Scott is CEO of Elara Caring, one of the nation’s largest providers of home-based care, with a footprint in the Northeast, Midwest and South. Elara Caring has recently brought together three award-winning organizations — Great Lakes Caring, National Home Health Care, and Jordan Health Services — into one transformational company.
Scott has years of experience as an industry leader dedicated to transforming health care to be high quality, personalized, and consumer focused. Most recently, Scott led Alignment Healthcare as the nation’s fastest growing and most disruptive Medicare Advantage and chronic disease management company. Prior to Alignment, Scott served as the President of Health Insurance at Cambia Health Solutions, guiding and transforming the four-state Regence Blue Cross & Shield into a disruptive and rapid growth payer. Prior to his experience in the healthcare sector, Scott built a career driving innovation, quality, and performance excellence as a managing partner at Alvarez & Marsal and a senior executive at Intel Corporation.
Scott is married to his wife, Sarah, and they have five children and one grandchild.
Enjoy this deep dive conversation with Scott exploring leadership philosophies, decision making, and how to handle adversity.
Matt: I wanted to break the ice for the readers of the Leadership Letter and get to know who you are a little bit better. So, is there any habit or unique thing that you love that other people might find interesting?
Scott: I don't necessarily have any unusual habits that I know of, but there are few unique things that I love. First is my best friend and wife of 31 years and my five kids and grandchildren. Second and likely more unique are my two dogs. I have a Labradoodle and a Standard Poodle. They're both great companions. My wife and I are convinced COVID has really been a conspiracy by the dogs around the world to get their owners home. Love my dogs!
M: With leadership being the theme of this interview, one of the commonalities that we see from leaders is that they typically read books or expose themselves to different types of thinking. Is there any book that has a particularly good influence on your leadership style or leadership perspective that you give to others or often recommend?
Scott: There's really two books that come to mind and they may be a little non-traditional. One of my passions is history, I think we can all learn lessons from the past. So, there are two books that have really stood out to me. One is Profiles in Courage by John F. Kennedy, where he profiles eight senators who demonstrated courage in the face of significant obstacles, which really set the tone for his presidential candidacy, his presidency and administration, and how he handled the Bay of Pigs as well as the civil rights movement. It's very relevant for the times we live in.
The other one that I read is Team of Rivals by Doris Kearns Goodwin. It’s about Abraham Lincoln during his presidency and his relationship with his cabinet. Many of them were adversaries and not necessarily always aligned. But they were all very important leaders and good at what they did. He surrounded himself with diversity of thought during a significant time of conflict for the betterment of the country. It wasn't simple or easy, but he swallowed his ego and became a leader during a time when the country needed it. It's a great book. It's a long read, but again, very relevant for the world we live in today and is a very good role model in terms of how I try to lead.
M: In regards to bringing together different perspectives, it sounds like Team of Rivals may have influenced your approach to building your leadership team. What do you look for when building a team? How do you go about assembling the team of people that you surround yourself with to achieve the mission for either Elara Caring or any endeavor?
Scott: I've had the benefit of being around many great leaders and many ineffective leaders. Which allows me to take the best and discard the worst. Similar to the thesis in Team of Rivals, right? I think it's really important to surround yourself with diversity of talent. Don’t just surround yourself with everybody that thinks the same. Diverse teams can push the envelope in terms of thinking. I like to think I fill my blind spots pretty well with people who can both lead and build great teams, but also can raise the game of the organization and push the organization to new heights. I think that's really important. And to that end, I think great leaders attract and develop great leaders, and poor leaders run off great leaders and leave you with “yes” men and women. Leadership is a core essential element to hiring for me. As the CEO that means, you’ve got to swallow your ego, you’ve got to listen, you’ve got to foster the team and get the best out them. I think productive tension with teams is healthy, as long as they attack opportunities and not each other. At Intel we were all trained in “constructive confrontation,” which was a core value. And last, in my opinion as the leader, you have to have the ability to surround yourself with leaders and advisors who can teach you, and you have to be humble enough to accept it. I've always had some independent advisors and mentors that I've used in my life and particularly as a leader. Oftentimes I seek these people who tell me what I need to hear and can try to help me in places where I'm not good. In summary, it's good leaders, diversity of talent, being humble enough to swallow your ego, surround yourself with people who fill your blind spots, have great mentors and advisors around you. I think those are all really important elements of leadership.
M: Do you have any particular story or example of someone that has had an impact or influence on your leadership style?
