Signature’s Hometown Revolution Wins Big at Eden Conference

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Earlier this month, we had amazing validation that our leaders are pioneering the Eden Alternative Movement where many previously believed it was for “one-off’s” or “not-for-profit” do-gooders only.

Let me tell you a quick, cool story that will show how dreams manifest when we commit, dig deep, and stay the course – the magic always happens!

Nearly a decade ago, I worked with the Pioneer Network (prior to their leadership change), and believed this “mind-set” needed culture change and a holistic caregiver approach for our organization.

We sent a few young revolutionaries up to Columbus, Ohio to attend their conference and assess culture change pathways, review operability, and decide if we could make it a widespread movement.

Since then, our Hometown Team started their Eden Alternative journey. They have “operationalized” culture change like no other mid-size operator ever!

They built custom culture change training, hardwired it into their daily culture and made it a big part of their vernacular. They also developed intergenerational learning through summer camps, enhanced the universal caregiver into the Holistic Caregiver model, and developed an Eden Alternative Milestone cadence, plus hundreds of other programming efforts that make it all work!

This past week, our team humbly accepted some big, meaningful awards that demonstrate we are a part of the change we all want to see.

Here is the list of winners:

    • Lucy Kennedy, an Elder living at Signature HealthCARE of North Florida, won the Eden Alternative International Elder Award. She was nominated for her work with Senator Gaetz to increase the personal living allowance for Elders living in nursing homes in the state of Florida. The allowance was raised from $35 to $105 per month. Senator Gaetz said Lucy not only inspired him, but impacted his career in a positive way!
    • Phillip Ramey, Chaplain at Riverview Health Care Center, received the Eden Alternative International Care Partner Award for his dedication to the Eden Alternative journey. Phillip exudes enthusiasm, leadership, passion and compassion for those around him, and is dedicated to making Elders’ lives more meaningful.
    • Mountain City Care & Rehabilitation Center won the Eden Alternative Master Gardener Award for their work with the Holistic Caregiver model. They are working on an Eden Alternative Path to Mastery 3, and continue to blaze a trail of innovation in health care modeling.
  • Angie McAllister was awarded the Nancy Fox Leadership Award for her leadership in culture change. She works with 60 homes in Signature’s Hometown segment to infuse culture change practices into the fabric of daily life.

In closing, we now have 28 Signature homes who completed Path to Mastery Milestone 1 and another nine who have completed Path to Mastery Milestone 2. This gives us 37 Signature homes who are fully immersed into the Promised Land and are helping us define the Revolution in a very tactical way!

 

Visiting Normandy Beach for the first time

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From the time when I was little, I enjoyed visiting cemeteries because they show “a deep reverence for life” that I needed to witness in the darkest parts of my own soul. Even today, I still make impromptu visits and make all my children go each patriotic holiday as a family tradition. We spent nearly a full day at Arlington last trip because I feel a deep connection to never forget “them” – them in a broad sense – my parents, war veterans, close friends, and family. Maybe it is as much about me being scared to be forgotten as well.

I can’t really explain it but I have thought about The Normandy American Cemetery and Memorial as a “bucket list” definite. However, I grew up with a deep belief we never need to leave the U.S. for recreational travel until we see all of our amazing country first. Call me a “Hikes Point redneck” if it makes you feel better, but there is just too much majestic beauty in America, that not seeing our own country first somehow made me a less patriotic American. And if anyone of us ever did see all 50 states, we would have seen so much topography diversity, people diversity, and climate diversity; we would not need to travel ever again. At least that’s what I thought until I witnessed Normandy, France last month.

Note: not to mislead anyone here, I have made various overseas trips in my lifetime, but mainly for business interests or a strong link to outside competitive golf, and a few foreign island romantic trips. Things like securing insurance at Lloyd’s of London, examining healthcare opportunities, or investing in restaurants in Beijing, China, and caddying for my kids in a Scotland golf event – just to give you some context.

