Focus on Value The impact of price transparency and quality on patients' care decisions

The federal government has introduced price transparency policies in hopes that consumers will be able to compare services and receive quality care that won’t break the bank. But not enough has been done to equip consumers to determine the overall value of the care they receive.

Understanding the out-of-pocket cost is essential for patients to make informed healthcare decisions. However, I believe patients need more than pricing data. They need to be equipped with information that takes into account other essential factors when making healthcare decisions that can affect the cost of their care over time.

Quality of care

As the healthcare industry moves toward pricing transparency, metrics on the quality of a given facility or service becomes especially important. After all, in seeking out pricing information, what patients are truly seeking to discern is the value of a given medical service—and quality of care is a fundamental component of understanding value and for the consumer’s long-term health.

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[Video] 2020 Resolution Strategies: How to improve personally and as a leader

EW Tibbs offers up personal strategies he uses to guide himself as a human being and also as a leader.

He explores how using memories and relationships translate directly to:
Improved work ethic;
Commitment to learn;
Having a deep compassion for others;
and a commitment to bring passion and energy into every interaction.


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Aristotle and Your “Curve of Happiness”

Someone once told me you can't go wrong invoking big names to bolster your content. So I'm invoking an old stand-by for this week's article: Aristotle.

Aristotle - and the Greeks, in general - did a lot of what we don't seem to do much of - thinking about their thinking.

Ari also came up with an idea that is foundational to personal success and happiness - a principle that eludes us more and more as we negotiate a helter-skelter, tweet-based culture.

It's another big word - eudaimonia.

Read the Full Article and find out what this twelve-cylinder word means - and then let me know your thoughts.

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2019 Franchise Buyers Review

Earlier this year, I wrote about the growing diversity in today’s franchise buyers. It’s fascinating and wonderful to work with such varied stages of life, needs, goals and interests all finding their “right fit” in franchising. There’s Millennials to later career Boomers. Multi-generational teams and semi-passive investor/owners continue to surge. Women are flocking to business ownership through franchising.

The franchise industry has responded in kind, both with innovative new brands, improved technology and more strategic approaches for existing opportunities. As we contemplate the possibilities of a new decade, let’s take a look at some notable data from 2019.

  • 62% Personal Services
  • 48% Multi Unit, Semi-Passive
  • 30% Business Services
  • 15% Existing Franchise Acquisition
  • 14% Health and Wellness

Personal services franchises topped our list, fueled by the buyers’ increasing desire to own a business that helps others while helping themselves. Franchises in this category include home services, children’s enrichment, fitness, beauty, and senior services. 2019 enjoyed a strong job market so it’s no surprise that semi-passively managed business models were also a popular choice. Companies large and small continue to outsource their needs, creating enduring opportunity for business service franchises

Where did they come from?

  • Air Force Veteran
  • Senior Vice President, SunTrust Bank
  • Retired Educator
  • Sales Representative, Pharmaceuticals
  • Executive Director, Cox Communications
  • Technology Officer, Medical Practice
  • International Serial Entrepreneur
  • Sales Director, 3M Company
  • Finance Executive, Nokia
  • Part Time Business Owner, Travel Industry

Where are they now?

  • Tree Services
  • Hospitality Staffing
  • Healthfood Cafe
  • Apparel Customization
  • Dance Fitness Studio
  • Commercial Property Maintenance
  • Child Enrichment
  • Men’s Grooming
  • Beauty Studio
  • Graphics/Printing/Signage Manufacturing

Will you move beyond “what if” in 2020?

A common denominator among successful business owners is the ability to move beyond “what ifs” to achieving desired results. Michael Hyatt wrote this thoughtful article on the Law of Diminishing Intent, which says,

“The longer you wait to take action, the less likely you will be to take it.”

There have never been more options in this growing world of franchising. Take advantage of our free franchise readiness assessment and let’s talk about the possibilities to alter the course of your career. Email me directly at This email address is being protected from spambots. You need JavaScript enabled to view it. or call 770-579-3726.

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WARNING! Retirement May Mess With Your Oligodencrocytes!

Oligo what?

Hey, I didn’t know we had them, did you? Yet another something in the “cytes” category roaming around our bodies.

I found out I had oligodencrocytes as I was slogging through my second reading of a challenging book entitled “Deep Work; Rules for Focused Success in a Distracted World” by Georgetown University computer science professor, Cal Newport.

I bought the book in hopes of finding an inexpensive antidote to my ADD and “shiny object syndrome.”

