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Latest Insights in US Healthcare
Episode 715

Amanda Berra, Research Leader at The Advisory Board

Latest Insights in US Healthcare

This episode features the outstanding Amanda Berra, Research Leader at The Advisory Board, a membership-based research organization

Amanda educates us on how her company researches and analyzes the most consequential problems to find answers not just in hospitals and health care but in other fields as well. She shares successes and improved outcomes,  ways to engage with the resources, insights on healthcare, mid-career change, and more. She also talks about systemness, 

some challenges of healthcare CEO’s and many other unique insights drawn from her expertise.  This is a great conversation you don’t want to miss!

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Latest Insights in US Healthcare

Episode 715

About Amanda Berra

Amanda is the Managing Director at The Advisory Board. She works with Health Care Advisory Board, the Advisory Boards’ flagship program for CEOs and strategy executives. She tracks macro changes to the health care market and their implications for different types of players. She also specializes in topics such as governance, hospital-physician partnerships, and reducing unwarranted clinical variation. She’s been leading or advising advisory board research studies since 2003.

Latest Insights in US Healthcare with Amanda Berra, Research Leader at The Advisory Board: Audio automatically transcribed by Sonix

Latest Insights in US Healthcare with Amanda Berra, Research Leader at The Advisory Board: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
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Saul Marquez:
Welcome back to the Outcomes Rocket, Saul Marquez here. Today, I have the privilege of hosting the outstanding Amanda Berra. She leads research studies and also the accelerator program, which creatively applies the knowledge, resources, and services available through advisory board research to top challenges at individual organizations on the research side. Amanda works with Health Care Advisory Board, the Advisory Boards’ flagship program for CEOs and strategy executives. She tracks macro changes to the health care market and their implications for different types of players. She also specializes in topics such as governance, hospital-physician partnerships, and reducing unwarranted clinical variation. She’s been leading or advising advisory board research studies since 2003. And she’s just an extraordinary person and I’m excited to have a great discussion with her here today. So, Amanda, so grateful that you’re here with us today.

Amanda Berra:
Thanks for inviting me.

Saul Marquez:
Absolutely. Now, before we dive into to what you do at the advisory board, talk to us a little bit more about what inspires your work there.

Amanda Berra:
Sure. Well, in general, I mean, I had a whole other plan for my life before advisory board, which you would never know since I’ve been there for at this point, almost 18 years. That had nothing to do with health care. But what I found when I came into Advisory Board, in every sense, is that it’s a great place for someone who likes to learn. So I think for me, the inspiration for pretty much everything that I do in health care is, first of all, just curiosity. I mean, there’s so much to understand in health care. It’s infinitely broad. It’s infinitely deep. It’s super complicated. I’m inspired by just the sheer amount of stuff that you can learn. Also, I have to say, depending on the topic, I’m motivated by frustration sometimes and horror sometimes. Like this can’t be the way that we want to deliver health care. This problem can’t stand. So sometimes those things will inspire some of the work that I do and the research that we do at Advisory Board, but also plenty of optimism. I think that most of the problems we see should have some kind of solution, and I think many of my colleagues think the same. So the quest to figure out what is that answer and how could you turn the ship and move things forward? All of those things have been huge inspirations for me in health care.

Saul Marquez:
That’s wonderful. Yes. That curiosity and man health care is one of those places to your point where just like it doesn’t stop and when you think it all changes and it all begins again. So how would you say, Amanda, what you do and what the Advisory Board does is adding value to the overall health care ecosystem.

Amanda Berra:
Yeah. So for those not familiar, Advisory Board is a membership-based research organization historically for hospitals and health systems mostly and now more diversified. So it also includes medical groups and industry members and all kinds of different folks who live under the umbrella of health care. And basically, it’s all about within the 18 different research programs that live there. It’s about every year figuring out what are the top problems that are faced by whatever is the topic area or the constituency that the research program serves and then prioritizing it, which is huge. So you have all the different things that are going on. And to give and train, what’s the most kind of pervasive, consequential problem or problems for the year? And then we have teams of people who analyze why is this such a common problem? If it’s been around for a while because it’s gnarly, why is that? And then after you analyze the problem, OK, how could you solve that problem or the associated kind of bundle of contributing problems? And then we take that answer and get it out into the market in every way we can think of. So meetings and web conferences and books and podcasts, Right., whatever it was.

