How health care leadership is evolving during the crises of 2020-2021

Tom Sullivan | April 13, 2021

The multiple crises unfolding since early 2020 have exposed longstanding inequities and problems in health care and sparked a new sense of urgency for today’s leaders to address them in earnest.

To invigorate thinking and establish relationships that drive impactful change, the Health Evolution Virtual Confab 2021 began on Tuesday with discussion leaders sharing their unique insights and experiences about how leadership itself has evolved in the last 12-15 months, the necessary investment to develop future leaders, and what they said needs to happen next for the health care system to strive toward becoming anti-racist.

In many ways, the longstanding real and severe inequities in health care were poised to exacerbate a pandemic such as COVID-19.

“Every organization that is touching health in some way needs to figure out its responsibility and its position to address inequities. Just to be really clear, it’s important to say that even though we assume everyone is on the same page about this, the inequities that we saw in COVID did not surprise a lot of us who have been working in health disparities for decades,” said J. Nwando Olayiwola, MD, SVP & Chief Health Equity Officer, Humana.

Identifying that responsibility and developing strategies to understand and act upon an organization’s position relative to advancing equity requires strong leadership today and among the next generation of leaders moving into the post-pandemic world.

Driving substantive change will impact some of health care’s core values, notably the way in which the U.S. finances and places a value on health, according to Carladenise Edwards, PhD, EVP & Chief Strategy Officer, Henry Ford Health System.

“We need investment in leaders who are willing to identify new ways of implementing change. Notice, I said new ways of implementing change. People who are brave enough and courageous enough to drive change and folks who can execute flawlessly,” Edwards said. “Then we need to figure out how to pay for it. Now, that doesn’t necessarily mean we go to the extremes as the political arenas have done, but it does mean we need that middle ground to make sure everybody gets what they need and has access to health.”

We thought that we were the gifted ones to do things for people and to people. Now we really have to do it with them. We have to engage the voices of those we are serving.

Lloyd Dean, CommonSpirit Health

Leadership among health systems, health plans, policymakers and other executives will have to become even more focused on achieving a future state of equitable access to care at affordable pricing. Among the foundational challenges to equity is earning trust when the systems have been broken and untrusted for so long — duly critical as trust is a necessary component of not just health care but leadership itself.

“As I think about this year and leadership, I’ve become much more intentional about trust. We particularly have been thinking about building and maintaining trust by being transparent, using data, using science, really communicating constantly with folks about what we’re seeing with COVID, why we’re making particularly hard decisions,” said Mandy Cohen, MD, Secretary, North Carolina Health and Human Services Department.

COVID-19, alongside the social injustice, economic and employment turbulence, have called into the spotlight a greater need for science, data and overall transparency among leadership, both for internal and external purposes.

University of California Health, for instance, embarked on work to evaluate its own structures to identify policies that may have survived because they were previously not recognized as unequitable, biased or discriminatory, said Executive Vice President Carrie Byington, MD.  

“None of us want to enable racism and we don’t want to be inadvertently complicit. So we’re looking at important policies that may have been developed 50 or even 60 years ago to determine if we are inadvertently contributing to or exacerbating racism,” Byington said. “We’re taking those hard looks internally and hopefully creating a safe enough space that people feel comfortable sharing and improving together.”

In addition to workforces, creating a safe space for learning and improving is also critical among patient populations and the communities health care organizations operate in. So is understanding how best to serve those groups of people and individuals alike.

“One of the lessons that I have learned, and as a leadership team we are focusing on, is that historically we’ve thought that we were the gifted ones to do things for people and to people. We’ve learned that now we really have to do it with them. We have to engage the voices of those we are serving,” said Lloyd Dean, CEO, CommonSpirit Health. “And I would tell you that I think that I, as a leader, am a better listener now than perhaps I’ve ever been in my career.”

Experts participating in the Confab 2021 agreed that listening is indeed more critical now than ever and equally important is deciding to take decisive action in the short-term that commences and informs longer-term strategies toward a more equitable world for both their own workforces and patient populations.

“The most significant anti-racist action we can take is to implement policies, protocols, and clear definitions around abusive behaviors taken against frontline staff. In a world that’s dominated by ratings and rankings so oftentimes we ignore bad things in the name of making sure that patient satisfaction scores are high,” said Sachin Jain, MD, President and CEO, SCAN Group and Health Plan. “We have to take a hard stance on this and say, ‘there’s nothing more important than actually making sure that the workforce feels safe in the course of delivering care.’” 

Taking immediate directionally correct initial steps will ultimately prove to be a journey that needs refining, if not overhauling entirely, simply because there is no blueprint for an equitable, anti-racist system that can be applied to health care.

“All of us have to learn about what an anti-racist health care system looks like and what anti-racism means. Policy changes and systemic supports are really critical to supporting a diverse workforce and leveraging diversity as an asset to create a business advantage,” said Laurie Zephyrin, MD, Vice President, Delivery System Reform, The Commonwealth Fund. “That can be very challenging but making sure that equity is central to the mission, thinking through how to tie it to business performance, and creating accountability, is the right thing to do.”

Day 2 of the Health Evolution Confab 2021 takes place on Wednesday, April 14. Discussion leaders will continue sharing insights about health assurance in the workplace, improving equity and outcomes among workforces, the power of diversity, measuring what matters, making an impact in the boardroom and servant leadership, among other relevant and timely topics. View the agenda

About the Author

Tom Sullivan, EVP & Editor-in-Chief of Digital Content

Tom Sullivan brings more than two decades in editing and journalism experience to Health Evolution. Sullivan most recently served as Editor-in-Chief at HIMSS, leading Healthcare IT News, Health Finance, MobiHealthNews. Prior to HIMSS Media, Sullivan was News Editor of IDG’s InfoWorld, directing a dozen reporters’ coverage for the weekly print publication and daily website. Contact: or @SullyHIT on Twitter.