Karin Hurt: It wasn’t until after we had finished the book, we were getting ready to start the whole book promotion thing—we realized we had fallen in love.
Erika Grotto: Looking for “the one” at work, today on HFMA’s Voices in Healthcare Finance podcast, sponsored by Red Dot.
Happy Valentine’s Day, and welcome to the podcast. I’m your host, Erika Grotto. On this episode, because we’re releasing on Valentine’s Day, we’re getting a little emotional. I’m speaking with Karin Hurt and David Dye of Let’s Grow Leaders. They’re a married couple who run leadership development programs, and they’re here to talk about the do’s and don’ts of workplace romances. But first, let’s catch up on what’s happening in healthcare with HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack.
Nick Hut: Hello, everybody. The No Surprises Act continues to be a top-of-mind issue for many people in healthcare finance right now. HFMA in January had a multi-part workshop on these new regulations, and Shawn, you had a lead role in that event. What were some of your key takeaways in terms of feedback you got from attendees and where folks stand in implementing these rules?
Shawn Stack: Yeah, Nick, it went really well. The workshop was very well attended. We had over 2,000 registrants for it. I think providers are getting a little closer. I think out of the two flows of the provisions, you know, one being the insured out-of-network and the other being the uninsured self-pay, the uninsured self-pay is a little less confusing and maybe a little more straightforward and further backed in provisions already being set. But the insured out-of-network still has a lot of work to be done by the agencies clarifying provisions and bringing in health plan oversight for more. But I think a lot of the providers are really working hard to get that compliance in both areas up, but definitely leading the pack is the self-pay uninsured sector.
Hut: The requirements surrounding good faith estimates is probably just going to get a little more daunting over the next year because the start of 2023 when CMS is planning to enforce the requirement for designated convening providers to offer estimates for all services that surround a primary service. Do you think—are convening providers and co-providers working together in the short term here to compile an all-inclusive good faith estimate for uninsured self-pay patients, or do you think they’ll take advantage of the relaxed auditing process for 2022?
Stack: Yeah, Nick, I certainly hope they have started their conversations with their convening providers or, you know, outsourced ED docs that are convening on these workflows. I think any convening partner facility that is delaying those conversations and working out the details with the co-providers are going to feel pressure come the end of the year if they wait that long with all the cue-up of the insured out-of-network provisions going into place for 2023, plus the audits ramping up for the self-pay uninsured piece. They’re going to be feeling the hurt if they wait that long, because it’s a very tricky process, setting up those agreements with those co-providers and getting those charges updated for that all-inclusive good faith estimate.
Hut: Yeah, thanks for that insight, Shawn, and there’s a process in place for resolving disputes between patients and providers if needed regarding these good faith estimates. Do you think providers could be overwhelmed in upcoming months in terms of getting ready for this process, or might it be not applicable in a lot of cases if a good number of the estimates fall between the $400 threshold range in terms of deciding what goes to arbitration?
Stack: Yeah, I think that’s something that providers are going to need to work on getting a solid playbook together and in place, maybe develop a boiler template for how they’re going to address those patient-provider arbitrations or dispute processes. I do think it’s going to be pretty labor intensive in the beginning to set precedent and to set the stage for what is going to be discussed with those entities that are doing the arbitration or the dispute with the provider and the patient, but I think after we get over that initial hump, it will be a little bit better. One of the big changes that came out there at the end by CMS and clarifications is that that $400 threshold is per provider or co-provider. So that gives the convening party a little bit more leeway on that $400 threshold, which is good.
Hut: Gotcha. And then regarding insured patients, how comfortable do you think providers generally are in terms of complying with the out-of-network notice and consent process, especially with the potential for overlap between federal and state rules?
Stack: I think that is going to be an issue that is going to linger, and a lot of confusion will linger as providers really try to wrap their heads around when that federal policy wraps around that state enforcement, if you will. Those are very complex sets of rules at the state and federal level, and it’s going to take awhile for the compliance teams at the hospitals to figure out which sets of guidelines they need to refer to for which set of circumstances, so I do think there’s a very heavy lift on the insured out-of-network side that we’re just beginning to explore and provide really good guidance to these providers in each individual state.
