What Is Your Team’s “Kryptonite?”

Media pundits, industry experts, ombudsmen, and just about everyone else in the United States is shifting the volume on healthcare reform up as 2014 implementation strategies approach.  Before turning up the noise, it is worthwhile to step back and examine the experience of the Pioneer ACO’s.  Of the thirty-two pioneer ACO’s, eighteen had a savings and fourteen generated losses.  Thirteen were generated savings and retain $76.1 million (in total); two increased costs, together they owe $4.5 million to Medicare.

The leadership of these organizations are entrenched in their analytics and analysis.  Moving beyond the Excel worksheets and charts, a question that must be asked addressed the level to which the organization’s physician leadership is engaged.  Is there a team present?  Most importantly, are the dynamics of that team positive?

The Mayo Clinic, Intermountain Health, Marshfield Clinic, The Cleveland Clinic have devoted years to building a physician and lay leadership structure focused on:

• Common team purposes and mutual accountability,
• Maximization of the unique, individual skills of each member of the team, and
• Working within a supporting environment.

The last decade has experienced exponential change in working relationships between physicians and non-clinical leaderships.  The impetus for creating greater integration is cost savings, quality enhancement, enhanced patient experiences and care.

An industry of accountants and attorney’s has paved the way for integration to occur.  The journey is strewn with different models, strategic plans, and consultant fees.

A result of these various integration models is focused attention on who is to be part of the team and sit at the table, the composition of the team – size, skills, roles, and the financial reward structure associated with successful team management.  All of this is important; if each element of the team’s structure works seamlessly, it doesn’t mean that the physician and non-clinical players are able to reach agreement, support innovative thinking, or move toward the highest levels of quality versus hitting a perfunctory targeted outcome level.

For the Pioneer ACO’s to be successful, physician integration is required to move pass the legal structure and achieve higher levels of quality outcomes.   Aggressive team members cannot be permitted; team members whose deference to the team forces them to withhold their own thoughts will destroy a team’s ability to achieve the highest outcome.  Either behavioral extreme severely restricts the potential of a team to be successful.

Faced with a decision to accept risk, or not, requires much more than the appropriate or perceived correct roles sitting around a table in a meeting.   These discussions require individuals to speak candidly, honestly, openly, and recognize the value of reaching agreement versus consensus.

Integration of various professionals with different backgrounds, experiences, skills, and tools is inherently a diverse team.  The strength required to build care delivery models that have not existed before is significant.   The source of that strength is the dynamics of the team.  The “kryptonite” of the team is its sole focus on infrastructure.

Source:  CMS.

Source for Picture:  http://x3lectric.deviantart.com/art/Superman-Kryptonite-Power-45069969