Saul Marquez:
That’s fantastic. And it really it begins right. like it begins with an idea or a focus area. And then you guys hone in deeper based off of what the members want to know and what’s important to them. And then you disseminate it via all these different channels.

Amanda Berra:
Yeah, and I would say I mean, the problem today in health care, it’s interesting. I was listening to some of your earlier podcasts to kind of prep for this session. And I heard one where you were talking about the lack of best practice sharing in health care. It’s funny because having worked at a best practice US company for so long, to me, I would say there are best practices everywhere in health care, but it’s just very patchy. So some parts of health care, there isn’t any sharing going on. In other parts, it’s almost too much. But there are like a billion solutions and examples of what others do. But there’s not a good way to filter down to, OK, what problem are we actually solving and then connect with how therefore should we move it forward. So it’s interesting.

Saul Marquez:
It really is. And so as do as you think about the work that you do there and how it’s helping all of us, what would you say makes what you guys do different or unique than what’s available?

Amanda Berra:
That’s a good question. Well, so in answer, I would say that there’s different kind of categories of sources of best practices out there and advisory boards different from all of them. So, for example, there’s consulting and there’s research that’s part of consulting. But to me, what Advisory Board does is that is different is I’m not really trying to sell any given solution. Like I’m just trying to answer the question as opposed to type an engagement. So to me, that’s better. I feel better about the fact that I don’t have any particular axe to grind in contrast to like academic research. I think advisory board can be a little bit more real-world in some ways. And also speaking as someone who does it, there’s not any pressure on me to be original. I don’t have to come up with some world breaking theory that is different from what anyone else has ever said. My goal is to reflect back on reality And how would you actually fix this? Even if the solution is in plain sight and others have said it, I can just say, hey, this other person discovered it. So you should check that out. And for me personally, coming from reporting, the big difference is I don’t have to do this research by myself. We actually operate as part of a team and a group all the time. So to me, that helps come up with some better answers. We get out there and talk to people. We interview a ton of hospitals and health systems. We read everything and then synthesize it, try to try to come up with sort of a simple takeaway answer that people can use.

Saul Marquez:
I love it now. Well said, Amanda. It’s the real world. It’s actionable. There’s no vested interest. It’s a really great way to do things. And so how would you say what you do has helped improve outcomes or improved on any business models out there?

Amanda Berra:
Great question. So that the challenging part about health care is every different part of it is trying to accomplish something different and or in some cases there are a lot of different goals in the mix. So if you look at advisory board research, it depends what the topic is. Some of the research that we do, the outcome, if it’s a quality problem, the outcome of the project would be to raise quality. So, for example, my colleagues a few years ago put out a big study about cancer lung screening programs and how you could set them up more efficiently. And the outcome of that was that the patients who used this type of model were caught in an earlier stage of the disease compared to before the hospitals or health systems implemented that model. In other cases, the research that we do, you would look at how costs went down from one year compared to what was projected and staff engagement scores rose overreduced mean for me the big success story for health systems that I work with because I spent a lot of time in strategy is someone saying, hey, that helped us to get organized on this and move out Right. innovation at our health system. We were doing a ton of it, but it wasn’t super formalized. Now it’s more organized, things like that. Thanks for helping us get a bunch of different efforts organized and moved forward.

Saul Marquez:
Yeah, and so what would you say is the best way to engage with the content you guys deliver? Right. Because at the beginning you mentioned webinars, podcasts, articles. Where do you start?

Amanda Berra:
How do you find the front door? Yeah, well, so there are resources that are available for anyone. And then also since it is a membership organization, there are some that are for members, for anyone. I would say if you search by topic, you will find some things that are in the public domain. So some blog posts. We also do have a podcast called Radio Advisory that explores different health care issues that are topical from week to week. And then if you’re a member, you can try searching the website. If you can’t find what you’re looking for, I would say call somebody the benefit of advisory boards it’s been around so long, it has so many different programs within it. The answer’s probably in here somewhere, but you might have to actually get on the phone with the union in order to track down exactly what you’re trying to find.