Hut: Alright, well, Shawn, it’s terrific to be able to get your perspective on this topic. We’ll definitely be keeping everybody up to date on developments surrounding these requirements at hfma.org/news and hfma.org/blog. And for HFMA members, our online Community has a forum that has proven to be a very useful resource. It’s called the No Surprises Act forum and is accessible in the HFMA Community. Shawn, I know you’re very involved in that.
I wanted to put a plug in as well for an hour-long webinar that Shawn and I have coming up. It’s going to be a deep dive into the landscape of healthcare disruption. We’ll be looking at all sorts of aspects of innovation and disruption from the major retail and commerce players like Amazon and Walmart, to the potential of wearables to shake up healthcare delivery and much more. That’s taking place Wednesday, March 2 at 2 p.m. Central Time. And as with most HFMA webinars, it will be free for members as part of their membership, so we definitely hope to see everybody then.
Stack: Thanks, Nick. Have a good week.
Grotto: In March 2003, I was working as a reporter for a small newspaper in the south suburbs of Chicago. It was a fun job. I got to tell some great stories, many of which have stuck with me all these years. But one assignment in particular truly changed my life. I was taking a flying lesson in a tiny little plane, accompanied by an instructor, a photographer from my paper, and my crippling fear of flying. On the day of my flight, I arrived early at this small municipal airport and wandered around for a little while, trying to work up the nerve to take to the skies. When I entered the flight school, there was a man standing in the lobby, back to me, looking out the window. He turned and said hello, and that was it. I forgot all about my fear of flying. I forgot all about my assignment. I didn’t know who this guy was, but I knew in that moment that I was going to marry him. Turns out he was the photographer the newspaper had sent to accompany me on my flight. We just hadn’t met before in the newsroom. His name was Matt Grotto, and this year, he and I will celebrate 15 years of marriage.
OK, so I’ll use any excuse to tell the story of the meet cute with the dreamy photographer. But it’s relevant today because our topic is workplace romances. And the beginning of our relationship was a little awkward, even though we worked at one of those places where at least a dozen couples met. We had to ask ourselves how much to share about our relationship, and with whom, and when. How much should we talk about work when we were together outside of work, and what if we broke up? So today, because it’s Valentine’s Day, I wanted to dive into this topic a little bit. I reached out to two people who can discuss how to navigate workplace romances, whether you’re in one, want to be in one or manage people who are in one. Karin Hurt and David Dye are the CEO and president, respectively, of Let’s Grow Leaders. They’ve written books on leadership together, and they’re also a married couple. They shared some insights based on their professional experience as well as their own personal love story.
Hurt: So, before founding Let’s Grow Leaders eight years ago, we were both executives. David led a variety of executive roles in human services, so we came together because we had a real passion for human-centered leadership and very practical tools. We met online—not that kind of online, although—
David Dye: I would have swiped right if that had been the situation, but it wasn’t. It was—we were both writing in the leadership space and got to know each other that way. And at one point, I actually found an article in a human resources magazine that, I don’t recall having placed this there. Well, I get to the end of the article and there’s Karin’s byline. So I called her and said, “Hey listen, I know we know each other from these leadership forums. We need to collaborate on something at some point. We are so aligned in our thinking.”
Hurt: And so we did. So we wrote our first book, Winning well: A manager’s guide to getting results without losing your soul, together. David was living in Colorado, I was living in Maryland. It wasn’t until after we had finished the book, we were getting ready to start the whole book promotion thing, we realized we had fallen in love. So we got married, merged our businesses together and now we get to do this as a husband and wife team.
