Hey Siri. Take me to value- based care! · on measure results. “If you can’t identify a decision that could be affected by a proposed measurement and how it could change those

This document (including, without limitation, any product roadmap or statement of direction data) illustrates the planned tes ting, release and availability dates for TIBCO products and services.It is for informational purposes only and its contents are subject to change without notice. © Copyright 2014-2019 TIBCO Software Inc. All rights reserved. TIBCO Proprietary Information.

Hey Siri. Take me to value-based care!

Deborah Bulger, CPHQ

Executive Director, Strategic Programs

Change Healthcare

[email protected]

mailto:[email protected]


Modern navigation

• Route

• Roadblocks

• Rest stops

• Recalculating!

• Restraint(?)


“Healthcare is a little more than 25 years into a

40-year-long transformation from fee-for-

service to value-based payment.”

- Michael Leavitt, president of Leavitt Partners, former governor and HHS secretary

Global Perspectives: Mike Leavitt on Health Care Costs and Higher Education

April 23, 2019


“We can’t predict. But we can prepare.”

- Margaret Heffernan, author, The human skills we need in an

unpredictable world

https://www.ted.com/talks/margaret_heffernan_the_human_skills_we_need_in_an_unpredictable_world


Hey Siri…Take me to value-based care!

Get Set Go!On Your MarkUnderstand the markers that drive

opportunity and action

Define opportunity segments

based on market characteristics

Take the pulse of your own

organization



“Like many hard problems in business

or life in general, seemingly impossible

measurements start with asking the

right questions.”

Douglas W. Hubbard, How to Measure Anything: Find the

Value of “Intangibles” in Business

On Your MarkUnderstand the markers that drive

opportunity and action


Markers

susceptibility to failure in the transition from

fee-for-service to value-based care

ability and willingness to invest in activities

needed to achieve success

Burden Propensity to act

Bed utilization

Hospital compare Star rating

% Medicare/Medicaid revenue

# ACOs/CINs

Revenue from risk-based contracts

Operating margin

Case mix index

Market concentration

Operating expense

VBC penalties


Key characteristics

susceptibility to failure in the transition from

fee-for-service to value-based care

ability and willingness to invest in resources

needed to achieve success

Burden Propensity to act

HIGHHIGH

LOW LOW


Quantitative analysis

Propensity to act HIGHLOW

Burd

en

HIGH

LOW


Qualitative analysis


Burd

en

HIGH

LOW

Fee-for-service market;

tried and failed at ACO

Not taking on risk but

wants to “behave as

though we were”

Early mover with multiple

ACOS, increasing

financial risk

Market climate driven;

outpacing our ability to

“keep up”


Propensity to act

Qualitative analysis


Burd

en

LOW

HIGH

Leverage your “unfair

advantage”

Innovate

“Move the herd” at a

pace they can sustain

Educate & Equip

Design “with a purpose”

Land & Expand

Find a “reason to

believe”

Protect & Defend


Get SetDefine opportunity segments

based on market characteristics


“Life's messy, clean it up, organize it, and

put it into a Bento Box.”

Brene Brown, research professor, author

The Power of Vulnerabilty

https://www.ted.com/talks/brene_brown_on_vulnerability/transcript?language=en


Opportunity Map

HIGH LOW

LOWHIGHLOWHIGH

Burden

Propensity to actPropensity to act


advantage”

Innovate



Educate & Equip


Land & Expand

Find a “reason to

believe”

Protect & Defend


HIGH

HIGH

Burden

Propensity to act

A real unfair

advantage is something

that cannot be easily

copied or bought by your

competitors

Service

Quality & Safety

People

Growth

Cost

Community

Navigation plan

• Capitalize on your

organizational strengths

• Elevate your personal brand


advantage”

Innovate


HIGH Burden

Propensity to act

Desired Outcome

Strategic Goals

Strategic Goals

Strategic Goals

Strategic Goals

Value Milestones

Value Milestones

Value Milestones

Value Milestones

Measure & Reward

Measure & Reward

Measure & Reward

Measure & Reward

Decide what action you will take based on measure results.

Outcomes

Achievement

Plan

LOW



Educate & Equip


HIGH Burden

Propensity to act

LOW

Decide what action

you will take based

on measure results.

“If you can’t identify a decision that could be affected by a

proposed measurement and how it could change those

decisions, then the measurement simply has no value.”

-Douglas W. Hubbard, How to Measure Anything, Finding the Value of “Intangibles” in Business



Educate & Equip


HIGH Burden

Propensity to act

LOW

Decide what action

you will take based

on measure results.

Better

Same

Worse

Up the ante?

Re-evaluate?

Corrective action?