I’m thinking 3-4 times through this book will have saved me the stigma and expense of the therapy I really need.

So it was that on page 36 of “Deep Work”, I found out that I have oligodencrocytes. We all do.

Why should we care?

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Decoding Executive Presence

Have you sat by the sidelines and observed someone walk into the room and their presence just fills the atmosphere? Have you been at a meeting where once someone starts speaking everyone in the room is drawn towards them in silence? Have you watched someone on video and still felt their charisma come through? Chances are you have experienced their “executive presence”. As leaders, executive presence is an important attribute to cultivate especially as you advance in your careers and aim for coveted roles. Leaders are constantly selling their ideas and getting buy-in from their audiences, and those with executive presence can get that done with a lot more ease than others. The common misconception is that you either have it or you don’t. The good news is that while some people may be more gifted in this area executive presence can be developed. It needs self-awareness, emotional regulation, openness to constructive criticism, and with some practice you could be awe-inspiring too!

Sylvia Ann Hewlett, the founder and CEO of the Center for Talent Innovation and author of Executive Presence, defines executive presence as how one acts (gravitas), speaks (communication) and looks (appearance). So, let’s break that down into characteristics.


  • Relationships. Cultivate your political savviness. Have a clear understanding of your stakeholders and develop long-term relationships with them both within and outside the organization. Focus on bringing value to them rather than a WIIFM (what’s in it for me) attitude. Use your network to build your competence and influence. Create your brand and market it. Become known as a subject matter expert so people listen when you speak.
  • Conflict Resolution & Stress Management. Nothing eats away at credibility more than display of stress behaviors. Maintaining composure through challenging situations or critical conversations is a key trait.
  • Confidence. Keeping a positive mindset enhances confidence. Preparation is another asset - knowing your material and audience and messaging appropriately enhances your confidence in delivery.
  • Authenticity. Know your worth and embrace your shortcomings. A leader’ strength is in their ability to acknowledge their vulnerabilities. The more “human” you appear, the more trust you can generate.
  • Charisma. We all have our assets. Know yours and make it a part of your charisma. Own it and hone it.
  • Observation. Learn by observing other leaders you admire. How they conduct themselves and interact with others. People watch and pick on traits and characteristics in professional settings and identify what stands out. As your social awareness increases, it makes you more self-aware too.


  • Articulation. Choose your words based on the audience. Use gestures, body language and words to make your message impactful.
  • Brevity. A sure shot way of losing people’s attention is being verbose. KISS (keep it short and simple)
  • Assertiveness. There is a fine line between arrogance and assertiveness, toe the line with caution. Assertiveness is attractive while arrogance is not!
  • Active Listening. Be present. Pause, reflect and respond is a mantra I learned from an executive coach and it never fails to impress.
  • Voice. Use your voice to get the desired effect on other. If you’re soft-spoken, project your voice. If you’re gifted with a loud voice, make sure to soften it based on situation and audience to not intimidate. Modulate your voice to draw in your audience and avoid monotone.
  • Engagement. Be aware of your audience and watch their verbal and non-verbal cues. How are they receiving your message? Use your wit to keep their attention. Ask questions, listen to feedback, encourage them to participate.


  • Posture. Body language, gait, eye contact all communicates your self-confidence. Power posing and controlled breathing before important events helps a great deal in enhancing your executive presence.
  • Presentation. Dress the part and be prepared. Be mindful of how you “show up”. Knowledge is power.

Leadership success largely depends on how willingly people want to “follow” you and cultivating a strong executive presence is imperative. You will see how easy decision-making becomes when you are able to effortlessly affect change with your executive presence.

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A Life Lesson Learned from a Thomasville Chair

2019 contained a lost summer for my wife and me. We decided to move from home-ownership to the rental world temporarily, in defiance of all conventional advice regarding balance sheet/net worth/equity/tax benefits, yada, yada, yada.

For a couple of months, we battled the remorse of leaving a large comfortable home on the 10th fairway of a semi-private golf course with this as a “backyard”:

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Holiday time off - does your culture allow equitable distribution?

How are you taking care of your employees during the holidays?

The holidays are considered a time of year when families gather the most. Consider this: are your newer employees able to enjoy this time with family? Is the time off policy equitable in your organization or are you, as a leader, shackled to the “way we’ve always done things” mentality of your organization’s culture? Are new employees offered the same time off considerations as those with seniority, or are they just the “low man on the totem pole” and have to wait for another new employee to come before enjoying the luxuries of seniority? Are you having problems retaining employees?

