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  • 5 factors for fifteen - A solid grasp of past and present industry trends can help you prepare for challenges ahead. Sedgwick’s thought leaders are helping clients by forecasting five primary factors that will impact our industry this year. Learn more.
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RIMS-2015-scienceI always look forward to the annual Risk and Insurance Management Society (RIMS) conference. For me, it is a time to reconnect with our great clients, stakeholders and friends. It is also an exciting time to forge new partnerships, and of course hear some of the most insightful people in the industry speak at the many educational sessions.

This year, I am also looking forward to sharing our theme “The science of innovative solutions,” and all that it means for our clients and the industry at large. I invite you to get a head start and visit our RIMS website rims.sedgwick.com. We have a wealth of information already available for you to read and watch. You can also request a meeting with our colleagues who are joining me at the conference.

I want to announce another Sedgwick innovation that I believe will be a significant RIMS-2015-edgenew resource for you. I am proud to introduce the edge, a quarterly publication dedicated to shining a light on our industry’s leading-edge topics that shape our collective future. Our thought leaders have written exceptional articles in this inaugural edition; I encourage you to read and share. Once again, Sedgwick is a catalyst for change.

Another exciting opportunity at RIMS is our sponsorship of the Spencer 5K Fun Run. You can still register and help support industry education. As a Spencer Educational Foundation board member, I can say firsthand that this is a great organization we should all support. This is the first year for the 5K Fun Run and I expect it to grow each year.

Finally, the learning opportunities at RIMS are always exceptional. Sedgwick has ten sessions planned with each providing a fusion of knowledge and expertise from our thought leaders and partners. Experience the energy of Sedgwick’s thought leadership by attending these sessions. To learn more, visit our educational sessions page at rims.sedgwick.com.

I also invite you to stop by Sedgwick’s booth (1621) or VeriClaim’s booth (1913) in the exhibit hall to spark a conversation during the conference. Explore our expert resources, innovative technology and powerful solutions. Find us on the exhibit hall map.

I look forward to seeing you at RIMS in New Orleans and wish you safe travels.

Dave North, President and CEO

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St-Jude-Voice-in-the-CommunityAt Sedgwick, our approach to community involvement has always been to support our colleagues in supporting causes about which they are passionate and that reflect the needs of the local areas in which we operate. This week marked the culmination of two important community service projects undertaken by our colleagues.

Sedgwick embarked last fall on an exciting companywide community engagement effort called Voice in the Community. We partnered with a cause-based clothing company and purchased custom-designed Voice in the Community t-shirts. Our 12,000 colleagues had the opportunity to buy a shirt, and each colleague got to choose where to direct the money from their purchase: to their office activity committee to support local community service projects, or to one of three national charities. Additionally, for each Voice in the Community t-shirt sold, our vendor donated a school uniform shirt to a student in an under-resourced area.

In total, our generous colleagues raised almost $44,000! Thanks to the efforts of our activity committees, more than $9,500 was distributed to non-profits throughout the U.S. We also raised nearly $6,000 for Feeding America, more than $6,200 for Toys for Tots and nearly $22,000 for St. Jude Children’s Research Hospital. With 100% of funds collected through the t-shirt sales going directly to charity, this initiative has truly been a win-win.

Building on the momentum of our Voice in the Community initiative, in December we held our 2014 holiday card campaign, which was devoted to brightening the lives of the brave children of St. Jude. We invited our colleagues, clients, vendors and friends to “embrace their inner child” and share photos reflecting the joys of childhood and the holiday season. Sedgwick committed to making a donation to St. Jude, up to $50,000, for each photo uploaded. We received nearly 250 photos and more than 1,750 views of our submission page and smile gallery. Our #sedgwicksmiles4stjude campaign helped to raise awareness about the life-saving work of St. Jude and brought smiles to the faces of all who participated.

St. Jude - Sedgwick check presentation

Dave North & Sedgwick MVPs present a check for over $70K to St. Jude from our #sedgwicksmiles4stjude & Voice in the Community campaigns

This week, we had the unique opportunity to visit St. Jude – located not far from our corporate headquarters in Memphis, Tenn. – and present a check to the hospital for more than $70,000. That donation includes Sedgwick’s holiday campaign gift and the monies raised by our colleagues through Voice in the Community. Our Most Valued Performer honorees joined members of our executive team at St. Jude for the check presentation, a tour of the magnificent campus and packing food bags for the families of children being treated there. It means so much to us to be part of St. Jude’s groundbreaking work to eradicate childhood cancers and other life-threatening diseases.