Grotto: Yeah, I love that, and that’s why I think the two of you and so uniquely positioned to talk about the topic that we’re here to discuss today. I’m excited to get into the topic of workplace relationships because there are so many strong opinions on all sides of it. But there are definitely some pitfalls that can get people into trouble professionally and personally. What are your thoughts on, if this is something you want to consider, you’ve got your eye on somebody at work, what are the things you want to be thinking about before you make that decision?
Hurt: So the first thing—and I have to say this because I have enough HR in my blood still—I have to say never your boss and never date a direct report. Absolutely, unequivocally, no. If you find yourself in love, walk away from the job or, you know, pick one, but don’t do both because we all know all the Me Too, everything, it’s just not appropriate.
Dye: There’s a power imbalance that you just cannot avoid. It’s there.
Hurt: You know, and with that said, I think, you know, when it comes to coworkers, my best is, I wouldn’t do it casually. I would get to know the person as a friend first because it’s a big move. Because if the relationship does not work out, you are then still coworkers. It was interesting, when we first started dating, we were very quiet about it because the leadership development community and the keynote speaking business is a small community. And we thought, we can’t put this toothpaste back in the tube. The rumors will fly, so we wanted to make sure before we were out—and I would say, it’s a similar thing. You don’t want to be casual because if it doesn’t work out you’re sort of stuck there with that situation. The other thing I would say is, you also don’t want to be doing things very secretively. I would say, “Yeah, we’re dating.” Because otherwise the rumor mill goes. So I would just be very forthcoming about that and certainly, if you are in the same team, I would let your boss know. Otherwise, people sense these things, and it’s just—you don’t want to be seen as someone who is sneaky, not trustworthy and that kind of thing.
Dye: And the other element that goes with that of these general principles to me is, know your rules. Every organization is going to have their specific rules around this, and to know those and abide by them. Because otherwise, you’re just creating trouble for yourself, your teammates, the person you’re interested in, all of those sorts of things. And be aware of the potential difficulties that it can create for your teammates, who are not even part of the relationship, but you now have privy information, even from a colleague, from a peer, because you’re talking about work outside of work that somebody else doesn’t have. And so the paying attention to all of those things, and we’re getting into the how to make it work, but all of those are things to take seriously and be aware of before you go down that road.
Grotto: Yeah. Well, I like that we’re getting into the how to make it work, and let’s go down this road a little bit. I can see, if you’re on a team with somebody, you’re collaborating with somebody, that can be rough, and David, as you mentioned, if you have a relationship with somebody, the person that you’re dating might be working with somebody else and coming home and saying, “Oh my goodness, you won’t believe this ridiculous conversation I had with So-and-so today,” and you’ve got to go and see So-and-so the next day at work. There are so many places where things could go pretty wrong there.
Dye: You know, as you’re saying that, we have days where we’ll come home from work, which involves us walking onto the main level of the house from each of our individual offices—How was your day today?—and I’m so glad to see my spouse because my coworker was a bit of a jerk today. And we’ll have those when we’re talking about each other, of course. But those are some fun conversations.
Hurt: Yeah, I think part of it too, just to make the dynamic of your relationship work, is being real clear of what hat you’re wearing. You know, are we in a work relationship at this moment, or are we in a personal relationship at this moment? And you know, the dynamics of those may be different. One of the things we have to be very clear about in our role is, we have distinct roles in the business. We write together, we collaborate on the development of our work, but I do sales and marketing, David does operations, and it’s very clear who owns which decisions on things. And if we have a conflict about something, I know which decisions I’m going to make the call, he knows which decisions he gets to take lead. That’s different from the way we collaborate as husband and wife. And it’s more of a, let’s get to a compromise here. So I think being clear about that so you don’t get your feelings hurt if somebody makes a tough call and you don’t agree with it, I think that’s different from how we function in our family.
Grotto: Yeah, you know, on the positive side—I mean, we’re talking about a lot of negatives, a lot of pitfalls, a lot of reasons not to get involved with somebody you work with—but there also is that understanding, right, of, “You won’t believe this thing that happened at work, but you will because we work together and we know all the same people.”
Grotto: Or “I know that you’ve come across this exact thing because we do the same thing.”
