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 capital investments are all in the public domain if one knows where to look.  A strategist's job is to synthesize all that data so that a few important, future-oriented questions receive sustained attention:

1. The Benchmark Question: 
What is our competitive position relative to the competition?

2. The Trendline Question:
Are we improving? I.e. what's the slope of our trend line? How do we know?

3. The Speed To Market Question:
Are we improving as rapidly as those around us? Are our improvement cycle times fast enough?

4. The Marketplace Expectations Question:
Are we improving as rapidly as the market demands, now and in the future? I.e. is our projected performance sufficient to succeed as customer expectations grow and evolve?

11:16 AM

An Industry Bankrupting Its Own Customers Cannot Thrive

Wonder why you haven't gotten a raise recently?  Does it seem your income goes less far than in years past?  Blame healthcare inflation.  Or, as one economist said recently, "...healthcare stole your raise."

 Brian Klepper, PhD, blogging at KevinMD.com predicts that healthcare is in for a new organizational structure.

At our first meeting years ago, Tom Emerick, Walmart’s then VP of Global Benefits, told me, “No industry can grow continuously at a multiple of general inflation. It will eventually become so expensive that purchasers will simply abandon it.”

He said it casually, as though it was obvious and indisputable.

Health care is playing out this way. From 1999 to 2011, health care premium inflation grew steadily at 4 times the general inflation rate. During that same period, the percentage of non-elderly Americans with employer-sponsored health coverage fell from 69.2 to 58.6 percent, a 15.3 percent erosion rate.

Health care’s boosters like to argue that it has buttressed the economy, and that it means more jobs and economic prosperity within a community. A February 2011 Altarum Institute report estimated that private sector health care jobs now account for nearly 11 percent of total employment. Since the recession began in December 2007, health care employment has risen by 6.3 percent while employment in other industry sectors fell by 6.8 percent.

[I love this next paragraph...]

But there’s a darker side. Health care’s ever-increasing revenue growth has come at the expense of individuals and firms that pay its bills, directly, through health plan premiums and through taxes, often instead of buying other goods and services. It transfers wealth to health care from everyone else. Like the finance services industry, health care has become a disproportionate “taker” industry, sapping economic vitality of America’s communities.

[Yep.  And it's time for state hospital associations everywhere to change the basis for their "economic benefit" calculations - calculations that still trumpet employment and purchasing data when it's clear the marginal benefit is negative.  Locally and nationally, we'd be better off spending more on education, infrastructure and innovation than on more health care.]

And it is also clear that a sizable part of health care cost is inappropriate and unjustified. It is related to procedures that are done unnecessarily, markups that are hidden, and a thousand ruses to make it cost more. The prestigious National Academy of Sciences Institute of Medicine recently estimated this waste at 30 percent of total health care expenditures, or about $765 billion/year. But any number of health care professionals I’ve spoken with agree that, based on their experience, the number must be significantly higher. Other estimates have suggested this. In 2008, the consulting firm PwC issued The Price of Excess, which calculated that about 54.5 percent of health care cost, or nearly $1.5 trillion annually, focused in every sector – supply chain, health information technology, care delivery and finance – provides no value.

Read the whole thing, here.

2:12 PM

"If we have learned one thing from the history of invention and discovery, it is that, in the long run - and often in the short one - the most daring prophecies seem laughably conservative." - Arthur C. Clarke (1917 - ), The Exploration of Space, 1951

7:05 PM

9 Health Care Jobs Expected to Grow by 2018

9 Health Care Jobs Expected to Grow by 2018

#3: Public Relations Specialists

As the health care industry becomes more technologically savvy, smartphones and social media will become more common tools of the trade, in addition to traditional machinery. Therefore, hospital public relations will grow 52%.

#9: Customer Service Representatives
Hospitals are trending toward customer service satisfaction, conducting surveys and becoming more attentive to patients as customers. Therefore, expect to see this field in health care grow 52%.

12:42 PM

Sun Comes Up, It's Tuesday Morning

Not very organized today, so you'll have to put up with a few random things catching my eye...

1.  Distrusting their government's message on nuclear safety, Tokyo residents self-organize and go looking for radioactive hot spots.  Guess what they find?

Watch this "self-organization" trend.  It's coming to a health care neighborhood near you.  Maybe they'll self-organize into a booster club for your current business model...though I wouldn't bet on it.

2.  The Regenstrief Institute (IN) launches an initiative to encourage innovation, naming John Duke, M.D., the Institute's first Innovation Officer.

"We are encouraging everyone associated with the Institute to come forth with ideas. Traditionally researchers develop ideas and then pursue funding. Learning from successful organizations such as Google, Facebook and Netflix, we are both accelerating and democratizing the idea process. We are encouraging everyone, from established researchers to fellows-in-training to software developers to research assistants to affiliated clinicians to let us know what they think has potential," said Dr. Duke, an internist and informatics specialist.

Democratizing the idea process.  I like that, having once worked with a hospital CEO whose idea of innovation was "I think big thoughts.  You do what I tell you."

3.  And Dr. Westby Fisher asks what would a doctor's version of Occupy Wall Street look like?

"Must doctors accept the pervasiveness and intrusiveness of the inside game in health care? If they didn’t, I wonder what doctors’ placards might say?"

Whatever they say, I'll bet the spelling improves (though not the handwriting.)

4.  Mother Jones' Kevin Drum  says the future is brighter than you think.  (Thanks for the heads-up to LongForm.org's "weekend reads for wonks.")

6:21 AM

MedCity News: What happens to healthcare reform if the individual mandate is overturned?

Try this: things continue spiraling downward until 2020, when a Republican President signs national health insurance into law.

12:33 PM