Knowing Our Market and Ourselves Rene Seidel The SCAN Foundation & Lori Peterson Collaborative Consulting

Framework for our Discussion A glance from the field First, stand still Understanding our market Bringing it all together Ideas to action

Knowing Your Market

Environmental Changes in how health care is organized and paid for  Dual Eligible Demonstration Projects  Community-Based Care Transition Projects  Accountable Care Organizations  ……..and other Payment Models o

Knowing Your Market Responsibility for providing medical care AND long-term services and supports falls on health plans  No or little experience with building a provider network for LTSS services  Health plans have basically three options: 1. Build internal capacity 2. Contract with for-profit entities 3. Contract with experienced local CBOs

The Terrain Change in care delivery and payment structures Value vs. volume Honed focus on care coordination Prevention and wellness Penalties and rewards Care delivery in lower-cost settings Chronic disease management High premium for innovation Changing consumer preferences Person-centered care

A Glance from the Field Beyond post-acute care networks Cross-continuum strategies Transitional care initiatives ACOs, Bundled Payments, VBP, Medical Homes Medical and social integration Rapid growth of home-based care delivery Partnering and aligning

The Marketplace is driving Collaboration Integrated care delivery models Providers are seeking scale/ growth Providers looking to trim costs from duplicative services –Incentive to collaborate to capitalize on one another’s differences, areas of expertise Survival Strategy –Blending of resources

What are the Opportunities? Growth and diversification Increase brand awareness Leverage existing expertise and client relationships Create operational efficiencies New service development New partnerships/ collaborations/ referral sources Initiatives: –PAC Networks –CCTP –Medical & Social Integration Advance mission

Discovering the right opportunities for your organization to pursue and ultimately initiate starts with an understanding of your market and your organization’s capabilities to meet what the market is requesting

First, Stand Still Before you rush to a market analysis or master strategic plan, examine the resources internal to your organization -People/ Infrastructure/ Process A strategy’s effectiveness is contingent on the organizational capability to execute it

Organizational Assessment Explore the capabilities and needs of your organization Evaluate your internal landscape –Do we have the aspirational culture? –The eagerness to adapt? –The agility to evolve?

Pre-Work Right people, right position Fluidity for change Process/ system/ infrastructure/ metrics Program evaluation Leadership alignment Honest self-assessment

What is the market asking of us? What futures should we be exploring?

Understanding your market Market evaluation –Market data review –How fast is the market moving toward integrated care? –What are foundations looking to fund? Competitor intelligence –What are our competitors doing? –Our potential collaborators? CBOs looking to sub-contract nutrition, transportation, frequency of social contact How are local hospitals responding? How will their evolving care delivery model change how we serve our community? Risk-bearing entities –Hospital/ ACO –Health plan These entities are “managing their financial risk to maximize profit” - Eli Veitzer, JFS What is our opportunity and more importantly, our value proposition? How do we help them mitigate that risk, while maintaining our core mission?

Stay informed on what is happening in our market Seek to better understand what we don’t know Engage in strategic conversations: assess future risks, challenges and opportunities? Market Pulse

Bringing it all Together Understand your environment –What are the emerging trends? –External market scan: who is doing what, how fast? Understand your organization –Internal assessment –The why? Look for opportunities to build skills/ partnerships –Who is going to help us get to where we are going? –How?

“The future is already here- it is just not very evenly distributed” -William Gibson, 2014

Transforming Concepts into ACTION

Moving from Why to How Assess potential strategies –Narrow down priority initiatives –Which initiatives have the potential for highest impact? Critical factors for successful implementation –Internal assessment; Capacity and skill-building Establish concrete timeline; roles/ responsibilities Cultivate external relationships Create work flow chart Ongoing communication plan and relationship building with key stakeholders (internal and external)

Pre-Work Assessment and Analysis Design and Implementation Measurement Continuous Improvement

Final Questions: What area provoked the most interest for you today? What level of priority does this hold? What action can you take to move your priorities forward? What assistance/ resources are needed? What do you need to learn? How will you do it?

LORI PETERSON COLLABORATIVE CONSULTING THANK YOU!