Saul Marquez:
I love it. Yeah, that’s great. And so, folks, Radio Advisory’s their podcast. Give them a listen. RadioAdvisory.Advisory.com, I’ll leave a link. They’ve done quite a bit over 50 episodes and all super researched, really interesting things. So definitely worth a listen. Make sure you listen to that. And so, Amanda, as you reflect on you’re almost 18 years there. It’s crazy how fast time flies. What would you say is one of the biggest setbacks you’ve experienced and a key learning that came out of that?

Amanda Berra:
Sure. So knowing you were going to ask this question, I spent a lot of time thinking about setbacks. And honestly, of course, I have made so many mistakes and there are so many great examples of things that I would do over or that are lessons learned. But I think a good one that people can learn from is back in 20. I think 15. I had an experience where I had the opportunity to hop from the health care practices with an advisory board to the higher ed practice that we had at that time. So we used to actually have everything. Advisory board does exist for colleges and universities and I had an opportunity to move over there, which the reason for doing that was basically sheer curiosity on my part. Like I don’t know anything about this. And I would say it ended up being a huge learning experience in every way. Right. It turned out to be extremely difficult to go from something that I had at that point, a decade-plus of experience in to something that I knew nothing about besides having experienced higher ed as a student. And at the end of the day, I figured out that I probably can offer more value in the industry, that I’ve accumulated all this contextual knowledge. And I ended up coming back to the Advisory Board. I would just say for me, a learning and something I would share with other kind of mid career professionals who are curious and always looking for new challenges is within health care. There’s so much you can do, right?

Amanda Berra:
If you want to try something new or learn something new, look within the context of what you’ve built up, all of your knowledge and expertise in and build on that as opposed to trying to find something completely new where you don’t have that advantage of all that of all the knowledge that that’s the lesson that I took away.

Saul Marquez:
Yeah, no, that’s great. And it’s a good lesson to learn. And you’ve got this deep, rich domain expertise. But I think it’s great that you made the move and you sort of got a chance to look back and reflect. And oftentimes it’s making those moves, learning those lessons to really even gain a sense of appreciation, wom’t you say?

Amanda Berra:
I absolutely would say so. It’s there unless it’s a really horrible experience, it’s hard to say. I wish I hadn’t done that and I don’t wish I hadn’t done it. Right. I met amazing people. I learned amazing things. And I will say from the health care perspective now, when I talk to academic medical centers, having spent time looking at universities, I definitely understand their world a little bit better. There’s always so much you can learn. But you will have an easier time if you can build on the engine, use the engine you’ve already built. Of all that knowledge, you can always you can always try something new and find a new corner to look around that uses some of the skills that you have.

Saul Marquez:
Great piece of advice. And Amanda, what are you most excited about today? I mean, you research a bunch of different neat things. You have a firm hold on kind of what’s going on at the macro level of health care. What excites you the most?

Amanda Berra:
There’s I mean, there’s always so much. But right now, for me personally, The Advisory Board, the team that I work with is doing a lot around what health systems call systemness. So, you know, any big hospitals are consolidating, systems are getting bigger, and they’re all also restructuring and reorganizing to try to move from a holding company type approach to an operating company type approach. It’s like, hey, we want to be more coordinated, we want to be more efficient. We want to get economies of scale. We want to take pockets of excellence that exist somewhere in the system and scale them up everywhere so it’s more standardized. But we also don’t want to be all corporate about it and stamp out all the variation that’s good and individual brand identities or cultural identities that exist within the system. So we’ve been doing a whole lot of research about what systems are actually doing and the fact that they don’t all even have the same goals. If you look at, for example, an integrated delivery network that really is trying to build a unified clinical delivery system, that’s one end of the spectrum. Other systems like big, big for-profit chains or something like that are not actually trying to be the same everywhere. They are actually may do things like encourage some internal competition. So what I’m most excited about right this moment is sharing some of the research that we did about that and working with individual systems to kind of clear up, OK, when it comes to systemness, what are the things that we’re trying to do as an enterprise? Where are we tripping up because of inconsistencies and duplications and disconnects? How could we solve that? And then what are some commonsensical things that any system should be able to do? For example, you should probably be able to flex staff across facilities and even regions when you need to. The covid challenge taught us that, but many systems can’t. So that would be like a foundational consideration that most systems should look at building in as a competency. Those are the kinds of discussions I’m really excited to work with systems on right now.

