knowing our market and ourselves rene seidel the scan foundation & lori peterson collaborative...
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Knowing Our Market and OurselvesRene Seidel
The SCAN Foundation&
Lori PetersonCollaborative Consulting
Framework for our Discussion• A glance from the field
• First, stand still
• Understanding our market
• Bringing it all together
• Ideas to action
Knowing Your Market
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
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
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
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
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
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
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
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
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?
Pre-Work• Right people, right position• Fluidity for change• Process/ system/
infrastructure/ metrics• Program evaluation• Leadership alignment• Honest self-assessment
What is the market asking of us?
What futures should we be exploring?
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?
• 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
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?
“The future is already here-
it is just not very evenly
distributed”
-William Gibson, 2014
Transforming
Concepts into
ACTION
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)
Pre-Work
Assessment and Analysis
Design and Implementation
Measurement
Continuous Improvement
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?