Sedgwick MVPs volunteer at St. Jude

Sedgwick MVPs volunteer at St. Jude Children’s Research Hospital

Our generous colleagues and committed clients, vendors and friends have helped us ensure that Sedgwick’s voice in the community remains loud and strong. Let us know what your organization is doing to promote community involvement.

Terri Browne, Chief People Officer

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pharmacy-rules-pill-bottlesThe wheels are slowly turning across the nation as state workers’ compensation regulatory agencies and state legislators focus on how to best respond to the prescription drug abuse epidemic and gain more control. Implementing a closed formulary is a strategy that has successfully reduced harmful and costly prescription drug use in Ohio, Texas and Washington state. This type of formulary, which was introduced in Washington in 2004 and in Ohio and Texas in 2011, limits drugs dispensed in workers’ compensation claims to specific lists based on medical guidelines.

Arkansas, California and Tennessee are now developing regulatory changes to try to introduce closed formularies. Results in Texas and Ohio prove that the introduction of a closed formulary changes prescribing behavior, and it significantly reduces the number of life-threatening and disability-extending prescription medications that are dispensed.

All of this begs the question: Why should employers and insurers wait for government intervention to address what is described as a national epidemic? They should not.

Employers need to ensure that claims and healthcare management administrators provide solutions to systematically manage prescription drugs at the point of sale and rebalance long-term claims demonstrating problematic drug use. This begins with the use of business rules that route claims triggered for review to specially trained pharmacy clinicians. The clinical review should provide evidenced-based decisions regarding the use of inappropriate drugs and potentially life-threatening drug combinations. This process removes the uncertainty for claims adjusters, and offers educational communication for injured employees and their physicians.

In addition, employers should review their claims and pharmacy management programs to make sure they provide routing mechanisms for appropriate intervention at the point of sale, and a consistent process for complex claims with chronic drug use or health safety threats. Analysis for rules development should focus on drug strength and appropriateness for the injury, length of prescription, prescribers involved and interaction with other prescription drugs. Compound medications must also be electronically routed for review by a clinician when they are dispensed. Alerting and engaging clinicians when compound medication activity occurs allows for targeted interventions, which can prevent long-term use and reduce drug costs. This process also helps protect the health of employees with workplace injuries and illnesses and supports a safer, faster return to work.

The outcome is simple. Claims adjusters should act as the decision-makers for prescriptions when claim compensability or relatedness is in question; and clinicians should intervene when the dosage, use, strength or associated prescribing practices are identified as potential problems.

Last year, Sedgwick’s pharmacy clinicians permanently stopped 35% of the drugs that were identified as inappropriate for the injury or medical condition at the point of sale. At the same time, the business rules deployed to identify adverse prescription drug trends and complex pharmacy issues resulted in a 25% decrease in the number of medications prescribed and a 41% morphine equivalent dose decrease.

It is good that state regulators are increasingly focusing on the prescription drug epidemic, but employers need to act now. Protect your employees and reduce pharmacy costs by making sure your claims administrator has systematic solutions in place to control the medications being prescribed within your workers’ compensation program.

Would you like to add a comment on the benefits of a closed formulary? Share your thoughts with us.

James Harvey, SVP, Managed Care Products & Product Development

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mental-health-wake-upThe startling news headlines have somewhat slowed since last month’s tragic Germanwings airliner crash which resulted in the deaths of all aboard. By now you are familiar with the story which repeatedly focused on the pilot’s mental state and diagnosis of depression prior to the tragedy. In light of this tragedy, new dialogue is emerging and many have begun to talk about the need for employers to reassess their policies, accommodations, and behavioral health programs to better promote mental well-being in the workplace.

The interchange between mental health concerns and tragic events is complex. When the media or others suggest mental illness is the root cause of violence, it stigmatizes those living healthy and productive lives.  It is misleading, for instance, to depict a person diagnosed with depression, as violent. The vast majority of people with a mental illness are not violent. And according to the CDC, only 25% of people who have mental health-related symptoms feel that others are understanding towards them.

Increasing awareness of and access to holistic healing and treatment, inclusive of physical and mental well-being, is critically important for health and productivity of a workforce.

We know that one in four Americans will experience some type of diagnosis related to mental health. A Gallup-Healthways Well-Being Index estimates absenteeism from workers diagnosed with depression costs employers an estimated $23 billion annually in lost productivity.  Many argue mental illnesses have an even greater impact on presenteeism by way of slowed productivity and workforce stress.