Scott: I worked at Intel for 17 years, and I worked there during the rise of the company. Andy Grove was the CEO for most of the time I was there, and this is a guy who set the culture and also lived it. He wrote books like Only the Paranoid Survive. We all had cubicles, including the Andy, to reinforce transparency and open conversations. Those were all critical elements and early lessons in my professional life. This is coming from a Hungarian immigrant who escaped a communist regime, the Nazi regime and the Soviet communism regime in post-World War II. He came to America with nothing, found a way to get educated, and became the father of the semi-conductor industry. So just being around a guy like that, who came from those struggles to build a great company was just an amazing role model for many us in my early career. As I grew in the company, I eventually became an executive. He was the guy that when you walked into a meeting with him, you’d better be prepared, you'd better be on your game, and even when you thought you “nailed it”, you walked out of that room knowing he was still ahead of you. That to me was the best experience I could have ever had. It was incredible being in an organization like that, one that had a leader who wasn't about him, but it was about the company, it was about what we were trying to build, and he lived it every day.
Like I said, I've worked for great leaders, and I've worked for some poor leaders and the key differences has been servant leadership. Making sure you're trying to actually achieve something and surrounding yourself with people who can help you do that, rather than be in control of it. I think that's a very important distinction. Therefore, you've got to be willing and confident enough to have smart people around you.
M: You mentioned servant leadership, what drew you to this particular style of leadership and why does it interest you?
Scott: As a technology leader I learned about leadership largely based on technical expertise in a field. It wasn't until I got into the healthcare space that the servant part became more prominent. I think it really just came from the fact that, the more senior you get as a leader, the more you understand that you're only as good as the people you hire and develop. I learned to serve them and to find ways to make them as successful as possible. Leading in healthcare has also honed my empathy and emotional intelligence because most of us are here to help people get and stay well, thus the servant leadership emphasis. I have found that clinicians become clinicians to help people. As a leader of clinicians and care aids my main job is to connect their work to a cause or a mission and to motivate and inspire them to give our patients their best every day.
M: Can you talk a little bit about the transition from Intel and the technology side, and what drew you into healthcare?
Scott: I had been at Intel for a long time and learned what great looked like. I ventured out and did corporate restructuring work. I was on the road for five years of my life with really dysfunctional, problematic companies. These were bankruptcies and organizations that weren't performing well, had bad culture, bad performance, you name it. I was having a great time professionally. In both a professional and family move I rejoined a few Intel colleagues at Regence Blue Cross/Shield. I wasn’t certain if I would enjoy the company and was apprehensive to enter what I perceived as a slow, stale, and bureaucratic organization. What I found was a company that wanted to change, wanted to be agile. What I have found in my 10 years in healthcare is we need fresh talent who can reimagine, change the game, increase the velocity, and embrace technology. Layer on top that your effort is helping people live better, healthier lives, has made the transition very rewarding for me personally. So, I really found a niche. I've been able to drive change. I've been able to infuse different types of talent into healthcare and really do some innovative things all for the betterment of the healthcare system, and the patients we serve. So that's the transition that I've been able to make professionally. I'm just having a blast every day!
M: Speaking of change - in the midst of COVID, how did you and your team approach preparing the organization for the potential challenges among so much uncertainty? Can you walk us through the timeline of when you guys were starting to be aware of these changes and how you prepared the team to potentially address something that is unknown.
Scott: I was sitting in Addison, Texas, our headquarters, with Chris Hardman our SVP of Communications and Marketing, it was on March 16, and we were looking at each other, like, wow, this is really going to be bad. By the end of that week, March 20, we had started our daily COVID-19 calls and all-hands on deck, anybody and everybody who needed to be in the discussion, crisis management began. When you grow up in a high-paced technology world and you’ve consulted within a bunch of companies who are really performing poorly, you quickly get into a kind of daily mode, hourly mode. That's what we did with COVID. Basically, seven days a week, anybody and everybody who needs to be on the call, we got on the call starting at seven in the morning. “Let's attack the problem” was our mindset. We set the tone early, we said, we're not going to just hunker down here. We're going to use this disruption to get ahead. So, I want innovation, I want problem solving and everybody needs to participate. Let's not paralyze ourselves, let's view this as an opportunity. Strangely enough, the organization really needed something like that, because we were three companies that came together with three different cultures, we had three different ways of doing business, and were struggling. But COVID has become a catalyzing force for, One Elara Caring. I think we've actually benefited from it. The other thing we did is a risk map process pretty early. We mapped the likelihood versus the impact of various challenges - patient access, facility access, technology access, PPE, workforce availability - can we get them home? We essentially mapped it out to say where are our big issues and let's go attack those. That helped us in terms of staying focused, and I would say the results have just been astounding as a result. The team is really vulcanized, we feel like we could do anything, and it has been empowering. We made decisions that would have typically taken months in hours such as our telehealth platform, our communications platform or work from home decisions, our PPE warehousing. We didn't have a warehouse, so we built the warehouse in about a week. We put our communications on rapid pace. We implemented videos, we got a texting platform, our intranet, email, Zoom conferencing, you name it. We were “all over it.” And then last, we said “How do we become a partner of choice?” We went to our referral sources and said whatever you need we're here to help. And we actually gave PPE to certain facilities who were in short supply. We said, look we're partners. So as part of this getting ahead and coming out stronger, those are the types of things that we really focused on. We really focused on building our team and being one Elara Caring coming out of this. And that's been our motto and it's working.
