Strategic Planning Process Under Repeal and/or …Strategic Planning Process Under Repeal and/or Replacement of the Affordable Care Act By James P. Young, Jr. PhD, CPHQ, PCMH CCE CEO

Strategic Planning Process Under Repeal and/or Replacement of the Affordable Care Act

By James P. Young, Jr. PhD, CPHQ, PCMH CCECEO Concordant Healthcare Solutions

www.concordanthealth.com

Assistant Professor Healthcare and Business Administration,

Associate Department Chair, Donald W. Maine College of Business

Davenport University

Johns Hopkins University Bloomberg School of Public Health PCMH/PATH Consultant

Presented at: Michigan Primary Care Association Annual Conference

Traverse City, Michigan July 24, 2017

Concordant Healthcare Solutions, Inc. 2017

Workshop Objectives

Apply the principles of Healthcare Strategic Planning to Maximize Stakeholder Value under Pending ACA Modifications

Identify Methods to Create and Sustain a Competitive Position Based on ACA Strategic Objectives

Demonstrate Methods For Leveraging PCMH Transformation To Maximize ACA Value

Source: Health and Beauty



CONCORDANT HEALTHCARE SOLUTIONS

: in agreement : having the same characteristics

What Ever It Was That Got You Where You Are Today Is Not Sufficient to Keep you There

Miller Heiman, Inc.

The Only Easy Day Was Yesterday

Navy Seals

Markets May Not Make You Compete, They Will Make You Wish You Were Competitive

James P. Young, Jr., PhD

Points to Ponder

The Difficult is Easy. Only the Impossible is Difficult

Author Unknown


Strategic Intent of the ACA


Landmark Studies That Created a Sense of Urgency to Reform Healthcare

Produced:Evidence Based Care

Strategies

Produced:Cultural Competency and Access Strategies

Produced:Consumer Engagement

Strategies Produced:Process Improvement

Strategies

Strategic Intent of ACA with FQHCs


Simkins vs Moses Cone

Source: Institute of Medicine

Slogans Strategy

7 Years-Repeal and Replace “Something Better”

What Have We Learned To Date?


Doing Nothing Strategy

7 Years-No Improvements Premiums IncreasingIndividual Markets Collapsing


Examination of Racial Disparity in Healthcare Satisfaction and Utilization of Preventative Healthcare Screenings for Retirees of Organized Labor: Application of Cox interaction of Client Health Behavior (2006)


To Primary Care Physicians:

“What is Your Mission?”

What Strategic Intentions Will Not Change Under Repeal and Replace?

Market Driven Competition

Consumer Guided Care

Pay for Value

Improved Access

Publication of Performance Outcomes Data

C = W + L = + C.VImprove Consumer Satisfaction/Trust/Compliance



Supplier Power Buyer Power

Threat of New Entry

Threat of Substitution

Competitive Rivalry

Competitive RivalryNumber of CompetitorsQuality DifferencesOther DifferencesSwitching Costs Customer Loyalty Cost of Leaving MarketEtc.

Buyer PowerNumber of CustomersSize of Each OrderDifference Between CompetitorsPrice SensitivityAbility to SubstituteCost of ChangingEtc.

Threat of SubstitutionSubstitution PerformanceCost of Change

Supplier PowerNumber of SuppliersSize of SuppliersUniqueness of ServiceYour Ability to SubstituteCost of ChangingEtc.

Threat of New EntryTime and Cost of EntrySpecialist KnowledgeEconomies of ScaleCost AdvantagesTechnology ProtectionEtc.

Source: Michael E. Porter (1980)



FQHC COMPARE?

Source: HRSA


MACRA Transforms Non Acute Reimbursement

Quality Activities (60%)

Clinical Improvement (15%)

Advancing Care Information (25%)

Quality Payment Program(Revenue Neutral)

Publish To ConsumersSource: CMS

Stakeholders Need Analysis Map Under ACA

FQHC

Established Patients/Families

State Medicaid

Direct Employees

Federal State Regulators

Non Direct Employees

Acute Care Facilities

Non Acute Care Facilities

Governing BoardSpecialty Referral

NetworkNew

Patients/Families

Private Payers

Population Service Area

Opportunities for Market Growth


ACA Strategic Management Process

Analysis:

Selecting ProcessExternal Analysis (SWOT)Internal Analysis (Core Comp.)Competitive Advantage

Formulation

Differentiation (Blue Ocean)Innovation

Implementation

Organizational DesignCorporate Governance

Best-in-Class Mission Statement

Best-in-Class Culture

Best-in-Class Performance Outcomes


HRSA Mission Statement Example:

Community Health Center will provide quality, primary health care services, accessible to all persons in our community including the medically underinsured and uninsured.

Modified Mission Statement Based on Play to Win Strategic Intent:

Community Health Center will lead the community in providing the highest quality, primary health care services, accessible to all persons in the population served including the medically underinsured and uninsured.

HRSA Mission Statement Guidelines-Mission is a statement that specifies an organization’s purpose or “reason for being.” The mission should capture the essence of who the center is, what the center does, and for whom. The mission should guide each day’s activities and decisions. It is the primary standard against which the organization’s plans and programs should be evaluated. The mission statements use simple and concise terminology, speak loudly and clearly, and generate enthusiasm for the organization. The mission is the core, it is the purpose of the organization.

Hamilton Clinic- Our mission is to be the leader in providing comprehensive, quality, community-oriented health care for the underserved of … surrounding areas.

