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Being Disrupted Ain't Fun. Deal With It.

Articles about disrupting healthcare, particularly those analogizing, say, Tesla's example with healthcare's current state, are frequently met with a chorus of (paraphrasing here) "Irrelevant! Cars are easy, healthcare is hard." You know, patients and doctors as examples of "information asymmetry" and all that. Well, let me ask you this: assuming you drive a car with a traditional internal combustion engine, how much do you know about the metallurgy in your car's engine block? I'll bet the answer is: virtually nothing. In fact it's probably less than you know about your own body's GI tract. Yet somehow, every day, us (allegedly) ignorant people buy and drive cars without help from a cadre of experts. Most of us do so and live happily ever after (at least until the warranty expires. Warranties...another thing healthcare could learn from Tesla.) Now, us free range dummies - impatient with information asymmetry - are storming healthcar…
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My Take On Anthem-Cigna, Big Dumb Companies and the Executives Who Run Them

After last Friday's Appeals Court decision, Anthem's hostile takeover of, er, merger with Cigna has but a faint pulse. Good. Unplug the respirator. Cigna's figured it out but Anthem is like that late-late horror show where the corpse refuses to die. Meanwhile, 150 McKinsey consultants are on standby for post-merger "integration" support. I guess "no deal, no paycheck..." is powerfully motivating to keep the patient alive a while longer.

In court, Anthem argued that assembling a $54 billion behemoth is a necessary precondition to sparking all manner of wondrous innovations and delivering $2.4 billion in efficiencies. The basic argument appears to be "We need to double in size to grow a brain. And just imagine all those savings translating directly into lower premiums for employers and consumers." 

Stop. Read that paragraph again. Ignore the dubious "lower premiums" argument and focus on the deal's savings.

$2.4 billion saved from a p…

Why Change Happens, Or Not

From LinkedIn:

Another Day, Another App, Another Satisfied Customer

How might health care providers use technology to turn customers' mobile phones into information displays and ordering devices? A few years ago, the NY Times outlined how retailers are doing it...
"(Designer Norma) Kamali is at the forefront of a technological transformation coming to many of the nation’s retailers. They are determined to strengthen the link between their physical stores and the Web, and to use technology to make shopping easier for consumers and more lucrative for themselves.
...

Cisco Systems, the supplier of networking equipment and services for the Internet, is also a leader in the field. The company’s Mobile Concierge system is capable of connecting customers’ smartphones to retailers’ wireless networks — so a shopper could type “Cheez Whiz” into a cellphone, then pinpoint its location in the store." Ms. Kamali's boutique installed a technology called ScanLife, "allowing people to scan bar codes on merchandise and obtain details about the…

Becoming Consumer Friendly In Five Easy Steps...Or Not

An article at hhnmag.com offers hospitals 5 steps to becoming more consumer friendly.

If you still think there's a secret sauce to your hospital becoming more "consumer friendly," these 5 steps are as good a place to start as any.  Unfortunately, it's a little like that old Steve Martin comedy bit where he says he'll teach you how to be rich. The first step is to go find a million dollars.

Step 1 from the article is realizing that "...a Medicare beneficiary with chronic conditions is different from a young mom who brings her kids in for an annual check-up." This is market segmentation for beginners, and, yes, one size decidedly does not fit all. I'm sure your marketing team's been saying this for a while.

Steps 2-5: have a strategy, metrics, a champion and resources. OK. Hard to argue with any of those.

But those things, alone or together, won't overcome culture. They're important components to be sure, but insufficient without a …

Is Healthcare Exploitative And Extractive?

I've had this post sitting around in draft form for far too long and it's time to get it off my chest.

Several years ago, MSNBC commentator Dylan Ratigan interviewed Umair Haque, author of The New Capitalist Manifesto: Building a Disruptively Better Business, founder of Bubblegeneration, Director of the Havas Media Lab and blogger at the Harvard Business Review. Though the topic wasn't healthcare, there was much for healthcare leaders to ponder.

Haque draws a clear contrast between productive wealth and destructive wealth.  Both count toward Gross Domestic Product (GDP) but only the former really contributes.

Says Umair,
"It’s easier to make money in the short-term through exploitation and the extraction and much more labor intensive with a higher failure rate and a much greater degree of challenge to actually advance and create something that is new and different and differentiates in its creation of value. “So to me, this is a crisis that is about failing to creat…

Does Your Strategy Account For the Future?

"Your rearview mirror is so small and your windshield is so large because what lies ahead is much more important than the past." (@CHRISVOSS)

What can we say about the future? 
It's uncertain and the end is always near. (Jim Morrison)  The future is much like the present, only longer.  (Dan Quisenberry)  The future is here.  It's just not widely distributed yet. (William Gibson)  Uncertain. As near as tomorrow. Long duration.  Limited (and uneven) distribution.

Think about how hospital strategic plans account for future competitor decisions.   If they do at all,  it's little more than simple extrapolation of past performance, a technique which, though understandable since that's where the data reside, is nothing more than crafting strategy in a vacuum.
It's much easier to track competitor performance retrospectively than to forecast future decisions.

Volume trends, market share, patient satisfaction, quality indicators, financial performance, major capita…

Behind Every Resume Is A Potential Customer...and Karma.

I recently heard from an executive colleague who, thanks to a merger, found herself looking for her next opportunity. Her story, probably depressingly familiar to many of you, was all about the big black hole of rudeness and non-responsiveness that so often sums up employers' attitudes toward candidates.

This colleague, thinking she'd see the healthcare world from a new vantage point, pursued opportunities with consultants, IT vendors, architects and other suppliers who, far from appreciating her solid resume, were like the 3 Stooges of clueless.

So back to a senior health system role she went, WHERE SHE NOW INITIATES AND MANAGES RFPs FOR SOME OF THE VERY SAME COMPANIES who wouldn't talk to her as a candidate, but profess their LOVE for her now that she's got money to spend on their services.

Not gonna happen. Any guesses who's off the RFP list?

I smiled when I heard her story, imagining the BusDev people working hard to grow the revenue pipeline, all the while b…
"We decided in 2005 that no hospital executive could apply to work in this (ambulatory) company. We wanted entrepreneurs who were more open to a different way of providing healthcare services. That has been very, very successful."

--Dan Wolterman, president and CEO of Houston-based Memorial Hermann Healthcare System, Texas' largest not-for-profit health system, from an interview in Modern Healthcare.

The Answer For Lower Healthcare Costs Is...

...Customer Service.

From the New York Times: Seattle's Iora Primary Care is a new model of primary care, seeking national scale and venture capital funding.  Though the ambition may be outsize, the concepts are not new. Daily team huddles. Health coaches. Taking satisfaction surveys seriously and mining results for actionable insights. Employer and payer partnerships. Pay-for-performance not volumes. Loose-tight operations (wellness options are "loose" - i.e. varying from site to
site, while EHR alignment is "tight" and non-negotiable.)

According to the article:
"...small change(s) can make a big difference in a patient’s health — what good is the perfect drug if the patient can’t swallow it? — but the extra-mile work it took to get there can be a challenge for the typical primary care practice in the United States. Harried by busy schedules and paid on a piecework model, many doctors rush from visit to visit, avoid phone calls and emails that …