Who Cares What Happens In DC: Building the Healthcare Enterprise That Can Survive In a Crazy Healthcare World

Published on June 8, 2017 by

First published in the April/May/June 2017 edition of Maine Medicine

I often get asked what I think is going to happen with healthcare reform in Washington and Maine. My answer is, “Who knows, but it does not matter, so don’t focus on it. Instead, build your organization’s (your practice’s / hospital’s / health system’s, community agencies, etc.) ability to survive in a crazy, unpredictable healthcare world so that, no matter what happens and how we get paid, your organization is positioned to survive, and perhaps even thrive.” To do that, I think you need to do at least these things:

  1. Build rapid ability into your organization, through good management structure and process, training in change management, recruitment of people who don’t wig out when the next change comes, etc. If your organization cannot respond to the changing environment by analyzing that change, determining how you should change in response, and then making your change happen with relative speed, you are doomed. And whining about change does not count as responding to change.
  2. Don’t build for a specific payment model, because we have no idea what the ultimate payment model will be, and there may be several. Build instead for organizational reliability, adaptability, accountability, and high level performance as part of a network of caregivers.
  3. Digitize everything. It will be the only way your organization can efficiently measure your caregiving performance, gather and report data about that, coordinate patient care across caregivers, etc. It will also be the foundation for innovation in multiple areas of patient care. So digitize or die.
  4. Be outstanding at what you do, and ruthlessly examine how your actual (measured) performance compares to that goal. If you are not outstanding, get there quickly, or stop doing what you will never be outstanding at doing.
  5. Be progressively and brutally efficient, because no matter what else happens, we are all getting paid less money for our care.
  6. You must be functionally integrated with the rest of the delivery system, or at least some network within it. At a minimum, this means you can effectively take and manage complex patients handed off to you, and help coordinate patient care proactively and effectively. It must also mean you can develop and deliver on common goals with other parts of the delivery system, etc. It means you can own your piece of some partnering organization’s efforts to improve outcomes for which they are primarily responsible. If you cannot reliably partner toward such ends, your organization will likely stand and fall alone.
  7. Add progressive value to everything you touch – your partnerships, your patient care, etc. If you are not constantly growing the value of your part of the healthcare delivery system some other organization that is doing so will progressively eat your lunch. Adding progressively includes improving the cost, quality, and efficiency (the value) of your care. Your organization may do all these things and still fail to survive over the long haul of delivery system evolution.But at Maine Quality Counts, we believe that organizations building these kinds of capabilities into real strengths have a much better chance of surviving than organizations that do not. (Learn more about Maine Quality Counts at mainequalitycounts.org)

Leave A Reply:

Note: Comments are moderated. If you'd like your comment to be displayed here, please follow these guidelines:

    1. Be nice. We encourage you to express your opinion, but we wll not publish rude, inflammatory or inappropriate statements.
    2. Contribute to the discussion. Your comments should be both understandable and directly related to the blog topic.
    3. Give us time. We publish comments a few times per week so it may take a few days for your comments to appear.
    4. Be aware of your audience. This is an open blog, which means everyone on the Internet can read it. Your comments may be repurposed and used elsewhere (e.g., Twitter, Facebook, LinkedIn, etc.)

Thank you for sharing your thoughts with our readers.