As a leader in rural healthcare, I can attest firsthand to the indispensable role the 340B Drug Pricing Program plays in maintaining healthcare access for our most vulnerable communities. For over 30 years, this program has served as a lifeline for rural and safety-net hospitals across America, allowing us to stretch limited resources and continue serving patients regardless of their ability to pay.

The 340B program represents a rare policy success: it costs taxpayers nothing while delivering tremendous value to communities in need. By requiring pharmaceutical manufacturers to provide discounts to qualifying hospitals in exchange for Medicaid and Medicare participation, the program helps offset the rising costs of medications that threaten to overwhelm our healthcare systems.

Rural hospitals operate on razor-thin margins. They serve communities with higher percentages of elderly, low-income, and uninsured patients, while facing all the challenges of attracting healthcare professionals to non-urban settings. The harsh reality is that without programs like 340B, many rural hospitals cannot survive.

Last week, my father-in-law passed away. As we all wrestle with and reflect on this loss, it’s hard not to think about the legacy he leaves behind – in the way he lived and the lasting impact he had on everyone around him.

We all leave a legacy whether we intend to or not. It's about the impression we make on the people in our lives, the values we demonstrate daily, and how we're remembered when we're gone. My father-in-law never set out to create a legacy. He was just living his life according to what he valued. Yet, in doing so, he left behind powerful lessons about what matters most.

In our continuing leadership blog series, we're pleased to feature Jess Nuutinen's insightful exploration of shared governance—a cornerstone concept in modern healthcare leadership. Jess brings a wealth of experience to this topic, offering a thoughtful analysis of how collaborative decision-making transforms healthcare organizations. As Frontier Strategy Partners continues to examine diverse leadership approaches, Jess's perspective highlights how distributing authority and responsibility across all levels of healthcare professionals creates more resilient, innovative, and patient-centered organizations. Her practical framework for implementing shared governance reflects our commitment to providing actionable leadership strategies that can be applied across various healthcare settings. Join us as Jess illuminates this powerful approach that bridges the gap between frontline caregivers and organizational leadership.

Shared governance is a vital framework in health care and nursing that promotes collaboration, accountability, and empowerment among nursing staff and other health care professionals. By fostering a participative decision-making process, shared governance allows nurses to have an active role in shaping policies, procedures, and practices that directly impact patient care and workplace dynamics.

Organizations face unprecedented challenges that demand focused strategic responses. Yet many healthcare institutions struggle with strategic clarity—developing plans that are unwieldy, difficult to communicate, and even harder to implement effectively. The A3 methodology offers a powerful solution to this common challenge.

Originally developed by Toyota as part of their lean management system, the A3 approach has found remarkable resonance in healthcare settings. Taking its name from the international paper size (11x17 inches) that serves as its canvas, this methodology constrains strategic documentation to a single page—forcing clarity, precision, and prioritization.

Delivering sustainable results requires more than just setting broad organizational targets. True success comes from creating a comprehensive system where every aspect of the hospital, from executive leadership to individual departments, aligns its efforts with a unified purpose. At the heart of this alignment lies a structured approach to goal setting that ensures the organization moves forward cohesively toward its mission and vision.

The strategic pillar framework offers healthcare organizations a powerful methodology to measure success across critical operational areas. By organizing goals around five foundational pillars—Quality, Workforce, Patient Satisfaction, Finance, and Community—hospitals create clear pathways for improvement while ensuring that priorities cascade effectively throughout all levels of the organization.

Communication stands as the foundational element that shapes organizational culture and drives employee engagement. Far beyond the simple exchange of information, strategic communication serves as the invisible architecture that aligns teams, builds trust, and propels organizations toward their goals.

Successful organizational communication hinges on three critical dimensions: the message content, the delivery mode, and the target audience. When these elements are strategically aligned, communication transforms from a mundane operational function into a powerful catalyst for organizational cohesion and performance.

We're delighted to launch our leadership blog series featuring unique insights from across our talented team at Frontier Strategy Partners. Craig Saylor kicks off the series with his thought-provoking piece on "Essential Leadership Tools" - a compelling exploration of intentional leadership practices that challenge conventional approaches. Drawing from his extensive experience, Craig offers valuable perspectives on mission-driven leadership, fact-based decision-making, team empowerment, and achieving meaningful work-life balance. His practical wisdom sets the perfect tone for this series, demonstrating the caliber of insights you can expect in the weeks ahead. Craig's ability to distill complex leadership principles into actionable strategies exemplifies why he's such a valued voice in our organization and the healthcare leadership community. We hope you'll find his observations as inspiring and applicable as we do.

