In today’s frenzied world of providing and marketing health care, an organization’s answer to one question can predict its future.
A panelist at Becker’s Hospital Review Annual Meeting cited how his CEO focuses team deliberations by asking: “Are we going to play to win, or just play at a level not to lose?”
Everyone knows that aiming not to lose isn’t a strategy for success, much less survival. So posing the question essentially challenges executives to think more strategically and competitively—to have more guts.
By connecting dots of advice from conference speakers, panelists, networking discussions and dinner confessionals with attendees, here are eight winning strategies worthy of every health care system’s 2018 playbook:
1) SPEED DATE, NOW.
It’s no surprise the economic model of hospitals and clinics is terribly compromised: Legislative uncertainty still surrounds the ACA. Medicare and Medicaid still reimburse pennies on the dollar. Drug costs continue to rise. Doctors and nurses remain in short supply. Patients demand better service, lower costs and transparent pricing. What is a surprise is this: With all health care providers in the same boat, the only way to deal with the category upheaval is for everyone to consider a merger, acquisition or partnership—even with those long considered to be competitors.
The need to win (that is, be economically viable and dominant in one’s marketplace) is prompting organizations to face the fact they can’t be all things to all people. So winners are focusing on where they can win by being the best at it in their marketplace. For all the other things at which they need only be at parity, they’re partnering with others near and far.
The result is a hub and spoke model on steroids. It’s why former foes are now forming alliances. Why academic providers are now partnering with other academic providers in their same market. It's why for the first time, even faith-based institutions are thinking about dating others. And to be close to patients, everyone is structuring themselves just as much for e-health and telehealth as bricks and mortar.
The economics of health care make it so imperative to affiliate with others right now that one panelist predicted that the US will likely have no more than 100 health care organizations by the year 2025. Consolidation is needed to address redundancies, reduce expenses and improve quality in areas where any single organization is weak. For example: In some markets, there’s an excess of hospital beds while in other geographies there’s a shortage, with some institutions running in excess of 100% capacity. For some hospitals, the majority of their procedures are the basics: birthing, orthopedics and chronic diseases such as diabetes. In contrast, the mainstay of a hospital across town could be psychoses, addictions and gunshot wounds. Responsibility for a community’s health means finding a financially viable way for all with a stake in a community to serve both populations.
No health care system can afford to do it all. So the smartest executives are speed dating now to search for a way to spread expenses across a larger population and take the risk out of their current reality. Today, acquisitions, mergers and affiliations are needed to mitigate risk.
2) REDEFINE WHAT’S RISKY
Risk used to be defined as things like expenses in excess of revenues. But now, that’s the situation most every health care institution faces. No wonder event panelists implied an expanded definition of what constitutes risk:
• Expense reductions made out of the context of a larger strategy for an organization’s future. (The larger strategy is identifying the market space in which one wants to play because in it, there’s the opportunity to win market share. And after identifying it, then sorting through what it takes in terms of core capabilities, personnel, locations and marketing to win in that space.)
• Cutting too much, too fast. (No organization has ever cut its way to greatness or sustainability.)
• Expecting to survive—even after expense cuts—on patient revenues alone. (Some speakers said this is impossible.)
• Not investing in innovation. Not coming up with new revenue-generating products and services. Not budgeting sufficiently for the kind of marketing it takes to dominate one’s marketplace. If one can’t afford to invest in all of these things, it’s a sure sign an organization needs to date, merge, be acquired or align with others that can.
• Denying that one needs to throw out the old playbook in favor of a new one that calls for new skill sets, and a new business model in service to the business you’re now in:
3) REALIZE YOU’RE NO LONGER IN THE BUSINESS OF HEALTH CARE. In an accountable care organization, you’re now in the business, not of providing care, but of providing health. Period.
One conference speaker shared the eye-opening experience of visiting patients in their homes. Though recently released from the hospital, they were not doing well. The diagnosis? Poverty and food deserts left their cupboards bare of any food. It’s sobering to realize it, but when one’s responsibilities are population health, one’s business includes tackling the social determinants of poor health. This includes empty refrigerators, dysfunctional families, vets suffering homelessness and PTSD, the opioid crisis, gun violence, nutritional ignorance and more.
When one is in the business of enabling and ensuring health, services and initiatives are more numerous outside the walls of a hospital or clinic than inside. And those playing to win are finding early victories through educational programs, a return to house-calls, mobile clinics, prescribing fresh fruits and vegetables (and having them available at pharmacies), providing patient transportation, underwriting housing for troubled vets and jobs for recently released felons so they can turn their lives around.
