In Part 1 of our conversation with Celeste Ortiz, Chief People Officer at Crossover Health, we learned all about her background and how she came to the company. In Part 2, she focuses on the power of culture and why team building is a superpower. She also describes the company’s transitions during the pandemic and the bright future she sees for the company. Part 2 of 2.
Culture is important. How do you hire beyond just skills to build the culture?
We studied that and looked for the success profiles of individual contributors. Are they a people leader? A senior leader? We created tools with these profiles that we embedded into our hiring and our performance reviews: 50% of our individual rating is based on skills, and the other 50% is based on how you live our values. Are you inspiring people? Are you fearless? Are you staying curious? This helps us look beyond just individual superstars to see who is also going to be a great team member, who is a great servant leader, and who is going to be able to lead people—these are all so critical, particularly in our team-based care environment.
Do Crossover’s values resonate with people?
I really think they do. But in order for the values to be real they have to be integrated into your people operating systems, so that’s what we’ve done. We’ve created a Values Rubric that literally lays out manager type-by-manager type, to show people what “success looks like” at each level in the organization. Because it’s written down, we are able to compare how people are doing based on this standard. It’s like, “Here’s what ‘Be Fearless’ looks like when you’re selling, here’s what ‘Inspire Others’ looks like when you’re managing people, here is what ‘Be Authentic’ looks like when you are caring for our members. In addition, our leadership training curriculum is built around our core values and includes 40 full hours of training, parceled out into bite size modules. We worked hard to thread the values throughout the content via storytelling. I hadn’t really seen storytelling implemented like I have at Crossover—we have these powerful, emotive examples of leadership that are easy to remember, and effectively allow more people to be able to have their own individual “Aha” moment.
As I previously mentioned, this is often the first leadership training course many of our medical leaders have ever gone through. Again, incredibly smart, driven people, placed in positions of leadership and authority with no formal training—still blows my mind. However, on the flip side, our medical leaders are so grateful for the opportunity and they really get into it, practice their skills, and get to work. No motivation problem there!
What’s your leadership style? What has helped you personally be successful?
I like to focus on outcomes, on creating an environment where people feel comfortable in the collaboration process. I love solving problems through teams, I love that people feel like they can come to work and be their authentic selves. I find that I focus on these three themes quite a bit in my work and it has helped me enjoy some success as a people leader.
But to be clear, this is really, really hard work. It’s long hours and long days for every single person on my team, so it also has to be fun and rewarding at the same time. One of the things I like about working so hard and creating this environment is that other people feel like they’re personally learning, and professionally growing—and that growth begets more curiosity and even more growth. If it’s too comfy, and you are not being pushed or pushing yourself, you’re probably not learning and most likely stagnating. Gotta keep moving forward, always!
What do incentives look like in a company with Crossover’s mission and values?
When I first got here, I was working on the foundations that will allow us to grow. The cool thing about having experience working in really large organizations, is that I was already exposed to a framework for compensation, and a framework for benefits, so now I can quickly modify and right-size those for this environment. It was really the right time to start adding some of these key structural items in order to actually enable the scale that Scott had originally challenged me to create here at Crossover.
Now I spend a great deal of time thinking about what the incentives should be to drive the results that we want, not just for today but for the next two or three years. We look at and interpret the Triple Aim as the lens for our goals. As it relates to ‘Quality’ we have now created and implemented the clinical Operating Standards associated with every clinic, every panel, and every provider. As it relates to ‘Experience’ we have the Net Promoter Score. As it relates to ‘Cost’ it’s continuing to evaluate how we drive our standard of care at a price that demonstrates value, not just low cost.
In working through this incentive concept, it’s been fascinating to wrestle through how to create meaningful incentives for providers. When I started 2 ½ years ago, the providers said to me “Hey. I provide great care. I get great Net Promoter Scores. What more do I need to do? Why would I need incentives?” It’s about letting them know that in order to keep growing professionally, you need to be challenged to practice at the top of your license, to objectively demonstrate your populations are moving toward greater health, and show that your teams are flourishing under your leadership. But more importantly, it helps them illustrate to their team that they’re building a cathedral, not just laying down some bricks. This is so much more meaningful, and such a rewarding way to practice, with a far broader impact than just cranking out patients everyday, and I believe results in much higher satisfaction. For the physicians and everyone else, the incentives allow the whole care team to engage around how they are performing overall while giving them a line of sight into what they can continue to do to make a difference with their members, at their clinics, and for the company. It is really powerful when it all lines up.
How are you managing the pivot to Digital First care models? How has this changed recruiting?
I think that the acceleration to telehealth puts a whole different challenge in front of us. The issue, really, is not what is required by this new model but rather what new behaviors are required of providers as well as members. There were some on both sides who didn’t want to do it, didn’t see or understand the value of how it works, and were just not experienced with this new model of asynchronous care. The pandemic didn’t really give people a choice—but once people were pushed into the asynchronous model and began to practice this way, they were really hooked.
We’re now offering our the “Crossover” service for our own Crossover’s employees—what we call “sipping our own champagne” —and working hard to understand how to learn from using our own care model on our own employees. We have gleaned some interesting insights from being one of the “clients” that our own account managers need to serve and keep happy. I love learning how we can play both sides at this game at the same time.
