A discussion with Change Healthcare’s CPO on culture, leadership, and the company’s growth journey.
By Noël Auguston
What makes a company culture distinctive and relevant amidst the complex nature of the healthcare industry? For companies in this dynamic market, balancing evolution and growth effectively with a compelling value proposition and inspiring corporate culture is key to competing for resources, talent and customers. Bright and talented leaders have the luxury of choosing who they work with, what culture they want to embrace, and where they want to play out their career. Companies that focus on building a sustainable culture and values system, on attracting the brightest most engaged individuals, and on investing in an organization’s development, are in turn able to solve some of the most challenging business problems. Conversely, a disconnect or misalignment in these areas can have an incredibly negative impact on the future of the organization.
Companies that are nimble around culture and people development also have an ability to flex and shift as the healthcare ecosystem continues to evolve. As a Chief People Officer (CPO), the focus on culture, on attracting and retaining talent, are immensely important, but in this environment, it is also the role of each individual within a company. Attracting high performing individuals and teams who embrace and foster disruption needs to be owned collectively across an organization.
At Change Healthcare, over the last three years, the company has grown to over 6,000 employees in 42 offices. Billions of healthcare claims flow through their system annually and they touch virtually all aspects of healthcare from providers and payers to pharmacies and consumers. In June, Change Healthcare and McKesson announced the creation of a new healthcare information technology company. The proposed new entity will combine substantially all of Change Healthcare’s business and the majority of McKesson Technology Solutions (MTS) into a new company with $3.4 billion in pro forma combined total annual revenues, creating one of today’s most diverse healthcare technology organizations.
Change Healthcare has been successful in evolving their culture as they have grown. Learning from other industries around how to create a sustainable culture and values system, they crafted a unique blueprint and values system for hiring and developing their people. They move fast, empower their teams and ‘go where the talent is.’ Creating talent hubs around various geographies has extended the Company’s culture out into the community, bringing the organization closer to customers and allows them to be competitive in recruiting and retaining talent, as well as building deeper relationships with their customer base.
We had the pleasure of sitting down with Linda Whitley-Taylor, CPO of Change Healthcare, who shared her professional and personal journey with Perspective Group. During her tenure, she has been instrumental in the company’s methodical approach to culture and values, fostering an environment that has resulted in a truly collaborative leadership team. The organization has come together to shift the company from a traditional culture to a much more progressive environment; a culture that tries to be more transparent, less hierarchical. We aimed to uncover the key elements of how an organization creates a strong culture and values system, and learns to evolve ahead of growth.
PG: You have been instrumental helping to evolve the culture at Change Healthcare. How has it changed in the last 3 years and what makes it unique?
LWT: The company had done a “health of the company” survey across the organization before I joined. Shortly after I started, I was handed the results and spent time going through all 6,000 comments, reading every one, as I knew that was the best way to understand what the organization was thinking. We then layered in focus groups and hosted listening tours at all the sites, with the intent to validate and get more insight from our teams across the organization. We took this input and also looked at the best practices in the market for technology companies such as Google, PayPal, etc. to understand how they approach culture and values, and began to craft who we wanted to be as an organization for the future.
While we came back with a number of different renditions on culture, we asked ourselves the question, what should our values be? We pulled together a cross section of leaders to talk about the historical values of Emdeon, focused on keeping the best of our history, while evolving for the future. That is how we got to the five values that we have:
- Top 10% — Excelling at everything we possibly can do, and making sure that others are pushing themselves to operate in the top quartile.
- Think big, start small, move fast — Came from the notion how do we allow people to stumble, fall and take risks and then excel as they go forward … learn from their mistakes, test things and if they don’t work, move on. This originally started around our product strategy and took off across the business.
- Customer centric — How do we make sure customers are at the core of everything we do, designing products and services, and our day to day operational relationships?
- Empowerment with accountability — Empower all of the organization to do the job they can do best, and hold the organization accountable.
- Hire and develop the best — We knew we needed to change our practices around how we go about hiring and developing people.
