Hatching Creativity: Conversations on Success, Innovation, and Growth
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Hatching Creativity: Conversations on Success, Innovation, and Growth
What to look for when hiring a healthcare consultant with Sarah Howe & Morgan Coyner.
Navigating the treacherous waters of consultant selection can be daunting; let's ensure you're equipped with the know-how to avoid the siren call of cut-rate expertise. Our latest discussion peels back the layers of due diligence necessary for businesses to confidently engage the right professionals. I'll share an eye-opening anecdote about a client nearly lured by the false economy of low-cost services. We dissect the perils of generic solutions, emphasizing the critical need for a consultant's authenticity and dedicated specialty. As we pivot to the healthcare domain, I break down the fee-for-service and value-based care models while underscoring the vitality of cultivating trusted referral networks.
Then, we wade into the nuanced world of retainer contracts through a lens of personal experience. I dissect various retainer arrangements, highlighting the imperative of aligning costs with the substantial value they must deliver. Open dialogue and transparency are the lifelines of these engagements, and I stress how clients should leverage their intrinsic knowledge of their own teams when collaborating with consultants. In a powerful final segment on addiction payment reform, we spotlight the Alliance for Addiction Payment Reform's trailblazing value-based payment system. Their mission to revamp substance use disorder services is not just a financial crusade—their profound vision is to reshape the healthcare landscape for the betterment of society.
Welcome to Hatching Creativity. This isn't just another behavioral health podcast. This is the place where thought leaders converge to talk about real life challenges, breakthroughs and pivotal aha moments. I just posted a video on LinkedIn this morning. It was actually pulled from an interview I did on the podcast about how to choose a consultant. There are so many consultants out there and we find, like you know, as a compliance organization, we get pulled into shit shows all the time that come in from hiring the wrong consultant.
Speaker 1:A funny story about that that I always laugh about is we were called into this facility in California. They were looking to get open. They needed a consultant and they wanted us to to handle their licensure and accreditation. And I don't remember what our price was. I'm just going to say 15 grand off the top of my head. You know whatever it was and when we create policies, we actually create your policies. We may use a little guidance of something we've done before, but it's your policies for your organization that we interview your staff about what you're actually doing and you know, build a professional set of policies and say we wanted 15 grand. The guy says he calls me back a couple of days later he goes. I got this guy named. There's this consultant, he goes by and he's willing to do it for $1500. I go first of all if your guy is professionally known, as that would be the first red flag, I feel like my first concern.
Speaker 1:My first concern and my second concern is what is this guy doing for? Yeah if he's going to give you this at $1500 and if you are willing to take it at 1500 bucks, then that is another concern and probably not a good fit for us.
Speaker 2:Consultants are a dime a dozen. I can say that because I mean, I worked with them for 25 years before I became one, and once I became one I was like oh my they're a lot of good and there's a lot of fly by night.
Speaker 1:So, sarah, as a consultant yourself, what advice would you give to somebody who was looking to hire a consultant for their organization?
Speaker 2:Yep, the first thing I would do is make sure they have some references that you can talk to find out what kind of work they've done, because you can have the glossiest, best pitch deck ever. But if you don't know their reputation, if you don't know what kind of work they've done, it's all just car salesmanship you really want, like anything else, you probably wouldn't go. Most of us, when we think about general sales and marketing right, and you know that's for marketing we're influenced by others around us. Tell us, you know we all wouldn't have iPhones if everybody around us didn't have iPhones and talk about what they love about their iPhone. I mean there are entire blogs that tell us did you know your iPhone could do this? We've created an entire brand of influencers. And so you take that on a microcosm or a micro scale and say, if I wouldn't buy this iPhone without finding out everything about it before I spend a lot of money, why would I do it with a consultant?
Speaker 2:Sure that makes sense In my business, like in my day to day business. So you know certainly word of mouth. I think from a consultant point of view, word of mouth is one of the most important things because, exactly what you say, people will call you and be like do you know a good consultant for that? And what they're really saying is what's your referral, what's your reference? Who do you know? Can you give a good reference? And that, I think, is the biggest thing for any consultancy. The other thing I would say is making sure that a consultancy stays within their lane of their expertise, and that's one of the things that I've found in really life about the firm that I work with, because this isn't a pitch for that firm, so I won't do that or say the name of it.
Speaker 1:You can say the name go for it.
Speaker 2:I won't do that because I don't think that's appropriate. But what I do think that I feel that we do really well is we will review something and say, mm, it's not, our lane looks like it might be but it's not. And we'll happily be like, but you know who's lane it is. You know ABC company over there, you know, and we are obsessively mission driven. And what is your mission? Who are you and what do you do? And there's a lot that. Will they get the sale right? Then they'll figure out what they're doing.