Being 49, I grew up with World War II history around me everywhere I looked – informally and formally. For as long as I can remember, I’ve read books in civics and history classes in my catholic schools or watched classic movies like the Longest Day, Saving Private Ryan and Schindler’s List. I heard war stories passed down from many different social settings which led me to believe that June 6 to June 8, 1944 are some of our country’s most sacred days that should be true U.S. holidays equal to many we celebrate now.

Being in an “aging care” industry and a Signature stakeholder, we have been blessed to serve and care for hundreds of military heroes and World War II veterans over the past decade. We have inducted many of these great men and women into our Signature Hall of Fame annually, and I’ve had the opportunity to thank many of them personally. I have put them all on such a pedestal because I never served, but I know how blessed we are to live in a “free democratic world” as American citizens.

We all know the epic story: Germany was trying to take over the entire world, eliminate all democracies, Jewish citizens, and establish a supreme uber “master race” that would become the first national world dynasty restoring all their WW1 losses ten times over. We know the D-Day plans designed by Eisenhower, Roosevelt, Churchill, and Patton were beyond high risk on the perfect weather day and the executional risk to make it work on those exact dates that were mere meteorologist predictions at best and took scenario planning to a whole new level.

Most of my generation may have missed seeing the academy winning “Longest Day” but may have watched closely during the beginning beach war scene in “Saving a Private Ryan” in Spielberg’s classic film. The opening scene is where the allied nations attempt to scale Normandy Beach as D-Day started, resulting in massive loss of American soldiers who knew the true risk of their bold assignment. Equally moving is the tearful ending scene at the Normandy Beach military cemetery.

In the final minutes of the movie, after Miller’s passionate imperative, “Earn this,” the camera cuts to an elderly James Ryan standing over Miller’s grave. Tears in his eyes, Ryan speaks to the departed Miller at his grave saying, “Every day I think about what you said to me that day on the bridge; I’ve tried to live my life the best that I could. I hope that that was enough. I hope that at least in your eyes, I earned what you have done for me.”

When you go to Normandy, France and walk the sacred grounds you will be changed forever, I promise. Yes, it is a long drive from Paris and it’s hard to predict the weather, so be flexible, and it is intense so you will leave there exhausted mentally, physically and spiritually!

First, away from the actual cemetery they have left the battlefield there with bunkers intact and the bullet holes, barbwire and bombed watch posts untouched, so when you climb into and look out you feel it – the raging seas, the brutal cold winds of the English Channel, and the improbable feat to make it up the beach walls. You realize if Hitler was not tricked by Patton’s “Operation Bodyguard” – the fake attack on the northern part – he could have taken every Ally Force out easily because the topography and set-up were in his favor and then some.

My lesson: You will realize even in one of our greatest military feats ever, war is so ugly and brutal that we should try to avoid it at all costs. But tyrannical threats who attempt human genocide to the free world must be dealt with and aggressively annihilated before they become too powerful.

Second, Normandy is really five different beaches that are 12 miles long with each having different challenges. So we need to fly over with the paratroopers at Utah Beach, storm the actual beach at Gold Beach with soldiers, reconsolidate allied forces at Sword beach, and get infrastructure into service to support operations and then take out beach heads at Juno Beach. This was due to the German artillery’s superiority and range that unless it all worked out, they would still win.

Personal lesson: You will realize many things went wrong that day and you see how the great liberators pivot, adjust on the fly, master contingency planning, and stay on task despite unfathomable headwinds and obstacles. Life is more about how we overcome our own fears and never forgetting our sacred goals because the world needs Heroes!

Third, I did not know this until the trip – France gave us the “land use rights” forever as a thank you gift for helping the free world save the concept of democracy, government for and by the people, and rid the free world of tyranny at the highest level ever.

With that in mind, the U.S. built a slice of heaven right there where it all happened: because of the synchronized white headstones, the grounds actually illuminate like you might perceive a vision of heaven!

