the rate of inflation for quite some time. That has led to calls to not only cut costs, but also for us to be more accountable for delivering a higher-quality, higher-value product; in our case, those calls ended up manifesting themselves as the Affordable Care Act and its attendant regulations. But we’ve also seen that defining and measuring quality is not so simple, especially since our outcomes often involve issues not directly related to medicine or to education. For instance, social and environmental factors such as housing and poverty drive about 60 percent of a person’s health—and these are things that we as healthcare providers have no control over. Additionally, we both rely on third-party payers (insurance in healthcare and federal financial aid in education), which creates a disconnect between the customer who pays for the services and the consumer of the services that can distort performance and expectations. And as I alluded to earlier, we face significant federal, state, and local regulatory burdens, which often manifest themselves as unfunded mandates.

eAIR: How has NYPH used data to develop and implement a strategic plan in response to healthcare reform?

NYPH’s strategic response to reform has a number of components, all of which were built on a foundation of data analysis. These components include our eight-year capital plan, our plan for an integrated delivery system and our HERCULES cost reduction initiative, all of which were informed by a wide range of data. We looked at our broader market from a number of angles: What is our market share trended over time and how do we compare against our competitors; what moves have they made in recent years, and what do we expect them to do in the future; and what is their financial position? We projected future demand for services by looking at the demographics of our marketplace and trends in healthcare innovation and delivery, in addition to understanding where our patients come from and why. We also looked internally, reviewing our internal costs, patient experience, and quality performance—and compared them against external peer benchmarks (finding, in some cases, that we had room to improve). Finally, we factored in the larger context, looking at what the future of reimbursement and regulation may be and what changes and pressures we expect the healthcare system to face in the coming years.

eAIR: Can you suggest key steps that institutional research, assessment, and planning professionals might take in developing and implementing a strategic plan on their campuses?

I think the first step is to truly understand your market. In industries like ours that do not have a history of being data-driven, we often operate on the basis of hunches and gut feelings, which means that we can fall victim to confirmation bias. To break free of that trap, it is essential to develop a truly objective look at your market, including things such as demand trends, market share, an analysis of your competition, and any potential disruptive innovations.

You next need to understand who you are as an organization. The first step is to build on the market analysis to develop a perspective on your place in that market—and that is where an exercise like a Porter’s Five Forces analysis can be helpful. It is also critical to take a close look at your internal data—including financial data and your performance against key internal and external metrics. Benchmarking those data against your competition puts that information into context—you might be doing well, but they could be doing better.

Finally, in order for any strategic planning effort to be successful, you need to have the right stakeholders included in the process. Coming up with that list means thinking not only about who has the right title, but also who the key influencers are—as you will need their buy-in if you want your plan to succeed.

These are extraordinarily challenging and exciting times, and knowing how to put together a strong strategic plan can help you weather change.