Sheri Shapiro is the Senior Executive Vice President and Chief Strategy Officer of CommonSpirit Health, one of the nation’s largest integrated health systems comprising 142 hospitals and 2,200 care sites across 24 states. With more than 20 years in healthcare management consulting, health system leadership and brand management roles, Ms. Shapiro brings experience in enterprise strategy and growth, physician alignment, partnerships and transactions, population health, and consumer product marketing. Becker’s Hospital Review named her one of the 50 Great Health System Chief Strategy Officers in 2022. Shapiro holds an MBA with honors in healthcare management from the Wharton School at the University of Pennsylvania and a BS in biopsychology with distinction from the University of Michigan.

Sheri Shapiro, Chief Strategy Officer at CommonSpirit

The Pulse: Can you share with us a brief overview on your background and the professional journey that led you to CommonSpirit?

Sheri Shapiro: As with any leader, it’s never a straight line. It’s a long and winding road. I worked in healthcare consulting for several years after my undergrad, and that helped me identify that the business side of healthcare was where my acumen was best placed. So, I proudly went to Wharton as part of the Health Care Management (HCM) program. While in business school, I got very involved in classes outside of the HCM major to leverage the experience to learn from other industries and as a result became very interested in consumer behavior. I joined Ford Motor Company as a career changer where I focused on product strategy and brand management for several years to immerse myself within the consumer products landscape. People are always surprised to hear the number of comparisons I make between the automotive industry and healthcare industry. I had a great experience at Ford where I had the opportunity to run a $3B-brand and launch the world’s first hybrid SUV, but after five years there I found myself missing healthcare so I ended up leaving to re-join healthcare consulting. While there, I loved the diversity of complex business problems we solved for clients. One of those clients, Trinity Health, eventually needed to replace a team-member who was leaving and asked if I would be interested in the role. This led to me to join Trinity where I ran mergers and acquisitions and partnerships before being promoted to Chief Strategy Officer. I spent seven years there when CommonSpirit reached out, leading me to join the team in June 2023. 

The Pulse: You mentioned you were able to draw parallels between your experience within the automotive industry and healthcare. In what ways were the two similar or distinct, and how do you think this insight has helped you in your current role? 

SS: Both are very high fixed cost, highly regulated industries. They are both industries in which you don’t always own your distribution channel – the automotive industry does not always own its dealerships and most of healthcare has a very fragmented supply chain in terms of how services and products get to the end-user, the patient. Operations management, operational efficiency, and high reliability are critical within both industries, because in both scenarios, when something goes wrong, people die. In terms of the differences, I would highlight that the automotive industry produces a consumer product and its emphasis on customer-centricity and differentiation through performance and high levels of service has not been observed to the same extent within healthcare.  I believe healthcare can learn a lot from this approach, because at the end of the day, we are a services organization. We are people serving people. If we don’t start to get more advanced around how to be service-oriented and focus on differentiation and sources of competitive advantage, then it will become very easy for organizations in healthcare to become commoditized.

The Pulse: What does it mean to focus some of these elements of strategy for a health system as distributed as CommonSpirit? 

SS: Any health system regardless of size that comprises a multitude of care sites, types of providers, and geographic locations, whether in a single market or across multiple, has to think about strategy within the context of how it can leverage its “system-ness”. This gets increasingly complicated the larger, more complex, and more diverse an organization is. I spend a lot of my time evaluating how we can leverage our system to deliver better care and better services to our local communities. It is not all about centralization, rather it focuses on identifying ways to deliver care at scale efficiently, consistently and with high reliability so as to reach more communities that need it. Linking these principles to local market strategy is where I spend a lot of my time. At the end of the day, care delivery is fundamentally local, even virtually. How do you leverage the system strategy to develop an advantage locally? How do you customize the ways in which care is delivered to differentiate amidst local market dynamics and the competitive environment? These are some of the questions I aim to address. Balancing and tying together the 30,000 feet strategic vision with the on-the-ground operations and local market differentiation is key. 