In terms of how this lives in our business now and for the future … I think the important thing here is that we stay true to our values. Culture is probably the most important thing you spend your time on, aside from making the numbers. Any good HR professional would tell you that if you get the culture right, you will have engaged employees and that will help drive your numbers. Because of this we were purposeful about the culture we were creating here. We didn’t want to be seen as your traditional healthcare company, but rather wanted to embrace the concepts found in successful technology companies. As we have acquired companies and scaled the organization, staying true to these values has been critical to successful integration.
We set aggressive goals for our business and high standards for ourselves, and we clearly communicate these standards during the recruiting process. Our company vision and mission resonate with team members who want to have a greater impact, who see the greater good in what we can achieve for stakeholders across the healthcare continuum. They see real opportunities to challenge conventional wisdom, have a bias for action, and be empowered and held accountable for results. We are honest that it’s not completely glamorous and that we must balance the needs of maintaining existing products with innovating for the future. While we work exceptionally hard, we also have an open and casual environment where we listen to ideas and have fun taking intelligent risks.
PG: What has been the blueprint for growth in hiring and developing teams? How has this evolved to keep up with the organization’s growth?
LWT: Over the last three years, we knew we needed to make a shift as a business. We had a lot of people who knew the payer, provider and pharmacy space, but our business had evolved. We shifted the business to report our financials as network solutions, software analytics and technology enabled services because that is what we are and what we aspire to be. This “re-orientation” meant we had to bring in fresh talent. We needed to look more broadly at people who were business builders, taking to heart ‘think big, start small and move fast.’ We also needed people who were passionate about healthcare and being a part of the disruption, asking themselves questions such as ‘can I build something to solve the biggest problems we have in the healthcare space?’ Hiring people who had worked at PayPal and built pay systems, or worked at Citigroup and built out their payments space. We focused on smart leaders who said, ‘I know how to build and want to transfer that to the healthcare space.’ We then had to figure out how to go after those leaders. Some came through referrals and Neil’s [Neil de Crescenzo, Change Healthcare CEO] network across technology and our recruiting efforts, but people also started hearing our story and wanted to come after us, saying ‘I want to work there … you are on to something unique.’ People were intrigued and wanted to be a part of it.
We have found that really smart people want to work in our space. Some of the brightest and most creative people want to be in a position to solve the toughest issues in healthcare. For example, we hired the person who was part of the team that created the Xbox because he wanted to see if he could take the skills he used in the tech space to solve bigger issues in healthcare. We believe the culture we have set gives us a competitive advantage in this space. One thing we learned early on was that if we were going to hire and develop the best, we had to meet that talent where they were. We believe there are very few roles in which you have to be in-person with those you work with every day. How could we possibly be a tech company and not leverage the technology that is at our finger tips?
In terms of development, after we established our values, we determined all the things we needed to change to make the values stick. We asked leaders what would prevent our values from being successful and they were candid with us. The leaders said we needed to change the following things: performance management, talent acquisition, onboarding process, developing leaders alongside our values, improve communications and enhance rewards and communications. We worked hard to change them all in a two-year period and implemented some well-received
programs across the organization:
Culture Ambassadors — This program was created alongside the development of our culture. Individuals raise their hand to be nominated and we select champions of our culture. They go through rigorous training around our core values: what do these values mean and how they play out in the business? They are engaged in events at their sites, conduct book clubs on topics linked to our values, and even interview EVERY leader that we hire into the business to assess for cultural fit. It is an effective way for us to have balance between results and values and collectively embrace how important it is to get the right cultural fit.
Performance Reviews — In 2016 we decided … wow, we will be early adopters of no performance reviews … and we told this to leaders who were thrilled and shocked. The goal was to move away from formality and increase ongoing and direct feedback. We realized we live in a world of Facebook, Instagram, and immediate gratification and people are looking to get that kind of feedback on a regular basis. We owe it to them to give them feedback on things they have done in real time vs. the concept of you worked on a project in July and next year you will get the review of all the things you messed up on in that project. To do this, we needed to provide our leaders with all kinds of tools around having difficult conversations, how to manage meetings, and set goals so there are objectives to drive the conversations across the business. Leaders and employees so far like this; they like the fact they can have a quick conversation vs. waiting until the end of the year and it is more impactful on the business. We will see how it goes, but so far so good. We are eight months into this new model, but believe it is something that will work for us.