Hurt: Erika, what you’re talking about is, I think, the ability to have a deep level of empathy for what’s going on with the other person. So this week, I had my very first solo in-person keynote since Covid. And I was nervous because it’s been a minute since I had to tell the story and click the clicker and do the thing and the audience—and because it’s very different from all the virtual keynotes that we’ve been doing. And I said, “I’m nervous. This is crazy, I’m nervous.” I don’t usually get that nervous before a keynote, and he totally got it. He understood exactly. And I don’t think many people could relate exactly to that situation, but I knew that he could, and so that made me very seen.
Grotto: Let’s turn now to the perspective of a manager or a leader. We’ve definitely covered don’t date your boss, don’t date someone who reports to you. I think we can all be pretty clear on that, but let’s say that you are the leader of a team and two of your team members begin dating. What do you want to be thinking about as the boss? Or if you find out that a couple of people are dating or they come to you and say, “Hey, just so you know…” Do you want to have a conversation about it, or do you just want to kind of keep an eye on things until you know whether there are issues to be resolved?
Hurt: Yeah, I wouldn’t worry about it too much unless there is drama. And if there is drama, I would nip the drama in the bud and say, “Look, here’s the thing. I’m fine with you dating, but my expectations are that we’re going to have the same collaborative teamwork as we did before you were dating.” And if there’s a specific behavior, one of the things we teach a lot about feedback conversations is, what is the behavior that you’re noticing that’s not good. Are you noticing that they are excluding other people on the team? What is it that you’re noticing? And then have a private conversation with them about that and say my expectation is this, and reset the expectations.
Dye: And you know I’m operations, rule guy, so I’ve gotta go back to the rules. As a manager, do you know your company’s policies? When that happens, if you don’t, go talk to your HR business partner, go talk to human resources and make sure you are in line with whatever is going on company-wide so that you’re not making an exception for something and then creating problems for yourself down the line.
Grotto: I want to kind of flip things a little bit and talk about the opposite of meeting at work, but going to work somewhere where your romantic partner already works, or you know, maybe even starting a business together. I mentioned that I met my husband at work. I love to talk about that because I love him, but we haven’t worked at the same company since a couple of months into our dating. And other than sharing a space right now, we don’t work together at all. But over the years, we have done some projects here and there, and it’s been fine, but we work differently with each other than we do with normal coworkers. So what are the ground rules there, and how do you keep your home and work appropriate separate?
Hurt: We do a terrible job at that.
Dye: It is significantly challenging and something that is a constant effort, is how I would say it. I want to go back to something that you said about treating one another differently, and this is something that we talk about from time to time. It’s easy to assume because you’re in that relationship and because you have that understanding, to take one another for granted and not to extend the same courtesy to your partner that you would to a coworker. I would never take this approach or this tone with a coworker, but did I just do that with Karin, or vice versa? So to call those things out and say “Hey, I noticed that that just happened, let’s not do that.” And have the conversation around that because those things can erode and cause damage if we’re not careful.
Hurt: Yeah, and an example. So we wrote a book called Courageous Cultures. How to build teams of problem solvers, customer advocates, we’re all about ideas.
Dye: Like celebrating ideas, inviting ideas.
Hurt: We go out all day long every single day. We’re working with teams, helping them uncover ideas, and we say, you have to respond with regard even if it’s an idea that you can’t use. We would never, ever encourage someone to say, “That’s a dumb idea.” But David will sometimes bring me an idea and I’ll be like, “That’s a dumb idea.”
Dye: She’ll just step right out and say, and I’ll pull the book out and be like, “Here’s a book you might want to read.”
Hurt: And I certainly would never say that to any member of our team. I would never say that to any executive team that we’re working with, and yet sometime, how I’ve felt, like, oh, I can say it to him. So you have to be careful about that. And I think the other is, we really found it vital to talk about role clarity, because as we were working together, because we merged two businesses that were very similar together. So he was used to being the president and doing all things, and I was used to running the whole thing—well, we can’t both run the whole thing. So we had to be like, this is yours, this is mine, this is ours. And we had a lot of conflict at the very beginning.
