Knowing Our Market and Ourselves
Rene Seidel
The SCAN Foundation
&
Lori Peterson
Collaborative 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 entities
3. 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?
• Market evaluation
Understanding
your market
– 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?
Market Pulse
• 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?
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 hereit 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)
Continuous
Improvement
Pre-Work
Assessment
and Analysis
Measurement
Design and
Implementation
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?
THANK YOU!
LORI PETERSON
COLLABORATIVE CONSULTING
LORI@COLLABORATIVECONSULTING.NET