One of the consequences of the pandemic is that it has forced the issue—and the change. We’ve been running focus groups inside the company and when we ask for feedback on the organization, we hear that people love this new model. When the opportunity presented itself to practice full-time as “virtualists” we had about 15 of our care team members opt in. It’s been really cool to see. They have walked through the Digital First door and they are simply not interested in going back to the physical clinic. And, it’s an experience that I think many of our members are having at the same time. I guarantee they never would have raised their hand to do this before, because they didn’t have enough knowledge or understanding of what the digital model really looked like.
How did Crossover’s initial experience with your own employees change how you see the Digital First model?
We are completely rethinking how we’re going to provide care through these new digital and asynchronous channels. Before, we said there was going to be a physical site for the virtual providers and now—with clients like Telemundo and Pure Storage which we are actively launching—the providers are working remotely from home. And those providers I mentioned who raised their hands to become full-time “virtualists” are now not going to be part of an in-person, office-based team that is virtually delivering care but physically together, which is very different from our original view.
What has remained the same, however, is the collaboration—these remote care team members still work together as a designated team for a defined population of employee members. This is critical because the relationships really matter—perhaps more than ever in a digital world—not just for the provider and the member, but also between the providers themselves. We believe this relationship-building among our care teams, and the connections made to each other and to the members, is one of the most powerful and unique features of what we are selling.
How do you replace the vital in-person team building that happened so readily in your daily in-person team huddles at each of the practices?
We’re doing it virtually now. We have team huddles every morning at all of our practices and even among our MSO functions. The leadership team bombs into the huddles with their own questions, asks what they can do, and has been helping navigate employee concerns through COVID-19. In fact, people are saying they feel a lot more connected, because the huddles are expanding beyond their team to other sites as well. People are telling me, “I never would have picked up the phone to call so-and-so across the country and ask how they’re doing something.” but now they feel much more connected. I’m excited about this. I think these connections are opening people’s minds to how much bigger Crossover is, and that is broadening their experience as well.
How is Crossover managing its way through the COVID-19 pandemic from your perspective?
We created a Command Center, and several associated task forces—clinical, client, communication, and pandemic—each with the assignment to address core issues in their domain (the often in the burning fire moment) as well as lift up and see what might be coming next. The groups were getting together daily, asking the big questions, what we needed to solve for, and used their collective best thinking to move forward. We rallied and worked together, addressing the complexities and perspectives of our different client views. We had some clients telling us, “Yeah, shut it all down.” And others were like, “Absolutely not, you must stay open because we are relying on your care teams.” Trying to navigate those concerns while addressing the clinical chaos of exposure risk was really challenging.
One of the fun things about working at Crossover compared to the other places I’ve worked, is that you’re not only working in your own company culture, but also in the culture of all these other companies that are our clients. I call it concentric mixing bowls—you have to find ways to combine several “ingredients” with all of these different organizations. On a daily basis, people like Sally, Stephen, and Scott were meeting with clients and saying, “I hear you. Let’s think about this in another way” whether that was from how we cycle care up and down, emerging patient safety concerns, laboratory testing, and a variety of other topics.
The other part of our response was to make sure our employees were our priority, ensuring their safety, and helping them feel comfortable raising all of the questions and sometimes the unknowables and they were concerned about. Immediately, even before the new mandates were put in place, we went to remote work. My team and I put new sick leave policies in place, and we were able to get them launched even before anyone needed them. We added two weeks of PTO for COVID-19-related situations, we worked with people who were uncomfortable coming into the clinics, and provided an orderly way to wind back down how we were staffing clinics by how we combined our different locations and teams. We ran the gamut from people who said, “Sign me up. Send me to the outdoor testing clinic. I’m there all day long.” to those who said, “My mom’s 90 years old and I can’t be exposed every day.” and we worked it out as a team, in every situation.
Even when we get out of the pandemic, the intensity of having a finger on the pulse of the employees is something that I’d want to hold on to. And I’d want to see that people checking in and staying connected the way they are now, continues as well throughout our company.
Speaking of the future, how do you keep the spirit of the company?
Everytime we do a Surf Session, I tell Scott, “Everyone wants to hear from you based on how you are thinking about the business. . I’m blown away by how he works throughout the weekend, and then comes back on Monday and says, “Okay, this is what I learned about the pandemic this weekend.” and takes the leadership team through it first thing Monday morning. Scott is remarkable. He lives, breathes, and eats through the company and is always thinking about how to continuously transform healthcare. The loyalty people have has so much to do with Scott and the other leaders in the company—it’s contagious. Everything that I’m doing is about capturing and maintaining that “servant leadership” spirit for everyone as we grow.
What’s your favorite memory of your time at Crossover?
I think it was right after I started when I went to my first meeting, which was a leadership summit. It’s the one time of year all the medical group people leaders and the MSO get together. I remember pulling someone aside and saying, “Wow, you did such a great job.” It was in a great setting, a country club in Saratoga, and I couldn’t believe I got to meet everyone and feel the energy of the company in that environment. They were people who totally bought into the vision and values, but they were also people you just wanted to be your personal physician. I thought to myself, what a remarkable group of leaders who were—and are—absolutely committed to what we do. It was a beautiful place, with such a unified team, and I just felt so privileged to be a part of it. Just a beautiful moment frozen in my memory.
Many thanks to Peter Heywood (one of our long-standing brand advisors and business consultants) who helped conduct these interviews.
Scott Shreeve, MD 