STUCK IN THE MIDDLE NAVIGATING MY OWN POLITICS WITH YOU: NAVIGATING THE POLITICS OF HEALTHCARE. 3/31/2016. HCCA Compliance Institute April 18, 2016

Transcription

1 STUCK IN THE MIDDLE WITH YOU: NAVIGATING THE POLITICS OF HEALTHCARE. HCCA Compliance Institute April 18, 2016 Jay P. Anstine, JD Compliance Officer Advanced Medical Imaging Consultants, PC NAVIGATING MY OWN POLITICS 1

2 OVERVIEW-NAVIGATION STRATEGIES Understanding The Political Landscape. Building Strong Relationships with Leadership. Using Diplomacy to Influence Behavior. Using Diplomacy to Resolving Conflict. Questions and Answers. Is Healthcare Political? Yes 2

3 HEALTHCARE POLITICS & COMPLIANCE POLITICAL POSITION OF COMPLIANCE? Commerce with All Nations, alliances with none, should be our motto. -Thomas Jefferson 3

4 AND IF ALL ELSE FAILS? UNDERSTANDING THE POLITICAL LANDSCAPE 4

5 UNDERSTANDING THE LANDSCAPE Overview: Identify key stakeholders in your organization. Identify the players in your market. Develop and maintain political-self-awareness. IDENTIFY THE KEY STAKEHOLDERS Senior Management Board of Directors Physicians (including liaisons-cmo, Med. Dir, etc.) Dept. Directors HR Director 5

6 IDENTIFY THE KEY STAKEHOLDERS Get to know them make sure they know you. Set-up Meet and Greets. Benefits? Understanding personalities, self-interests, motivations, connecting history & relationships. IDENTIFY THE PLAYERS IN YOUR MARKET Who is a partner? Who is a competitor? Who are the key physicians groups? Who are the contracted payers? 6

7 IDENTIFYING PLAYERS IN YOUR MARKET Government Officials Legislative, Executive, Judicial branches Federal, state, and local levels Examples: DHHS, CMS, OIG, OCR, DOJ, Senate Finance Committee, House Ways/Means, MEDPAC, etc. Governor, Legislators, Dept of Health, Medical Board Mayor, City Council, etc. IDENTIFYING PLAYERS IN YOUR MARKET Tips: Ask around. Study Up. Internet search Scan new stories, and periodicals, subscriptions 7

8 POLITICAL SELF-AWARENESS Be mindful of your surroundings. who likes who. who doesn t like who Be mindful of key stakeholder pressures. STAKEHOLDER PRESSURES-CEO Public: High quality, lost cost services. Board: Improve the bottom line. Board: Do more with less. Dept Leaders: We need better equip/more staff. Workforce: Be a great leader & environment. Civic Leaders: Be a good community member. Compliance: Follow those rules. 8

9 STAKEHOLDER PRESSURES-CFO Dept. Leaders: CEO/Board: CEO/Board: CEO/Board: Government: Hey, we need more resources. Stay within budget. Fight reimbursement cuts. Reduce those denials. Billings are compliant. Compliance: Follow those rules. STAKEHOLDER PRESSURES-DEPT. LEADERS C-Suite: C-Suite: C-Suite: Staff: Staff: HR Dir: Meet your budget. Do more with less. Manage others effectively. Lead us effectively. Resolve our conflicts. Reduce staff turnover. Compliance: Follow those rules. 9

10 STAKEHOLDER PRESSURES-HR C-Suite: C-Suite: C-Suite: Staff: Mgmt/Staff: Reduce staff turnover. Hold down expenses. Positive work environment. Ensure our safety. Resolve our messy issues. Compliance: Follow those rules. STAKEHOLDER PRESSURES-CMO C-Suite: Physicians: Physicians: Physicians: Keep the docs in line. Keep the suits off our back. Resolve our issues. Fight for us. Compliance: Follow those rules. 10

11 STAKEHOLDER PRESSURES-PHYSICIANS Hospital CEO: Service & Quality Outcomes! Group/Practice: Be efficient and bring in $$$. Group/Practice: Don t get sued. Self: Make $$ to justify schooling. Regulators: Do more with less. Compliance: Follow those rules. STAKEHOLDER PRESSURES-NURSING C-Suite: Quality and outcomes! C-Suite: Pass surveys and inspections. Patients: Keep us safe. Physicians: Be more efficient! Compliance: Follow those rules. 11

12 STAKEHOLDER PRESSURES-COMPLIANCE CEO/C-Suite: Keep us out of trouble. CEO/Govt: Resolve issues timely. Dept Leaders: We NEED to be able to do this. Self: Do the right thing. Govt: Follow those rules. BUILDING STRONG RELATIONSHIPS 12

13 TOP 5 COMMENTS AIMED AT COMPLIANCE. 1. Are you Crazy? You want us to do what? 2. We ve always done it this way 3. You just don t know operations 4. You re just an obstacle to me getting done. 5. Do you know what the I do for a living? BUILDING STRONG RELATIONSHIPS Overview: Establishing Rapport. Building and Maintaining Trust. Supporting Your Leaders. 13

14 ESTABLISHING RAPPORT Rapport = mutual understanding. Strategies: Know the services provided and your market. Take an active interest in your leaders. ESTABLISHING RAPPORT Taking an active interest? Initiate the Meet & Greet Department walk-thru Shadowing Rounding 14

15 ESTABLISHING RAPPORT Tips: Set time aside to study up on your market. Find out their story in life & profession. BUILDING AND MAINTAINING TRUST Trust = actions not words. Strategies: Be consistent with your work. Be clear with communications and expectations. Be thorough in your approach. 15

