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| Dear Friend,
The slow fade to irrelevancy plagues not only celebrities and TV shows, but entire industries.
Quick quiz: If a patient or a payor has the choice of having a procedure performed (A) on a hospital inpatient basis, or (B) on an outpatient basis, then, assuming it's safe to perform that procedure on that patient in either setting, at which setting will it be performed?
If your answer was "A," then I suggest that you stay away, far away, from Las Vegas.
Although, in general, physicians will be taking a cut in Medicare reimbursement, this post centers on the continuing shift from hospital inpatient care to outpatient care in general and, eventually, to care delivered in the ASC setting.
As foreshadowed in its interim pronouncement, CMS announced the addition of over 200 billing codes to the 2021 ASC fee schedule for Medicare, and it's almost a given that private payors will follow the lead.
Even more revealing is that CMS finalized its proposal to eliminate the inpatient-only list in its entirety over the next 3 years.
As I stated in the August post . . . shh . . . hang on for second. Can you hear that? Yes, it’s the American Hospital Association screaming.
In the long run, for those physicians performing facility-based services, such as anesthesiologists, these pronouncements are clear signs that unless your business model takes into account the fact that hospitals as we know them will soon no longer exist, your business might soon no longer exist.
And, of course, on the flipside, for all physicians who understand that competing with hospitals on the facility-side is becoming easier and easier, it’s time to consider
ASC development.
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| | | Business Life in the Time of Coronavirus Mini-Series
The coronavirus crisis caused a short term economic crisis for many medical groups. Our mini-series shows you the way out. Plus, many of the concepts discussed are applicable during both good times and bad.
[If you haven't already seen them, follow this link to watch our entire series.] |
| | Watch Tuesday's video here, or just keep reading below for a revised, more polished transcript:
As a medical group or facility leader, you're dealing with problems all the time. Problems of varying types.
But have you ever stopped to consider the importance of questioning whether the problem is something that you can indeed fix, or whether it's something that's either impossible to fix, or so difficult, it's a complete waste of your time?
The distinction is tremendously important. Many leaders look at problems, they call them “challenges”. They think that the challenge can be mastered. But that challenge is so far out of their hands that maybe, just maybe, they have a tiny bit of influence. But the chance of truly doing anything is near impossible. It is a thankless task. It is a task that is (in all probability) doomed to failure.
Many people would tell you, "just keep pushing harder!” No, that's the wrong advice!
If you focus on what you can accomplish, that will get you to where you want to go. Focusing on what you can never accomplish, or on what is so difficult to accomplish, will never get
you anywhere.
I don't mean to ignore things that are difficult, but which can be accomplished. That's an important distinction.
There are some things that many group leaders, and many facility leaders, complain about. When they really think about it, there's just no way they're ever going to effect change.
The classic example is a disruptive physician: Are you ever going to make that physician not disruptive? Are you ever going to make that physician a team player?
Now, maybe you try once. But if the disruption continues, are you going to try to rewrite the code of Dr. X's personality, or are you simply going to get rid of him or her?
I maintain that that is clearly one of the types of problems that can never be solved, can never be changed.
So, if that can't be accomplished, stop wasting your time. Focus on what you can achieve, the pay-off is far better.
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| | How to Deploy the Secret Sauce of Opportunistic Strategy
Webinar On Demand
They say that COVID-19 has changed the world, creating the "new normal." Many of your colleagues and many hospital administrators are running scared.
Others, leaders like you, know that crisis means opportunity.
Let me provide you with the strategic tools and insights that you need in order to seize opportunities, whether they’re in the context of your current business relationships, the expansion of your business activities, or the creation of new ventures.
You will learn:
•Defense as a defective default: It’s necessary, but not sufficient.
•Exploiting weakness: Drop the guilt and identify opportunity.
•Flat line negotiation is fatal: Understand its myths and limitations.
•Negotiation reality: Learn to identify and deploy on multiple planes to affect the outcome.
•Maneuver: Harness the power of maneuver, both in overall strategy and in specific negotiation strategy.
Others see a crisis and freeze in fear. Learn how to see the opportunities and obtain the tools to increase your odds of obtaining them.
The price to attend is $479. The cost of not attending is astronomical. |
| | | Wednesday - Does Your Group Own Its Future or Are You Merely Renting It? - Medical Group MinuteWatch the video here, or just keep reading below for a slightly polished transcript:
Henry grew his restaurant from a shack selling hot dogs into a wildly successful business generating an incredible profit. It took years of labor, great service, and development of superb relationships with customers.
Then it ended.
You see, the restaurant was Henry's sole business. And, it was located smack dab in the middle of a county fairground.