Saul Marquez:
That’s fascinating. And you happen to work with many CEOs and strategy people instead of health care. So you’re having these conversations weekly.

Amanda Berra:
Yeah, and that’s because they’re having these conversations all the time with me. It’s interesting if you look at some of the other types of organizations that you have on the show, Right., if you’re a startup or something like that, it’s relatively small type organization, has a clear goal trying to get to scale , get to IPO. Health systems are trying to do all kinds of different things. They I sometimes call them like the rhumba of strategy. Right. They’re trying to do like five different kinds of goal sets at any given moment. They have not just multiple hospitals, each of which have hundreds or thousands of people who work there, but often multiple different markets, tons of different stakeholders. And it’s really hard for them to make sense of all of those things and tell a coherent story to everybody who’s even just part of the organization about why are we doing the things that we’re doing if we need to change, why? What are we trying to build? What therefore do we need to do this year? how do we need to come together around common goals? They’re all trying to do that. And it’s really impressive to watch them try to make sense of all of this and turn the ship. But everybody needs to they need to get cost down. They need to get quality up. They need to improve patient experience. They need to address the staff burnout problems that they have. All clinicians are burned out and they need to figure out ways to do that efficiently with the resources that they have.

Saul Marquez:
Well, yeah, it’s certainly so true. And you called it the rhumba of strategy. I love that. I think it is the correct way to describe it. And kudos goes out to all the health executives out there leading these provider organizations. It’s not easy. We’ve had a lot of challenges this past year, so hopefully we’re learning from it. It’s intriguing, this idea of the of this going from holding company to sort of operations approach a lot of really interesting ideas. Amanda, can’t thank you enough for the curiosity that you’ve sparked in me, but also in the listeners. Just want to remind everyone that The Advisory Board is cranking out this type of thought leadership. Amanda does such an incredible job of it, so be sure to check them out. We’ll leave links to how to engage with the blog that she mentioned at the beginning of the podcast, their own podcast. So, Amanda, before we conclude, I love it if you could just share a closing thought and where the outcomes rocket listeners could get in touch with you.

Amanda Berra:
Sure. OK, closing thought kind of related to this complicated organization topic for those who work in leading big complicated organizations or those who want to work with them as customers. My thought for you is spend time trying to figure out what problem we are solving at any given moment in time. It’s really easy to throw out a lot of solutions, pursue a lot of different kinds of things, but especially now, again, in the COVID era, no one has time to chase everything right. In the COVID era, most system leaders will say, we want to transform, we want to learn from this. We want to use this time as a springboard. But also we’re exhausted. Our people are exhausted. Our resources are constrained. So spend time thinking about what problems are we trying to solve, which ones actually need solving right now and which ones is it OK to kind of put aside and be kind to yourself and your teammates and your customers knowing that they just have so much going on? You can always find me at Advisory.com. Send me an email. I’m BerraA@advisory,I am on Twitter kind of intermittently, but you can follow me there and I’m on LinkedIn.

Saul Marquez:
Outstanding. Well, Amanda, fantastic. Thank you so much for sharing your expertise and your unique insights. Health care today, we are certainly grateful for you and definitely looking forward to staying in touch.

Amanda Berra:
My pleasure. Thanks for inviting me today.

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Things You’ll Learn

  • If you want to try something new or learn something new, look within the context of what you’ve built up, all of your knowledge and expertise in and build on that as opposed to trying to find something completely new where you don’t have that advantage of all that of all the knowledge.
  • There’s always so much you can learn. But you will have an easier time if you can build on the engine you’ve already built. 
  • Spend time trying to figure out what problem we are solving at any given moment in time

 

Resources

Blog: https://www.advisory.com/blog

Podcast: https://radioadvisory.advisory.com/

Website: https://www.advisory.com/

LinkedIn: https://www.linkedin.com/in/amanda-shoemaker-berra-9801a72/

Twitter: @AmandaBerra