Winning at population health will require every ounce of one’s insight, foresight, resourcefulness, audacity and fearlessness. It will require expertise in what it takes to concept and successfully launch new protocols—new products, services, and business models to tackle the larger ills of society that affect the health of a community. It will take a leadership team skilled as much in innovation and marketing as in diagnosing and treating physical ills. And it will require the end of siloed operations and their integration and alignment with the help of data feedback loops.
4) MAKE DATA YOUR FRIEND
Big data, local data, patient data, behavioral data, satisfaction data, quality data, compliance data, revenue data, YOY improvement data, competitive data. Winning requires selecting the right data (informative metrics but not so many as to obfuscate or overwhelm) and turning it into feedback that everyone along the continuum of care can use to improve patient outcomes, efficiency and financial performance.
Just as has long been true for years in sports and conventional businesses, in population health analyzing and leveraging the right data is also required to win. Today, anyone who does not embrace data—including that which could improve their own performance—will not win in the business of health.
5) DON’T WAIT ANOTHER DAY TO GET THE RIGHT PEOPLE ON THE BUS
As Scott Becker noted in his closing remarks at the annual meeting that bears his name: Winning is not hard when your team is great. But it’s a real challenge when your team is simply good.
It’s not just that you don't know if you have the horsepower to get tough things done and done fast. It’s that you can’t afford to wait to find out. It’s why you must know how to quickly ID people with great potential and coach them for greatness. Few leaders (including those in HR) have the time outside of their day-to-day workload to do such assessments. Most don’t have the state of the art tools. So winners often hire outside specialists to coach them from good to great.
6) SEEK A HIGHER CALLING
People already working hard will naturally think they have no more to give. But something mentioned by a few conference speakers might provide inspiration: We’re all playing—not just to have the organizations and the populations we serve win—but to have our local economies win for years to come.
Whether in large cities or rural areas, healthier people are easier to educate, more trainable, better able to keep their job and take care of themselves in retirement. They’re better able to be entrepreneurs, excel in new fields of endeavor, concept big new ways to solve a community’s challenges and address opportunities for the good of everyone. Winning at population health is tantamount to economically strengthening the U.S. with all the good that would ripple and multiply to each and every one of us.
Admittedly, as victories go, a stronger, healthier economy is the ideal. For with more jobs and more money flowing into any community, more and more good things can happen. But winning requires the belief that winning is not a pipe dream. And for any doubters, the conference provided this advice:
7) DREAM BIG AND HAVE NO PLAN B. This strategy came from a conference speaker who for eight years led the fifth largest economy in the world, California, and dealt with health care issues facing over 40 million people. His name? Arnold Schwarzenegger. Born poor in an economically struggling post-Nazi Austria, at 15 he felt despondent about his future. Yet he saw stories about America where people rose to be more of who they were or aspired to be and he dreamed of becoming famous and the highest paid actor in Hollywood. It’s an understatement to say it was against the odds. But he exceeded his dreams many times over because of two things:
• Hard work: 8-10 hours at a job of heavy labor, then putting in several hours of physical training while at the same time taking college courses to earn a business degree.
• Having no Plan B: He explained that knowing he could always revert to a Plan B would have kept him from doing all he had to do to succeed against the odds.
In other words, in each phase of his career—bodybuilding, acting, politics, and now philanthropy—he succeeded by playing only to win, never to just place or show.
So for anyone hesitant to dream about what one's community could be like if its economy improved, for anyone reluctant to speed date, redefine risk, innovate or befriend data, Becker's Hospital Review Annual meeting offered this strategy:
8) DEVELOP YOUR GQ.
Of course, IQ stands for Intelligence Quotient. But the highly regarded Toby Cosgrove argues a different ability is needed to win in today’s marketplace. It’s GQ. In fact, the usually modest Cosgrove credits his success leading the Cleveland Clinic to his GQ, or “guts quotient.”
While IQ is measured through written and oral tests. GQ is measured by one's vision and courage in the face of face of difficult trade-offs; a track record of bold strategy when tackling seemingly impossible odds. Another GQ metric is action because there's a stopwatch warning time is running out.
Essentially, Cosgrove is saying that winner’s play to win every hour of every day. So, in light of all you’re responsible for accomplishing for your organization, how would 10 of your closest colleagues rate your level of play? What would they say is your GQ?
And would you be proud of the answer?
Marsha Lindsay is Chief Strategist for Growth, Brand and Innovation at Lindsay, Stone & Briggs. Her firm specializes in the successful positioning, launch and accelerated growth of brands and their innovations and was recently named by Ad Age as a Small Agency of the Year for their thought leadership, creative prowess and marketing effectiveness. Clients her firm has served include Tampa General Hospital, SSM Health, Marshfield Clinic, Delta Dental, GE Healthcare, Exact Sciences and Forward Health.
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