2013 lessons - 2014 plans

The world is speeding up - either truly or as a product of my age!  But Healthcare is spinning at warp speed and the centrifugal force has thrown many off course or out of the game all together.  While at the same time, those at the core, the early adopters are holding close to the strategy and staying in the spin.  (I may also have watched too much Olympics this week for the imagery.)

This is what I have witnessed this past year.
1. Early adopters moved through the alpha stage and either made adjustments or lowered their commitment to risk.  They are still ahead of the curve and making it harder for others to get to that place at the center.
2. The cautious, curious and joiners in the field, put players on the field, also learning some lessons, and reached to the center to affiliate or join.
3. The wait and see crowd or non-believers began to feel the pull of the force to spin them way out of their comfort zone and off course.  Course corrections either followed group 2 for the lucky ones or followed truths from the past that may continue to spin them farther from achieving success.
4. Those who were not in the game at all and hang on normally by their fingernails, either made dramatic changes to position them in a completely new way or they began the final death spiral as the safety net evaporated for most stand alone and safety net hospitals.

I believe this was the year where those that can partner and those that can't matters; it may be the number one success factor for the foreseeable future.
The second critical success factor is recognizing whether there are any differentiating factors or whether your organization is really a commodity in the market that needs to be rationalized and maximized on value basis.
The third notion that may have eluded organizations in group 3 as their stability began to spin away, was that there is no admission based strategy in their future that is sustainable.  They have maximized assets or have costly excess capacity, and their value is in their provider structure.

The interesting thing about these groups is that traditional measures do not predict them.  Their profitability of the last 10 years is not an indicator of their next 10 year success.  What matters is the infrastructure that they have built to reduce the cost of care for the population they serve and the ability to recognize how that moving parts play into that.  Investment strategies for those who are on course are different from those who are not.

And lastly, those that were losers over the last 5 years have little chance to capitalize their future.  There opportunity only exists if they have a capturable market population that is of value to a group one organization.  Its not only about you any more, its about your patients.

The plan for 2014: group 1 moves to refinement of their ability to handle risk and expansion to achieve critical mass.  Group 2 aligns with the best group 1 partner they can focusing on central v local service definitions, access to capital and networks,  reduced overhead and increased content experts; group 3 wakes up yo the realities of their market value and seeks a network or begins the slow and steady decline of days cash on hand.  Group  4 sees a lot of closures, some recovery and partnering, and some restructuring and the re-emerging as ambulatory or other continuum provider.

Let's see what happens.