Speaker 1:But we can deal with you know, can you? You're saying is also so relevant for providers, because how many providers do you talk to who say and you ask them what is your specialty, what area do you focus on, what demographics do you work best with? And they'll go oh, we work with everybody. And you go oh, so you can work with anyone from their early twenties who are dealing with alcoholism to their late fifties who are dealing with opioids, and they'll say yes, Yep.
Speaker 1:Unfortunately, what ends up happening and this is part of the problem with the fee for service model is that they end up treating everybody.
Speaker 2:You have to end up the grant funding model, and that's where, when you come back full circle, where value based care becomes really critical, where you do need to treat the whole person there's no doubt about that, for sure. But you're also where do you begin and end as a provider? So we are here. We are a substance use service organization. We do the full continuum of care. Maybe we even do prevention in the schools, maybe we do harm reduction and outreach on the street, we do direct service treatment, and then maybe we have recovery housing.
Speaker 2:But what we don't necessarily do is diabetes management, however, what we should do is figure out how to screen that person, find out what's going on with their diabetes, and get them to one of, again, our referred partners that we know and trust. And then not only do we do that, but we don't hand them that card right. We say hey, you know what, morgan, you've got an appointment tomorrow for your diabetes checkup, we've got a transportation, we're gonna get you over to that federally qualified health center, we're gonna get you over to that community health center and we'll pick you back up.
Speaker 2:There's your lane your lane isn't actually doing the diabetes management. It might be. If you're an FQHC you can do all of that under that roof 100%. But you figure that out. What is your mission? And if the mission is exactly what you said, we're here for everything, we're everybody and we'll serve them. That's a good thing. But then you figure out what we mean by serve.
Speaker 1:Sure.
Speaker 2:And that's maybe just driving Morgan to that next appointment.
Speaker 1:Now you also talked about referrals and getting letters of reference from people or references. But we also understand that nobody's going to give a reference that is not going to give them a positive referral. That doesn't usually happen. Are there any other suggestions that you may have to try to vet somebody or an agency?
Speaker 2:So, along with. So, yeah, I think there's two things. There's one being able to say who can I talk to about the work you did, which is absolutely. While they're not going to give a bad reference, I will say you can glean a lot of like how did they work with you, what was their style, what did they? I mean, that's not a good or a bad reference, it's how do they work, because some they might be wonderful consultancies, they just have a different way of working right? Not everybody works well. So that's one thing. But the other is do you have any work samples?
Speaker 2:Any good consultant firm has work products that they can share. They can't share everything because there are privacy and confidentiality and they should, of course, make sure that if they're sharing anything, they're asking their client if it's okay, they probably have some samples on their website. But you also want to say do you have any? Say if you're a strategic planning, for example. Do you have a strategic plan you can show me? If they don't, I'd be surprised If the answer is well, we have a whole bunch, but all of them are private and we can't show you. But you can redact a lot worst case if you need to.
Speaker 2:In general, most will say we get those calls all the time because we work with consultants at APNC where they'll say, hey, I'm pitching for something else. Would you mind if I showed them the strategic plan you wrote Go for it, go for it, right, go for it. We're a nonprofit, we're public, in the public interest anyways. So what do we have to hide If they don't have any work product to show you again? It might be amazing. I just trust, but verify. We do that in our lives. Why would we not do it with the money we're going to spend in our business?
Speaker 1:Yeah Well, this is your operation. This is going to be your livelihood and your reputation and your name. You got to make sure that you vet this out and you get the right person. Another thing I've come across is not everybody pricing you get what you pay for.
Speaker 2:You get what you pay for. Yet I will say and this is one of the things that I learned coming into consulting that it's more of a science than I thought it was, versus an art. Maybe not every consulting firm is different, but I strongly suggest most of us are similar in the sense that we all have a good spreadsheet with our hourly rates. We've been doing this long enough to say this project should cost us about 10 hours, 20 hours, and I'm going to need five of Sarah and 10 hours of Morgan. I'm going to need an analyst who's going to write it up, and they're at this rate, and this amounts to X If they can't tell you how they arrived, arrived, what's arrived, arrived. Thank you Arrived. What I'm here for, that's what you're here for, thank you. Help me speak.
Speaker 1:Grammatical support.
Speaker 2:Grammatical support. Right, that's what I do best. If they can't tell you how they've arrived at that number, I would really question it. And that doesn't mean they need to show you the spreadsheet, but they can usually say well, we think this project will take about 20 hours. It'll take about six weeks. And here's who's gonna be on the team Morgan's gonna be doing the communications and Sarah's gonna be doing the analysis and Jim over there is gonna be running data or whatever it may be. So you know what you're paying for. I mean, a good proposal isn't 20 pages long. I mean it's literally here's what you need, here's who we are, why we're a fit, here's what it's gonna cost you. Who's gonna be on the team?