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Remember, nearly 10,000 men and four women all perished at nearly the same time, and all are buried in perfect symmetrical lines, with no distinguishing details noted on the grave markers. With all of them buried together, it takes a casualty number out the textbooks and brings it to life. You feel like you can still hear their voices in the crashing waves on the wall and they are still talking to us even today, telling us to make sure it never happens again.

Personal Lesson: You quickly realize most of us will get to experience a full life (have a family, a career, and reach our potential) as free Americans because these 10,000 died on the same battlefield for each of us on one long summer day. Eighty five percent of these heroes were between the ages of 17-23 and did not get to build a family, a career, or realize any of their dreams, so we all need to leave this world making it a better place in their honor!

Note: The Normandy American Cemetery and Memorial was designed by architects Harbeson, Hough, Livingston and Larson of Philadelphia. It was created to capture various metaphysical feelings that you cannot find in many places in the world as Americans. First, the layout puts the divine God in the center and plants spheres around it with perfect field alignment in each tombstone, reminding us that in the chaos of life uncertainty there is a “divine plan for the world and each of us”. Second, each headstone faces west toward America and reminds us we are all God’s people, regardless of religion preference. This is evidenced as you see cross headstones next to the Star of David headstones all encountering the ultimate goal – spiritual salvation. Last, everyone is equal here on the hallowed grounds and in God’s eye as well, and is a great reminder for all of us.

Personal Lesson: In my struggles and daily frustrations, I sometimes forget there is a greater plan for all of us than we might even know, we are all always equal in God’s eyes and I need to always face toward the “proverbial holy city” in everything I do.

As visions flow over you, you observe multi-generational families in prayer, and you walk the length of four football fields looking at names, dates, and state origins, forever noting state losses were huge, especially in New York and Pennsylvania. You run into heroes like Theodore Roosevelt, Jr., son of a president Teddy, who made the voyage to serve at 56 years old.

And yes, we did search out the two brothers that Spielberg used for Saving Private Ryan. Their last name is actually Niland, not Ryan, and the third brother lived after being captured as a Japanese POW for a year, then was liberated.

You could walk for weeks just to show proper respect to each hero but you have anxiety because it seems impossible to get to each row. After a while, it hits you and you realize they would do it all over again and the regret you had for them in your own heavy heart turns to quiet spiritual peace.

As we all hope salvation feels from our earliest teachings because these timeless leaders quietly tell you they would do over again because they served a greater purpose than themselves. Their ultimate sacrifice has been rewarded by God because he wants his people free, every life equally valued, and his divine dreams for the world are still a possibility.

Most important lesson: People that serve a higher calling rarely have regrets or need a second chance. They live to serve a divine purpose. It is not how long we live; it is what we do with our time. I fear death sometimes too much to really live and I learned a valuable lesson walking with THEM today in how they served their CALL!

What we can learn from Dr. Jay McGowan’s Legacy

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First, I want to disclose that I am extremely biased about President McGowan. Personally, I am very blessed to be a Bellarmine alumni from the class of 1989, and I see the pride that my brother Ray has as a graduate several years before that.

The dates matter because 1990 was the year a young first time president and unproven visionary leader named Jay McGowan (who was only 45 years old) walked onto “the high school on the hill” (as many called it to my dismay back then).

I later became a member of the Board of Overseers for six years and I had the opportunity to see the intimate side of his leadership style up close and personal. The things I learned from President McGowan are immeasurable.

But, I have come up with my top six leadership lessons we should all learn from President Jay McGowan (there are many more but too much to list out):

