For those of us old enough to vaguely remember life before prospective payment, it is easy to understand why cost-plus reimbursement might be described as the “good old days.” Like a leisurely drive on a straight country road, if you paid attention, maintained a reasonable speed, and navigated the occasional slight curve, you were fine.
Changes that began in the 1990’s significantly changed the landscape. Comparable to a multi-lane freeway, the speed of change increased significantly. Dramatic shifts in hospitals’ relationships with physicians, managed care constraints and increasing risk in payer reimbursement models were like the vehicles coming on and off freeway access ramps. If you made adjustments as necessary, and adapted to the changing traffic flow, you survived.
But like driving the dramatic, curve-filled Highway 1 along the rocky Pacific Coast, today’s healthcare roadway is filled with significantly more risks – as well as potential rewards. Leaders who are in the driver’s seat of provider organizations must pay much more attention to the speed with which they implement major changes to be sure they don’t lose key constituencies along the way.
Think of it this way: if we were driving a small, high-performance sports car we could zip through the hills and curves on Highway 1 easily. But large, complex provider organizations with many constituents to bring along handle more like a Greyhound bus. If we take the curves too fast before our staff, physicians, Board members and patients understand both the “why” and “what” of major changes, we risk careening off the cliff into a devastating crash.
Given the altered terrain, following are key ideas to consider when navigating today’s risky healthcare highway.
Collaborative planning is essential
Gone are the days when a small group of executives could craft strategic plans in isolation and still successfully implement new initiatives. Today, the strategic planning process is more important than the document it produces, giving key players opportunities to both weigh-in and buy-in to critical changes in care models, cost management and clinical service line development.
Education is vital
The economic issues facing healthcare over the next decade are daunting, so it should come as no surprise that many of the changes proposed to lower costs and deliver higher quality care are extremely complex. For Board, health system, and physician leadership, a solid understanding of the incentives and risks associated with new care models is critical to crafting appropriate responses and gaining support for significant change.
Transparency has never been more important
When key partners feel as if they have been left in the dark regarding new strategies, initiatives have very little chance of succeeding in the long-term. While it may require a greater investment of time in the early stages, transparency builds the trust that is absolutely essential. Developing innovative care models that will be successful from both clinical and financial perspectives is not possible without a commitment to transparent processes and communication.
In an environment as complex and changing as healthcare today, it is unwise to abruptly step on either the brakes or the gas pedal; the former risks being run over by competitors while the later risks moving beyond the organization’s capacity to manage change and bring along key constituents. Smart, strategic organizations pay attention to adjusting their pace to appropriately respond to both the anticipated as well as the occasional unexpected curves in the road ahead.