The Pulse: Can you give us an example of what that looks like? As you mentioned, care is becoming more personalized, and by extension, more localized so how can you ensure that the organization continues to scale?

SS: I don’t think anyone has figured that out yet across the entire industry, whether for-profit or not-for-profit. It remains a huge opportunity in healthcare. The key is to really understand who you’re serving, and what their needs are. Healthcare has historically been very poor at doing this. A lot of organizations express a desire to be patient- or person-centric, but what does this really mean? This is where consumer-focused companies spend a lot of time on market research, customer segmentation, and really understanding deep-seated needs of their customers. We don’t see this as much in healthcare. It is evolving and moving in this direction, but it’s not there yet. Focus your time, energy, and resources on delivering services that address, in a scientific and data-driven way, what the customers need, as opposed to what physicians or payers need. There is a lot of opportunity to leverage customer research to tailor the way we deliver care to match the way in which people want to receive care.

The Pulse: Can you elaborate on CommonSpirit’s efforts in relation to health equity and population health, and how these integrate into its broader strategy? 

SS: Compassionate care is part of everything we do. I think it is built into the DNA of people who go into healthcare, no matter what your role is. At CommonSpirit, Hello Human Kindness is our tagline. It is front-and-center for everything we do. We strive to approach care in the most holistic way around mind, body, and spirit. It’s not just a consequence of supporting data or standard of care, it’s our philosophy. We factor in the whole person for everything we do. For instance, with respect to health equity, we spend a lot of time building into our intake processes and EMR a lot of information about an individual’s background, race, ethnicity, religion, zip code, and social determinants of health. These provide context as to where their mindset may be with regards to how they approach care, the ways in which they access it, and what support systems or structures they may have in place in their daily lives. We track this information and measure disparities in health outcomes so that we can devise a plan to mitigate any differences by putting in place the appropriate services. We also have the Lloyd H. Dean Institute for Human kindness and Health Justice, which leverages research to identify and promote the adoption of compassionate clinician behavior linked to better outcomes. CommonSpirit is a young organization formed with the merger of two large health systems in 2019. During the integration process we realized that we had a wide array of population health-oriented value-based care arrangements that had been relatively successful but disjointed. So, we aggregated the skills, capabilities and competencies that allowed us to be successful across these local markets to create a system-wide infrastructure that centralizes analytics and contract management, enabling us to enter value-based arrangements more efficiently while still supporting      care management at the local level. 

The Pulse: Can you comment on how health systems’ role has evolved within the patient journey as a result of all the stress put on the entire healthcare ecosystem during the pandemic? Conversely, have there been any opportunities that were catalyzed by the public health emergency that you are excited to explore further?

SS: With the onset of the pandemic, health systems had to bridge the gap between delivering care and solving fundamental public health problems. What we learned as a country was that our public health, whether you call it a safety net or infrastructure, was fundamentally not prepared to deal with a massive public health emergency. A lot fell on hospitals and health systems, because they were large facilities with a lot of capacity that were centrally located in many communities and could be used as hubs for vaccine and screening clinics. Even doctors’ offices were shutting down, and it was up to hospitals and health systems to pick up that slack. It was a dual burden, because in addition to these services, hospitals and health systems had to also maintain their core function of delivering care to very sick people. Our workforce was putting themselves at risk coming to work every day, so we had to consider how we needed to take care of our workforce on top of this as well. The challenging circumstance raised the bar in terms of what it takes to be a good leader during a crisis, and how organizations create in crisis situations. Coming out of the pandemic there is a lot of resilience, a lot of continued support and care of our workforce, and preparedness. As a result, one of the silver linings that has emerged has been the rapid migration to digital and virtual. Even change-resistant patients and physicians were forced to shift to virtual consults during the pandemic and found themselves favoring it. I think that’s here to stay, even if not at the magnitude at which it had been utilized during the height of the pandemic because a virtual setting is not appropriate for all types of care. Another related silver lining had been the adoption of Hospital-at-Home solutions for lower acuity care. Innovation spurs out of crisis so there are a lot of new ways of thinking, new collaborations that have emerged as a result. My hope as a strategy leader is that we don’t lose this momentum. 