M: How do you and your team make decisions when you are facing that adversity? Do you have any mental models or decision-making framework for how you approach things?
Scott: I think when you're faced with real adversity you cannot fake great leadership. That's the first foundation. I have found key attributes include courage under fire, decisiveness, holding your team accountable, but also giving a path to success. I also believe you’ve got to amp up the frequency of your team meetings, make decisions with imperfect information, ensure you've got good team meeting discipline, listen more than speak, pulling more people into the conversation, and full transparency – no hiding the ball. That's really important because you don't have all the answers as a leader and need the best information you can accumulated to make informed decisions. Many times, I have found people down in the organization who really do understand, so go find them rapidly. Then from there, you’ve got to really focus just on what's important. That's why I said we did this risk map early; prioritize and stay true to your values, stay agile. I think agility is such an important element during these types of challenges. Prioritize what you determine is important, have a plan.
We also consistently find most people are capable of doing so much more than they think they can if you give them the right environment. As a leader, it's really giving them and creating the environment for success. So, in summary it's not anything magical, other than, get into a different gear fast, get people engaged, get the transparency and communication going, get people who can make decisions.
M: I read an article about Elara Caring's response to COVID, and I think one good example of moving quickly and addressing change is around behavioral health, the impact of stress and anxiety, especially with seniors with medical conditions that are potentially at more risk than others. How are you approaching or have you adapted your behavioral health and mental health models to support some of these new found challenges for that population of patients?
Scott: We’ve had a great behavioral health presence for some time focused on the Medicaid population with severe addiction, anxiety, schizophrenia, and depression. We're talking really, really challenging mental health. That's kind of the roots of our behavioral health product offering. So, when COVID appeared we knew access challenges and loneliness/depression would emerge as serious issues in mass. We basically said, how do we take what we've done with this Medicaid population and import it into our mainstream business. We've developed a product offering, taking it to our referral partners, and package that up. Now, it's trying to make sure we have the right resources out to field to handle the volume of demand. But I would say, to just summarize, we started with a severe mental health product and service in the home and transported the product into mainstream home health. We have immediate and instant credibility with our referral partners due to our depth of skill. We're finding that we're really seeing the benefits of that, and we're going to blow this out in all the regions in which we operate.
M: Last question, do you have any new habits, behaviors, beliefs or perspectives that you've developed recently or in the past few years that have had a big improvement on your life?
Scott: The biggest habit change, particularly in the last five, six years is making time to think big. It's easy to get wrapped up in the day to day, particularly when you're trying to build and integrate a company. So, now I block time on my calendar, literally to say - okay, I need to get out of my comfort zone here and think big. I learned this in reading about Bill Gates. I found that very interesting and I’ve tried to adopt the model in a small scale, and I think it works really well. I view this as a habit because I take time on my calendar and say to my assistant, no one is allowed to book anything during these four hours. I lock myself in the office and ask myself - Do I have the right talent? Do I have the right strategy? Are we truly innovating? If not, why not? Are we taking care of our customers? How will we grow faster than our competitors? Am I leading in a way people will follow? I have found I have grown as a leader and stay focused with my teams with what really matters.
I'd say the second thing, and it’s equally important, as I've developed over the years is who I decide to work with. I made a statement earlier, I've seen really great leaders and really poor leaders. I increasingly do not tolerate toxic people in my life, and particularly in the organization. As a leader, that's one thing about me that I’ve just become intolerant of super toxic people. I don't mind aggressive people. I don't mind assertive people. I don't mind people who have a strong point of view. I just don't like toxic people, people who try to tear teams apart, who ultimately aren't engaged in what you're trying to do and see everything is a glass half empty. That's just not something in my professional life I prefer to deal with anymore. That’s more of a personal habit that I’ve developed over the past number of years.
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