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The Impression of Transparency

Ford, Eric W. PhD

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Journal of Healthcare Management: May-June 2021 - Volume 66 - Issue 3 - p 157-159
doi: 10.1097/JHM-D-21-00110
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The Art Institute of Chicago, with its wonderful collection of Impressionist art, is one of my favorite places to visit when I am in town. The Impressionists are widely regarded as artistic geniuses who revolutionized the way we look at not only art but the entire world.

While I marvel at the beauty of the paintings and sculptures, I am also keenly aware that they (both the people and the art) were products of their time. In particular, the Industrial Revolution provided artists with tools that were unavailable to earlier generations. Purchasing paint in a tube, taking the train to the countryside, propping your canvas on an easel, painting with a brush strengthened with a metal ferrule, and viewing your subjects at leisure in a public park were all new to the 19th century. The ability to go out and capture the world in a new light was world changing. Furthermore, many of the Impressionists were well-to-do men and women who could afford the many innovations that were becoming available; they had the time and ability to focus on their art and realize their visions. Granted, there was no lack of artistic genius among them; nevertheless, the art they created was as much a product of their environment as of their own craft.

Like the Impressionists, today’s healthcare leaders are poised at the dawn of a new era. The information revolution is making it possible to create connections among activities and people in previously impossible ways. Recognizing that fact, the U.S. government has required hospitals, health systems, and insurers to bring their reimbursement rates into the light by way of the Centers for Medicare & Medicaid Services’ Hospital Price Transparency rule that went into effect on January 1, 2021. Many healthcare leaders and outside observers feel that the rule is misguided. Most consumers will not be able to use the data to make informed purchase decisions. In fact, the data may give people the wrong impression of what care actually costs to deliver. Therefore, rather than complying with the rule’s mandate or its spirit, some health systems have either buried their reports deep in their websites or posted nothing, instead electing to pay the daily penalty. Metaphorically speaking, we were hoping for Pissarro and Renoir’s tableaus of everyday life. Instead, we got Pollock’s scattered paint drops and Rothko’s opaque blocks.

Nevertheless, many health systems are making earnest efforts to provide consumers with actionable pricing data on nonemergent procedures. Although even these attempts at price transparency are not always pretty, I as a consumer would rather have the self-portrait of a mentally troubled, one-eared man than no Impressionist paintings at all. (I know van Gogh was a Post-Impressionist—please grant me some artistic latitude here.)

Venturing a bit further into the topic of art, my interview in this issue of the Journal of Healthcare Management is with Michael A. Slubowski, FACHE, president and CEO of Trinity Health. He is an artist in his own right—he plays guitar as a creative release from the pressures of leading a national healthcare system. We also talk about his estimable career and how he thinks the COVID-19 pandemic will affect health systems’ well-being going forward.

Our yearlong series of columns on Great Comebacks continues with a thought- provoking piece by Britt R. Berrett, PhD, FACHE, director of the Naveen Jindal School of Management’s Center for Healthcare Leadership and Management at the University of Texas at Dallas. Dr. Berrett discusses organizational learning. In particular, he suggests that crises can have long-lasting effects on organizations—similar to post-traumatic stress disorder. Under such circumstances, he outlines the steps leaders can take to renew the organization.

The first of our research articles comes from Katy Ellis Hilts, PhD, Valerie A. Yeager, DrPH, Paul K. Halverson, DrPH, FACHE, Justin Blackburn, PhD, and Nir Menachemi, PhD, from the Richard M. Fairbanks School of Public Health at Indiana University in Indianapolis, Indiana, and P. Joseph Gibson, PhD, from the Marion County Public Health Department in Indianapolis. They provide a nice example of how to conduct a thorough systematic review of research literature on the topic of health system community engagement, which is increasingly relevant as we emerge from the COVID-19 pandemic with a new way of thinking about care delivery.

Next, RAND Corporation researchers Denise D. Quigley, PhD, Kerry Reynolds, PhD, Stephanie Dellva, and Rebecca Anhang Price, PhD, conduct a systematic review of the patient experience and its relationship to organizational outcomes. I struggled with whether to accept their piece for publication, as they found a relatively limited number of articles for their analysis. However, the rigor of their review cannot be denied, and the fact that this stream of research is still in its early days is a sign that we are on the front edge of the paradigm. The article is well nuanced and merits a careful read.

This issue concludes with the research of Brystana G. Kaufman, PhD, from the Duke University School of Medicine and Duke-Margolis Center for Health Policy in Durham, North Carolina; David Anderson, William K. Bleser, PhD, Mark B. McClellan, MD, PhD, and Robert Saunders, PhD, of the Duke-Margolis Center for Health Policy; Jeffrey Clough, MD, from Duke University and the Duke Clinical Research Institute in Durham; and David B. Muhlestein, PhD, JD, and Nathan Smith, PhD, from Leavitt Partners in Salt Lake City, Utah. Their research takes a new look at one of the main questions regarding accountable care organizations: How does patient mix impact profitability? Essentially, the results show that “it depends.” For those considering the accountable care organization alternative, this piece provides excellent food for thought.

I hope you find this issue enjoyable and informative. It is one of our more challenging reads, which seems appropriate for these challenging times. I look forward to enjoying the art—and seeing you—in person at the 2022 Congress on Healthcare Leadership in Chicago.


Finally, a note of thanks to those who reviewed articles for us in 2020. They are recognized at It is the work of such volunteers that truly makes peer-reviewed journals possible. To learn more about serving as a reviewer, visit the Reviewer Information page at and drop me a line at [email protected].

© 2021 Foundation of the American College of Healthcare Executives