  1. A great leader must create a vision that is clearly understood by all vested parties from day one so everyone knows what is at stake. Most of us could recite 20/20 vision framework because he painted the full canvas early so we could all see it!
  2. A great leader blends the rich heritage of the past through respecting it greatly, but couples it with the unlimited hopes of the future, so you never lose anyone along the way and everyone can then share in it! I remember crying with alumni from the 1st class in Springfield, MA at our 2011 National Basketball Championship and Jay made us all a big part of that magical day.
  3. A great leader will raise his office and duties to the highest moral and ethical standards possible so the role and office are enhanced to the highest level of accountability. Bellarmine has been a model organization with amazing board representation and record breaking results for 26 years.
  4. A great leader builds great teams through “shared vision”, providing high autonomy for their teams to grow and flourish around them, and ensuring the responsibilities and autonomy are evenly matched so engagement is maximized.
  5. A great leader celebrates the success of everyone around them so we all enjoy the journey and not miss the sacred moments of presence. Every Bellarmine event was a celebration of our people’s “faith and works”. My induction into the Gallery of Distinguished Graduates with Jay by my side is still top moment for me and my family.
  6. All leaders must have deep subject matter expertise but the great ones are renaissance men who have the spirituality, the cultivation, the passion for the liberal arts, and the world views that intersect their eco system together in a very rich way. Every conversation for me was truly just new “learning jewels”.

I remember hosting my first Bellarmine fundraiser in my home at Palm Beach Gardens, Florida nearly 10 years ago at the request of President McGowan, which made me realize three things that night:

  1. Dr McGowan presented a bold compelling vision called “20/20 vision” that left many confounded on how a small successful liberal arts college could make these bold moves so quickly and he never missed a target since those early talks.
  2. As a small university, I did not realize the amazing reach Bellarmine already had that was way beyond Louisville. Cars pulled up to the circle driveway from various coastal spots everywhere to be part of “our special place” that is inside our hearts, but was never a destination for Bellarmine people.
  3. I knew that if he was right, and it all could become a new reality, there would never be a better legacy to leave behind than his 20/20 Bellarmine Vision masterpiece. This changes everyone who touches it and expands our reach now internationally. Since Dr McGowan is now sitting with Saint Robert Bellarmine, it will be our job to finish the last few pieces in his honor.

Thank you, President McGowan, from the entire Bellarmine Family.

What is an Intra-preneurship Pillar Anyway?

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As I reflect back over the founding and formation of Signature HealthCARE with our amazing board in 2007, and the complicated, brutal healthcare environment that we work within today, I am constantly reminded why we have three foundational pillars in place – Learning, Spirituality, & Intra-preneurship. These anchor the organization when we face 200 mile-per-hour headwinds, like we do today, trying to crush our spirit!

Of the pillars, obviously the third pillar, Intra-preneurship, is the harder to understand, visualize or replicate. Many want to call it “innovation,” which is the most over used word today outside of “good.”

As you would expect, everyone gets Spirituality and it is a big attractor, and Learning is what we all need to really grow, but this last pillar seems to suggest we misplaced a word on our web page…

But in a nutshell, it is quite simple: it’s about building “best in class” companies inside of a company, keeping our best leaders forever, and supporting self-actualization so innovators, visionaries, and entrepreneurs may engage within the organization to create a dream factory. Just the other day I saw another example of it alive and well at the Revolution!

Here is the skinny…one of my top, local CEOs Peter Falk (who has been killing it with us for years, has a diverse background in both ALFs and skilled healthcare, and was a partner in developing and operating some ALFs previously), decided to build a new division for the Revolution called Signature Lifestyles. This is a high-tech, innovative environment that is affordable for elders and is our newest partner. Peter said, “Trust me”…and we did!

I was blessed to stand next to Peter at the ribbon cutting this week in Jefferson City, Tennessee in front of a packed house of local officials, legislators, and stakeholders, as we celebrated Signature Lifestyles. This came from a complicated piece of dirt which he delivered beyond my wildest dreams. New construction on schedule and below budget, and is the coolest new product I have seen in the assisted living space!

And for a cherry on top, we got to meet Mrs. Miller, our first customer who moved in before we even opened!

Like every visionary, Peter Falk has it all – beautiful wife Mari working by his side, our ad firm “The Agency”, proud of the new brand they helped create, my top Development Director Tara getting a special award for collaboration, and it hit me – American capitalism is alive and well, great ideas when harnessed can change communities and your best leaders always over-deliver!!

