Align the Correct
Solution Supported by
If a hospital seeks a uniﬁed response with its medical staﬀ to a health care payer
system that is coalescing around many new forms of contracting,
is better than less. e same goes for doctors, but they have a diﬀerent perspective
since they may have any number of choices based on their practice discipline and
their time horizon left to practice. Why go through a transition that is costly and
complex when one option may be to simply practice out to the end of a career and
drop the keys on the carpet as you exit the building? Longevity and position in a
market are diﬀerent for a hospital than for a physician. Both need to operate from
some kind of plan or vision of where they want to be in the near-term future.
ese new forms are coming through structures like aﬀordable care organizations (ACOs) and
Centers for Medicare and Medicaid Services (CMS) and other groups that are rediscovering
forms of capitation and population management and bundled pricing. Each market is moving
at its own pace from traditional fee for service to something else. Generally, this “something
else” will have a diﬀerent contracting platform that transfers more risk to the providers and
attempts to measure something that is not now measured—like quality or eﬃciencies or some
other metric that cannot be done by any one set of providers.
Long-term planning aside, health care delivery is a response to near-term needs. Capital that a
hospital develops is certainly a longer-term decision, but many of the diﬀerent aspects of this
book surround short-term and near-term development. Planning horizons of 4 to 5 years are
challenging for anyone in health care. Other authors, the futurists mentioned in the introduc-
tion, can look out 20 and 30 years to a diﬀerent place, but without a near-term plan, the read-
ers of this book will not be around that long.