knowing our market and ourselves rene seidel the scan foundation & lori peterson collaborative...
TRANSCRIPT
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Knowing Our Market and OurselvesRene Seidel
The SCAN Foundation&
Lori PetersonCollaborative Consulting
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Framework for our Discussion• A glance from the field
• First, stand still
• Understanding our market
• Bringing it all together
• Ideas to action
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Knowing Your Market
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Knowing Your Market
Environmental Changes in how health care is organized and paid for
Dual Eligible Demonstration Projects
Community-Based Care Transition Projects
Accountable Care Organizations
……..and other Payment Models
• o
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Knowing Your Market
Responsibility for providing medical care AND long-term services and supports falls on health plans
No or little experience with building a provider network for LTSS services
Health plans have basically three options:
1. Build internal capacity 2. Contract with for-profit entities3. Contract with experienced local CBOs
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The Terrain
• Change in care delivery and payment structures
• Value vs. volume• Honed focus on care coordination
Prevention and wellness• Penalties and rewards• Care delivery in lower-cost
settings• Chronic disease management• High premium for innovation• Changing consumer preferences• Person-centered care
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A Glance from the Field
• Beyond post-acute care networks
• Cross-continuum strategies• Transitional care initiatives• ACOs, Bundled Payments,
VBP, Medical Homes• Medical and social integration• Rapid growth of home-based
care delivery• Partnering and aligning
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The Marketplace is driving Collaboration
• Integrated care delivery models • Providers are seeking scale/ growth• Providers looking to trim costs from duplicative
services– Incentive to collaborate to capitalize on one another’s
differences, areas of expertise
• Survival Strategy – Blending of resources
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What are the Opportunities?
• Growth and diversification• Increase brand awareness• Leverage existing expertise and
client relationships• Create operational efficiencies• New service development• New partnerships/ collaborations/
referral sources• Initiatives:
– PAC Networks– CCTP– Medical & Social Integration
• Advance mission
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Discovering the right opportunities for your organization to pursue and ultimately initiate starts with an
understanding of your market and your organization’s capabilities to
meet what the market is requesting
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First, Stand Still• Before you rush to a market
analysis or master strategic plan, examine the resources internal to your organization- People/ Infrastructure/ Process
• A strategy’s effectiveness is contingent on the organizational capability to execute it
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Organizational Assessment
• Explore the capabilities and needs of your organization
• Evaluate your internal landscape– Do we have the aspirational
culture?– The eagerness to adapt?– The agility to evolve?
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Pre-Work• Right people, right position• Fluidity for change• Process/ system/
infrastructure/ metrics• Program evaluation• Leadership alignment• Honest self-assessment
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What is the market asking of us?
What futures should we be exploring?
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Understanding your market
• Market evaluation– Market data review– How fast is the market moving toward
integrated care?– What are foundations looking to fund?
• Competitor intelligence– What are our competitors doing?– Our potential collaborators?
• CBOs looking to sub-contract nutrition, transportation, frequency of social contact
• How are local hospitals responding?• How will their evolving care delivery model change
how we serve our community?
• Risk-bearing entities– Hospital/ ACO– Health plan
• These entities are “managing their financial risk to maximize profit”
- Eli Veitzer, JFS
• What is our opportunity and more importantly, our value proposition?
• How do we help them mitigate that risk, while maintaining our core mission?
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• Stay informed on what is happening in our market
• Seek to better understand what we don’t know• Engage in strategic conversations: assess future
risks, challenges and opportunities?
Market Pulse
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Bringing it all Together• Understand your environment
– What are the emerging trends?– External market scan: who is doing what, how fast?
• Understand your organization– Internal assessment– The why?
• Look for opportunities to build skills/ partnerships– Who is going to help us get to where we are going?– How?
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“The future is already here-
it is just not very evenly
distributed”
-William Gibson, 2014
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Transforming
Concepts into
ACTION
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Moving from Why to How• Assess potential strategies
– Narrow down priority initiatives– Which initiatives have the potential for highest impact?
• Critical factors for successful implementation– Internal assessment; Capacity and skill-building
• Establish concrete timeline; roles/ responsibilities• Cultivate external relationships• Create work flow chart• Ongoing communication plan and relationship building
with key stakeholders (internal and external)
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Pre-Work
Assessment and Analysis
Design and Implementation
Measurement
Continuous Improvement
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Final Questions:
• What area provoked the most interest for you today?
• What level of priority does this hold?
• What action can you take to move your priorities forward?
• What assistance/ resources are needed?
• What do you need to learn? How will you do it?