November 2020, Volume XXXIV, Number 8

cover story One

100 Most Influential
Health Care Leaders

e are pleased to present this special feature recognizing 100 leaders who help make health care in Minnesota a global model of excellence. Once every four years we invite our readers to submit the names of colleagues whose outstanding leadership can be acknowledged in these pages. We thank all those who participated in the nomination process and those who helped with the submissions.

The individuals presented here represent a cross section of the breadth and depth of Minnesota’s health care delivery system, from clinical care to health care policy to administration and management. In presenting this quadrennial feature it is not intended to say these individuals are more important or do better work than their many colleagues involved in leadership. It is intended to provide a snapshot of the depth and complexity of issues that shape health care delivery and the diversity of individuals leading these efforts.

 As if there were not enough challenges already, in preparation of this feature the COVID-19 pandemic is the major concern for every health care organization.  As we navigate to a post-pandemic future the need for leadership has never been greater.  As we face the difficult problems described by the men and women on this list we thankful for them, congratulate them, and wish them all the greatest success.

In preparing this feature we asked each of the nominated health care leaders to answer the two questions listed below. Their responses provide a unique and kaleidoscopic overview of health care in 2020.

  1. What are the biggest challenges facing health care delivery today?
  2. How is your organizations preparing to meet these challenges?

Sue Abderholden, MPH

Executive Director | NAMI Minnesota

Challenges: Living with uncertainty; physical isolation; and disruptions in employment, health, school, and life events are negatively affecting the mental health of Minnesotans. The murder of George Floyd and racism has added to trauma experienced by the BIPOC (Black, indigenous, and people of color) community. The CDC says that more people struggle with anxiety, depression, and substance use. Our fragile mental health system may not be able to respond to increased demand.

Strategies: NAMI is working to raise awareness, especially around suicide prevention. We are advocating for increased funds for our mental health providers, continuing the lessening of restrictions surrounding telehealth, and expanding and diversifying the mental health workforce.

Sen. Jim Abeler, DC

Abeler Chiropractic Clinic

Challenges: All the challenges that existed before the Covid-19 pandemic are now magnified. In my view, a huge share of the access, quality, and cost issues are related to the extreme over-involvement of the payers. That focus continues on doctors as though they are all outliers. Not true. The payer “middlemen” extract a huge cost toll while providing little benefit. The best care coordination is still best done at the clinical level with empowered doctors and staff. Quality care still has to matter..

Strategies: The Legislature is really poorly suited to address these problems. “Health care” has become a slogan. Large systems and payers stifle the innovation that doctors would wish to implement. Instead they are silenced. Patients suffer while payer profits drive care.

Todd Archbold, LSW, MBA

CEO | PrairieCare

Challenges: We face a mental health crisis and systems that lack the ability to adequately identify and treat both physical and mental health in a fully integrated way. Accessing mental health care can be difficult, due in part to stigma and fragmented care networks. Emergency rooms have become a common entry point for those experiencing a mental health crisis.

Strategies: We work closely with hospitals, clinics, and schools to create integrated care models that allow for easier access to timely mental health care. Tools such as online screening help with early identification, telephone consultation, and community education to help increase awareness of services, shine light on the prevalence of mental illnesses, and decrease barriers in accessing mental health care.

Kyle Bauer, CPA

CEO | Cuyuna Regional Medical Center

Challenges: We will be challenged to keep costs at a sustainable growth rate while seeing significant increases in the health care needs of all patients, including growing numbers of Baby Boomers. Much of our experienced work force is part of that generation, so we will step up our efforts to recruit and retain workers across our spectrum of services.

Strategies: Most health care costs are driven by individuals with one or more chronic conditions. We have initiated a number of programs such as focused care management, palliative care, and hospice care to help manage these conditions and avoid trips to the emergency room and the hospital. We have also developed a number of programs to recruit, retain, and engage staff.