An hour later, sitting with Peter’s father and brother basking in Peter’s success, I asked them what Peter was like as a boy. They told me he was mover and shaker, and the hardest worker they knew and boy, is he smart!

And when I walked away, I kept thinking how blessed we are to have this pillar which creates new revolutionary partners on a regular basis. The Revolution will never die, not because of anyone person, but because the human spirit inspires itself when we let it!

This new organization, Signature Lifestyles, will become a revolution inside of a revolution. How cool is that?

Take a look for yourselves at siglifestyles.com

Are New Year’s Resolution Rituals a Good Thing?

For as long I can remember, it has always been a Steier family tradition to write our New Year resolutions during New Year’s dinner because writing them out and saying them was a way to “claim them”, which is our theory.

For many years we would tape our lists on our private mirrors until the kids found a way to remove them when they started to look bleak and that they might not happen. With all the new technology, we film them now and watch them from the prior year before we start. This has made me realize five important takeaways:

  1. I only deliver on 60% of what I write out as an annual average since I have tracked it!
  2. There are things I always want to do, but never get to because of a lack of personal work life balance that I have never conquered.
  3. Time goes by very fast and the line “this is not a dress rehearsal” by Rose Tremain is more true at nearly age 50 for me then when I was 30.
  4. My kids see how hard it is to execute on their big dream goals because of the sacrifice it really requires. It is more about personal choice than even parenting.
  5. A new start with deep reflection reviewing prior year failures and setbacks is therapeutic and really needed to correct bad habits (at least for me).

Just to increase my own personal accountability and so I feel the pressure to really deliver on the year I embrace being 50, here are mine for 2016:

  1. Get my faith back on track with more daily structure and quiet down the secular noise around me.
  2. Put more time in with my entire family and each of my four children individually. Over the holidays I saw that each has unique life obstacles and special aspirations. I cannot help manifest their journey in a group setting.
  3. Embrace my profession and industry as a true leader who can lead without fear during uncertain times, discern critical decisions with boldness and dig in side by side with my people to show them I understand the work.
  4. Become a better problem solver and true innovator. Healthcare is going through a dramatic and painful transformation and I must embrace the epic challenge and not complain about or make it an excuse.
  5. Lose the 18 pounds I put back on in 2015 from missing work outs, taking off my Fitbit and not recording my calories on “Lose It” daily. It all snuck up on me slowly during 15!
  6. Be a better partner to all ventures including business, civic, and spiritual in a way that brings real value to any organization.
  7. Be a better friend by reducing my personal judgement of others coupled with increasing my ability to forgive, so my world around me feels more connected and the painful pinging in my heart subsides and fills with joy and acceptance.
  8. Turning 50, I want to complete a small bucket list that includes completing my first full marathon, earn my boat captain license, complete another book with my team, and help the Thomas Merton writings become an important film for the next generation of leaders.
  9. Move on finally emotionally from both parents passing away several years back. I have finally dealt with many open issues – way too late – with help from close friends (selling the house, giving away prized possessions).
  10. Find out what happened by locating my birth parents for closure and peace of mind.

In the end, I think getting ready to turn 50 is something you never saw as fathomable when you are young, so it is putting good pressure on me because I know my time is shorter, there is still too much to do, and without improving myself none of it will happen!

When I reflect back, I still feel the pain and suffering that you never thought you could endure or overcome still part of my own soul, l but will never come near to the joy or happiness I have felt along the way.

This year is the year of positive thinking and deep commitment to personal change, because now at my age I can easily become a creature of habit. I just want to get that childhood passion back that I had decades ago to get better, self-regulate actions with good discipline, even if no one else even cares, and be a better version of myself that God knew was possible all along!

Help me be accountable as we move forward together and feel free to share your 2016 personal resolutions because this could finally be our year!!

