|H&HN Web Exclusive|
The phrase "the pace of change in health care is relentless" seems to be in the first paragraph of almost everything I read. It is safe to say that it is so commonly used that to those of us who worry about these things it sounds like a cliché. And clichés are personally abhorrent and to be avoided at all cost. Then again, it's true: The pace of change in health care really is relentless.
Every week, announcements herald a string of new developments that cause communal eyebrows to raise in wonder — and sometimes in confusion — all across health care land. My personal favorites are the variety of alignments being forged across the whole health care spectrum. Not just because some are interesting business strategies, but also because the attendant human dynamics are both formidable and fascinating. To categorize some of these partnerships: hospitals with hospitals, hospitals with insurers, hospitals as insurers, insurers with insurers, hospitals with physician groups, physician groups with physician groups, insurers with physicians, physician groups as direct primary care insurers and venture capitalists, venture capitalists with whomever looks good, hospitals with Walgreens, Walgreens with physician groups as an ACO, Wal-Mart with state agencies as a funder of delivery system improvement research. Did I miss any players? Probably several.
Even those hospitals determined to stay "independent," like the ones detailed in this issue's cover story, are reaching out for relationships that will shore up the weaker spots and extend their reach through clinical collaborations with others to improve patient care and access needed services. No man is an island, and that's true even if you're the only one within hundreds of square miles.
All this activity may look like the mother of all barn dances, but, clearly, institutions have a variety of serious underlying strategies — all of which tie back in one way or another to meeting the new standards underlying health care reform that set the rules in a value-based future. That means turning the definition of success on its head. We want to keep people healthy and out of hospitals. And when care is needed, to provide it with high quality at a low cost. The best of the progressive leaders are working hard to create a platform for long-term success — even if it means hardship in the short term.
The nontraditional partnerships that we are now seeing flocks of were not unheard of in the last five years but they were indeed rare birds. The signal is clear that everyone is positioning his or her enterprise for change and aggregating skills. Why would insurers and providers be interested in each other? Both need to determine the cost of care for a given population and manage and coordinate that care. It's as old as time: One has something the other one needs.
What will come of all this significant change? Let's hope innovation is a big winner. Leaders are no longer managing institutions. They are managing organized systems of care. They will select initiatives — no matter how small — that show promise of the greatest impact enterprisewide and work to scale those innovations across the organization. Some thoughtful watchers believe there is no lack of innovation in health care. What's missing is the ability to scale innovation in a big way and relatively quickly with a fanatical attention to process detail.
This is the most interesting and exciting time in health care delivery. The pace of change may be relentless, but the possibilities for real transformation are limitless.
— You can reach me at firstname.lastname@example.org.