Posts
Like it or not, the Game Has Changed. So too must productivity. To simply maintain productivity is to fall further behind every day. Why? Because reimbursement continues to erode - a trend that is certain to continue given rising healthcare costs.
By way of a recent example, California experienced a significant decrease in Anthem Blue Cross reimbursement for PT providers ($75/visit cap) this month (Feb 2010). Meanwhile Anthem also announced premium increases for members of 39%. Then of course there is the proposed 21+% decrease in Medicare fees for 2010... Will there be more cuts? Count on it!
With eroding payments productivity must increase if compensation and profits are to be maintained, much less increased. And of course, increased quality of care does not come without investment!
So what does it take to improve productivity in practices today?
1. It begins with acknowledgment that: the “Game has Changed” and that the pace of change is quickening and irreversible... that productivity in current business models is not stable, sustainable, or scalable... that it's time for decisive action.
2. It progresses in dialog with key stakeholders with whom tough realities are discussed candidly and unemotionally, and implications are explored broadly. A consensus is formed and articulated as nonnegotiable business principles.
3. The dialog then expands to engage staff in a series of conversations (not presentations or proclamations) through which realities are explored, shared understandings are formed, implications are considered, loyalties are tested, and commitments are volunteered.
4. It is through talking, dreaming, debating, and yes, arguing that comprehensive plans are formulated and funded.
5. The Game Changes. The implementation of priorities, performance standards, training, responsibilities/accountabilities, work processes/flow/deliverables, information systems, advancement and compensation are all part of the process.
6. Finally, those Changes are leveraged to secure new business opportunity and competitive advantage for profitable growth!
Anything less, is less than serious. Anything is will predictably fail. The cost of not improving productivity is high.
The need for such change surpasses individual practices and encompasses the profession in its entirety; including professional and trade associations, universities that prepare professionals, continuing education, and even vendors. But first, it will take root and form in a small nucleus of practices that will set the pace for the profession and will find considerable opportunity and reward in doing so.
Productivity is a potent Game Changer and potency is what the current market environment demands.
Futures are being determined in the productivity decisions that are made and in the actions that are being taken, whether those decisions are consciously intentional or not.
The automobile industry is being framed by fuel efficiency and value; and so too is the health industry.The game has moved from the friendly, comfort, and predictable to the aggressive, competitive, and chaotic. The new game is fueled by productivity and innovation. The market demands that we lead, follow or get out of the way. Which will it be?
Are you a Game Changer? Got your game face on? Got your game on?
Get productive!
In the next Game Changer post we'll consider Utilization...
All The Best!
Bob
© Copyright 2010
Performance Builders
Tuesday, February 9, 2010
Saturday, February 6, 2010
Thursday, February 4, 2010
Game Changers - Productivity (Part 2 of 3)
To repeat where we left off...
While external factors have had their impact on productivity, there have also been critical internal factors at play – education and training, infrastructure investment, management priorities, and matters of professional comfort and convenience.
Despite the elevation of entry level education to the doctoral level for PTs, most enter the profession with little if any business orientation; this despite the fact, that healthcare accounts for 1/6th of the US economy.
Most therapists also arrive with little if any structured training or experience in delegation to support staff – even to staff who are credentialed professionals (e.g. PTAs). Task stratification, work assignments, and supervised delegation are cornerstones of productivity but remain under leveraged at best and unleveraged at worst within the profession. The result is underperformance and unnecessarliy constrained capacity within practices and the profession as a whole.
Infrastructue investment has been another internal detriment to productivity. Simply stated there has been too little. There are also matters of investment with good intentions but disappointing results. A prime example of that is the current rush toward the perceived need for electronic medical records in rehab with too little regard or understanding of productivity and return on investment implications. (more about that in another post).
It is extremely rare to find practices strategically and systematically investing in making their people more productive. That despite the fact that practices are service based with labor the single largest expense. Optimizing staff productivity and capacity through training and infrastructure investment should be the primary expense management strategy of practices but seldom is!
Too often productivity improvement is no more than owners, administrators, or managers periodically mounting their bully-pulpit or soap-box to threaten, admonish, cajole, plead, or beg staff to work harder or longer or to bill more units. Staff without adequate understanding, training, systems, resources, performance standards and accountability are not to blame, and thus are not the primary solution.
Productivity begins with purpose, leadership, strategy, and investment. It begins with an end in mind and is executed with passion and attention to detail. Only then can the benefits of productivity be harvested and respect for individuals be protected.
That is not to say that front line clinical professionals are not a critical part of the problem and of the solution. Professionals are afterall people first. All people have a tendency to do what they perceive to be in their own best interest. Work related comfort and convenience are important.