The fact that the county leased the facility out multiple times each week for large events which drew tens or even hundreds of thousands of people, most of whom where hungry
and who had no option of eating somewhere else on the grounds, was no longer of any consequence when the county refused to renew Henry's contract and, in essence, gave
his business to a new "vendor."
In reality, Henry never really owned his business. He was simply its caretaker. He just realized it a bit too late.
in essence, this is the same situation many hospital-based groups have created for themselves. Their entire business is, in essence, located on "leased space," that is, at
a single hospital. And, that lease is probably abysmally short, it might even be subject to termination at any time on 90 days notice.
And soon, due to the wave of financial alignment with hospitals, office-based specialists
will increasingly be in the same boat.
More and more hospitals are more and more upfront about the vendor status they have placed you in. Even if you resisted expansion of your business for years out of some misplaced notion that you would be poaching on your colleagues down the road, pay attention to the lesson of Henry and his restaurant: It was a concession stand -- just as is, in many hospital administrators' minds, your practice.
Whose mind will be easier to change, the administrator's about your vendor status or your own about the need to strategize, and then act, to preserve your future?
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| | | Listen to the podcast here, or just keep reading for the transcript.
I just read that a 30 second spot during this year’s Super Bowl sold for around $4.5 million.
Super Bowl commercials garner all sorts of buzz for being “creative,” but creativity isn’t selling. If you thought it was, just ask RadioShack how it turned out for them: Last year their Super Bowl commercial was feted as extremely creative. This year, according to the Wall Street Journal, they are just or a day or so away from filing bankruptcy.
The problem is confusion of purpose and that’s where this lesson applies to you and to other medical group leaders.
The purpose of business is to gain customers, not to be the most “creative” simply for creativity’s sake. In other words, having ad agencies or the folks who sell ads (television networks, newspapers, magazines, and radio stations) tell you that your advertisement is the most wonderfully creative thing they've ever seen is not the same as causing Ms. Selma Smith of South San Francisco to buy a six pack of Bud.
According to Time.com, Anheuser-Busch’s 2014 Super Bowl ad, “Puppy Love," was voted the top commercial during the game by viewers on Hulu, earned the top spot on USA Today’s Ad Meter, and dominated the other Super Bowl ads on YouTube.
Gee, that’s great. But they apparently put very little Bud in anyone’s fridge: Budweiser sales are down around 50% from 10 years ago.
The purpose of your business is to gain patients and that often means satisfying other customers, too (hospitals, other facilities, and referral sources) in order to have access to those patients. Deliver what those customers want. That’s delivering value.
Don’t do what your competitors are doing just because they’re doing it or because you might get some award for it.
Clydesdales and puppies might bring tears to your eyes but they don’t bring Bud to your lips. |
| | | Calibrate Your Compass
Read our exclusive RedPaper to guide you through this evolving situation.
The coronavirus crisis caused a short-term economic crisis for many medical groups. Our RedPaper shows you the way out. Plus, many of the concepts discussed are applicable during both good times and bad.
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| | Help Us Help You With Helpful Content
What tailored content would you most like to see during this
time? How can we focus on solutions to your most pressing strategic concerns?
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| | | | We all hear, and most of us say, that the pace of change in healthcare is quickening. That means that the pace of required decision-making is increasing, too. Unless, that is, you want to take the “default” route. That’s the one is which you let someone else make the decisions that impact you; you’re just along for the ride. Of course, playing a bit part in scripting your own future isn’t the smart route to stardom. But despite your own best intentions, perhaps it’s your medical group’s governance structure that’s holding you back.
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| In fact, it’s very likely that the problem is systemic. The Medical Group Governance Matrix introduces a simple four-quadrant diagnostic tool to help you find out. It then shows you how to use that tool to build your better, more profitable future. Get your free copy Free.
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| | | | Whenever you're ready, here are 4 ways I can help you and your business:
1. Download a copy of The Success Prescription. My book, The Success Prescription provides you with a framework for thinking about your success. Download a copy of The Success Prescription here.
2. Be a guest on “Wisdom. Applied. Podcast.” Although most of my podcasts involve me addressing an important point for your success, I’m always looking for guests who’d like to be interviewed about their personal and professional achievements and the lessons learned. Email me if you’re interested in participating.
3. Book me to speak to your group or organization. I’ve spoken at dozens of medical group, healthcare organization, university-sponsored, and private events on many topics such as The Impending Death of Hospitals, the strategic use of OIG Advisory Opinions, medical group governance, and succeeding at negotiations. For more information about a custom presentation for you, drop us a line.
4. If You’re Not Yet a Client, Engage Me to Represent You. If you’re interested in increasing your profit and managing your risk of loss, email me to connect directly. |
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