Within the workplace, the pendulum has swung too far towards “don’t ask, don’t tell.”  Workplace stigma discourages employees from disclosing diagnosis and symptoms for fear of ramifications from their company and peers, and employers seem to not want to know.  There needs to be a balance between workplace safety and privacy combined with a culture of health and offering support for employees that need it.

There are certain industries such as the airline, nuclear, and transportation where monitoring of mental health status for employees in certain jobs is performed, but even then there are stringent guidelines.  The Americans with Disabilities Act includes mental health issues in the non-discrimination guidelines which has furthered awareness of accommodations.  The Germanwings tragedy reinforces the need and opportunity to treat mental health with the same importance as physical health. Where I think we need to look is toward a more open dialogue in the workplace that frees both employees and employers from fear.

This current tragic event should spur discussion about how employers can make it safer for employees to discuss behavioral health issues. Rather than making this a negative and driving people deeper into the shadows for fear of repercussion, employers have an opportunity to improve benefit solutions.  Consider evolving wellness, behavioral health, and employee assistance programs, with leave of absence, disability and workers’ compensation. Integrate these programs with group health and wellness programs as key components with equal importance of physical health.  Developing programs which allow and encourage employees to come forward and discuss mental health symptoms, diagnosis, and well-being in a safe environment is a huge step forward.  Creating a culture of health and breaking down mental health stigma is not easy, but with leadership on board there is significant opportunity for improvement.

At Sedgwick we are prepared to help you look at and build programs that can effect change for a healthier workforce. Your employees are your most valuable resource and working together we know it is possible to begin to achieve greater balance. Last year we posted a series of blogs on why employers needed to pay more attention to stressed out employees. I encourage you to go back and review these for some great information.

I am also excited that in May Sedgwick will embark on an initiative to look deeper at how we all can improve behavioral health and well-being in the workforce.  Our initiative will bring together the nation’s leaders in mental health policy and treatment, along with employers to address the current need for a pre-disability mental health model.  This is such an important and complex topic and it is timely and necessary in order to reduce workplace stigma, build a resilient workforce, and to improve health and productivity of the employees and employers.

How do you feel about bringing the mental health discussion to the forefront at work? Please share your thoughts and ideas and let’s begin a health dialogue as employers on mental health.

Kimberly George, Senior Vice President, Corporate Development, M&A, and Healthcare

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healthcare-team-consolidationNot that long ago, the insurance industry, if not the business world, was rocked when Connecticut General and INA merged to form CIGNA. Today, mergers and acquisitions are a common everyday occurrence.

Once an M&A announcement has been made public, there is a plethora of activities and actions that need to be addressed, including staffing, location of personnel, budget and culture. Each one of these areas, even in a small way, can have an impact on your claims program.

The culture of the organization is most likely to change in some fashion. This change can have a negative impact on the claims professionals and corporate morale. The culture needs to be addressed as soon as possible, but change could take months and even years as the organizations finalize consolidation and weave their way through financial, regulatory and business barriers. Read Kathy Shostek’s recent blog, “Successful healthcare consolidation requires consolidating culture,” for additional culture considerations.

The process of merging cultures, operations and risk management objectives (profitability, reputation, community, growth, etc.) that affect the claims process is a daunting task. Couple this with the mechanics behind the claim process that include insurance programs, information systems for claims processing and defense panels, and the success of the task at hand gets even more complicated. All of the aforementioned are important, but culture is a far more critical concern to be addressed immediately.

As soon as an M&A announcement is made, it sends an immediate shock wave through all employees with a common theme. The claim staff may fear losing their jobs or losing opportunities formerly available. This fear can negatively impact productivity and may even result in employees leaving the company to seek jobs elsewhere. It is important for the organization, its managers and HR staff to recognize this and react promptly. The failure to do so can result in escalated claim costs to the organization, along with the loss of reputational risk at a staggering rate.

The organization needs an effective plan in place to address potential loss of staff. Senior management should be involved in the planning and development of contingencies in the event of involuntary terminations of the claims and risk management staff. This begins with the evaluation of exposures based on the type of insurance program for the acquired organization.

A claims program that is bundled with a carrier, whether it be first dollar or a deductible program, presents little disruption on human capital since the claims program is being handled by the carrier. If a retention and a third party administrator are used, again the exposure is limited and there is time to evaluate once all transactions are completed. If the claims program is self-administered, however, action needs to be taken to address the loss of any key personnel.

