Alignment, Not Sameness: An Interview with Mary Brainerd

Don’t you just love those moments when someone says something so simple, so clear and therefore so brilliant, light bulbs literally go off in your head? I sure do and it happened to me in a recent conversation with Mary Brainerd, CEO of HealthPartners.mary-brainerd

HealthPartners is the largest consumer governed nonprofit health care organization in the nation, providing health care services and health plan financing and administration serving more than 1.5 million medical and dental health plan members through a care system that includes a multi-specialty group practice of more than 1,700 physicians and over 22,500 employees.

Mary joined HealthPartners in 1992 and has been the President and CEO since 2002. Through her tenure, she has steered the organization through financial challenges, dramatic growth, diversification, integration and, of course, a mountain of regulatory and marketplace dynamics.

I asked Mary what she has learned along the way that helps shape the way HealthPartners tackles questions and approaches innovations, the changes required to bring the organization’s “Triple Aim” vision of “health as it could be, affordability as it must be, through relationships built on trust,” to life.

“We have been working on alignment, not sameness,” she responded.

There it was. In three words she put her finger on one of the most vexing challenges I see bold leaders confront. Alignment is a topic that comes up all the time. Top team alignment. Functional alignment. Goal alignment. Strategic alignment. Too often when folks talk about it, what they really describe is “sameness.” People in lock step. Processes that force one way of operating.

The light bulb that went on for me is that “alignment, not sameness” invites options for translation, implementation and ownership – while still achieving the shared vision and course of action needed to perform effectively.

What does this mean in practice? “We are less prescriptive about how to do things but very clear about what we ask people to sign up for,” Mary said. Alignment is in the “signing up.” Mary gave several examples: “I sign up for:

  • Working to achieve the ‘Triple Aim’
  • Transparency
  • Identifying issues to solve (We don’t hide problems or blame or excuse. We identify them to work them.)
  • Moving forward, not getting trapped by the past.”

I asked her when she discovered “sameness” didn’t work. Mary said she couldn’t say precisely, but she recalls when a first small hospital joined HealthPartners: “It was immediately clear they had a better sense of what worked in the community than anything that we could dictate from Bloomington (HealthPartners headquarters). The local board knows what fits the community and the community health needs. There is no message I could give that has more impact than the passion and connection with the community.”

“Alignment, not sameness” requires bold leadership. “I have strong convictions and a point of view I like to bring to the table, but I have no corner on knowledge or truth. I know I don’t have all the answers. I think of myself as an ‘incomplete’ leader – who together with my team, collectively are ‘a pretty good leader,’” Mary explained. Boldness is a team sport.

I asked Mary what stands out in the leaders that she sees demonstrating boldness. “They stand for something,” she responded. “They are comfortable with ambiguity and not afraid of being different. They value what others bring.”

When facing a big challenge, Mary says, “Build a team comfortable with ambiguity, and curious. Don’t listen to the old views such as, ‘You can’t better both customer experiences and financial performance at the same time.’ And likely, there is no science. It is a lot of learning, trying, figuring out what to build up and continue, and what to let go of.”

Mary continued, “You have to focus and stick with it. We are persistent. Anything hard and worth it doesn’t land the first time, or the second… you just keep going until you find the right path. We really don’t get discouraged.”

And finally, Mary said, she thinks a lot about the changes they are making in human terms: “How does what I do affect you? We are successful because we have built a workforce that really understands how what we do contributes to your experience – how it will affect you. Plus, our scale today is way different. This goes back to alignment, not sameness. People need to see their fingerprints on the organization. It’s not what I did. It’s what we did, together.” has a few definitions for alignment. The one that most fits this discussion is: “a state of agreement or cooperation among persons, groups, nations, etc., with a common cause or viewpoint.”

Sameness is defined as “lack of variety; monotony.”

Let me leave you with a simple question: How do you ensure that any work toward alignment in your organization doesn’t drift precipitously toward sameness = monotony?

As the first Aveusian to work in the U.S., Asia and Europe, Chris has a unique perspective on how leaders drive material and positive outcomes in today’s global marketplace.