Nashville as the Healthcare City 

While Nashville may be synonymous with Music City for many, Tennessee’s capital city is steadily building its reputation as the nation’s premier market for healthcare leaders. More notably, Nashville is fast-emerging as a top destination for organizations and executives seeking to shape the nation’s healthcare landscape through connection and collaboration.  

Home to a dynamic ecosystem of more than 900 healthcare companies, Nashville now supports an estimated 333,000 local jobs in the industry and generates in excess of $97 billion in revenue across the world’s healthcare markets.  

At the nexus point of this ecosystem sits the Nashville Health Care Council (NHCC)—a premier association of industry leaders working to strengthen and elevate Nashville as the Healthcare City. Founded in 1995, the Council serves as common ground for the city’s vibrant healthcare cluster, offering immersive learning experiences and engagement opportunities for its members to exchange ideas, share solutions, build businesses and grow effective leaders.  

“Nashville is recognized as a city of innovation where ideas can take root and flourish, and for nearly three decades now, NHCC has been a force for positive change in healthcare,” said Dr. Ralph Alvarado, Commissioner of the Tennessee Department of Health. “The Council creates a space for dynamic interactions among healthcare leaders, where new and groundbreaking solutions can emerge for the industry challenges we face.” 

A career physician and Tennessee-based public health servant, Alvarado has many occasions to interface with the Council’s people, partners and programming—but his most recent connection to the Nashville Health Care Council is as a cohort member in the 2024 Council Fellows program.  

Fellows Program as catalyst for change 

Now in its 11th year, the Council Fellows program was established to create a nationwide network of emerging healthcare leaders who share both a common language, and a commitment to address the industry’s most pressing challenges, improve care delivery and increase value for the U.S. healthcare consumer. Already, the program boasts more than 30050 alumni—the majority of whom are serving in executive leadership roles at healthcare organizations across the country.  

“We all know healthcare is at a turning point, and we are taking that curve very rapidly,” said Nashville Health Care Council President Apryl Childs-Potter. “The Council Fellows program positions participants to examine healthcare from a multidimensional perspective, grow their leadership skills, grow their businesses and establish roots within our local ecosystem that will continue to serve them throughout the course of their professional journey.” 

Over the course of five months, Council Fellows engage in nine experiential learning sessions on topics ranging from cost of care and health equity to innovation and market segments. The program culminates in a two-day, future-forward planning intensive where cohort members discern collective opportunities to achieve impact at scale. NHCC also fosters connection between current Fellows and program alums to ensure a growing network of conscientious leaders working toward a common goal. Additionally, Fellows have the chance to both learn about, and directly support, NHCC’s primary objectives of growing and attracting businesses to Nashville, building strong talent pipelines and telling the Nashville healthcare story.  

“The Nashville healthcare market is different from anywhere else I’ve worked in the country,” said Greg Aaron, a Kentucky-based tech solutions executive for Oracle Cerner. “As an outsider, it’s interesting to experience this culture where you may work for one organization today and be at another company tomorrow, but everyone still wants to find ways to work together toward the common goal of improving care. I travel to major healthcare markets and tech hubs all over the U.S., and there’s something very unique about the community here in Nashville.” 

Aaron and Alvarado are two of this year’s 32 Council Fellows.  

The 2024 program garnered a record number of applicants, and the 32 Fellows selected represent not just the public and private sectors, but 13 distinct industry segments, including payors, investors, health system executives, clinicians, entrepreneurs, higher education and government officials.  

“I’ve participated in other programs like this led by top-tier organizations, and this cohort feels different,” said Dr. Lisa Fitzpatrick, 2024 Fellow, former Chief Medical Officer of DC Medicaid and Founder & CEO of Grapevine Health. “What I like about this group is the diversity of leaders here. These are operational people who all have different expertise, are deeply experienced and are performing different roles in healthcare.”  

In total, this year’s cohort comprises executive-level stakeholders from 30 different organizations—four of which have newly joined Nashville Health Care Council as a result of having a Fellow in the program. And, while Tennesseans make up the majority of the cohort matrix, 14 Fellows are traveling in from out of state to engage in the program’s extraordinary networking and learning opportunities. 

“We strive to find the most experientially diverse class of Fellows possible because we want the cohort to engage in discussions they may never get to have at work,” said Michael Burcham, Council Fellows Chair. “Only through honest conversations can we change the landscape of healthcare, which is why each Fellow holds a different perspective than the leaders sitting beside them.” 

Game theory for greater collaboration  

Honest conversations have proven a cornerstone of the Fellows program throughout the cohort’s opening retreat and subsequent sessions on cost of care, health equity and health policy. In an era where respectful discourse has become counterculture, Nashville Health Care Council is practicing disruption by engaging a group of senior leaders from every healthcare sector in sustained, transparent conversation on topics about which many Fellows may inherently disagree. 