Typically, the wrong approach is taken to address a temporary loss of staff. This usually entails absorbing the caseload using existing claims professionals. If there is a large staff in place, this may be acceptable for short periods of time with the caseload distributed among many professionals. More times than not, though, the claims staff is already at or above an acceptable workload. Adding more claim volume, even if small or short-lived, can have detrimental effects on loss costs.

One successful approach is to outsource the claims. This can be done on a temporary basis using third party personnel. The staff can come from insurance brokers, third party administration companies or perhaps even claims staffing companies. The locum tenens approach can be quite successful. While the cost of this short-term staffing solution is typically high, the alternative consequences are much more adverse. This approach allows more flexibility and will aid in creating a long-term claim program solution.

A recent example of this type of approach involved the merger of two large community health systems. Proper planning allowed for temporary placement of claim specialists in the acquiring company’s headquarters to provide for uninterrupted claims administration. This not only maintained identical benchmarks for measuring claim costs (open caseloads, expenses, closing ratio, etc.), but improved the morale of existing staff, who could see the organization’s commitment to staffing the program at levels that did not create additional hardship.

The key to a smooth M&A transition, from a liability claims outcomes perspective, is proper planning through an enterprise risk management approach that addresses the exposure before it gets to the critical stage.

Tim Over, MPH, ARM, AIC, SVP – Specialty Claims

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We5KLogo_horiz are just a little under a month away from RIMS 2015 in New Orleans. You, of course, are thinking of the great sessions and networking that RIMS brings each year and – yes, you can admit it – also thinking of Bourbon Street and jazz.

This year we want you to also think about putting on your running/walking shoes on Tuesday morning, April 28, for the Spencer Education Fund 5K Fun Run.

What: Spencer 5K Fun Run presented by Sedgwick

When: April 28, 2015

  • Registration begins at 6:30 a.m.
  • Race to start by 7:00 a.m.

Where: New Orleans (Meet outside Harrah’s)

Now I know what you are thinking…”you want me to get up at 6:30 a.m. on Tuesday morning and run?” Yes that is exactly what I am saying. Why? Because we want to raise funds to increase opportunities for risk management and insurance education students and our goal is to hit $10,000 by the end of the race.

We already have a good number of hearty souls – or is it soles? – registered to participate. (Sorry I couldn’t resist the pun.) Several of us have been training since January and posting our pictures on Twitter. You can view some of those by following @SpencerEdFnd or @Sedgwick #Training. We encourage you to add your #selfies and join our virtual training team.

The most important thing to note: even if you don’t run, you can donate. By donating, you are still supporting the Spencer Education Fund. All the money raised helps grow the number of students who are seeking to make risk insurance a career choice. So don’t wait, visit the site and register or donate. It will be a beautiful race course, a great chance to meet some fellow runners and to meet others who care about the risk and insurance industry.

Watch this short and entertaining video of myself and Jonathan Mast on a recent training run. It gives you a good urban training experience. Thanks to Digistream Investigations for donating the action cameras we used for our training video. Jonathan and I will be wearing these on race day to capture all the fun and festivities.

Spencer 5K training video

If you need more information, please feel free to contact me at Jarrod.Magan@Sedgwick.com or @jarrodsmagan or @jonathandmast on Twitter. Now lace up those running shoes and get moving.

Jarrod Magan, VP, Client Technology Services

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PA-HB467The Pennsylvania House of Representatives is currently considering a bill that would allow employers to direct treatment of their injured workers to coordinated care organizations (CCOs). Employers’ ability to direct injured workers to certified networks of physicians with proven track records of success has been shown to positively affect both medical costs and return-to-work rates.

Sedgwick supports and encourages our clients with Pennsylvania workers’ compensation exposure, and any others who feel it may impact their business, to stand behind this employer medical control bill. Contact your local Pennsylvania legislators and voice your support for House Bill 467; we have drafted a sample letter to use. To identify your Pennsylvania legislator, click here.

