Tom Robertson, Executive Director of the Vizient Research Institute is joined by an old friend, Mike Dandorph, President and CEO of Tufts Medicine in Boston. Before assuming his current role, Mike was President, Rush University System for Health and Rush University Medical Center in Chicago, and prior to that he was the long-time chief strategist for the University of Pennsylvania Health System in Philadelphia. Mike shares his thoughts on leadership, comparing experiences in different models of AMCs. The conversation then turns to macroeconomic challenges facing the American health care system and Mike’s views relative to potential systemic changes.
Michael J. Dandorph, MHA
President and CEO
Vizient Research Institute
[00:50] Organizational structure is less important than staff alignment for a health system’s success
[3:47] Tufts Medicine aims to treat their patients as consumers and organizes for accountability, quality outcomes and invests with patient priorities
[4:10] Other key components are: physician alignment, incentives rewarding the right behavior and putting the right people in the right positions
[5:40] Culture plays a role in keeping the patient the center of attention as opposed to research
[07:34] Mergers and acquisitions: integration is really hard because it requires a lot of change, and humans don’t like to change
[8:56] In mergers, clinical teams need to come together to address programmatic integration, performance improvement, service rationalization and that takes trust. Leaders can help by creating an environment with honest conversations.
[11:10] U.S. health system higher costs aren’t translating into better access or better quality of care. It’s not just a provider issue, but a societal issue. Resources need to be deployed in a way that has a higher impact than it has now.
[14:08] Rate regulation won’t change the social determinant issues, but if health care organizations don’t control costs, the government may intervene
[17:44] Supply-induced demand is not the health’s industries big problem, it’s very sick people. Instead, where we take care of patients need to be considered to cut costs
[19:56] During the pandemic health care organizations came together in a broader ecosystem to provide the best care
[23:21] The current health system is so complex that it will have to be partially dismantled to be more rational. The insurers have gotten in the middle and that creates a huge administrative expense. 20% of costs is attributed to billing preapprovals and authorizations.
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Michael J. Dandorph's biographical information