When you round on your employees (and as a leader you should be rounding regularly on your employees), ask them if they feel they get enough time off during the holidays. Ask them if they feel the culture of holiday time off requests are equitable for ALL employees. Then, look at your holiday PTO policies. Oh! You don’t have a separate one for holidays and regular time off? Interesting. Have these policies kept up with the newer workplace standards and the expectations of current generations? Studies have shown that current generations value time off. It does not mean they will work any less hard or be unproductive. They are just looking for that work-life balance.

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Charges are irrelevant to the patient’s bottom line

With increased calls for healthcare pricing transparency from consumers and government entities alike, hospitals’ chargemasters are moving from proprietary information to public knowledge. However, putting chargemasters under the microscope has not led to the clarity that patients are seeking regarding quality care at a price they can afford.

Nearly two-thirds of physician respondents in a 2019 NEJM Catalyst survey said that patients do not have enough information to affect the cost of their own healthcare–related decisions, and more than three-quarters of respondents say that assessing the total cost of care is extremely challenging for patients.

Rather than increasing understanding and empowering the consumer, hospitals’ efforts to be open with their charges have highlighted a fundamental misunderstanding between hospitals and payers, and the patients they serve: the definitions of the terms “charges,” “payments,” and “costs.”

A difference in terms

In public discussion of healthcare costs, these terms are used interchangeably, but in fact have completely different meanings to hospitals and insurers. A “charge” is the price listing internally for the hospital and the starting place for negotiations with insurance companies.

In public discussion of healthcare costs, these terms are used interchangeably, but in fact have completely different meanings to hospitals and insurers. A “charge” is the price listing internally for the hospital and the starting place for negotiations with insurance companies.

It is almost never the amount that an insured patient is billed—hospitals in the U.S. billed an average of 3-1/2 times what they received in payments for all of the services they provided in 2015, according to True Cost of Healthcare. The term “charge” is just the sticker price. While hospitals are getting better at reducing the actual cost of care-to-charge ratio, it isn’t reimbursed that way by insurance companies, which will be prohibitive in moves toward reducing the “charge” amount.

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Looking Forward: Healthcare innovations making an impact

With challenges such as the rising cost of healthcare, red tape that can create obstacles to providing quality patient care, or adjustments that come with increased transparency requirements, it can be easy to let discouragement color your outlook on the future of the healthcare industry. But I sincerely believe that this is the best time in history to be part of this field. We have the ability to impact people’s lives and futures like never before. There are countless technological innovations that are truly providing better care for patients at lower cost, creating better patient experiences and thriving communities.

I have had the privilege of working with several developers and inventors who are designing cutting-edge innovations that give me such hope and excitement for the future of healthcare. Here are just a few examples:

Improving patient experience

Wait times in a clinic or hospital ER have long been pain points for patients—and healthcare organizations are feeling the pain too in the form of low patient satisfaction scores that negatively impact reimbursement from insurance companies. Technology is being developed that gives updates on wait times and care directly to the phones of people in the waiting room via Bluetooth connections. Furthermore, hospitals can use this data to track and improve their process flow to reduce wait times, educate their staff, and lower the cost of care by increasing efficiency. Read full article.

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Why Your Free Time In Retirement Doesn’t Feel Right.

Remember the last time you were "in the zone" where you became so immersed in something you loved that time disappeared and the work just simply flowed without much effort.

Maybe it was at work, or at play or being immersed in a favorite hobby. Regardless, it's one of those infrequent conditions that can contribute to life satisfaction.

Mihaly Csikszentmihalyi, Hungarian-American psychologist formalized the condition with his 1990 book, "Flow", revealing his research on the nature and importance of finding something that can take you "into a zone" or what he called a "flow state".

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The White Coat Might Just Be The Cape That Hospital Leadership Is Looking For

I am often asked today if I am a doctor or an administrator, my response is both, always! You might ask, can a physician really be both? The answer is yes, BUT not every physician. If you take the group of all physicians, the first cut is those that are interested, then it is narrowed by those that are prepared: either through formal education, life experience or both, and the final cut is those that have the demonstrated ability to lead by inspiring a diverse team and operationalizing a vision. Today this represents a rather narrow playing field.

It is important to remember that doctors are different; many have dreamed of being a physician since childhood, and rank among the best and brightest, with often only the top 0.5% of high school students eventually being accepted into medical school.

