We’ve all heard the expression ‘change is constant’ but what does that really mean for organizations in the midst of massive industry shifts, new business strategies, or organizational restructuring? The short answer to travel the fastest and most effective transformational superhighway is to take change management capabilities in-house.

Transformation has become a permanent state-of-being for organizations instead of the event it used to be with an exciting beginning, a fear-filled trough in the middle and a defined end. Companies can no longer delegate the change function to an army of consultants because the nature and origin of the change are becoming too complex. Today, projects morph, mergers and acquisitions take place mid-project and new competitive forces change strategies faster than in the past.

This bumping into and layering change on top of one another is causing confusion and slowing progress. Managing change, therefore, must become an organization-wide skill for your company to effectively fulfill strategic objectives.

Change management capability needs to be incorporated appropriately at every level to equip your organization to handle the layers of change it requires to meet its business objectives. Done successfully, the path to innovation experiences less go-to-market friction. Organizations gain the ability to be nimble to meet market conditions while improving the capabilities of their team instead of exhausting them in a confusing haze of change.

First, acknowledge change impacts your organization’s effectiveness
Too often we see leaders ignore or stiff-arm the soft skills needed to lead a team through change. When you ignore or fail to recognize the need to get your organization on board with a new direction, productivity drops and errors increase. People need a vision or a ‘why’ behind the strategy before they upend their way of operating to help your new objective. Give them the why early and often and progress toward the desired outcome will come much more quickly.

Second, build change capability within the team
Skip the army of outside change-makers. In the age of outsourcing, cross-functional team transformations, and the importance of speed-to-market, managing change needs to shift to an in-house function. The complexity of enterprise operations simply requires a daily awareness that is too costly for outsiders to completely embed themselves in–you may as well employ them. It’s Capto’s position that it is better to build the capability within existing teams.

Not every executive, VP and manager must take on the full cycle of change, but they do need to understand their role in making change happen quickly and effectively. Executive sponsors set the tone for the strategic change taking place. Their role is to establish the vision and generate excitement and buy-in for the business objective. It’s also their job to sustain the vision when the project pivots course, hits delays and achieves milestones along the way. It’s key to be transparent and keep the vision—the outcome—top of mind for the team.

Project leadership knits vision and execution together. Their role is to communicate up, down and across the organization even when—especially when—the change effort hits difficult roadblocks, time and budget delays or competition from other priorities. The importance of communicating when things go well in addition to when they veer off-course cannot be stressed enough. Employees understand imperfection, but they run scared when they know the project is off-target and there is silence at the top. It’s better to take on the temporary disgruntle of a shift in the project than to send valuable resources into a downward spiral of job security and performance panic.

Project managers already have the technical and organizational skills to move projects through the organization. The communication is more tactical on this level. It needs to motivate, quell fear, reward progress and create urgency all at the right time. The project manager also needs to identify and escalate validated concerns up the chain to reinforce support of the project and the team.

Managing Change In-House Leads to Stronger Teams that Reach Goals Faster
When change is fluid inside your organization, your project fatigue is reduced, employees are motivated by the transformation and the team’s overall productivity is increased. Ultimately, developing your in-house capability change allows you to reach your goals faster with a team ready for more.

Article originally published in HiMSS Business Edge.

With the ACA repeal not clearing its first legislative hurdle, it appears that Obamacare will remain in effect for the foreseeable future. Payers and providers will need to continue to work together to implement new payment models that maximize performance for both parties under the ACA and MACRA frameworks.

Currently, ACO models promise to align payers and providers around the shared goals of keeping patients healthier and thus reducing the cost of care. In practice, however, creating the actual contracts that transform that theoretical alignment into mutually acceptable business commitments has been elusive. Two of the primary reasons for this have been organizations not understanding which types of alternative payment models will be the best fit for their organization, and not knowing how to structure payment contracts to maximize their immediate and strategic value to the organization.

 Figure 1: Payment Model and Organizational Model Relationship

Understanding where the care organization is along the value-based spectrum is necessary to determine which type of payment and risk sharing models are most appropriate – see Figure 1 below1.  As the figure illustrates, you should not enter global capitation arrangements with up and downside risk if you are a small independent practice. It is critical to first understand the payment models to maximize your returns and outcomes for patients.

Once the right payment model is determined, it is necessary to bring in the right team to ensure success.  Don’t be reluctant to leverage the external ecosystem to assist you in developing the right contracting terms and providing the data you will need to make informed and timely decisions.  ACOs often structure partnerships to maximize the value they can expect from various parties, including:

• Actuaries – Actuaries can help ACOs understand statistical, financial, and patient population trends.  Actuaries can also assist in developing risk models.
   