Physician recruitment has become more than a matter of filling positions—it's about creating meaningful connections between talented healers and the communities they serve.

At its core, physician recruitment tells a deeply human story. It's about professionals who have dedicated their lives to healing, searching not just for a place to practice, but a place to belong. Healthcare organizations must recognize that beyond competitive salaries and cutting-edge facilities, physicians seek environments where they can make meaningful contributions, grow professionally, and find fulfillment in their calling.

Many physicians carry memories of environments where they were “put on a high-speed treadmill and forgotten” (actual quote from a previous Physician I recruited regarding the culture of his/her prior employment)—their insights overlooked, their concerns minimized, their growth stunted. These experiences profoundly shape what they seek in new opportunities: workplaces where their voices matter, their expertise is valued beyond clinical skills, and they can actively shape the future of patient care.

It's been just short of one week since we crossed the Nebraska state line, greeted by those familiar words: "Nebraska - the good life." After several days immersed in this community, I can confirm that simple phrase holds even more meaning than I anticipated. It's not just a slogan on a highway sign, but a lived reality of the community we've joined, the life we're building, and the good we're already beginning to do together.

During my interview process, I found myself looking up in Lexington High School's cafeteria where 46 flags hang, each representing a different nation, each telling a story of journey and belonging. Now, after a week of meeting the people those flags represent, I'm even more moved by what this symbolizes. These aren't just decorations—they're declarations of a community that has chosen to celebrate its diversity rather than be divided by it.

Emotional intelligence (EI) continues to be recognized as a cornerstone of professional success in today's complex workplace. Since our previous exploration of EI assessment tools, the landscape of work has evolved significantly, presenting new challenges and opportunities for applying emotional intelligence principles. This updated perspective aims to deepen your understanding of how emotional intelligence can be leveraged for both personal growth and team development in contemporary work environments.

Organizational culture often serves as the invisible architecture supporting everything from day-to-day operations to long-term strategic goals. While metrics such as patient satisfaction scores and clinical outcomes deservedly command attention, the cultural foundation of an organization ultimately dictates how effectively these objectives are realized.

We're thrilled to announce a new weekly blog series focused on leadership from the diverse voices of our Frontier Strategy Partners team. Starting next Monday, March 10th, each week a different member of our team will share their unique perspective on leadership, drawing from their wealth of experience and expertise. This series aims to provide you with practical insights, strategies, and tools that you can implement in your own leadership journey.

Our first contribution will come from Craig Saylor, who explores "Essential Leadership Tools" - a thoughtful examination of how we can lead with intention rather than simply falling into established patterns. Craig challenges us to reconsider how we approach leadership positions and offers concrete strategies around mission-driven efforts, embracing facts, equipping our teams, and maintaining work-life balance.

Many of us reach a plateau in our careers where improvement seems to stall. Despite our best efforts, we may find ourselves unable to identify the barriers holding us back or the specific changes needed to overcome them. This phenomenon is precisely what renowned surgeon and public health innovator Dr. Atul Gawande explores in his insightful presentation on the profound impact of professional coaching.

Dr. Gawande shares a compelling personal narrative about his journey as a surgeon who, after years of practice, found his improvement curve flattening. Like many accomplished professionals, he initially experienced steady progress in his early career, watching his complication rates drop year after year. But after about five years, this improvement plateaued, leading him to question: "Is this as good as I'm going to get?"

What follows is a remarkable testament to the power of external perspective. Dr. Gawande invited a retired professor to observe his surgical technique—a practice uncommon in his field but standard in others like music and sports. Despite believing his performance was flawless, he received a page full of observations about small but significant details he had missed: suboptimal lighting, improper elbow positioning, and other subtle inefficiencies that affected his performance.

Organizations face a constant stream of new ideas, opportunities, and potential projects. While innovation and forward thinking are essential for growth, attempting to pursue too many initiatives simultaneously often leads to diminished results across the board. This creates a fundamental tension: how can organizations maintain laser focus on current strategic priorities while ensuring valuable future opportunities aren't lost?

