2 min read June 2023 — Joseph Machicote, chief diversity and inclusion officer at Premier, talked about defining and reframing culture as a strategy for recruitment and retention, how conversations around equity need to be context-specific and locally grounded, and how the healthcare industry has evolved by engaging in more practices that build trust within communities.
What have been some of the key highlights for Premier in 2022 and where do you see your priorities lined up for 2023?
Premier is a healthcare improvement company with a mission to improve the health of our communities. We work with more than 4,400 hospitals and health systems and approximately 250,000 other providers, supporting them with integrated data and analytics, collaboratives, supply chain solutions, and consulting and other services, helping to enable better care and outcomes at lower costs.
Just as people can deal with symptoms of long COVID-19, the healthcare industry also has issues stemming from pandemic fallout and macroeconomic issues that it is working through. Our hospitals and health systems are still seeing post-COVID-19 labor and wage challenges. While this doesn’t change our role and mission, we do need to strategize so that we can assist our members by making sure they have access to critical supplies and that they have the solutions needed to deliver high-quality care.
To this end, we are delivering innovative solutions that we are confident will help support our members (hospitals, health systems, nursing homes, etc.) as they emerge from this unprecedented crisis. This includes leveraging our legacy group purchasing power to lower non-labor costs – without sacrificing outcomes – for all healthcare providers. It also includes building out our direct sourcing business – S2S Global® – to ensure our nation has a healthy and resilient supply chain. We are also doubling down on PINC AI™, our suite of AI-enabled clinical, margin improvement and value-based care technology solutions. Lastly, we are expecting tremendous growth from Contigo Health®, our contract platform that connects self-insured employers with providers.
What are some successful recruitment and retention strategies that you are using?
We are at an inflection point when it comes to work culture right now. Culture is what attracts people to an organization, keeps them there and can ultimately chase them away. Today, when you have hybrid and work-from-home arrangements, people talk about the kind of culture that we lost during the COVID-19 pandemic.
For example, in a remote world, I basically need an appointment to give my colleagues a high five or have a quick conversation, whereas before I could walk into their office and just high five or deliver a message in real time. That has definitely changed workplace culture. As we work through this new cultural paradigm shift, if we focus too heavily on what was, then we are going to miss the opportunity of what could be. This is a challenge for employers of all stripes.
There are a lot of buzz words that have been used over the last several months, such as ‘burnout’ or ‘quiet quitting,’ but the behaviors and feelings the terms characterize have been around forever. We need to work on modernizing culture by taking everything that worked pre-COVID-19 and redefining the cultural context for this next evolution of human interaction.
The healthcare industry is grappling with these issues because we are dealing with a legacy culture in a new work era that is being compounded by talent shortages, due in part to those in the field retiring at an unprecedented rate. Since people are leaving medicine, it is incumbent on those of us in the industry to reinvigorate and generate an interest in pursuing careers in the field. Just like the sports industry has figured out how to recruit talent in middle school, we need to do a better job of making young people excited about the opportunities in healthcare. You don’t have to be a nurse or a doctor – there are an infinite number of job functions in medicine that so many are unaware of. We have a unique opportunity to bring the “cool” factor back to this industry.
How is the healthcare industry overall addressing issues of equity and what can be done better?
I believe health equity means that everyone has a fair opportunity to be healthy and that when they are visiting medical professionals, they are being asked the right questions with respect and attentiveness. Premier specializes in collecting and analyzing data that we can use to follow the patient journey and ensure our members are delivering high-quality care.
From a health equity point of view, the conversations we are having really highlight the difference between context and content. Health equity is the North Star, so we should all be working on the content of how you get there. Today, I find that there are more content conversations going on when it comes to health equity, whether that be around racism, class, socioeconomics, zip codes, rural and urban neighborhoods, or any number of different issues. We all know that there are hundreds of different social determinants of health, so what people need to solve within different communities is understanding the needs of the specific population because every community is different.
From there, we are seeking to understand what the critical issues are in any given community. For example, in some communities, health equity is focused on race, while in a community with a more homogenous population, race might not be the fundamental issue. It comes down to the population you are dealing with and then addressing the needs of the individual, taking a patient-centric approach instead of just focusing on a specific issue and applying a one-size-fits-all approach.
How have you seen the healthcare industry evolve and change throughout your tenure and if there are any noteworthy trends right now?
I grew up in Harlem in New York City, and I’m Hispanic and Black, so most of my family suffers from high blood pressure. Most of the folks on my mother’s side at some point in their lives have had strokes, so I try to be a strict, healthy eater. But, growing up, the nearest supermarket was several blocks away from my home. Fortunately for me, my mom was a nurse, my grandmother was a nurse, and my great-grandmother was a nurse, and I was raised by all three of them. They were able to give me a very different health experience than most of the people in my community.
Closing the gaps in education is a core area that we have seen improvement in – and it is critical that we continue to chip away at this issue. It impacts every facet of life – it is table stakes. With regards to healthcare, if we better educate our communities, we will begin to dissolve the lack of trust many have in the healthcare industry. We will see folks be better able to advocate for themselves and the patient-clinician partnership strengthen resulting in health equity improvements.
Here in Charlotte, I have got to give kudos to Atrium Health for all of the work they are doing. I am working with a couple of individuals from Atrium in an effort to address homelessness, which is obviously a primary social determinant of health. The fact that an individual does not have a safe home – and all the things that go with that, including a refrigerator to put food and medication – is a critical problem and barrier to good health. It is table stakes. I see Atrium trying to solve the problem from the contextual point of view – how do we get people in homes. I am seeing a lot of trends in the right direction and am optimistic we will see scalable solutions come to the fore.
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