The Council intentionally frontloads its Fellows program with candid discussions on the industry’s most complex and polarizing topics—namely, rising care costs, disproportionate access and our nation’s widespread health equity issues—navigated by individuals who, outside the sanctity of their cohort, may often find themselves on opposing sides of the table. 

What’s more, Nashville Health Care Council does not push the Fellows to adopt one “right” position for each issue, nor advocate for like-minded thinking as a desired program outcome. 

Instead, the Council packs the program’s immersive learning sessions with presenters and perspectives from every corner of the industry, giving voice to the myriad sides of the U.S. healthcare story and, in the process, breaking down the binary “us vs. them” (e.g., public vs. private, provider vs. payor, patient vs. hospital system) mentality that so often surfaces as a barrier to effective conflict resolution and change.   

To set the stage for this work, Nashville Health Care Council also dedicates a significant portion of its two-day opening retreat to exploring the intersection of strategic negotiation and game theory, guiding Fellows through a four-step process to, when negotiating, identify and solve for shared interests. Led by business strategist and claims consultant John Lowry, this session outlining the anatomy of a deal is designed to help leaders solve for mutually beneficial outcomes amidst uncertain, and even adversarial, circumstances.  

Recognizing the critical need for nuance when navigating healthcare’s complex frameworks, the Fellows program demonstrates thought leadership in its development of thoughtful leaders, armed with a shared vocabulary and the tactical skills to solve for win-win outcomes and cross-continuum solutions.  

Where financial viability meets moral responsibility 

In the program’s initial session on cost of care, Fellows discussed the sobering reality that while the U.S. spends twice as much on healthcare per capita as comparable nations (fully 17.3% of the GDP), U.S. life expectancy has seen a steady decline since 1980, now significantly lagging behind the G7 nations and ranking 53rd overall among all surveyed countries.  

Presenters engaged Fellows in animated conversations around physician economics, wage growth and inflation in healthcare—pertinent to strong talent pipeline development—as well as care-delivery innovations driving the Medicaid service model. The cohort also discussed the challenge of balancing financial stability against moral duty as an industry rooted in caring.   

“How can we help move the industry toward reasonable financial expectations that may not be the most profitable for each interest, but still allow each interest to remain financially viable and also make the morally right decision?” asked Ascension St. Thomas President & CEO Fahad Tahir, in a question posed to Fellows toward the close of his presentation.  

A recent Nashville Health Care Council Fellows alum, Tahir is embodying the Council’s “change through collaboration” mindset in his efforts to help rebuild both workforce and consumer trust as head of Nashville’s largest non-profit community hospital. Asserting that a leader’s role “is to make a big organization feel small,” Tahir emphasized Ascension’s threefold mission to grow revenue, grow income and provide more charity care. 

This symbiotic, albeit complex, relationship between philanthropy and profitability emerged as a clear theme in subsequent sessions on both health equity and health policy—from the Fellows’ onsite tour of Faith Family Medical Center, a non-profit primary care clinic serving uninsured/under-insured individuals in Middle Tennessee, to a discussion of legislative health policy priorities with Nancy-Ann DeParle, managing partner and co-founder of Consonance Capital Partners and Former Deputy Chief of Staff for Policy to President Barack Obama. 

“When you start from the proposition that none of this work should be for profit, that’s a difficult position,” said DeParle, who joined the private equity space to support capital access for healthcare entrepreneurs and innovators. “Nashville has a very unique opportunity to help people better understand that having a margin enables you to have a mission.” 

Health vs. healthcare in America’s social contract 

Healthcare spend, and the driving question of who’s left footing the bill, was a focal point for the Fellows’ health equity immersion, as well—though this session prompted a broader understanding of health to include the many social services (e.g. public parks, playgrounds, housing security, public transit, access to healthy foods), also known as social determinants of health, that contribute to a population’s overall well-being.  

In conversation with Dr. Tony Iton, Senior Vice President of Healthy Communities for The California Endowment, Fellows were cautioned not to conflate health with healthcare, as Iton noted that “healthcare is only responsible for about 10% of health status, while the other 90% of health status has to do with opportunity.” Renowned for his research naming zip codes as a more powerful determinant of life expectancy than genetic codes, Iton emphasized narratives as the key driver of policy in the U.S., and policy as a leading driver of social determinants of health, or those elements that make up America’s social contract. 

“Stories, not data, drive most of the policy in this country,” said Iton. “And policy creates the conditions people have to navigate in order to be healthy.”  

By extension, Iton illustrated that while the U.S. may lead the world in healthcare spend, when looking at total health investment per capita—inclusive of elements in the social contract—the U.S. is not the big spender. On the contrary, in nations that claim the world’s best health, for every $1 spent on healthcare, $2 is spent on social services. That ratio in the U.S.? Just $0.55 spent on social services for every $1 spent on healthcare.  