Speaker 1:Right, you don't need information overload on that.
Speaker 2:No, don't be dazzled.
Speaker 1:And you know, what else I've come across recently and I've seen it in a few areas of the country is for certain projects that are finite, like getting somebody licensed and accredited right, that's a finite project. And I'm seeing consultants charging a monthly rate with a no real standard timeframe involved, which is such a conflict of interest. Right, it's going, hey, it may take us nine months or it may take us 18 months, but we're gonna continue to charge you as we're waiting for the state to do what they have to do. And you're going wow, that doesn't seem to be in their best interest to do this quickly, but people pay a lot more than they need to when they do that and they really don't have any transparency as to what's being done.
Speaker 2:So you know a lot of that. I think that the nature, you know, the challenge, I think, in consulting is the nature of the retainer business, right, and needing to pay your bills. And yet again and I'm biased because I do believe I work for a very ethical company or I wouldn't work for them, right. But we say all the time we don't want you to be paying for something you're not getting, because then one day you're going to wake up and go what did I pay for? I'm done and I'm gonna tell all of my friends what you did to me, Like those are all the things, right.
Speaker 2:So what we actually write into all of our contracts is, after it's either three or six months, depending on how long if it's a retainer contract that we will have a meeting.
Speaker 2:It's usually six months. If it's a one year retainer, we will have a meeting six months in to check the economics, make sure the hours are still what we thought they would be and we have a conversation if you're getting what you want, if our hours are matching, and here's where we're at, so that the economics make sense. The other point of that, too, is to make sure we're still working, because if we just we don't believe that it's not in anyone's best interest for you to pay for the privilege of maybe talking to me when you need me. Yeah, but that is a model and I'm not slamming that model because there is something to be said. I myself have had great consultants on retainer that I paid for months without talking to them and when I needed them, you better believe I used them and I used all their hours. So there is that model and you as you as the consumer.
Speaker 2:I was more than happy and I will say in my previous career when I ran the Illinois Association, I had a PR consultant to this day if he walked in the door I will tell everybody to hire him. He was worth every single solitary penny I ever gave him. And there would be months where he and I would not talk and then the legislature would do something and I would pick up the phone and be like we got an issue and he'd be like right, here's what we're gonna do, here's how we're gonna do it. And my name would be in the paper the next day and that's why I kept him on retainer. But I knew that value To me. That was his value, so his retainer was worth it to me.
Speaker 2:If when I called him, he said, I'll get back to you, I got a meeting, that conversation was gonna be very different, right, and that's never how it went. So you know when you do those. I think it's really important. What you said, mike, is when you make a decision on a retainer contract, is it really a project that you're paying for over time to help your own companies? Economics of paying? Is it the privilege of having an expert on call, or is it somewhere in the middle, where it's a project but also advisory consultancy work, that you wanna be able to call Morgan and say hey, morgan, I need your advice. What is it? What are you? If you, the consumer, don't know what you're looking for, anybody anywhere will tell you what they think you'll pay.
Speaker 1:No.
Speaker 2:I mean just like a car.
Speaker 1:When you say retainer, so like we've got a couple of different types of retainers that we do. One of them is kind of like an attorney right, when you put money in the tail and when you need something you reach out and you call right and that's a piece of it. That doesn't seem like what you're talking about for retainer, though I'm curious about that.
Speaker 2:Right, these are more like. You know, $5,000 a month is what we pay and that's how much you pay, and in that $5,000 a month you get a certain whatever, whether that's every month or report. They're gonna get on a call with you or they're gonna be available to you at any time because they provide advisory services, consultations. So you know, from a purely economics point of view, to pay your staff and keep the lights on a retainer contract is the best option, right, From just an economic point of view, for a company to keep doing their work. And from a consumer point of view, are you getting what you pay for every month? You know, are you getting that three, four, 5,000, 10,000? I mean, these retainers can go as far as we want, right, Depending on what they are.
Speaker 2:I mean, if you wanna call up my firm and look at everyone on the team and you wanna say there's 20 people there and I want to be able for them to pick up the phone, Even if it's in the dead of night, I wanna be able to talk to one of them, yeah, you're probably a $40,000, $50,000 conversation, right Versus a project, right, you can figure that out.
