Strategic Growth and Business Relationships Course Three – June 7 Presented by Patrick Gauthier. Overview. Review Causes and Conditions Discuss Strategic Implications for Business Development Review Options Affiliation, Association Joint Venture, Strategic Partners Merger Acquisition
Course Three – June 7
Discuss Strategic Implications for Business Development
Joint Venture, Strategic Partners
Open DiscussionLearning Objectives
Business Operations and Process
Business Infrastructure and IT
Instability (A. Toffler)
Decay and Irrelevance (G. Hammel)
Tipping Point (M. Gladwell)
Strategic Inflection Point (A. Grove)
Value Migration (A. Slywotzky)
Disruptive Innovation (C. Christensen)Causes and Conditions
For the unprepared, The Winds of Change can appear chaotic and as disruptive
…or they can appear as a dynamic, inter-dependent series of incremental improvements to our health care and health insurance systems.
The difference is preparation.The difference is planning.
Knowing what each successive wave entails allows you to deliberately sow the seeds of your organizational changePlanning Makes the Difference
MH and SUD services will be included in basic benefit packages. Essential Benefits will be defined and mandated.
All plans in the health insurance exchange will be required to adhere to the provisions of the Wellstone/Domenici Parity and Equity Act.
Medicaid enrollees, including newly eligible childless adults, will receive adequate health coverage, including MH/SUD coverage.
MH/SUD will be included in chronic disease prevention initiatives.Reforms
MH/SUD workforce included in packages. Essential Benefits will be defined and mandated.workforce development initiatives.
Prevention and treatment providers to be eligible for community health team grants aimed at supporting medical homes.
Expanded Medicaid coverage for all Americans below 133 percent of the federal poverty level (est. 16 million)
Health insurance exchanges created for individuals and small employers to pool risk and purchase insurance (est. 16 million).Reforms
Structure, Governance and Shared Savings
IT Infrastructure and Data Management
Population Health Home
Rx & Lab
By various estimates, at least 120 million people PLUS all those that become insured via Medicaid expansion and Health Insurance Exchanges including small group and individual policies = an additional 32 million
82 million are in self-insured plans
CHIP and Medicaid managed care plans
460 health insurers and 120 Managed Behavioral Healthcare Organizations (MBHOs)Parity Impact
Counties and Cities
75% - 90%
Corrections & Courts
Health Insurance Exchanges
32+ Million Uninsured
Medicaid Managed Care Plans
Housing & Jobs
Standards & Science
Need for interoperable, certified information systems and Meaningful Use of health information
Managed care and utilization review
Medication Assisted Treatment (MAT)
ACOs and Patient-Centered Medical Home (health home) models
Population Health Mgmt
Standardization and normalization of data, terms and toolsWhat to Expect
Attention to Meaningful Use of health informationMultiple Chronic Conditions
Focus on integration and innovation
Electronic billing (electronic data interchange - EDI)
Affiliations, joint-ventures, and partnerships
Reporting of quality, outcomes and financial dataWhat to Expect
Implementation of certified information systems (EHR) Meaningful Use of health information
Vertical integration (“one-stop shop”)
Horizontal integration (strategic partnerships)
New approaches to reimbursement like Global Payments
New populations to serveOpportunities for…
Assess Business and Strategic Plans Meaningful Use of health information
Assess IT Infrastructure
Assess Partnerships and Alliances
Assess MarketNext Step: Assessment
Business Plan Meaningful Use of health information
Joint Venture, Partnership, Alliance
Staffing Plan (Recruitment & Retention)Next Step: Planning
Vision – what will you become?
Mission – how will you become what you envision?
Goals – what incremental achievements will enable you to satisfy your mission?
Objectives – what tactical steps will enable you to meet your goals?
Commit capital and develop a budget Meaningful Use of health information
Address outsourcing and the need for periodic expertise
Commit to Performance Mgmt
Keep distractions and competing priorities to a minimum
Hold people accountable
Align efforts so time and energy are not wasted
Provide reinforcements, encouragement and rewards (recognition)
Become Learning Organizations
Innovate and grow from your Core Competencies
Encourage some risk-taking, experimentation and tolerate mistakes
Tension will exist between:
Paradigms: past, present and future
People vying for roles
Short and long term needs
Profits and investments in the future
The team and the individual
Dissent and agreement
“Business” and “Recovery”
The “way we’ve always done it” and innovation
The challenge is one of making the tension
creative and productive