A case example
In 2011 Blue Cross/Blue Shield of Illinois (BCBS) cut the fees they paid us. It was significant. For doctoral-level clinicians the cut was by 15 percent and for master’s level clinicians, by 30 percent. BCBS clients provided half our income. This change would affect everyone. This was going to have a major impact on our organization as a whole and on each clinician. We needed a plan. We needed it fast.
What we did
Fortunately, a leadership planning day was already scheduled. We came prepared to discuss possible budget cuts. (See how we do our regular meeting here: How we use regular meetings to build our culture.) The leadership team weighed each cut. We considered the financial and emotional implications of each. And by day’s end, we had a plan.
We also developed a plan for sharing this bad news with each of our clinicians. We created a spreadsheet for each clinician that provided answers to these questions:
- If you do exactly the same amount of sessions, how will your income be affected?
- If you want to keep your income the same, how many more hours will you have to work?
We gave each clinician the information. And we met individually with each to go over the information.
How clinicians responded
The result? About 50 percent of our clinicians decided to increase their level of activity. The others maintained their schedules and accepted a pay cut. Interestingly none of the frustration was directed at our leaders or the organization. Of course no one was happy with the reduction of fees. And yet they seemed satisfied with how we responded.
And as leaders we accomplished what we were trying to do. We gave clinicians what they needed to make their own decisions. And we respected the decision each made. Furthermore we supported them in the ways we could.
To me this is an example of staying focused on the big picture. We were able to care for our employees while preparing them for unfortunate news.
The lessons we learned?
Years ago, we developed a set of guidelines that we use to help us stay on track. We call this document “Our Philosophy of Working in Community.” Included are two principles:
- Prepare the staff for changes affecting any part of the organization by providing reasonable explanations and enough lead-time for appropriate processing.
- When an employee will be affected by a proposed change, discuss the options in a collaborative decision-making process as is practical.
This crisis provided an opportunity to test our ability to use these principles as a crisis was developing. They held up pretty well.