Let’s take a deeper dive into what the bill is about. Many employers note high medical costs and long disability durations associated with their Pennsylvania workers’ compensation claims. Studies support this finding; according to the Workers Compensation Research Institute (WCRI) CompScope Medical Benchmarks for Pennsylvania, released October 16, 2014:

  • Medical payments per claim increased 5.8%in the years 2012-2013, driven by hospital inpatient and outpatient payments
  • Longer temporary disability durations and larger settlements drove higher than typical indemnity benefits per claim in the years 2009-2012
  • Litigation expenses were higher in Pennsylvania in the years 2009-2012 relative to other states studied

In an effort to address these concerns, HB 467 was recently introduced before the General Assembly of Pennsylvania. This bill would provide employers who establish a list of one or more designated CCOs for the treatment of employees the ability to require treatment only with participating providers for the duration of their injuries. Currently, Pennsylvania law requires only that an employee incurring a workplace injury seek treatment through a panel of providers (which must be designated by the employer and can include up to four CCOs) for 90 days following the initial visit.

In a memo to all members of the Pennsylvania House of Representatives, Rep. David Hickernell wrote, “Unfortunately, CCOs have never been implemented as intended because they are subject to the same 90-day limit that governs provider panels, so employers have always preferred to simply establish a panel.”

Other states which give employers similar ability to direct care to certified networks have seen successful results. For example, the Texas 2014 Workers’ Compensation Network 2014 Report Card Results showed that:

  • Overall, networks have improved cost performance relative to non-network
  • Networks tended to have lower utilization of hospital services than non-network
  • Networks reported higher return-to-work rates than non-network and had lower average numbers of weeks off from work than non-network.

HB 467 is currently being vetted by the Labor and Industry Committee. If the bill makes it out of committee and passes the House, it will be sent to the state Senate for further caucus/committee discussions and finally a floor vote. Similar legislation proposed in 2013, HB 1646, died in committee.

We will continue to monitor the progress of this bill and keep you apprised of any significant developments. Should you have any questions, please contact your Sedgwick client services representative.

Eddy Canavan, VP, Workers’ Compensation Practice & Compliance

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DOL-spouse-blogOn February 25, 2015, the U.S. Department of Labor (DOL) issued new rules revising the regulatory definition of “spouse” under the Family and Medical Leave Act of 1993 (FMLA), which entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons.

What prompted this change? Previously the definition of spouse for purposes of FMLA was based on the state where the employee resides and, because it is a federal law, it relied on the definition of marriage under the Defense of Marriage Act (DOMA), which defined a marriage as being between one man and one woman. In the U.S. Supreme Court’s decision in United States v. Windsor, the court struck down this definition under DOMA as unconstitutional. However, FMLA regulations maintained the state of residence rule for defining a spouse. This left multi-state employers with the burden of keeping up with the ever-changing same-sex marriage landscape at the state level to ensure employees, needing leave to care for their same-sex spouse, were being afforded the protections of the FMLA based on their state of residence.

Following the Windsor decision, President Obama instructed all federal agencies, like the DOL, to review any relevant statutes and implement that decision. Therefore, the DOL announced its revision of the definition of spouse under FMLA regulations on February 25. The revised definition becomes effective on March, 27, 2015, as follows:

Spouse, as defined in the statute, means a husband or wife. For purposes of this definition, husband or wife refers to the other person with whom an individual entered into marriage as defined or recognized under state law for purposes of marriage in the State in which the marriage was entered into or, in the case of a marriage entered into outside of any State, if the marriage is valid in the place where entered into and could have been entered into in at least one State. This definition includes an individual in a same-sex or common law marriage that either:

(1) Was entered into in a State that recognizes such marriages; or

(2) If entered into outside of any State, is valid in the place where entered into and could have been entered into in at least one State.”

What does this mean for employers who are subject to FMLA? Most significantly, the administration of leaves for same-sex spouses will be less burdensome as employers will not have to keep track of whether a same-sex marriage is legal where the employee resides but rather only if the marriage was legal in the state where it was entered into or as the DOL refers to as the “place of celebration.”

The DOL announcement on the new rules is available here.

Things employers need to consider as a result of this change:

  • Update FMLA policies if they currently include a detailed definition of spouse.
  • Use caution in requiring proof of same-sex marriage if you do not require proof of marriage for opposite-sex spouses for purposes of taking leave.
  • Train supervisors or anyone involved in the FMLA process of the change in definition as some employees will be entitled to FMLA protection where they were not in the past.
  • Remember this change does not impact state leave laws that provide leave for Domestic Partners or Civil Union partners. While the employee would not be eligible to take leave under FMLA (only applies to legal same-sex marriages), they still may be allowed leave under state law.
  • If you outsource your leave administration to a third party, ensure the third party is in compliance with this change.

Do you have additional questions regarding this change? If so I would be happy to answer them. Feel free to leave a response in the comments section or send me an email.