The Pulse: What do you see as hospital and health systems’ role in the transition to value-based care models? One lever that has historically been used to generate savings has been reducing acute admissions. How do you think about challenges, opportunities, and catalysts in this regard as you set strategy?  

SS: It is a critical question, but I don’t think it’s a one-size-fits-all for every health system. What role to play in value-based care is a strategic question for every health system, and the answer will vary depending on how they want to differentiate and compete. If some health systems want to devote their resources toward entering the hospital care space, there is a role for that but then they better be the best hospital in the country. CommonSpirit has more than 2,200 care sites, of which 142 are hospitals, across 24 states. We have a lot of diverse sites of care so for us the idea of participating in, and driving the transition to value-based care is exciting. Value-based care is, fundamentally, an economic model within which there are multiple arrangements and structures. Therefore, the next step is figuring out what is the portfolio of value-based arrangements that we’re best suited for. Or where do we want to start and then evolve into? Because if you don’t align the two, you can fail miserably.

The Pulse: Looking at the big picture, if you could redesign any part of the healthcare system, what would you want to address? 

SS: So many, but I’d start with two. The first is something that seems very basic and simple – we need to eliminate the clipboard. This notion of handing someone a clipboard with forms to fill out is antiquated. We can perform very complex tasks on our mobile devices so there is no reason there shouldn’t be a more streamlined, digital way of sharing healthcare information, and we shouldn’t need to fill out the same details multiple times. The second redesign is much more complicated. There needs to be fundamental economic restructuring of how healthcare is funded. Presently, the closer an organization is to the end customer or the patient, the farther they are from the healthcare dollar, and this fundamentally does not make sense. The fact that the healthcare dollar starts so far upstream from the patient, and that the entities delivering direct care are so much further downstream from the economics removes the economic incentive and alignment needed to deliver the best care in the best way at the best price. The people delivering care need to be able to manage the associated spend rather than being compensated for treating downstream symptoms. CommonSpirit has a population health services organization that has the infrastructure to be able to do this, and it is something we are very excited about. 

The Pulse: What has been the largest barrier in driving the type of digital adoption that you highlight? Is it an aversion to change or a more fundamental aspect of the technology and its application in healthcare? 

SS: It’s both. Change management is very hard, especially in industries such as healthcare. It takes strong leaders with the fortitude to make tough decisions and have difficult conversations. Changing the “that is how we have always done it” mindset is where strategy fits in. If we can get the organization excited about what we’re trying to be, people will get on board. Internal change management is critical, along with strong leadership and collaboration skills, because nothing gets done in a silo. Successfully linking strategy to execution and to operations is critical, but on the flip side, I get pitched all the time. Every startup is convinced they have the best solution to solve the most important problem. While there are a lot of great solutions out there, and CommonSpirit has been adopting a number of these, too many are spot solutions that only work for a certain type of patient with a certain type of disease with a certain payer contract. That doesn’t work for a health system, which must treat everybody and is not able to implement 100 different solutions. It is a similar dynamic for patients. A patient can have multiple conditions and does not necessarily want to have to interface with separate platforms to access care. We need technological solutions that are flexible and universal or can be expanded to more patient types over time. Similarly, infrastructure solutions cannot solely be managed by external vendors. They need to be able to integrate with the rest of our information systems to enable us to holistically understand the patients we serve.      

Interviewed by Akanksha Santdasani, January 2024.

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On Feb 15-16, 2024, Wharton is excited to feature more expert perspectives at our annual Wharton Health Care Business Conference. This year’s conference is themed ‘The Resilience Edge.’ Conference details and tickets are available here.