The healthcare delivery system is transforming from an institutional acute care based model to a community post acute, and even pre-acute, population health based model. But the transformation is more complex than that. When there are value shifts in any economic sector, certain assumptions can be made and applied to healthcare.
- When risk shifts from the payer to the provider, a cycle begins that shifts power from the provider to the customer.
- With such a shift, the Value Chain is reengineered, accompanied by mergers, acquisitions, divestitures, closures, and rising customer expectations of service.
- As this occurs, standardizing clinical processes necessitates the responsibility for health care to be downloaded: doctors to nurses, nurses to technicians, technicians to paraprofessionals, etc.
- New Information Technology continues to generate rapidly expanding quantities of data which, coupled with advancements in data analysis, allow for identification of patterns of disease, gauging efficacy of treatments, and spotting links between causes and symptoms.(BIG DATA)
- Advances in Technology represent the “breakthroughs” in cost and quality which occur when the value-added chain is restructured, leading to innovative, elegant changes which create a new paradigm where existing methodologies become superfluous.
So, how to lead through the economic deregulation of healthcare? What leader characteristics are required to “pull it off”?
Economics 101: those who benefited most from the old order are the slowest to adapt. The leader of tomorrow must:
- Have Vision; be able to paint the picture of the new hardscape of healthcare for the organization while dealing with the realities of today – the proverbial one foot in the present and one foot in the future.
- Be a Paradigm Buster; don’t wait for a shift to react. Stay ahead. As hockey great Wayne Gretsky said, “Skate to where the puck will be”.
- Be Customer Focused and Patient Centered; it is more important to own the customer than the product.
- Now, More Than Ever, Maintain Focus on Reducing Costs while Increasing Quality Outcomes.
- Create the Leverage to Forge Strong Partnerships for Fitting into a Chain of Value and a Distribution System.
- Be Data Driven and Invested in Technology; watch where value is shifting and shift with it.
- Have Faith in the Future and be Willing to Challenge the Status Quo.
How should providers prepare for 2015?
Organizations should prepare for 2015 by retooling themselves into a partner whose performance characteristics make it sought after by Bundled Payment projects, Accountable Care Organizations, Transitional Care Models for Value Based Purchasing and Chronic Disease Care Management, etc. That means developing and delivering the care programs of the future today. This translates into the following mandates:
- Demonstrate Outcomes via transparent data specific to the potential partnership
- Develop a Utilization Review Approach to Care Modeling for Home Care – Proportional and Acuity Safety Based
- Employ Data Integration and collaboration across the partnership
- Ensure Dynamic Patient Risk Stratification with associated algorithms for care management
- Shift Care Focus from Patient Dependence to Self Management
- Emphasize Population Health Management – Chronic Disease Transitional Care
The Chinese curse, “May you live in interesting times”, certainly applies to health care today. These are the most interesting and exciting of times. A new generation of health care professionals and leaders have been handed the challenge of a lifetime. They just might pull it off!