16 BUILDING TRUST Tips: Under-promise and over-deliver on deadlines. Own your faults and mistakes. Don t be afraid to say I don t know. SUPPORT YOUR LEADERS Support = being engaged to their work. Strategies: Be a resource for them (treat em like a client). Advocate on their behalf when appropriate. Recognize them when appropriate. 16

17 SUPPORT YOUR LEADERS Tips: Be on time for their mtgs/actively participate. Make it easy for them to find information. Send thank you notes & manage up. USING DIPLOMACY TO INFLUENCE BEHAVIOR 17

18 WHAT IS DIPLOMACY? Diplomacy is the art of letting someone have your way. -Daniele Vare A diplomat is a man who always remembers a woman s birthday, but never remembers her age. -Robert Frost THE COMPLIANCE DIPLOMAT? Commerce with All Nations, alliances with none, should be our motto. -Thomas Jefferson 18

19 DIPLOMACY TRAITS Rapport Empathy Active Listening Assertiveness Self-Control Confidence Planning Conflict Resolution COMMUNICATING DIPLOMATICALLY Strategies: Actively listen. Know your audience. Exercise self-control. Balance politeness and honesty. 19

20 COMMUNICATING DIPLOMATICALLY Exercising self-control ask yourself: Does this need to be said? Does this need to be said by me? Does this need to be said now? COMMUNICATING DIPLOMATICALLY Honesty Politeness 20

21 COMMUNICATING DIPLOMATICALLY Tips-Verbal Communication: Develop a communication plan adjust as needed. Keep the focus on the issue not the person. Avoid aggressive words (always, never, etc.). COMMUNICATING DIPLOMATICALLY When do you discover writing an emotional ? As you type it. After you've sent it. 21

22 WRITTEN COMMUNICATIONS? Tips-Written Communication: Emotional? Hold off on hitting send. Proofreed, proofreed.and proofreed proofread. Use a 2 nd set of eyes. Write to assume it will be read by others. COMMUNICATING WITH LEADERS Mindset of Healthcare Leader? Highly educated. Fast pace/address constant uncertainty each day. Strategic planning/decision-makers. Act by group think model (e.g. committees). Expected to excel at managing relationships. 22

23 COMMUNICATING WITH LEADERS Strategy: Communicating with Leaders. Identify then mirror their communication style. (e.g., , phone, in-person, etc.) Make information easy for them to locate. Be prepared when you meet with them. COMMUNICATING WITH LEADERS Tips: Communicating with Leaders Know how decisions are made in the organization. Always keep their pressures in mind. If consulting follow I.R.A.C. or S.B.A.R. 23

24 COMMUNICATING WITH PHYSICIANS Mindset of a Physician: High achiever/competitive by nature. Expected to be efficient/quick with decisions. Autonomous decision makers. Trained to be precise. COMMUNICATING WITH PHYSICIANS Strategies: Communicating with Physicians Communicate efficiently less is better. Engage them in the process if you re seeking buy-in. Use situational examples they can relate to. Don t just bring problems, bring solutions. 24

25 COMMUNICATING WITH PHYSICIANS Tips: Communicating with Physicians Be able to answer. what do you need from me? Leverage your physician champions when necessary. Avoid corporate jargon. Build rapport whenever possible. DIPLOMACY SKILLS: STRATEGIES FOR RESOLVING CONFLICT 25

26 CONFLICT RESOLUTION-OVERVIEW Step 1: Identify parties & negotiation styles. Step 2: Understand all points-of-view ( POV ). Step 3: Identify negotiables, nons, & walk-aways. Step 4: Find common ground. CONFLICT RESOLUTION: STEP ONE Identify Parties &Negotiation Styles 1. Competitive ( I win, you lose ). 2. Accommodating ( You win, I lose ). 3. Avoiding ( I lose, you lose ). 4. Compromising ( We win some/lose some ). 5. Collaborating ( I win, you win ). 26

27 CONFLICT RESOLUTION: STEP TWO Strategy: Negotiation Styles. Key questions: Identify each party s style and positioning. What are the leverage points for each side? CONFLICT RESOLUTION: STEP TWO Strategy: Understanding POV. Key questions: What are each sides motivations/interests? What specifically do they object to and why? What are their political pressures? 27

28 CONFLICT RESOLUTION: STEP TWO More Strategies-Understanding POV. Ask questions and regurgitate understanding. Walk-a-mile (observe, shadow, walk-thru, etc.) Role-Play (e.g., try advocating both sides). CONFLICT RESOLUTION: STEP THREE Strategy: Identifying Negotiables & Nons. Key Questions: What would you like to see happen and why? What are you willing to give up? If we can t resolve-what does that look like? 28

29 CONFLICT RESOLUTION: STEP FOUR Strategy: Finding Common Ground. Seek to have each side to demonstrate empathy. If struggling: ask each side to present a solution benefitting the other. Make sure each side gets value for concessions. CONFLICT RESOLUTION Overall Tips for Conflict Resolution: Do your homework on all sides to the issue. Don t let emotions drive decisions regroup. Pick your battles/keep lurking pressures in mind. Keep the focus the issue not the person. 29

30 FINAL COMMENTS Be mindful of your surroundings & pressures. We have to have issues to be employed. Periodically step aside to gain perspective. Find a support system. AND AGAIN, IF ALL ELSE FAILS? 30

31 QUESTIONS? Jay P. Anstine, JD Compliance Officer Advanced Medical Imaging Consultants, PC