• External Data Sources & Analytics-as-a-Service Providers –The more data sources you have and the more robust your ability to run predictive analytics on that data, the better your financial and quality decisions will be.  Analytics also provides the ability to monitor and adjust as you go based on KPI’s. Leveraging Insights-as-a-Service (IaaS) providers simply allows you to buy answers to specific queries instead of building your own analytics infrastructure, often presenting a faster and less expensive path to the desired outcome.  
   
• Payers – Entering into ACO contracts with payers should not be thought of as a zero-sum game.  Any data, analytics, or technical support that can be supplied by the payer can often be further leveraged for the success of both parties.

 In keeping with the idea that this is not a zero-sum game, be sure to align the incentives down to the practitioner level. Creating a tiered shared incentive plan based on the overall goals of the ACO with all practitioners will drive the desired outcomes. 

Providers and payers alike face significant upheaval in how business is conducted, and how care is delivered and reimbursed. With forethought, planning, and well-structured partnerships you can maximize your incentives, pursue strategic goals, increase quality, and boost margins.

1 Source: Adapted from Shih A, Davis K, Schoenbaum S, Gauthier A, Nuzum R, Mccarthy D. Organizing the U.S. Health Care Delivery System for High Performance. The Commonwealth Fund. 2008.

Capto's CEO, Tracy Currie, was recently interviewed by Telecom Rambling's editor, Rob Powell. Their discussion covered IoT in telecom and healthcare, big data and IT investment strategy.

Read the interview.

Projects are the primary implementation vehicle of the corporate strategy. Insights into the progress, roadblocks and speed bumps of those projects is the critical role your Project Management Office (PMO) needs to perform flawlessly. The PMO tracks corporate strategy and ensures the project portfolio contains the right projects and resources to ensure the expected return on the strategy.  Properly performing PMOs should be identifying and alerting the executive team of projects drive further investments and alerting the executive team to need of projects that require reprioritization, additional support, postponement, scaling back, or even cancellation to deliver the strategy.

Here’s the problem. PMOs often underperform—badly.

Batting .500 in baseball is all-star performance, but a PMO performing at 50%—or even 62% (see Figure 1)—is a dismal commentary on the current state of project outcomes. If your supply chain performed at this rate, there would be serial pink slips. The Project Management Institute’s recent survey estimates $122 million wasted for every $1 billion invested (12%). Worse still is spending money this poorly on the wrong projects. Ouch.

Think of it this way. Your team is climbing a mountain and you’ve underestimate the food and water needed. No one sounds a warning. Half of the team doesn’t make it and is strewn along the the trail. Those that summit see that a competitor has already summited the correct mountain–right next door. You are left with a delayed strategy that is relying on an exhausted, famished, and demoralized team.

Figure 1: Project Management Institute, 8th Annual Project Management Survey, 2016

PMOs have been around for a solid 20 years, and it is still often the weakest strategy link beleaguered in scope creep, which eats up valuable time, intellectual capital, motivation and budget dollars.

What Your PMO Should Be Doing for You

PMOs must understand available resources in terms of budget, talent (skill and capacity), and leadership (ability to drive change, build organization capability in the right areas in the right sequence).

Governance of, and transparent and appropriate visibility into, programs and projects is key to optimizing your organization’s performance. The PMO must communicate with the leadership team to make game-time decisions on priorities, asset investment allocations and strategic shifts.
The PMO should be flawlessly executing on the following:

• Verify, through a cross-functional intake process, that the projects be approved for execution are the correct projects, in the proper sequence, to effectively implement the corporate strategy.
• Organize programs in a way that creates synergy, coherence, and coordination between projects.
• Determine if individual project managers have the tools, skills, and resources needed for success.  This includes all necessary governance processes and metrics to evaluate the health of the entire portfolio.

A Poor-Performing PMO Means Your Strategy Fails

A strategy without execution is a waste of time.  PMOs, by definition, should be a high-performing, critical capability to effectivity and efficiently execute on the right things, in the right sequence at the right cost.  Full stop.

MedCity News recently published my article on the benefits of Insights-as-a-Service, which moves your investment closer to the actionable insight faster than building and uncovering it in-house.

Photo: MedCity News

Buy (don’t build) healthcare data insights to improve data investment ROI

Healthcare organizations have been investing heavily in big data analytics, software, hardware, staff, and services to get insights into quality and cost. These insights will be critical as healthcare facilities take on more and more risk in a value-based care model. About 40 percent of healthcare providers are expanding IT budgets, a recent IDC Health Insights report revealed. The report noted that analytics is the top reason for the increase.

However, building an analytics-driven practice is just a midway point to the insights that healthcare organizations need to fully leverage their data investments...

Read the MedCity Article