Catching up with Florida Gov. Rick Scott, and what healthcare providers need from Kentucky’s next governor

Florida Gov. Rick Scott was recently on his road show to recruit and sell the Sunshine State like never before. He also decided to send letters to Kentucky business leaders inviting them to the Sunshine State for expansion, while making time for face-to-face meetings.

Gov. Scott bragged (accurately) about the hundreds of tax reductions he and his team have passed, the new and improved bond ratings, the job creation and the reason he believes he will not need Medicaid expansion. Why? Because everyone will have a job before he leaves office!

Signature is still a large health care provider in our former home state of Florida so we always make time to educate, update, and discuss health care policy in context to the goals of the Revolution. And Gov. Scott was ready for us like no other, to hear how the Revolution was playing out back where I grew up.

I remember when every health care organization bolted from Florida, less than two decades ago because they had the same problems we had today. No one was left when we first started to grab the mailed-in keys, saying, “we left town so good luck!”

I met Gov. Scott a few times over the years related to health care, but he knows the Signature Revolution left the state just six years ago because Gov. Crist and Sen. Atwater thought we were bluffing. So, we moved to the Bluegrass State after much deliberation and a great opportunity. We believe the spirit-led call was the right call, but the painful struggle to help bring about inches of change is beyond any vortex I have ever seen.

This recent meeting with Gov. Scott was much different, though, because I wanted to thank him for the great progress from my limited point of view. I see the change Florida has made since we left, and I don’t love it all, but I love 80% of it. He made hard calls early, helped people anticipate the pain, and then managed like a great CEO would. There is no pension time bomb, there has been a return to prosperity for many, and great discussions are taking place at the health care policy level, led daily by the FHCA team that makes the complicated process work.

I watch Kentucky struggle and be discussed at national conferences in a negative light – at least in my long-term care and post-acute industry – like never before because the data screams for change. It is beyond a crisis, if not an epidemic! Kentucky is now scoring near the bottom in nearly every post-acute category as we struggle through another mud-slinging campaign for governor, awaiting one to emerge and lead us out of health care darkness. The recent ads are definitely the opposite of the Lincoln-Douglas debates that we crave as engaged voters; I wonder if we will ever get it right, here.

Since we left Florida six years ago, I have kept my finger on the pulse of both states’ ability to build consensus and modify policy that yields opposite results. For example…

  • Florida has improved oversight to a culture of performance improvement linked to QAPI goals; Kentucky ranks second to worst in the nation in provider fines, at 10 times the national average.
  • Florida made significant steps to address out-of-control litigation; Kentucky dropped to the worst place in America with out-of-town law firms because of our health care economic engine for growth.
  • Florida is considering rebasing their Medicaid system to a ‘quality outcomes approach’ as we speak; Kentucky sits idle, celebrating the fact that we were one of the first case mix states from the Patton administration.

Florida modified their Certificate of Need (CON) laws and process, providing a hybrid solution that protects legacy providers but creates more flexibility for new capital and new construction; Kentucky has the oldest physical plants in the country, and keeps the tightest CON constraints anywhere in the country.

I watch our governor’s race with great hope for real change. I pray for a more bipartisan approach to unify the Commonwealth, finally, but the health care debate has been impossible to set up, even as board chair of Health Enterprises Network.

Do not take me wrong, we love our team. We love the people’s passion, spirit and commitment to excellence here in the Commonwealth. We have upgraded our senior team to world class here in Kentucky, but we just need the government to finally get things done that take us out of the bottom five quickly, or no other health care organizations will be here long term.

We need the next governor to not be afraid of being a one-timer. Someone needs to pull the Band-Aid off because, as I speak in D.C. this week, my peers laugh at our expanding Kentucky portfolio, thinking we are delusional based upon every meaningful statistic my industry tracks.

No one can argue that we need cabinet change for oversight and punitive tactics during the next administration. We need a plan for medical reform immediately. We need reasonable tort reform, and we need better educational and workforce plans because we cannot find the skilled workforce we need to compete in many rural markets where we try to serve our elders.

