Kimberly Smith, Partner and Managing Co-director, Eastern Region, Witt/KiefferMedical Travel Today (MTT): Lets start with a bit about Witt/Kieffer and your background as it relates to healthcare. What can you share with us? Kimberly Smith (KS): Witt/Kieffer is an executive search firm thats been in business for more than 40 years. Our historical focus and the lions share of our current focus is on the healthcare industry, and most of our efforts center around helping organizations like hospitals, health networks, physician groups, insurers and other groups find and place higher-level healthcare executives. Roughly 80 percent of our work is in this area, while the remaining 20 percent falls mainly in the areas of higher education and non-profit organizations. I was an executive for several healthcare organizations for many years, and so it was a natural transition for me to become a search consultant and help similar organizations to find new leaders. MTT: You were recently quoted in FierceHealthcare as saying that, for most health systems around the country, the re-election of President Obama validates what they have been working towards anyway. Can you elaborate on that? KS: Before I address the quote, let me offer some context. Ive spent most of my career in healthcare, and I reside in Massachusetts where healthcare reform has already been in effect for several years. Weve gone through the trials and fits and starts that comprehensive reform entails. Even with the challenges to implementation, its clear that integrated deliverya key aspect of reform where organizations are able to provide a so-called continuum of care to patientsis the best model for care delivery and that the trend toward integration is inevitable. Aligning incentives and shared risk and shared investment in the outcome of patient care is inarguably the right thing to do. So even though these are aspects of government reform, healthcare professionals and organizations have been moving in that direction for some time. I think its safe to say that, even if Obamacare had unwound, most health systems were going to adopt dramatically different models and types of care anyway. MTT: How do you see healthcare reform impacting the growth of medical travel, both domestic and international? KS: In general, reform is encouraging larger health networks and new types of insurance plans, both of which are opening up opportunities for patients to seek care in facilities and locations they previously could not go to. At the same time, reform is also encouraging hospitals and health systems to reach out to a broader patient base. Let me provide one example: A key element of reform is bundled payments, or packaged pricing of care costs. Inbound medical travelers from abroad are, for the most part, paying cash, meaning their payment is unfettered by federal, state and commercial payers and the bundling requirements. In the healthcare world, there is very little cash business left. The beauty of the inbound medical tourist is that the revenue drops immediately to the bottom line. Therefore, its likely that large healthcare providers that have the resources will continue to reach out to these tourists. On the domestic side, the important thing for healthcare providers is not just to grow ones market, but to also keep a steady volume of patients coming to facilities. In the case of surgical centers, for example, youve got so much invested in fixed overhead in operating rooms that you have got to drive well-paying volume through it. In some places operating rooms run 24/7, and any down time is a financial drain. Appealing to domestic medical tourists is a way of making this happen. These are just a few ways that reform is impacting medical travel and will continue to do so. MTT: What are the obstacles to the acceptance of medical travel and do you see those being overcome in the near future? KS: On the inbound side Id say theyre the same thing you or I would have traveling abroad. Things like potential language barriers, finding a place for family members to stay, ensuring that they can take time off from work to accompany you, etc. In addition, it simply takes a lot of resources, including money. Not everyone can afford to do it. As for the outbound U.S. traveler, I think the biggest issues are in the area of liability and malpractice issues and security. As Americans were very accustomed to having a certain level of emotional security and guarantees that well receive the best possible care. As an example, in many countries you can get over-the-counter medicines that we cant get here. Thats because we have a Food and Drug Administration (FDA) and other protections in place that are designed to ensure we get treated well and are not unnecessarily harmed by care or medication. Not all Americans are fully informed about the lack of protection that exists when traveling abroad. When there are few regulations, risks go up. I would urge all medical travelers, regardless of point of origin and destination, to always be mindful of the cost/safety balance. It has to be considered. As for Americans traveling domestically, I think there are just some ways of thinking that will have to be overcome. So many people are accustomed to their insurance paying for everything, but this is changing as new types of coverage are emerging. For example, lines between states are blurring as healthcare networks cross borders and employers with operations in multiple states seek the best care and plans for their workers. This is opening up the potential for employees to seek care beyond the limits of their traditional providers, and is really opening up domestic medical travel options for these employees. MTT: In your efforts to place high-level executives, is knowledge of medical travel a desirable factor? KS: It depends on the persons role. If were asked to do a search for, say, the senior vice president in Planning or Business Development at a Mayo Clinic or Lahey Clinic, there would be an expectation that they are familiar with or connected to the industry. For many of the systems we work with that have international operations, Id say that its a given expectation. However, I will also say this: For executives who have worked at major hospitals and health systems overseas, coming back home and finding work is not always easy. For whatever reason, their domestic peers dont always view their experience as relevant to whats happening here. Its unfortunate because they tend to come back with a broader sense of how to deliver care and a new level of cultural sensitivity. These are things that should be valued. About Kimberly Smith, FACHE Kimberly A. Smith, partner and managing co-director of the Eastern region for Witt/Kieffer, applies leadership development, operations, physician relations and staff and patient satisfaction expertise when identifying the right candidates for her clients. Based in the firms Boston office, Kim conducts searches for senior executives on behalf of hospitals, health systems, integrated delivery systems, managed care clients, colleges and universities, and community and cultural organizations. Kim joined Witt/Kieffer after many years in senior-level operations and human resources at Northeast Health System and Beverly Hospital in Beverly, Mass. She served as chief operating officer for the Beverly Hospital Hunt Center and was an integral member of the senior management team that positioned Northeast Health as a leader in vertically integrated healthcare systems. Most recently, she was president and CEO of Jewish Memorial Hospital and Rehabilitation Center in Boston where she had executive accountability for the 207-bed long-term acute care hospital. She has also served on a number of committees in the Massachusetts Hospital Association in Burlington. Kim is currently active in the advancement of healthcare leadership, which includes serving as a Fellow in the American College of Healthcare Executives (FACHE) and as president of the HealthCare Management Association of Massachusetts, a chapter of the ACHE. In addition, she has served in leadership roles in community organizations. She is the former chair of the Southern Essex Workforce Investment Board and the former co-chair of the North Shore Healthcare Consortium, a collaboration of more than 20 hospitals and higher education institutions. She also chaired the Cooperative Education Employer Advisory Board of Gordon College in Wenham, Mass., for 10 years.