Michelle Benson, CPA, MBA

Senator | MN Senate, Chair Health and Human Services

Challenges: COVID and civil unrest compel us to evaluate how we accelerate change and ensure that health care meets the needs of all Minnesotans.  Financial realities will force difficult choices including closing and repurposing of facilities.  We must seize the lessons learned during the first year of COVID to accelerate health care transformation. Building health care careers for minorities, retraining current systems to understand the unique experience of minority populations.

Strategies: Listen to new ideas, contemplate their long-term impact  and reduce regulatory barriers to achieving both innovation and a reduction in health disparities.  We can use our influence (and health care dollars) to open opportunities that will keep Minnesota as a health care leader without leaving so many Minnesotans behind.

Jesse Bethke Gomez, MMA

Executive Director | Metropolitan Center for Independent Living

Challenges: We need to build upon our health care platform to meet the needs of people where they live, play, and work. There are about 625,000 people with disabilities and about 680,000 people over the age of 60 in Minnesota. Building our direct care long-term services and direct care workforce is an opportunity to more efficiently deliver care and build up our economy at the same time.

Strategies: Thanks to a Community Innovation grant from The Bush Foundation, we are leading a statewide community innovation personal care assistant project in pursuit of a new credentialed Certified PCA role as a third tier to Minnesota’s PCA programs serving people with disabilities and people over the age of 60 in their homes and in their communities.

Shirley Brekken, RN, MS, FAAN

Executive Director | Minnesota Board of Nursing

Challenges: Health care delivery is dealing with issues of the past as well as emerging ones.  Health disparities, healthcare staffing shortages, workplace hazards and long working hours continue.  Health care is directly connected to all of us, and the delivery system must transform to meet the emotional, physical mental and financial impact on the patient care expectations and experience.

Strategies: The Board of Nursing purpose is to protect the public by assuring practitioners have the necessary knowledge and skill to provide care.  As health care delivery transforms, nursing regulation must respond in a relevant, evidence-based manner that supports innovation while not losing sight of public safety.

Merlin Brown, MD

Owner | Southdale Physicians · CEO | SolarteHealth

Challenges: The healthcare system is so complicated that patients have no idea how to navigate through it. Therefore, they have a very poor experience and are unable to make wise choices.  The prices are so inflated and are not transparent that many patients are not getting the medical care they need or are overpaying.

Strategies: My organization is addressing these 2 issues. I am in an independent practice with very low overhead. I can improve a patient’s experience for less, while giving higher quality health care. I also have developed a new healthcare plan that leverages the quality and savings of these kinds of practices. Real prices, real choices, and real healthcare.

Twila Brase, RN, PHN

President and Co-founder | Citizens’ Council for Health Freedom

Challenges: The mission of medicine has been overtaken by the business of health care. The focus has shifted from patients to profit. Federal laws have created a corporate version of socialized medicine for all (health plans), which control the dollars, data, and decisions. This is a perversion of the “all for the patient” ethos.

Strategies: Building our Patient Toolbox (patienttoolbox.org), protecting consent rights for data-sharing because ‘he who holds the data makes the rules’ (HIPAAhurtme.org), protecting medical ethics by promoting direct-pay practices (jointhewedge.com), and restoring access to affordable non-managed care coverage such as medical indemnity insurance, health care sharing, and the right to opt-out of Medicare without losing Social Security benefits (MedicareOptOut.com).

Sally Thomas Buck, MS

CEO | National Rural Health Resource Center

Challenges: The vulnerability of rural health facilities to maintain access to care. Rising financial pressures with low volume providers, workforce shortages and lack of consistent broadband services to integrate technology. Social determinants of health  impact health outcomes at a greater rate than metropolitan areas. COVID-19 has exposed the financial fragility of many rural health organizations that rely on outpatient services and Medicare for the majority of their revenue, yet are critical for emergency services.

Strategies: To identify emerging issues on rural providers and communities, gather the best practices to prepare, and  create solutions to build state and local capacity to improve performance. This includes technical assistance, information, tools and resources for the improvement of rural health care.

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