Sharon Andrus, Director National Technical Compliance, Disability Administration

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Dave North, president and CEO of SedgwickI spoke with Robert Wilson at WorkersCompensation.com last month about the upcoming ABA Midwinter Conference where I will deliver the keynote address. Bob asked me what I thought would be important future trends for the workers’ compensation industry. As I told Bob in his blog, “Trying to predict the future by looking at a rear view mirror is complicated and often misleading.” I really believe that we must be looking forward and thinking of innovative ways to address the issues we face today.

The majority of people attending the ABA conference practice law in some form. Legislative change and reform, maybe more so than anything happening in 2015 and the next three to five years, will impact the lives of people who went to work and by the end of the day suffered some type of injury that changed their livelihood. Sedgwick has been focused on how we can make a difference to improve the laws and the processes so that everyone receives the best outcome. I often say our colleagues at Sedgwick are focused on making people whole again.

One initiative that I am very proud of is Sedgwick’s role in the Association for Responsible Alternatives to Workers’ Compensation (ARAWC). Sedgwick is a founding member of this organization whose main objectives are (but not limited to):

  • Delivering better medical outcomes and higher process satisfaction for injured workers without the cost and burden of traditional workers’ compensation.
  • Driving state economic development through the attraction of employer savings.

Sedgwick’s Chris Mandel is leading our efforts on this front and recently wrote an excellent blog outlining the legislative and industry objectives of ARAWC; I would encourage you to read the complete post.

At the conference, I also will address the changes in the law profession and how I see it mirroring some of the same challenges in the medical world. I am very interested to talk to those of you attending and, for those who are not, I encourage you to leave your thoughts here on our blog or reach us on Twitter @Sedgwick and let me know what you think the biggest challenges are in relation to the law and workers’ compensation.

I appreciate the work Bob Wilson and everyone involved with the ABA Midwinter Conference has put in leading up to the conference this week. I encourage you to learn more about the conference and if you can’t come this year think about next year. As Bob said, Naples, FL is probably better than just about anywhere you have been the last three months.

Dave North, President and CEO

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ID-10093552-healthcare-consolidation-cultureConsolidation of hospitals and health systems may have hit an all-time high as health reform and market forces continue to drive mergers and acquisitions. It is important for healthcare organizations to address the cultures that exist in different facilities during the consolidation process. There is a clear relationship between the culture of an organization and its performance. The norms, values and beliefs of culture also have a big impact on behaviors that support, or do not support, a safe environment in which to provide patient care.

The time to begin assessing organizational culture begins with the due diligence process. In addition to looking at financials, facilities and properties, bylaws, human resources, insurance, etc., there is an opportunity to assess vision and strategy, overall corporate culture and, more specifically, safety culture. Leaders should begin planning to merge cultures as early as they plan to merge finances and assets. If they fail to do so, conflicting cultures can, at best, delay a successful merger and, at worst, contribute to a work environment that is unsafe and unreliable. This has implications for the patients receiving healthcare services, as well as the providers and staff delivering them.

A central question to ask is, “What culture do we need to achieve the goals of our merged healthcare organization?” Many organizations seek to implement a culture of respect, one that is safe, and fosters learning and growth. Once identified, leadership must support the creation of that culture. The following steps can help shape the desired culture:

  1. Start with a baseline. Collect the most recent employee and provider satisfaction surveys, patient experience of care surveys and culture of safety surveys for the organizations being consolidated. The results may be very different for each one. Lean what’s best about each one and what needs improvement. Understanding the current state is key to setting goals for the desired future state.
  2. Plan to create the “consolidated” culture. Engage clinical leaders, executives and managers in planning for culture change with alignment of mission and vision. Some organizations hold an offsite retreat for this process. Identify approaches for communicating expectations, modeling behaviors and celebrating successes.
  3. Employ relationship management. Use leadership walkrounds or other forums to build trust. Talk to providers and staff at various levels in the merged organization, gain their perspective, involve them in planning and reinforce their commitment to the organization.
  4. Implement culture change strategies. Leaders and managers must be relentless in communicating and reinforcing the message about the vision for the merged organization’s culture. Allow for flexibility in meeting established goals. Provide rewards in the form of approval and recognition – honor those exemplifying the values being shaped and the culture being melded.

Planning to address organizational culture early on in the merger and acquisition process can mean the difference between thriving in the new world of healthcare and merely surviving in it.

Kathy Shostek, RN, ARM, FASHRM, CPHRM, CPPS, Sr. Healthcare Risk Management Consultant