Leadership accountability, diversity, inclusion, and equity were among the topics in an intriguing conversation between DiversityInc CEO Carolynn Johnson and Bernard J. Tyson, Chairman and CEO of Kaiser Permanente, during the fourth annual Total Health Forum in New York City on March 21.

Kaiser Permanente, inducted into the DiversityInc Hall of Fame in 2018, is the nation’s largest integrated managed care consortium providing health care to 12 million people. Tyson personally signs off on executive compensation tied to diversity, diversity metrics, and progress, goals, and achievements for supplier diversity.

Q&A

Johnson: What are the critical challenges in equity, inclusion, and diversity facing the healthcare industry?

Tyson: The industry now has more concrete data that really quantifies the disparities. So, there’s no denying what we all know as being realities. I think, as we are moving toward precision medicine, the opportunities to make sure that we are allocating resources to close that gap is a challenge, but it’s a tremendous opportunity.

I think, the last piece is, [Kaiser Permanente], you and others have talked very much about the distinction of diversity and inclusion. Obviously, we have concluded [and] you’ve concluded, that you can have a number count and you can have a diverse leadership team or a diverse population. The question is: who’s setting the tone and the narrative? That’s what inclusiveness is about.

Can I be my whole self and modify the environment that accommodates my needs? Or, do I have to come and strip myself of who I am?

Many organizations now are trying to figure out how to create a more inclusive environment. And, at the end of the day, when people ask me, ‘What’s the value proposition?’ [I’d say that] in addition to you just wanting people to feel good about what they’re doing — the business proposition is that people are more productive.

Johnson: All of what you said is definitely true. But having leaders who are thinking about this and not making you deal with it, I think that’s 75 percent of the battle.

Tyson: No question. It’s always a work in progress. Because, as you know, you bring people together and you have varied views and perspectives and issues. What has happened historically in companies and corporations and businesses and in society, the majority population has defined the norms and the expected behavior in those environments. We all come from unique perspectives. We were brought up differently. As much as we’ve talked about integration, many of us have come from segregated family circles and neighbors.

There’s a wealth of experiences — all good — that comes from that upbringing. The question is how to leverage that I may look differently at the same problem you’re looking at because my history tells me this.

I’d rather have an environment where everybody’s leaning in, in the debate and in the discussion; and know that they have a right to say whatever they want to say. And, then, we get to the best answer and then we execute; as opposed to [being] in an environment where it’s politically incorrect. Those are environments in which you are not getting the highest productivity possible.

Johnson: That’s a great segue into the next question. When we’re talking about culturally responsive care, how is Kaiser advancing the mission there?

Tyson: We continue with the centers of excellence [where we] focus on and take care of the different populations. I would say that we’ve been ahead of the curve for years now with race-based data, [which is then reported] to management, the organization, the board, and to the public. The whole point is to figure out why there are gaps. So, we remain proud that you can see by ethnic groups, by sex and sexual orientation, quality continuing to improve.

But, at the same time, you can also see gaps that still remain. That becomes a mystery that people want to solve, which is, ‘I know I’m doing the right thing, but why is there still a gap?’

I think the third part of our building block now really tells us what to do. That is, we’ve focused on it predominantly from care delivery. How much more care should I be given? Or what additional treatments? Now, we’re saying, no, actually, it’s about the social determinism. So, in addition to medical excellence, we also have to really focus on social care.

So, that’s the cultural competency level that we’re operating at now, in the 21st century. We’ve demonstrated, in the mid-Atlantic, for example, with a variety of ways of providing care and also being creative like our blood pressure checks in barbershops, that you can, in fact, measure the high-blood pressure of African-Americans like you can any other population.

We have shown that.

Johnson: You have to meet people where they are.

Tyson: We used to say it was about equality. And in many companies, that’s what people think about. That everybody’s getting equal. Well, no, that’s not the right answer.

It’s equity. Everybody’s getting what they need.

And so, to your point, it’s meeting people where they are so we can get the right outcomes.

Johnson: What advice can you offer leaders grappling to make diversity, inclusion, and equity a priority at their organization? When I think of questions like this, there are leaders in particular, but you and Randall Stephenson at AT&T always come to mind. Randall talks about this regularly. He was at Code 2018 and the question was asked: Why are you doing so well as a tech company when Silicon Valley is falling apart in so many different ways on the same subject? And, his one-word answer was — a priority. So what advice would you give around making this a priority?

Tyson: First and foremost, you have to get the complete buy-in of the CEO because it’s not a program. It’s not an ‘initiative.’ It is every day. It is what you see when you look out and add up your assets and your liabilities.

There are key roles that people can play in furthering the agenda of creating a diverse and inclusive environment that understands equity, but you’ve got to make sure the ownership is coming directly from the top. Why? Because the CEO sets the narrative and owns the narrative of the organization.

And so he, or she, would need to make sure that this is written in the narrative of the organization. And then, you have people working on it, and working at it.

The question is: what’s the most important ingredient to really get an organization to make it a part of their DNA? It’s that top leadership. Right behind that CEO would be the top team, and then it works its way throughout the organization.

I think the second part of it is, on the other end, you need champions. You need individuals who are willing to have an attitude of ‘By any means necessary.’

Our organization has had it historically well before I was there. Our organization has dealt with and continues to deal with race and sexual orientation. It’s in our DNA. It happened when we decided early on with our forefathers. They decided not to segregate our hospitals.

There are many companies where you will see a train of thought of how they evolved over time. But now, my concern continues to be when I hear people ask, ‘What’s the business case?’ I think that’s the most naïve question that could be asked when you look at whom you’re taking care of and where the money is coming from, and the greater society in which we live, and you want a business case for diversity?

Johnson: I’m definitely there with you in the spirit of assuming good intent, until you can dig in. Because we’re seeing so many changes in who sits in that seat, I’m not as bothered now when I hear that question because they’re bringing whatever they heard someone else say. And so for me, as of lately, that’s an opportunity to educate people. But in your space, how progressive Kaiser is, I would imagine that anyone asking that question has not paid much attention to what you all have done. You live the business case every day.