Health equity speaker and Fellows alum Leslie Meehan, Special Projects Director for Tennessee Department of Health (TDOH), also zeroed in on health disparities by zip code and spoke to the importance of funding the social contract. Uplifting TDOH’s goal to “flip the script on health” through grants for public access spaces and housing partnerships with Habitat for Humanity, legal aid services and the state’s primary land-owning organizations, Meehan also highlighted TDOH’s recent launch of a Culture of Health Grand Rounds, designed to help Tennessee clinicians better understand the impact of housing decisions, urban infrastructure and the placements of parks, groceries, schools, etc. on public health. 

“In the current healthcare model, we treat disease and injury, educate patients on risk behaviors and wonder why public health isn’t improving,” said Meehan. “The approach we’re promoting through TDOH is to recognize environmental inequities, realize that social determinants are major factors impacting our health and rescope our business models accordingly to address these determinants.” 

Beyond the many health benefits of TDOH’s grant-funded projects for public-access places and spaces, the state’s investments in public transit, housing affordability and artful urban infrastructure will also elevate Tennessee as a desirable destination for businesses and individuals alike, further enhancing our local communities through economic development. 

“In our process of reimagining how we support Tennesseans, we’re putting an emphasis on providing aesthetically pleasing spaces that serve community needs and are welcoming of all,” said Meehan. 

Policy talk as precursor to D.C. delegation 

In the Fellows’ session on public health policy, cohort members explored the ever-evolving landscape of laws, regulations, actions and decisions governing the U.S. health care system, talking pharmaceutical costs and clinical trial diversity with PhRMA VP of Policy & Research Scott Woods before discussing current and future health policy trends in back-to-back conversations with DeParle and Ford Koles, Advisory Board VP and National Spokesperson. 

Specifically, the Fellows focused on five health trends that are likely upcoming focal points for the federal government, including Medicare Advantage, GLP-1 and gene therapy drugs, site-neutral payments for hospitals, the role of private equity in healthcare and (of course) artificial intelligence. Koles challenged Fellows to consider the role of AI within the reimagined workforce social contract, particularly as a means to help reduce workforce burnout and position caregivers to work at the top of their license.  

“The first question is never, ‘What is my AI strategy?’” said Koles. “The first question is, ‘Why do all my nurse managers quit?’ The second question is, ‘Is their task mix appropriate to their accrediting and license?’ Question three is, ‘Can I take any busywork off their plate?’, and then the final question, ‘Could a robot do that busywork?’” 

In mid-April, Council Fellows took part in a dedicated panel discussion on Data & AI as part of a larger, 3-day Nashville Health Care COuncil delegation to D.C., for which the policy session was a timely precursor. More than 100 Council stakeholders traveled to the nation’s capital attended educational sessions and engaged in candid dialogue with elected officials on the topics of workforce, behavioral health and data & AI. DeParle encouraged Fellows to proactively connect with federal policymakers on the topic of AI specifically, advising legislators on the ways in which each healthcare sector might or might not wish to integrate artificial intelligence in future years.  

The Fellows’ conversations on health policy also underscored the critical importance of negotiating for win-win outcomes when human life, and quality of life, is at stake. 

“Public health transcends politics,” said Alvarado. “At some point in our lives, we will all interact with one or more healthcare services or systems in some way. The Fellows program is an inflection point—a non-political space, for non-partisan collaboration with others— dedicated to the prospect that regardless of affiliations, every person’s well-being matters.” 

Nashville Health Care Council Fellows Program: Paving the Way for Career Achievement

Many cohort members recognize their Fellows experience as a definitive turning point in their careers.  

Dr. Nate Miller, for instance—an emergency medicine physician tasked with clinical quality and operational performance oversight across Vanderbilt University Medical Center’s ERs—calls NHCC’s Fellows program an inspiring and enlightening experience that “will undoubtedly reshape my clinical and administrative practices.”  

“Our exploration of cost of care, health equity and health policy has illustrated an opportunity for all members of the healthcare ecosystem to broaden their lenses and embrace synergism over competition for the good of our patients and society at large,” said Miller. “As a practicing clinician, I have been energized by my colleagues’ passion for innovative care models, industry disruption and individualized patient care, and I look forward to working together to help evolve the healthcare industry and continue to meet and exceed the needs of those around us.” 

Cohort member Meryl Holt, similarly, credits the Fellows program with enabling connections and discussions that “make positive change at scale possible.” As Head of Legal and Chief Compliance Officer for Cadence, a health technology company helping national health systems deliver care beyond hospital walls, Holt is charged with supporting Cadence’s growth amid healthcare’s complex and highly regulated environment. 

“Our cohort’s incredibly diverse set of experiences and backgrounds positions us to talk holistically about solutions to some of the biggest challenges facing healthcare, using both a business and a public policy lens,” said Holt. “The only way we can effect change systemwide is through thoughtful, transparent dialogue and creative, collaborative solutioning. The Fellows Program affords us an opportunity to do exactly that.”  

About Council Fellows