A key competency of success in our culture is one of confidence. We tease our CEO that he has 6,000 direct reports. He spends the time developing relationships with all levels across the organization and if he knows you own a certain process, he doesn’t feel the need to go down the chain of command to get an answer. He will simply pick up the phone and call you directly to get the information he needs. Hierarchy is not something that we value in the organization and, frankly, if I had one wish, I would probably like to get rid of titles altogether. I think they have a tendency to drive too much of the bad behaviors in an organization. This requires a leader to have a broad emotional range to work with people across all levels of the organization, a skill that we are fortunate our CEO possesses and models for others. Neil has been an incredible partner around culture and bringing the values home for the people in our organization.
PG: What have been some of the biggest challenges to finding diversity within healthcare technology and how has Change Healthcare addressed these?
LWT: Technology recruiting is highly competitive, and the playing field gets even narrower when you are sourcing talent that also has experience in the healthcare industry. While we value these areas of expertise, we also look more broadly to ensure we are hiring the best. We have made it part of our strategy to address diversity challenges by enhancing our network internally and externally. We created:
Women of Change Healthcare — Allows us to better understand female talent across the organization. It allows us to engage, develop and see the leadership capabilities of our female leaders. Since the program started, there has been a significant increase in female representation in Director and above roles.
A two-year rotational program — Recent college graduates are hired to rotate every six months across the organization, in a variety of cities, to learn different aspects of our business.
A network group called Stars and Stripes — This network supports the vast number of veterans that Change Healthcare has hired over the past three years (335). In collaboration with Blackstone, we set out to invest in recruiting veterans, as well as their spouses to help us better drive our operations while giving back to those who have served us so well.
SPEAK — A resource group focused on creating an environment within the Change Healthcare community that promotes diversity and inclusion, providing opportunities for all minorities, LGBTs, cultural sub-groups, and friends to promote diverse partnerships among all team members throughout the company.
All of these efforts are about remaining relevant in the market. We look to hire a mix of leaders with healthcare experience and those outside the industry. The balance between the two allows us to have diversity of thought in an industry that is ever-changing and moving at such a rapid pace. Many times, we have found that it is more about the fit of a leader within our culture and their past performance, than industry experience. While we have made progress here, we frankly need to continue our concerted efforts to ensure we are sourcing and developing exceptional talent to be the best at what we do.
PG: You spent time at GE and Amerigroup earlier in your career. What are the key learnings from your prior roles that have helped prepare you for the growth and challenges at Change Healthcare?
LWT: I’ve learned over the years that almost anything can be accomplished through three things: 1) People 2) Processes 3) Tools, and if you invest in these three you will likely get to the end result you need to get to.
Establishing goals with employees and helping them see their way to accomplishment throughout the year is really important. I am a huge advocate that 50% of one’s performance should be rated by accomplishing one’s goals and the other 50% should be rated on how well they live the values—a lesson I learned early on in my career at GE. A leader who accomplishes his/her goals but doesn’t know how to treat others along the way is not a leader we should be rewarding. Balancing the ability to accomplish your goals and treating people right is vitally important.
When I coach people to think about their careers I tell them to always take the role that no one else wants because those are the experiences that will advance you further than any other opportunity you sit around waiting to come your way. Everyone seems to think they need a perfect mapped out plan for their career roles, but we all know that’s never the way it works.
Your career isn’t accomplished by creating a perfect roadmap, it’s more about taking advantage of what comes your way at the time it makes the most sense. The only constant in life is change.
If you aren’t willing to go with the flow, be a constant learner, and remain flexible you will never be successful. Frankly this is what makes your career exciting and allows you to take advantage of all the best opportunities.
PG: What would be your advice to companies embarking on a similar growth journey around culture and values?
LWT: Invest in your people. You can do this in creative ways that don’t always cost a lot of money.
