The New Face of Health Care: Why Nurses Are in Such High Demand

As new models for dealing with the rising costs of health care emerge, new types of leaders are taking over, with skilled nurses rising to the top.


The national conversation about health care reform focuses relentlessly on cost reduction. While bending the cost curve is extremely important, improving quality is also essential -- but sometimes downplayed -- in today's reform equation. Grappling with quality challenges has attracted a new breed of health care leaders: physician and nurse executives.

Higher quality leads to better outcomes and reduced costs, according to the experts. That's why many organizations are forming Accountable Care Organizations (ACOs), integrated networks of hospitals, clinics, physicians, and other providers held accountable for the quality and cost of care for a specific patient population, such as Medicare beneficiaries. ACOs provide incentives by offering bonuses when providers meet quality standards and keep costs down. For example, providers get paid more for keeping their patients healthy and out of the hospital -- just the opposite of the traditional fee-for-service payment system.

The ACO initiative officially launched this year. Hospitals, physician groups, and payors are scrambling to create their own clinical integrated structures, poised to take advantage of early bonus payments or potential rate increases driven by quality over volume considerations. The Centers for Medicare and Medicaid Services (CMS) estimate that ACOs could save Medicare up to $940 million in the first four years, based on participation levels and successful implementation. However, ACO-style health care remains untested.

These new leaders are arriving with strong clinical backgrounds and nuanced perspectives on patient care as well as physician behaviors.

As new care models emerge, new types of leader are taking the helm: physician and nurse executives. There has been a major uptick in the number of requests for physicians and nurses who are prepared to lead health systems, academic medical centers, community hospitals, and managed care organizations. According to the executive search database at Witt/Kieffer, there are already 64 physician CEOs leading U.S. health care systems with thousands more in the talent pipeline. They are exchanging their lab coats for a seat in the C-suite, taking advantage of opportunities to lead during the post-reform era.

These new leaders are arriving with strong clinical backgrounds and nuanced perspectives on patient care as well as physician behaviors. They are charged with the enormous task of preparing health care organizations to thrive in this age of quality and cost accountability. Most importantly, based on their clinical credentials and patient care experience, they bring the voice of actual caregivers to the executive offices and board tables where strategic decisions are made.

Among physician executives new titles are emerging, such as chief quality officer and chief clinical integration officer, signifying a strategic move to remake the organization's capacity for seamless delivery of care. Physician executives are tasked with bringing the medical staff and the executive team into full alignment. Physician executives understand how providers think and can encourage the consistent use of best practices throughout the medical staff. To be successful, health care organizations can no longer afford to use the "us" (practitioners) against "them" (administrators) paradigm. They need a combined talent approach that puts the best minds on the field, advancing quality, safety, and cost goals together.

Presented by

Christine Mackey-Ross is a senior vice president of the executive search firm Witt/Kieffer. Previously, she worked in nursing administration and as an oncology clinical nurse specialist.

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