Our peers are bolting as we speak, my mailbox is full of medical records requests for the next 50 lawsuits from out-of-state law firms, and we fight through survey wars that are really unnecessary to improve quality in the state.

I still believe something great can happen here, and I pray for every political leaders to pull down the info from these web sites and tell me why we want to be ranked there! Let’s get unified, all share some pain, realize who the real enemy is, and bring it full circle so we become the beacon light that we know we can!

I told Gov. Scott I would see him on my next family vacation or at our new grand openings, where we won a few CONs, but our hearts and minds are in Kentucky – where we can make a real difference.

With that, we strongly urge all our Kentucky stakeholders to go out and make your voice heard!

Which school of thought prepares post-acute providers for future success?

jkw_LHE_041513_208Leaving the LTC100, you could almost feel the ground starting to shake – and you can really feel it.

It is scary for most of us mere mortals who do not have a crystal ball to consider questions like: What is the real rate of change? How much risk can you tolerate? How does operational fatigue play into it all? And how do you get your team on the same page anymore while continuing to focus on core fundamentals that get harder daily, new mental modes required to assess the future, and the cultural implications on all of your stakeholders who just need to provide great care to the more complicated residents, 24/7?

Personally, I could see Anita M. McGahan’s framework of Industry Cycles of Change in many sidebar conversations, even if they did not know they were using it!

There are really too many conferences with spins on same themes, so many talking heads everywhere around us that could operate a lemonade stand, and the plethora of online healthcare futurist bloggers telling us we are all screwed in the end, that we should give up and go into medical tourism.

I ask myself often, ‘how many futurists can you trust without just giving up and throwing in your towel (or in my place, the keys), anyway?’

There seem to be only four distinct schools of thought circling around post-acute providers that I know intimately with no clear, absolute boundaries between them.

Heck, with leadership turnover at many shops, hospital C-suites changing rapidly, and REITs getting scared of future rent collectibility in many tired and dated centers, I always say just pick one that you believe in your heart and go with it.

The schools of thought I run into often…

School 1 – When we do the basics of quality, post-acute services will be chased by everyone so keep it simple, be a late adopter and in the end they need you anyway. Keep solid surveys, keep your team on fundamentals, squeeze your last liquidity left in the core business of fee-for-service and the other vertical healthcare providers will help pay you to convert later?

School 2 – We must be the first to embrace the new healthcare policy, new customer mindsets, and related technologies. Go ahead and grab the ‘halo effect’ and brand equity, because they all need to find innovative providers. During that vetting period, your team can learn things like rapid prototype options and innovation frameworks, and by trying many versions, you will be the first to figure it out. You know your core business is declining daily, so why wait? Recreate like the Blue Ocean framework taught us.

School 3 – What the heck is going on? Heightened regulatory scrutiny, closing networks, hundreds of new middlemen taking pounds of flesh soon, growing staffing challenges, just to name a few. These demands are getting insane and too risky too swallow. The provider has very little upside left – get the heck out of dodge and let one of these futurists or competitors who do not believe it will change buy us because the good days are over. Half of my close peer friends are thinking this way as we speak.

School 4 – Our best days are ahead of us. Just ‘Andy Dufresne’ it, like Shawshank Redemption, because with digital paperless, EMR, hand-held technology, value-based alignment, gain sharing, more transparency, and lower costs, we are going to win big anyway!!! We will be ahead of surveyors finally, see customer activity virtually, and that old way was misaligned anyway. So let’s get on with it and finally make some real hay in a more aspiring way – because when it finally turns, it will be beautiful.

Here, where we are at the Revolution today, we try to live School of Thought #2, but every time we stumble big time, we revert back to School of Thought #1. But School of Thought #4 will make all of the pain turn to joy someday if we can just see the mountaintop.

There are so many mixed signals from external forces that make it challenging to get everyone on the same page, so over-communicate if time permits and don’t ever give up because they all need us even if they act like they don’t. We are still the most inexpensive service that no one ever wants, but many really need like never before.