Physician leaders as chief / corporate medical officers, or CMOs, in healthcare is not a new concept. Transposing this role to a new sector, senior housing, and elevating it to a corporate leadership position, however, is relatively new. And it is greatly needed.
The senior housing industry is realizing it no longer can sit on the sidelines of managing the multifaceted healthcare demands of its residents. It created a home for these residents and prides itself on its social and hospitality amenities. But it no longer can stop short of addressing the very reason most residents choose this option: a concern for healthcare in an elderly and vulnerable population.
CMOs help guide, direct and manage the increasingly complex healthcare challenges of this industry’s residents. The rapid growth of the senior living sector soon will encompass an entire generation of 72 million baby boomers — born from 1946 to 1964 and turning 54 to 72 years old in 2018 — that is on the road to retiring in the next 10 to 15 years. Life expectancy for those who have reached 65 years is 83 for men and 85 for women, and one in four will live into their 90s.
This silver wave, as some like to call it, will have a significant effect on the senior living sector, because 70% of baby boomers will require long-term care at some point. Annual spending on long-term care in the United States has reached almost $275 billion, with approximately 47% being paid by Medicaid and 23% being paid by Medicare. (Fifteen percent of current assisted living residents rely on Medicaid to pay for daily services, according to the National Center for Assisted Living.) An estimated $450 billion of uncompensated care also is provided by family or friends.
These compelling statistics create the opportunity to rethink the way healthcare is delivered in senior housing to the more than 50 million baby boomers who will reside within its walls.
The early influence of the boomers on senior housing already is being felt. An industry that traditionally has focused almost solely on hospitality now is gradually evolving into a more integrated care setting in which healthcare services are blended with hospitality and housing services to fully support residents’ medical, social and housing needs.
A sign of this evolution in senior housing is evidenced by a few organizations that have incorporated the expertise of broadly educated and highly experienced physicians into the C-suite to help lead and manage the complex healthcare demands of residents. In Canada, Revera has added a CMO and is the only Canadian senior housing corporation to have done so. In the United States, Presbyterian Senior Living in Pennsylvania has implemented a vice president and corporate medical director position and is one of a few to have made this commitment to residents.
How do these physician leaders, in the new role, bring value to their corporations? And how do they improve healthcare services in this setting?
Here are just some of the potential responsibilities of a CMO:
- Help drive alignments with referral networks.
- Act as a liaison between administrators and physicians at all sites within the organization to create mutually beneficial working relationships.
- Correct inconsistencies that occur when individual physicians are unaware or unfamiliar with corporate policies and procedures.
- Encourage physicians to become more committed to the organization through engagement practices designed to improve resident outcomes.
- Participate in operations leadership as well as clinical strategy development and implementation.
- Develop policies and procedures for contemporary issues, such as the use of medicinal marijuana, telemedicine, etc.
- Develop and lead a corporate strategy for data and analytics.
- Support, oversee and expand a nonphysician practitioner program.
- Develop and implement special projects, such as a geriatric psychiatry program; an aggressive, Six Sigma analytic approach to process improvement, such as one to eliminate falls; standardizing the admission and discharge process, crucial in transitioning residents in or out of the community and in preventing hospital readmissions; and reducing offsite transportation costs via partnership of local medical directors with community specialty physicians.
- Connect with other organizations nationally and represent and promote the organization at national conferences.
- Act as an authoritative voice that represents the organization in speaking publicly on topics of interest.
- Work cohesively with the corporate healthcare team to direct an effective and unified corporate approach on important issues and initiatives.
Corporations considering adding a CMO to their leadership need to consider the attributes of the company that would draw potential candidates. The most important feature of a highly effective organization that would attract high-performance physician-leaders is commitment to excellence. This commitment is demonstrated through integration of excellence standards not only into program operations but into management and governance as well. Other features include consistent leadership and alignment among senior leaders, effective change-management processes and open communication that flows in a multi-directional fashion.
Highly effective physician leaders working within innovative and supportive organizations have the power to influence change. The outcome to be expected is the successful delivery of superior quality healthcare and attaining satisfied patients, physicians, allied health professionals and senior leadership.