Physician Executives are wired differently; they are decisive, based on an unwavering priority hierarchy:

  • Patients
  • Mission of the Organization
  • Personal Needs

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Staying Grounded and Minding the Gap

I’ve read a number of articles on the Iceberg of Ignorance, originally published in 1989 by Sidney Yoshida, reporting that top leaders only understand about 4% of what is going on in their companies. Does this sound right to you? If you are a CEO, you may not believe it, but do we really know? If you are a manager or supervisor, you may believe this about your bosses, but not yourselves. If you aren’t a manager or supervisor, but report to one, you may completely agree with this statistic!

While no leader in a large organization can truly know everything that happens on the front line, what are the best practices we can employ to ensure that we stay in touch with our staff? With our busy meeting schedules, how do we get in touch with what is really happening in our organizations?

I have used a few tactics over the years. Besides rounding on patients and staff, which I truly enjoy, I love to be present at as many recognition events as possible - quarterly leadership awards, patient experience milestones, annual tributes to Nurses, Doctors, Allied Health, etc. “Lunch with Lee Ann” is monthly event that I started years ago with both managers and staff.

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New Year's Resolution: Become a Better Leader!

In all the hustle and bustle of the holiday season, its easy to forget that in just a few weeks most of us will be looking at the New Year and a list of resolutions or promises that we have made to ourselves that we hope to accomplish. Some of our old favorites are bound to make the list, lose some weight, exercise, give more to charity, get back in touch with family or old friends.

But what about including in this year’s list the commitment to be a better leader next year?

Research tells us that when we write our goals down, we are far more likely to achieve them, so begin the year by taking a good hard look at what is means to be a leader, remember, you may have the title but being the leader of people requires these fundamental building blocks, can you complete these?

1. Vision: All successful leaders have a clear vision and a steadfast belief in where they are going, and they hold fast to this vision through good times and bad.

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Can We Become Age-agnostic? Do Your Part – Be a “Perennial”

The deeper I get sucked into this vortex of dialog about aging – older vs elder, saging versus aging, retirement versus rewirement, etc., etc., ad nauseum – the more I sense that we are creeping to the edge of an age-agnostic era.

What does that mean? It means that instead of our identity being tied to a number it will be tied to how we choose to pursue our life.

Show of hands: how many of you mid-lifers and beyond would find that refreshing?

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Are You On a Two-tank Journey With a One-tank Mindset?

Stan is a C-level executive in his late fifties. He’s done well, thriving and progressing in the volatile, high-pressure world of healthcare. Also, like many at his level in this chaotically-evolving industry, his career was recently disrupted when he was laid off, despite a stellar performance record, following the merger of two health systems.

Rather than withdraw and lick his wounds, Stan wisely invested in a career-transition program that equipped him to re-enter the industry at a level very close to what he was when laid-off. His successful re-entry happened in just under six months, about half the amount of time re-entry takes for most execs at his level.

I connected with Stan just as he was wrestling with which of two attractive offers to accept to continue to move his career forward – a situation I consider to be a “high-class problem”.

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The healthcare industry has much to be thankful for

"It’s not so much what we have in this life that matters. It’s what we do with what we have."
-Fred Rogers

In my years serving as CEO of healthcare systems, I always took special care around this time of year to express my thankfulness to our employees for their hard work and compassion, and for the amazing work we get to be part of every day in the healthcare industry. This year, I would like to share what I am grateful for with you—my friends and colleagues—in hopes that you will stop and reflect on the many blessings in your life and work, and find meaningful ways to share that gratitude with those around you.

1. Compassionate, dedicated healthcare professionals

It is the caring, brilliant, committed people we work alongside every day that make this such a special time to be part of the healthcare field. Together we have the privilege of healing and inspiring our patients and communities. It is an honor that I do not take for granted.

2. Innovation and advancements

In the span of my career, I have seen incredible advances in the medical field. 90% of what we do in hospitals today wasn’t available to patients 50 years ago. From digital technology to curing diseases, innovations in modern medicine are increasing people’s quality of life.

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Leadership Made Simple but NOT Easy – Achieving Cultural Transformation in Healthcare


Attaining most any goal or dream requires us to do something different, which goes against the natural human tendency to stay in our comfort zone. Transformation has to start with change, but we resist change until the pain of staying the same exceeds the pain of change...yes, PAIN is the catalyst and friend of transformation.

Understanding the difference between change and transformation is important. Transformation requires a change of culture. A change of culture requires strong leadership, the kind of leadership comfortable with creative disruption. To simplify the difference between change and transformation remember that checking off items on a “To Do” list can bring change, but transformation requires completing items on a “To Be” list.