Speaker 2:But a good firm will also say we're gonna continue to monitor the hours that we're spending on this For you, the consumer, but also for us, because there's a flip side of this. You're doing a retainer that's $5,000 and we're giving you $10,000 worth of phone calls because you're calling me every day. So on both sides of that conversation needs to be, we're gonna come back together at a certain time and we're gonna be like all right, so here's what we've done, here's the hours we've put into this. Here's what the math looks like. Are we still cool? We're good, right, this is still working on both sides of this equation. So it's the other thing. Consultants should be able to tell you what they did, how long they did it for and what it caught. I mean, go back to the transparency and coverage.
Speaker 1:Meeting minutes too. We share meeting minutes always. You know it's. Yeah, we do some very similar kinds of things. We name it a little bit differently, but it's really important to be able to access somebody should you need them.
Speaker 3:Yeah, and I think what people, when they're looking for a consultant, forget, like you go out looking for a consultant because you need an expert and something you're not an expert in.
Speaker 3:And so, but you're still an expert in your company, and the consultant is not Only one who knows that, and so you know. I used to work, we worked with an IT consultant and we were doing this big overhaul of our software and they sent me these instructions for how to roll it out with my staff. I looked at them. I said that is not gonna work Well for all our other clients. I said listen, if you don't tell my staff to hit next, they will not hit next. They are scared, they're gonna break the whole system. Well, everyone would just hit next. I said I'll give you 10 people, give them your directions, let me know what happens. Two people click next. I said I know my team, you're gonna need to do something different here, and people, I think, are afraid to say that because, well, you're the IT expert.
Speaker 3:If you say so, but like I am the expert on my team and if I know this is not gonna work with my team, I also have to feel comfortable saying that to you. And so I think you it's easy to kind of roll over and just say, like the consultancy expert, I'm gonna let them do whatever. But like you have to be, you have to find someone that you can have that kind of conversation with, to say, like there are lines where, like I'm gonna have to pull the reins back because my team is my team and every team operates differently. And if they're, I think if your consultant is not open to that, like to me, that's a red flag.
Speaker 3:You can't treat every client the same because they are not the same. And so when I like, when Sarah and I talk about consultants, like if we're looking for one, that's something I care about, it's like are they gonna trust me to be the expert in what I'm the expert?
Speaker 1:in the same way, I'm trusting them, yeah it's the same thing as when you're looking for a medical provider too. You have to be able to advocate for yourself.
Speaker 1:Yes, you know your body and what you're feeling better than anybody else is going to. And at the same time you're right having an understanding of your organization, because I see, we see all the time it's owned by a medical professional, right, and their medical is on point, but their operations really need some help, or their clinical side is not up to the level of their medical side because it's owned by a medical professional Things along those lines Right.
Speaker 2:Well, yeah, and that's. I think. Everybody knows their business, right, yeah, so sometimes all of us can get outside of our lane and think, because we know this part of the business, we know that, like you said, I know I have never been a clinician ever in my life, but I have been around so many that I you catch yourself being like, oh, that's probably such and such disorder and I'm like, whoa? No, I don't. Why did I? You know, we all do that, right, you've been around, you're adjacent to it, so we know it, and you're talking consulting, you want, you want that expert, you know?
Speaker 2:but, also Morgan's 100% right.
Speaker 1:Yeah, I love that. Yeah, I love that it's. That's really helpful. Can you tell the audience and the people listening the name of your consulting firm and what you guys do?
Speaker 2:Yeah, so I work for Third Horizon Strategies and, as such, apnc is one of our clients. So that's how this unique relationship works here. I'm a senior director with Third Horizon Strategy. We are a small boutique healthcare advisory firm that is based in Chicago. We have staff in every time zone in the country, so we're all across the country and we focus solely on healthcare and the mission of improving healthcare.
Speaker 2:So that has obviously a very strong footing in behavioral health, because we just can't address healthcare anymore without talking about our mental health and substance use.
Speaker 2:But it goes beyond that to like we talked about data analytics, looking at transparency and coverage, value based claims, value based payments. I mean, I think one of the things that we do that's a little unique is we manage a few different projects that are they're not for the economics, they're for the mission. So one is called the Alliance for Addiction Payment Reform. So if anybody is working in the addiction space, we've taken providers and payers from across the country and brought them together to talk about how we better pay for the performance of substance use disorder services and developed a value based payment system. That I will tell you, because I find this really cool, because I did not do it because I am not that smart. If you go to the website for the Alliance, it's just incentivizerecoveryorg, and the reason why I want to bring it up is totally free. It's not going to cost anything, and on this webpage is the value opportunity calculators.
Speaker 1:Thanks for tuning into Hatching Creativity. We appreciate your support. Please don't forget to like and subscribe and tell all your friends about the show and remember it's never just about one thing.
