Toss The Default Model

by joeflower on January 20, 2015

There are no winners in the fee-for-service game.

It’s time to toss the whole business-as-usual model — for your own good and the good of your customers.

The emerging Default Model of health care — the “consumer-directed” insured fee-for-service model in which health plans compete to lower premiums by bargaining providers into narrow networks — not only does not work for health care’s customers, it cannot work. This is not because we are doing it wrong or being sloppy. By its very nature the Default Model must continually fail to bring our customers what they want and desperately need. Ultimately it cannot bring you, the providers, what you want and need.

Take a dive with me into the real-world game-theory mechanics of the health care economy, and you will see why. It’s time to rebuild the fundamental business models of health care.

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Why You Should Ditch Your IT System

by joeflower on November 20, 2014

So you spent millions to billions of dollars on information systems over the past few years, right?

How’s that working out for you?

For a large percentage of you, whether or not you admit it, not so well. What you bought needs some serious tweaks, re-engineering, re-thinking, re-vamping.

For an even larger percentage, maybe most of you, the best advice is: Junk it. Throw it out and start over. [click to continue…]

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Survivable Health Care

by joeflower on September 24, 2014

Health care is fragile. It survives in a much narrower band of circumstances than most of us realize. Right now many hospitals and systems are having a second down year in a row. They’re consolidating, laying off people, working through major shifts in strategy — all because of what we must admit (if we are honest) are relatively minor economic shifts, such as small reductions in utilization and Medicare payments, a blunting of accustomed price rises, and stronger bargaining from health plans. If minor revenue stream problems put your entire institution in jeopardy of chaotic deconstruction, it cannot be called robust. At the same time, an increasing number of vectors outside the sealed world of health care could overwhelm and kill your institution, from climate chaos to pollution disasters to epidemics and the loss of antibiotics. These two concatenations of threats, within and without health care, have similar and interlocking answers. The extent to which your institution is bloated, profligate of resources and highly dependent on its current streams of revenue, energy and human resources is exactly the extent to which it is a system with very little reserve capacity. In an increasingly high-variance world, your survival depends on getting green, lean, resilient and smaller.

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Half the Cost. Half the Jobs?

July 24, 2014

If we manage to halve the cost of healthcare, does that mean half as many jobs? Not necessarily. Here’s why.

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Will Tech Revolutionize Health Care This Time?

May 27, 2014

Will some of these new technologies actually transform health care? Which ones? How can we know?

There is an answer, but it does not lie in the technologies. It lies in the economics. It lies in the reason we have so much waste in health care. We have so much waste because we get paid for it.

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Obamacare premiums are going to “skyrocket”? Forget about it.

April 5, 2014

It’s getting harder and harder on the right to come up with new ways to say it isn’t working when it actually seems to be working.
So what’s the latest? This fall, Obamacare premiums are going to “skyrocket”!

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Strategies for Doing More with Less

March 29, 2014

How can hospitals and health systems survive on a lot less money? What are the strategies that turn “impossible” to “not impossible”?

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What About the Poor?

January 28, 2014

In comparison with the actual scale of the problems, most of the business models and strategies in health care have been sleeping like overfed dogs. It’s wake-up time in America.

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The Mind of the Building: Capital Planning in the Next Healthcare

September 24, 2013

Health care organizations are changing shape — and building. Think it through — or you will fetter your change.

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The Missing Ts: Four Key Dimensions of Strategy

July 31, 2013

If you don’t have a structured way of driving your choices through the four Ts — transparency, targeting, trust and trim — you’re headed for T as in trouble.

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