It’s football season, and both of my favorite teams, college and professional, are having what fans ruefully refer to as “rebuilding seasons.” In other words, they’re stinking up just about every stadium in which they play. A combination of factors is to blame: lack of talent, inept coaching, bad luck.

Oh, and the other guys are better.

Health care is in the midst of its own rebuilding season, though this one has been around for several years now and is expected to drag on for another decade at least.

While some hospitals are struggling, it’s not because they don’t have the skills or leadership. Rather, the rules of the game keep changing; the road to value-based care is full of twists and turns and there's a proliferation of confusing, sometimes contradictory regulations, measurement requirements and market pressures. What’s more, the change is happening in different ways and at a different pace from one area of the country and one type of provider to another.

But you’ve got to give hospital leaders credit. This issue of H&HN is filled with examples of hospital executives who are rewriting their playbooks as fast as they can. They’re introducing new strategies and reassigning players. They’re looking at what’s working somewhere else and adapting it to their own situations. While the challenges are intimidating, nobody’s ready to head for the locker room.

The cover story presents three case studies of hospitals and health systems that are implementing new strategies to treat chronic pain and, thereby, helping to stymie the opioid epidemic that is ravaging so many American communities.

This month’s installment in our Clinical Management series describes how some hospitals are redesigning pediatric services to improve care for children and reduce costs.

In a Q&A on Page 30, Kenneth Kizer offers one example of how providers can strengthen their benches, in this case by using paramedics to check on patients in their homes and avoid unnecessary trips to the hospital.

And in the Executive Dialogue beginning on Page 49, hospital executives and technology experts explain how predictive analytics can forecast trends and lead to more effective care.

There is plenty of other evidence to underscore the need for the field to adjust its game. You've probably heard that the Massachusetts Hospital Association last month renamed itself the Massachusetts Health & Hospital Association. MHA President and CEO Lynn Nicholas explained, “As the health care system becomes more value-driven, each component of the system is increasingly focused on maintaining a person’s health throughout their lives — as opposed to healing them when [they] fall ill.”

The goalposts may be moving — and moving and moving — but health care professionals are already scoring some impressive points. — Reach me at