Most organizations have a set of primary initiatives that demand significant resources, executive attention, and cross-functional collaboration. These initiatives typically represent the organization's most important strategic priorities and require sustained focus to execute successfully. However, during the execution of these critical initiatives, new ideas continuously emerge. Some arise from market changes, others from customer feedback, and still others from internal innovation. Each may hold tremendous potential value, yet adding them to an already full plate risks diluting focus and compromising overall execution.

Hospital leaders must continuously balance essential operational demands with long-term strategic goals in an increasingly complex healthcare landscape. A practical framework gaining traction is the concept of "big rocks"—critical but non-differentiating initiatives that, while consuming significant resources, sustain hospital operations without driving competitive advantage.

"Big rocks" represent substantial organizational commitments that are crucial to operations but do not inherently enhance market differentiation. These initiatives require extensive resources and attention but primarily serve to maintain hospital functionality rather than provide a competitive edge. Typical examples include facility renovations, electronic health record (EHR) system implementations, and regulatory compliance programs—necessary components of healthcare operations that rarely create strategic distinction.

We often find ourselves paralyzed by anxiety and indecision when facing difficult choices. What if there was a systematic method to overcome this paralysis and make better decisions, especially during our darkest moments?

Over this past year, I've discovered the transformative power of Stoic philosophy in my own life. During a particularly challenging period, these ancient practices provided me with a practical framework for navigating uncertainty and making difficult decisions with greater clarity. What began as intellectual curiosity evolved into an essential toolkit for emotional resilience and rational decision-making when I needed it most.

This personal experience is precisely why Tim Ferriss's presentation resonates so deeply. He articulates and systematizes the very principles that many of us discover through our own trials with uncertainty and adversity.

When an employee decides to leave an organization, their departure creates a unique opportunity. Exit interviews, often conducted as a mere formality, can instead serve as powerful diagnostic tools that reveal underlying cultural dynamics and trust issues within an organization. These final conversations offer insights that might otherwise remain hidden beneath the surface of daily operations.

The value of exit interviews lies in their timing and context. Departing employees, freed from concerns about career repercussions, tend to provide more candid feedback about their experiences. This honesty creates a window into organizational realities that standard employee surveys or performance metrics might miss entirely. The retrospective nature of these conversations allows employees to articulate patterns observed throughout their tenure, providing longitudinal data about how culture and trust have evolved over time.

"Sometimes the best you can hope for is gridlock." This statement reflects a perspective on American politics that has become increasingly common. Yet beneath this cynical observation lies a more nuanced reality about how the American political system was designed to function and how balanced government can potentially restore the practice of compromise.

The American system of government was intentionally structured with competing powers and overlapping authorities. This design creates natural tension between branches of government and between federal and state authorities. These tensions were not accidental but purposeful—the founders believed that good governance would emerge from deliberation, negotiation, and compromise. In this context, compromise represents a strength of the system, not a weakness. It's the mechanism through which diverse perspectives combine to create more robust and well-considered solutions than any single viewpoint could produce alone.

In emergency departments across America, healthcare providers face a daily ethical and legal mandate: treat every patient who comes through their doors, regardless of ability to pay. This obligation, enshrined in federal law through the Emergency Medical Treatment and Active Labor Act (EMTALA), stands in stark contrast to the practices of health insurance companies, which retain the power to deny coverage for these very same emergency services after they're provided.

This fundamental disconnect in the American healthcare system has long frustrated providers and patients alike. Now, a groundbreaking proposal in California seeks to address this imbalance by holding insurers financially accountable for improper coverage denials. The legislation, which would impose penalties on insurers who repeatedly deny valid claims, represents one of the boldest attempts yet to reform how insurance companies handle coverage decisions.

With Berkshire Hathaway reporting $47.4 billion in operating earnings for 2024, Warren Buffett's latest insights offer timely lessons for healthcare organizations aiming to strengthen their investment programs. Hospitals and health systems face unique challenges: they must balance strict regulatory requirements, credit rating considerations, and community care obligations while pursuing long-term financial stability.

One of Buffett's most pointed observations centers on the vulnerability of paper currency. "Paper money can see its value evaporate if fiscal folly prevails," he warns, noting that "in some countries, this reckless practice has become habitual." This caution is particularly relevant for hospitals, which typically hold substantial cash reserves to ensure smooth operations and manage major capital expenditures. Although liquidity is critical, a heightened awareness of inflation and currency risk calls for more sophisticated cash management strategies. Importantly, Buffett notes that "Fixed-coupon bonds provide no protection against runaway currency," suggesting the need for more dynamic approaches to preserving purchasing power.