By Gregg A. Masters, MPH
Part One in a continuing series exploring the ‘all in’ healthcare eco-system (as enumerated by Reed Tuckson, MD aka @DrReedTuckson below)
There is no room in the cost curve to accommodate things that don’t add value
An article published late last night titled ‘Hospital Groups Will Get Bigger, Moody’s Predicts‘ presented itself while I was just preparing for the extraction process after a long day of engaging with the continued saga of health reform, accountable care, and the delivery mechanisms to witness their growth and efficacy. So I was too tired to do anything but re-tweet the article. This morning energized by caffeine and a modest sense of being untethered from some very important dialogue elsewhere, I am compiling this blog post.
My series of tweets which afford the context of the essential heartburn I experienced reading these ‘deja-vu’ of sorts headlines (I intend to offer further rationale and context interspersed with the tweets) are posted below:
But first up, is the ‘cognitive dissonance’ trigger [as in, you must be kidding, right?]:
To wit I note an another conventional wisdom assertion (though the track record of strategic market projections may be a little suspect i.e., the mortgage meltdown):
Somewhat reminiscent of the crystal ball forecasts of the best and brightest circa mid 1980’s…
With reference to the potential over-reach of the Moody’s headline I remind…
Then the seemingly and perpetually elusive strategic challenge in healthcare, i.e., realizing the proper alchemy between vision and execution as metaphorically enumerated by Dan Fogelberg:
‘..it’s never easy and it’s never clear, who’s to navigate and who’s to steer, and so your flounder drifting ever near the rocks…’
Contrary to the likes of Jeff Goldsmith’s bold and erroneous assertion, that finance and delivery need not be integrated to satisfy & restain the ‘rapacious appetite’ of the healthcare conundrum…
2healthguru: If context is king, history is its oxygen. Leading & bleeding edge sit side by side at alter of c-suite success. Who are you listening to?
So will it be well intended ‘deja-vu all over again’, or have we really learned something this time? Judging from a recent HealthLeaders Media CFO survey, I am not particularly encouraged that we’ve resolved the ‘cultural conflict’ (or perhaps better framed as Deming’s – ‘It is not necessary to change. Survival is not mandatory’) challenge wherein Fogelberg existentially frames the elusive blend between vision, strategy and operations by hospitals or their system parents!
2healthguru: On Moodys: One more time, the ‘finance guys’ are disproportionately represented in the strategy domain. bean counters are not strategists!
I then offer select context from a very large pool of ‘strategic misfires’ aided and abetted by the best and brightest thinkers including the then ‘Big Six’…
This led to the following concluding thought/admonition of sorts:
As mentioned in the introduction, this is a series on the pursuit of the ‘all in heathcare eco-system’ a term I first heard used at the Digital Health Summit at CES 2012 in Las Vegas via United HealthGroup’s Dr Reed Tuckson, Senior VP for Medical Affairs, a man who in my book get’s it.
For Dr. Tuckson’s opening remarks, click here.
As someone who AHIP’s senior brass may not count as a friend per se, i.e., I have been rather critical of their stewardship of the industry since it’s GHAA roots, between the likes of Dr. Tuckson and Mark T. Bertolini, CEO of Aetna aka @mtbert, I actually have some hope for a re-aligned payor community as partner/enablers of ‘patient centered’ accountable care.