Navigation plan

• Develop an outcomes

achievement plan

• Stay focused on milestones



Educate & Equip


LOW

HIGH

Burden

Propensity to act

5 Stages of Design Thinking

Empathize

Define

Ideate

Prototype

Test

This work is in the public domain in the United States because it was published (or registered with the U.S. Copyright Office) before January 1, 1924.


Land & Expand

https://en.wikipedia.org/wiki/public_domain

https://en.wikipedia.org/wiki/United_States

https://commons.wikimedia.org/wiki/Commons:Publication

https://en.wikipedia.org/wiki/United_States_Copyright_Office


LOW

HIGH

Burden

Propensity to act

This work is in the public domain in the United States because it was published (or registered with the U.S. Copyright Office) before January 1, 1924.


Land & Expand

Empathize

Walk me

through…

Describe

the experience

If I were to

listen in…?

How do

you…?

Navigation plan

• Establish an “early adopter”

• Engage in design thinking


Land & Expand

https://en.wikipedia.org/wiki/public_domain

https://en.wikipedia.org/wiki/United_States

https://commons.wikimedia.org/wiki/Commons:Publication

https://en.wikipedia.org/wiki/United_States_Copyright_Office


LOW

LOW

Burden

Propensity to act

Building A Storybrand: Clarify Your Message So Customers Will Listen, Donald Miller

What does the

hero want?

Who or what is

getting in the way?

What is at stake if

the hero fails?

Who came to

the rescue?

What was the

outcome?

Improve OR

start time

accuracy

Surgeons

arrive late$210,000 per year

in excess cost

Chief of

Surgery80%

improvement

Find a “reason to

believe”

Protect & Defend


LOW

LOW

Burden

Propensity to act


Tell me the “so what?”

Navigation plan

• Departmental initiatives that

improve quality

• Tell your “story”

The personal,

emotional,

meaningful

outcome…the

human narrative.

Find a “reason to

believe”

Protect & Defend


Go!Take the pulse of your own

organization


“One way to motivate action is to make

people feel as though they’re already closer

to the finish line than they might have

thought.”

Chip & Dan Heath, Switch: How to Change Things When

Change Is Hard


Introducing… Explorer Opportunity Map

40


Resources

Books

How to Measure Anything: Find the Value of “Intangibles” in Business, Douglas W. Hubbard

The Organized Mind, Daniel J Levitin


Switch: How to Change Things When Change Is Hard, Chip & Dan Heath

Articles

Leading a team approach to value, Michele Molden, MBA, FACHE https://healthcare-conversation.com/2019/03/26/leading-a-team-approach-to-value/

14 unfair advantages you don't realize your startup has By Chris HeivlyCo-founder, MapQuest, and entrepreneur In residence, Techstars

https://www.inc.com/chris-heivly/14-unfair-advantages-you-don-t-realize-your-startup-has.html

Design Thinking, Interactive Design Foundation Deb's note: "I do not promote any particular methodology, however, this site has a really good outline of the phases of design thinking"

https://www.interaction-design.org/literature/topics/design-thinking

Design thinking in healthcare, Henry Doss, contributer, Forbes, Inc. https://www.forbes.com/sites/henrydoss/2014/05/23/design-thinking-in-healthcare-one-step-at-a-time/#6772d0843f1a

TED Talks/Videos

The Power of Vulnerabilty, Brene Brown https://www.ted.com/talks/brene_brown_on_vulnerability?language=en

It's not fair having 12 pairs of legs, Aimee Mullins https://www.youtube.com/watch?v=JQ0iMulicgg

The human skills we need in an upredictable world, Margaret Heffernan https://www.ted.com/talks/margaret_heffernan_the_human_skills_we_need_in_an_unpredictable_world?language=en

Storybrand One Liner Exercise | Donald Miller | EntreLeadership TakeawaysDeb's note: "This is a great way to both tell your story AND find your "unfair advantage" and brand!

https://www.youtube.com/watch?v=HFergI0UOAs

https://healthcare-conversation.com/2019/03/26/leading-a-team-approach-to-value/

https://www.inc.com/chris-heivly/14-unfair-advantages-you-don-t-realize-your-startup-has.html

https://www.interaction-design.org/literature/topics/design-thinking

https://www.forbes.com/sites/henrydoss/2014/05/23/design-thinking-in-healthcare-one-step-at-a-time/#6772d0843f1a

https://www.ted.com/talks/brene_brown_on_vulnerability?language=en

https://www.youtube.com/watch?v=JQ0iMulicgg

https://www.ted.com/talks/margaret_heffernan_the_human_skills_we_need_in_an_unpredictable_world?language=en

https://www.youtube.com/watch?v=HFergI0UOAs

Documents

Hey Siri. Take me to value- based care! · on measure results. “If you can’t identify a decision that could be affected by a proposed measurement and how it could change those