Mel Hall, the ‘relentless pragmatist’ who formerly led the patient survey firm, is seeking to unseat incumbent Republican Representative Jackie Walorski. Mel Hall never set out to run for public office, but the former CEO of Press Ganey is reentering the public spotlight to run for Indiana’s second congressional district.
Hall cited his time serving as a Methodist minister in Detroit as the inspiration for his ‘relentless pragmatist’ approach during his 15 years leading Press Ganey. Hall’s guidance at the helm of the patient survey firm led to significant market growth and influence for the company by the time he stepped down in 2012.
In an interview with HealthLeaders, Hall reflects on his experience as a business leader in the healthcare arena, the slow embrace of value-based care in the healthcare industry, and promote change in Washington if elected to Congress next month. The following transcript has been lightly edited.
HL: Why are you running for office, and what do you think in your experience makes you qualified to be in Congress?
Hall: I am convinced that we can do better in our country than we’re doing now. For me, part of that is we need people who are used to being held accountable for results. Every month at Press Ganey, I stood in front of all the employees and laid out our targets from the previous month and what we’re going to do during the next month to improve them. That sort of maniacal focus on continuous improvement is what, in my view, led to the great success at Press Ganey. I think that’s missing in Washington. I think Washington is broken, and I think both political parties are to blame for that. I’m a Democrat, but I’m a centrist Democrat who has been focused on results and making something better my entire life.
HL: What have been the biggest changes in healthcare since you left Press Ganey, and how does that affect your idea of where the country needs to go in healthcare?
Hall: When Press Ganey was founded, we heard the voice of payers, device manufacturers, insurance companies, occasionally doctors, and even less so, nurses. But the one voice that was muted, if not actually silent from the mid-90s to the 2000s, was the voice of the patient. We did a survey in the mid-90s and asked, “Does your hospital administrator have any compensation at risk based on patient satisfaction?” It was about 2%–3%, but it grew steadily, and by the time I left, it was something like 75%–80% of hospital leaders had compensation at risk based on patient engagement and patient satisfaction that helped to change the culture. I think that move to make sure we hear the voice of those who are actually receiving the care, those with preexisting conditions or those who didn’t have any healthcare at all, is a significant change and one that needs to continue.
HL: What’s the most effective way to promote value-based care in the coming years?
Hall: I think it has something to do with measuring outcomes. I’m not talking about a one-size-fits-all [approach] because different hospitals have different patient mixes, but we should have measures based on expected outcomes. I think we also should think about being more transparent. We are almost the only country in the world where you don’t know what it’s going to cost to get a knee replacement or hip replacement before you go in. There’s significant variation whether you get your knee or hip done in Texas or Chicago by way of cost. Those are a couple things that we can do right now. We can be much more transparent in our pricing and in quality metrics that go alongside of that pricing. Because for higher quality, patients might decide to pay more, but we need both costs and quality measures.
HL: Do you think that there’s a need for the government to get more involved in addressing the prescription drug prices?
Hall: I think certainly we need to do more than we’re doing to drive down prescription drug prices, no doubt about it. Medicare should be able to negotiate drug prices, and they can’t now and that’s something we [could] do right now.
HL: Where do you stand on the proposal of Medicare For All legislation? Do you think that is the pragmatic approach for the party going forward?
Hall: As I said earlier, it’s taken us [16 to 17 years] to move even partially from fee-for-service to pay-for-performance. Medicare for All is not practical because of the significantly increased costs, but I do think there are many things that we can do to ensure that our healthcare coverage is better.
HL: Does some of that include bringing back aspects of the ACA that may have been defunded or stripped away by the Trump administration, like the individual mandate?
Hall: Yeah, I’m open to all sorts of ideas, like the individual mandate, but I try not to deal in hypotheticals. I think we can continue to find new solutions. We ought to be able to guarantee access [to healthcare] and folks should have quality care, but I think there are probably more efficient and consistent effective solutions than the individual mandate
HL: What gives you hope about healthcare’s ability to transform?
Hall: I am optimistic because I actually believe most Americans, and most people in healthcare, want to solve problems. I think if we have incentives in the right place, we can bend healthcare the way it needs to. I think if our incentives are on quality outcomes and price transparency to ensure that we are eliminating a lot of waste, healthcare leaders will follow that. 20 years ago, nobody talked about patient satisfaction. Now entire hospital teams are not only judged, but compensated based on that. That hasn’t been the MacGuffin, but that’s an example of how healthcare can change based on incentives. I think we can do the same with quality metrics. We’ve seen that a little bit in the pay-for-performance CMS quality score card; we’ve seen some movement there.
HL: What should hospital executives and health system leaders take away from your candidacy?
Hall: I think for people who work in healthcare, their primary motive is to make things better. I believe that to my core, that for most people in healthcare, it isn’t a job, it’s a calling. Whether that is a nurse, a hospital administrator, or a physician, most people get into healthcare because they want to make a difference. I believe in people who lead healthcare—doctors and nurses—are in it for the right reason. Most people in their life want to do well and do good and to make a difference.