Listen to your employee population. People come from different places and all have different ideas and perspectives. Bring those ideas back to what people have told you, as they want to know their ideas add value to the business. They will come along with you if they believe they are part of the journey. Do an engagement survey at least every other year and work hard at the items the team members tell you will best drive their engagement. Show them progress and be candid about areas that are challenging. Keep the door open, listen, and think about how we get to a solution; the partnership that HR has with the business around this is critical. Employees and leaders are HR’s customers, and we need to treat them as such.
In terms of evolving a culture, start with your company values – define what makes your company’s culture stand out. Change Healthcare’s values are less about the traditional words you would label as values. We consider ethics, integrity, and teamwork as basics that, frankly, should be assumed as givens. Just like we expect you to be qualified for the role you have been hired to do (which of course we confirm through the interview process), simple values are part of the standard “price” of entry. Instead, we looked at what sets our company apart. We created company values that express the attributes of how we work with our customers and one another. We are customer centric, we value empowerment with accountability, we are top 10%, we think big, start small, and move fast, and we hire and develop the best.
Start with who you want to be as a company, even if you aren’t there yet. Even if the values are aspirational. Start with defining your culture. Then focus on building the tools and processes to make your aspirations a reality. We have a great employee base with long tenure who had some concerns about the pace of change and the amount of new talent we were infusing into the business. We listened to those concerns and in a very short time created a learning and development organization to help everyone have opportunities to learn and grow in their careers. We have devised advanced leadership and development programs across the organization. Investing in team member development has helped provide our teams the right resources to best align to the new requirements of a changing business and feel equipped to manage and adapt to change.
PG: What are your aspirations for Change Healthcare in the next few years?
LWT: I am really proud of what we have built here at Change Healthcare. The joint venture presents an opportunity to bring together the complementary strengths of McKesson’s MTS business and Change Healthcare, to deliver a broad portfolio of solutions that will help lower healthcare costs, improve patient access and outcomes, and make it simpler for payers, providers and consumers to manage the transition to value-based care. We are embarking on an exciting time as we determine how to best merge two cultures, two organizations, and two operating models into one new company. We are working through the pieces of how we pull together these two very successful organizations into one. Everyone sees what this can be down the road: the commitment, enthusiasm and excitement is there. People see the potential in making this something great. What I love most about my work is the ability to fix, grow and build. I look forward to the opportunity to begin a new journey in helping the team shape the new organization.
A final thought: We are fortunate we have accomplished a great deal as an organization; it is really exciting! We have put together a terrific leadership team and that makes all the difference in the world. We are collaborative and transparent with one another and we truly enjoy working together. That is part of the secret and magic to implementing cultural advances. We have a talented organization here at Change Healthcare, with people committed to creating a unique company. People want to work with smart people because they can learn, and I think that is one of things team members get when they come here- the brainpower of the collective organization. If anyone can change it, you can change it, because of what you have brought into the organization … it is then up to you how you operationalize those changes and advance the organization’s thinking broadly for the future.
“I think the important thing here is that we stay true to our values. Culture is probably the most important thing you spend your time on, aside from making the numbers.” — Linda Whitley-Taylor, CPO of Change Healthcare
”We look to hire a mix of leaders with healthcare experience and those outside the industry. The balance between the two allows us to have diversity of thought in an industry that is ever-changing and moving at such a rapid pace. Many times, we have found that it is more about the fit of a leader within our culture and their past performance, than industry experience.”
About Noël Auguston
Noël Auguston is a Partner at Perspective, focusing on the innovative healthcare space. She leads the firm’s efforts around Health Tech and Digital health, specializing in senior-level executive recruitment and human capital advisory across a broad range of functions. She partners with VC/PE investor backed clients and public entities working to place key leaders who will drive growth and change within organizations.
Perspective is a human capital advisor specializing in executive search, leadership and culture assessment and organizational design and development. Market segments addressed span the continuum of the life sciences and healthcare industry, including healthcare information technology, pharmaceuticals, biotech, medical device, diagnostics, healthcare payer and provider segments. Perspective’s services inform a broad array of leadership and functional roles including, board of directors and CEOs as well as commercial, finance and research and development executives.