Dye: Till we got that clear. The other element of that clarity that I would encourage listeners who are working through this scenario to think about is emotional clarity. And what I mean by that is, the way that I show up as a partner to Karin is different than the way I show up as a business partner to Karin. And it has to be. As a partner, as a life partner for Karin, I’m going to show up—you know, there is no wall I won’t talk to go through, right, that’s what life partnership is all about. From a business perspective, there are different decisions that have to be made, and sometimes the answer is, “Gosh, I wish I could but I can’t,” or “I have to choose not to in this context.” And if we allow the thinking from the life partner to go into the other one or vice versa, that creates confusion and—at least from my experience—an untenable situation emotionally. So to have some awareness of those things because it’s easy for those lines to get blurred. And you know, and you’re coming from a good place, and you want to support the other person, and I want to help. And what’s most helpful may not be responding positively to that idea right now. It may be to backburner it for a little while and get this other thing done.
Grotto: Well, thank you both for joining me today. This has been a fun topic to talk about. It’s always nice to talk about love.
Grotto: And to kind of get into some of these workplace things that—you know, not everybody who’s listening is going to be in a relationship or even relate to this or have to deal with employees who are in a relationship or whatever, but I think there are takeaways here for a lot of people. And who knows? Maybe listening to this will make someone want to talk to that special someone at work. I don’t know. If any listeners are asking out their work crush, well, don’t email me. But you can tell me about it at a later time. But Karin Hurt, David Dye, thank you again so much for joining me today.
Hurt: Absolutely our please.
Dye: Thanks, Erika.
Grotto: We’re going to take a moment now to speak with our sponsor for today’s episode, Red Dot. Welcome once again, Red Dot CEO Michael Bumann.
Michael Bumann: Hi, Erika.
Grotto: Healthcare is notoriously siloed in literally every area you can imagine. And depending on where you sit, you might have some different ideas about how to overcome that challenge. Tell me about how partnering with Red Dot can help build trust around leaders, staff and patients.
Bumann: Erika, always nice to catch up with you. Thank you for this question. Trust, as you know, is super important. And looking at it from two parts, internally, when the staff sees that leadership recognizes that the old way is not working and takes steps to make changes, obviously that fosters and builds trust, especially in the circumstance where Red Dot provides its value. Where we’re dealing with a complex patient class, helping them to avoid revictimization through debt collection and other negative aspects of that process. The staff certainly recognizes when an old way is more harmful and a new way is better to the patient. So we see that internally turn out that way. Externally is a little bit more clear in that a patient who, you know, views what they refer to as their hospital recognizing that they’re in a tough spot and that they take the time and make the effort to treat them both as patients and as people. And when they realize they’ve taken the step to partner with us to create a solution for really a very trying time in their life. That immediately floats back to the way that they view that hospital, the way they feel about that hospital, and really does make sure that their patient experience is going to improve.
Grotto: Alright, well, thanks for tackling that question. I know it was a big one. And thank you again for joining me today.
Bumann: I appreciate it.
Grotto: Red Dot is the best technology-enabled acquisition solution for hospital self-pay motor vehicle accident accounts. Hospitals can now leverage Red Dot’s solution to improve their bottom-line revenue while dramatically improving their patient relationships while avoiding debt collection activities. Red Dot: Good for hospitals, good for patients. To learn more, visit reddotmgmt.com.
Voices in Healthcare Finance is produced by the Healthcare Financial Management Association and written and hosted by me, Erika Grotto. Sound editing is by Linda Chandler. Brad Dennison is our director of content strategy. Our president and CEO is Joe Fifer. Don’t forget to sign up for our Beyond the News webinar. You can sign up at hfma.org. If you have any topics you’d like to hear more about on our podcast, reach out to our team. You can email us at email@example.com.
Hut: Alright, yeah, we can get going here.