Ochsner Physician Executive Describes Leadership Skills Required in New Healthcare Ecosystem

Oct. 15, 2019
David Carmouche, M.D., says that as a population health leader, you have to build connections to other ecosystem players

Population health efforts usually require working with many other community organizations, which may be a new experience for healthcare leaders. In an Oct. 14  presentation, David Carmouche, M.D., president of Ochsner Health Network and senior vice president of community care at Ochsner Health System, shared his perspective on succeeding in the new health ecosystem.

During an American Hospital Association Physician Alliance webinar, Tracy Duberman of the Leadership Development Group began by describing some research she and colleagues have done to look at how the healthcare ecosystem is changing and the types of leadership skills it will require. “We know that partnerships and collaborations are happening at an increasing pace,” she said. “You have to learn how to support dialog with multiple stakeholders.”

Carmouche oversees the community care division of Ochsner, a large integrated health system based in New Orleans. That includes primary and urgent care,  as well as population health activities and value-based care contracting. He leads payer/provider partnerships and a statewide clinically integrated network. Previously he served as chief medical officer for Blue Cross/Blue Shield of Louisiana.

Carmouche described Ochsner’s work with Blue Cross on a new insurance offering with a narrow provider network as the type of challenging project he has to work on. Making it work forced him to understand the perspectives of individual consumers, employers, brokers, payers and clinicians.

Looking across the sector more broadly, Carmouche described a “dizzying pace of change” in terms of mergers and acquisitions. “New entrants such as digital companies and well-financed startups are trying to pick off pieces of healthcare profit pools,” he said. It is not clear what the impact of CVS/Aetna and Walmart’s foray into health centers will be. “With uncertainty everywhere, you have to embrace it as part of the norm,” he said.

He recommends when working on collaborations or partnerships, emphasize the positives. “You have to deal with failures or missteps, but have enough wins for both organizations to keep the interest high and keep partners working together,” Carmouche said. To do so, you have to know how to course-correct. He said Ochsner launches small initiatives and creates ways to measure progress.

“This work is really hard, but it is the most rewarding work I have ever done. At times I am frustrated, but we realize Ochsner will never change the health of Louisiana alone,” he admits. “It takes more time than I thought, with a large number of meetings, phone calls and board briefings. But there is value in the discussion, even if nothing happens. There is tremendous value in being a learning organization, and we have learned a lot along the way.”

Duberman stressed that the type of leadership skills that Carmouche demonstrates can be fostered and developed, which is what her firm is working on. She asked him to reflect on his growth.

“I am just figuring it out myself and I am not formally trained,” he said. “My success was forged by opportunities given to me along the way. But I realize this can be taught and cultivated,” he said. As a population health leader in your organization, you have to build connections to other ecosystem players you could leverage on behalf of your organization, he added.

He recommends acting as a  convener: “It is not difficult to get ecosystem partners to talk. Starting the dialog is not difficult.”

Carmouche also said you should start asking better questions. “Being interested and thirsty for information is important. Seek first to understand partners’ perspectives and check your assumptions at door. Allow others to raise concerns without you anticipating the answer.

More pointedly, he said, consider others’ point of view. Learn their business, their fears, their incentives. That can surface misperceptions and allow you to view the world from their perspective.

Finally, he suggests widening your horizon. “I have learned more from this work than I ever learned swimming in my own lane. For me, that involved going to employer meetings and interacting with broker sand HR folks. Historically I had never gone to those. Seeing that broader horizon allows you to step into this leadership role.”

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