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Healthcare execs, do you know what’s in your chargemaster?

A hospital’s charge description master (CDM), or chargemaster, is often referred to as the “heart” of the healthcare revenue cycle. It includes codes for every procedure, material used, medication, and service that a healthcare organization provides its patients. It is the structure that drives the hospital, and is the starting point for billing patients and insurers and complying with public reporting. A typical health care system chargemaster may contain 15,000 to 25,000 entries, according to Becker’s Hospital Review.

Neglecting your chargemaster can lead to inaccurate billing, regulatory risks, claim issues with payers, and low patient satisfaction scores, all of which affect your healthcare organization’s revenue. Your hospital can’t afford to overlook this essential piece of its operations. Ongoing evaluation of your chargemaster with an eye toward increased calls for pricing transparency in the healthcare industry is the key to maintaining a chargemaster that will serve your organization, as well as its payers and patients.

Ongoing maintenance

With so many diverse components in a chargemaster, it can be extremely difficult to set up correctly. Failing to update any of the components can result in negative outcomes for your healthcare organization. Often, when hospitals add new items to their chargemaster, they simply copy existing charges. However, this can be problematic because the new charges may not have the same requirements (e.g. CPT codes, modifiers, revenue code, or pricing) as the item being copied. Care should be taken to make sure the new charges are set up correctly.

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Identifying your next career move

I recently had the honor of co-presenting with Mike McBride, Regional President and COO of Ascension St. John, at the American College of Healthcare Executives - Southeast Texas Chapter’s conference in Houston. Our session, “Identify Your Next Career Move,” took the attendees through what makes up a successful career transition -- from self-branding to job interview preparation and all the steps in between.

Key takeaways from our presentation:

Access your mindset

Are you a glass-half-full type of person? Are you in a dark place in your current workplace? Building confidence is a key ingredient to success. To enter a transition without the highest level of confidence is a formula for failure. You must rebuild confidence before you start.

Unpack your baggage

At a certain point in our lives we all acquire baggage. That's a given. It's what you do with that baggage that matters most. Have you shoved it to the back of your closet to deal with later, or is it neatly unpacked and sorted and processed? If it is the former, then you have work to do. You will not make headway in a job search until you have dealt with your baggage.

Speak to your achievements

How are you at speaking to your abilities and achievements? If you cringe at the thought or don't know where to start, you have some work to do before you are ready to make your next career move. Never assume that the person interviewing you will read between the lines just because you have it as a bullet on your resume -- you must verbalize it.

Know your value

What is your superpower? Determine what differentiates you from other people who may be competing for the same job. If you are having trouble determining what makes you different, form an informal advisory board made up of close friends and colleagues. These are the people you can not only trust to tell you what your strengths are, but also areas where you can improve.

Develop your criteria

Create a list -- in priority order -- of factors that matter to you as you seek a new opportunity. Culture and mission should always rank somewhere on the list, but should also include personal factors that are specific to your work/life situation. Use this list as a guide when you determine if an opportunity is right for you.

Identify and research target organizations

Develop a list of companies and organizations that you have a strong interest in. Why are you interested in each of these companies? Be specific, and if they don’t align with your criteria list, then revise. If they do, research them thoroughly. Start connecting with individuals who work at this company on LinkedIn and developing genuine relationships within these organizations.

Build and work your network

Research shows that you will find your next opportunity through someone you know. A good, quality network takes work. You must be intentional and consistent in your outreach efforts to nurture and grow your network. Set aside time each week to focus on cultivating relationships within your industry.

Polish and build your professional brand

You are how others perceive you to be. Your brand includes everything from your resume to what shows up when your name is searched for online. While some perceptions can be outside the realm of your control, many are controllable. You can create the professional image you want to portray. Areas include your:

  • Resume
  • Verbal self-introduction (Answers “Tell me a little bit about yourself.”)
  • LinkedIn profile
  • Google search results (Are they positive/negative/neutral?)

Own the interview

Once you have an interview scheduled -- investigate, practice and prepare. Research those interviewing you. Reach out to network connections that may have inside knowledge of the culture of the organization or might provide you with a connecting point that could prove invaluable once in the interview. Practice your talking points out loud or with a trusted friend. Be prepared to explain an awkward exit from a previous position or extended career gaps on your resume.

While sometimes it takes seeing a certain job posting to spark your desire for a career change, it’s far more effective to begin working on the areas above well in advance of that moment. That way, when the right opportunity does come along, you are ready to start that journey.

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