Our mission-Beaumont HealthCompassionate, extraordinary care every dayOur visionTo be the leading high-value health care network focused on extraordinary outcomes through education, innovation and compassion



CONCORDANT HEALTHCARE SOLUTIONS

: in agreement : having the same characteristics

Mission Statement:

To Be A Leader In Maximizing Value for Stakeholders in an Increasingly Competitive Healthcare Profession

Strategic Intent of ACA Consumer Centered Care

Consumer Choice

Consumer Control

Consumer Compliance

Greater Value (Lower cost, Higher Quality, Improved Patient Experience)


Mission to be the best at…..

Pillar 1 Pillar 2 Pillar 3

Core Competencies

Identifying Your Competitive Advantage


Aligning Core Competencies (Pillars) with a PCMH Best-in-Class Transformation Strategy


Patient/Provider Mission Alignment

Your Mission Statement

Patient’s Mission Statement

Strategic Care Plan

NCQA PCMH Alignment

• Team Based Care and Practice Organization (TC)• Knowing and Managing Your Patients (KM)• Care Management and Support (CM)


Achieve PCMH Recognition Strategy

Achieve PCMH Transformation Strategy

Transform To The Best PCMH in The Service Area

Strategy

Play The Game

Culture

Play to Win

Culture

Play Not To Lose Culture


LEVELS OF PATIENT CENTERED MEDICAL HOME STRATEGIES


Mission:All Patients

Will Live to Be a Healthy 100

Years Old

Welfare Reform Medicaid Reform

Increase Waivers/Reduce Benefit Time

Pending Strategic Next Steps for Law Makers

Decrease Demand




Blue Ocean Strategy:

How to Create Uncontested Market Space and Make the Competition

Irrelevant (Kim & Mauborgne)


Blue Ocean Strategy: How to Create Uncontested Market Space and Make the Competition Irrelevant

(Kim& Mauborgne)

Key Principles:

• Define Blue Ocean Strategy• Reconstruct Market Boundaries• Focus on the Big Picture, Not the Numbers• Reach Beyond Existing Demand• Get the Strategic Sequence Right• Overcome Organizational Hurdles• Build Execution into Strategy

CHC Translation

• Create a Culture of Innovation• Create a Competitive Culture• Lead and Not Follow Markets• Excel in Value Added Service Strategies• Excel in Value Added Support Strategies • Excel in Anticipating Market Changes• Be Skillful in Conducting Competitor Analysis

Use One Adjective to Describe This Behavior


Use One Adjective to Describe This Behavior


The Desire to Win is an Important Part of Human Motivation

Concordant Healthcare Solutions, Inc. All rights reserved

The Courage To Expand Your Strategic Comfort Zone and Embrace Change is Essential for Our PCMH Success in Rapidly Changing Competitive Environments


Comfort Zone

Courage/Discomfort

Expanded Zone

Strategic Analysis Process

Strategic FormulationProcess

Strategic ImplementationProcess

What is Your Mission?

Are You In It To Win It?

What Core Competencies Do You Possess? Do They Give You a Competitive Advantage?

What Unique Value Can You Offer To Stakeholders?

Do You Have An Innovative Culture?

Do You Have A Competitive Culture?

Do You Have A Winning Culture?Sustain A High Performing Team With Best-in-Class, Market-Driven Outcomes







Column1 Column2 Column3 Column4 Column5 Column6

Please Answer Each Question Based on Your Personal ExperienceStrongly

DisagreeDisagree

Neither

Agree Nor

Disagree

AgreeStrongly

Agree

I have a good understanding of how our Patient Centered Medical Home benefits patients

I know what contributions I can make to help our Patient Centered Medical Home be competitive

Our patients understand our Patient Centered Medical Home model

My team would like to learn more about what we can do to outperform our competition

I would like to be a member of a winning Patient Centered Medical Home Team

I know what contributions I can make to help our Patient Centered Medical Home outperform our competition

We have a winning culture in our Patient Centered Medical Home

I would like to learn more about how we perform against our Patient Centered Medical Home competition

Providing competition for awards between Patient Centered Medical Home departments could improve our competitive culture

We do a good job of advertising our Patient Centered Medical Home to patients and the community

I have all of the resources needed to outperform our competition

I enjoy being a member of a team that outperforms competition

Knowing how patients feel about our Patient Centered Medical Home is important to me

I have a good understanding of how patient surveys are used to improve our performance

I have a good understanding of how we are performing compared to our competitors

Creating a more competitive Patient Centered Medical Home culture would improve our performance

Providing awards for outperforming competition would increase our desire to win

I would like to be recognized for helping our Patient Centered Medical Home outperform competition

I would like to learn more about how our competitors can affect our income

I prefer to see our Patient Centered Medical Home win rather than lose

I understand why collecting Patient Satisfacation data is important


Is Your PCMH Team Ready To Win Against Growing

Competition?


What is Your Strategic Thinking Mode Under ACA?

TroubleGrowth Even Keel Overconfident

Adapted From Miller Heiman, Inc.

Receptive To Change

Resistant To Change


C = W + L = +C.VEmbrace This

The Strategic Intent of Repeal and Replace the ACA Requires You To:


C = W + L = +C.VMaximize This


C = W + L = +C.VCelebrate This


Questions?

By James P. Young, Jr. [email protected]

www.concordanthealth.com

248.321.3899

Thank You!!!


http://www.concordanthealth.com/

Documents

Strategic Planning Process Under Repeal and/or …Strategic Planning Process Under Repeal and/or Replacement of the Affordable Care Act By James P. Young, Jr. PhD, CPHQ, PCMH CCE CEO