Transformative new executive roles: How to pick and pay them

The emphasis on population health management and increasing proliferation of accountable care initiatives is changing the structure of healthcare organizations. While traditional leadership roles will continue to manage hospitals' operations and employees, new positions designed to guide organizations as they traverse from volume- to value-based care models have already begun to emerge.

"Just look at the variety of titles of folks presenting at this conference," Mark Laney, MD, president and CEO of St. Joseph, Mo.-based Mosaic Life Care, said at Becker's Hospital Review's 7th Annual Meeting in Chicago. "There's a chief patient experience officer, chief of business intelligence, director of strategic performance, chief of network integration, chief of population health, chief of market solutions. The list can go on."

As hospitals and health systems set out to navigate the new demands and influences impacting the industry, the need to create new roles becomes evident. However, developing and embedding new roles comes with its own challenges, according to David Bjork, PhD, senior vice president and senior advisor at Integrated Healthcare Strategies.

"These new jobs are often developed on the fly," Dr. Bjork said. "The accountabilities of the jobs are vague because they are invented as they go. There is no existing labor market to compare to and the jobs aren't standardized — often the people who are doing it are learning on the job."

It takes a certain type of person to fill a newly created role, Dr. Bjork added. They must have a strong entrepreneurial drive, be flexible and be a strong collaborator but also a team player. Many organizations set their sights on individuals in leadership roles in other industries, such as health insurance or retail. But regardless of where the individual comes from, a key element of creating a new leadership role is designing the job functions around the individual's talents and skill sets, not the other way around.

On top of recruiting, the other principal challenge associated with creating new leadership roles is determining the appropriate level of pay. Because new positions like chief patient experience officer or chief of population health are just beginning to surface, there is little to no data available for boards to use as a basis for setting compensation.

According to Dr. Bjork, this is up to the board to decide, but it must approach the process carefully.

"There isn't a right rate of pay for [a newly created role]," he said. "It must be tuned for the person based on his or her competencies, skills and experience they bring to the job — you're not just matching medians."

Anthony Bohn, system vice president and chief human resources officer at Louisville, Ky.-based Norton Healthcare, emphasized that ultimately, the pay must be sensible.   

"At the end of the day, you must be able to say, 'This is reasonable,'" he said. "Even though it may be hard to clearly outline responsibilities and data is lagging for people in these new roles, you have to be able to prove reasonableness." Additionally, documenting precisely how a salary is decided upon will be critical if there are every compensation-related issues down the road, as well as for recording data.

And like all change in healthcare, overcoming hurdles during the creation of new leadership requires a concerted effort, education and patience.

"All of these new and evolving positions take time," said Dr. Laney. "It takes time to develop the person and the new program they are heading. As an industry, we need to be able to put teams together that will work three or four years from now. You can't just flip a switch and turn these programs on."

More articles on leadership and management:
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Politics, physicians, patients and IT payments: 3 health system experts reveal their 5-year strategy and outlook
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