Change takes energy and comes with uncertainty. Lives are busy. One-on-one services packaged in one hour appointments for all patients, without delegation responsibilities are comfortable and satisfying for the professional on multiple levels. But, it is neither a clinical or business model that is financially stable, sustainable, or scalable! That’s the simple truth.
Let’s be honest and respectful with each other – it’s the way professionals relate. There is a significant culture of comfortable productivity that dominates the rehabilitation profession. That culture is protected and perpetuated whenever the quality trump card is played in productivity discussions.
Why does it have to be quality or productivity? Why not quality and productivity? It is where quality and productivity intersect that value is created, patients and communities benefit, professions are advanced, and future opportunities are secured. Professional advancement, job security and financial prosperity is dependent on value creation as measured by clinical and business outcomes – not one or the other, but BOTH.
Only by enhancing productivity and value (i.e. providing better results for more people at less cost) can professional security and prosperity be expanded. The simple reality is this: the need for health, rehabilitation, and fitness services is increasing rapidly and will continue to do for several decades. Those who expand capacity and value will be well rewarded. Those who don't will eventually be replaced. It is the way of the market. There is no place to hide. It is true for professionals, practices, and the profession. Evolve and adapt or go extinct.
Productivity is a measure of contribution, relevence, value, and vitality. Productivity is a matter of professional pride and possibility. Productivity means potential and prosperity. Productivity is a Game Changer!
Leading practices are Changing the Game today! They are doing so from the inside out while they have time. They are not blaming others and are not waiting for the inevitable. They are listening to the worries, needs, and preferences of the communities they serve. They are responding with new services provided in new ways with enhanced value to more people. And, they are being recognized and rewarded. They are sparking a revolution.
It was during the American Revolution that patriot Thomas Paine said, "Lead, follow, or get out of the way!" And so it is today with productivity in healthcare...
To be Continued...
All The Best!
Bob
© Copyright 2010 Performance Builders
While external factors have had their impact on productivity, there have also been critical internal factors at play – education and training, infrastructure investment, management priorities, and matters of professional comfort and convenience.
Despite the elevation of entry level education to the doctoral level for PTs, most enter the profession with little if any business orientation; this despite the fact, that healthcare accounts for 1/6th of the US economy.
Most therapists also arrive with little if any structured training or experience in delegation to support staff – even to staff who are credentialed professionals (e.g. PTAs). Task stratification, work assignments, and supervised delegation are cornerstones of productivity but remain under leveraged at best and unleveraged at worst within the profession. The result is underperformance and unnecessarliy constrained capacity within practices and the profession as a whole.
Infrastructue investment has been another internal detriment to productivity. Simply stated there has been too little. There are also matters of investment with good intentions but disappointing results. A prime example of that is the current rush toward the perceived need for electronic medical records in rehab with too little regard or understanding of productivity and return on investment implications. (more about that in another post).
It is extremely rare to find practices strategically and systematically investing in making their people more productive. That despite the fact that practices are service based with labor the single largest expense. Optimizing staff productivity and capacity through training and infrastructure investment should be the primary expense management strategy of practices but seldom is!
Too often productivity improvement is no more than owners, administrators, or managers periodically mounting their bully-pulpit or soap-box to threaten, admonish, cajole, plead, or beg staff to work harder or longer or to bill more units. Staff without adequate understanding, training, systems, resources, performance standards and accountability are not to blame, and thus are not the primary solution.
Productivity begins with purpose, leadership, strategy, and investment. It begins with an end in mind and is executed with passion and attention to detail. Only then can the benefits of productivity be harvested and respect for individuals be protected.
That is not to say that front line clinical professionals are not a critical part of the problem and of the solution. Professionals are afterall people first. All people have a tendency to do what they perceive to be in their own best interest. Work related comfort and convenience are important.
Change takes energy and comes with uncertainty. Lives are busy. One-on-one services packaged in one hour appointments for all patients, without delegation responsibilities are comfortable and satisfying for the professional on multiple levels. But, it is neither a clinical or business model that is financially stable, sustainable, or scalable! That’s the simple truth.
Let’s be honest and respectful with each other – it’s the way professionals relate. There is a significant culture of comfortable productivity that dominates the rehabilitation profession. That culture is protected and perpetuated whenever the quality trump card is played in productivity discussions.
Why does it have to be quality or productivity? Why not quality and productivity? It is where quality and productivity intersect that value is created, patients and communities benefit, professions are advanced, and future opportunities are secured. Professional advancement, job security and financial prosperity is dependent on value creation as measured by clinical and business outcomes – not one or the other, but BOTH.
Only by enhancing productivity and value (i.e. providing better results for more people at less cost) can professional security and prosperity be expanded. The simple reality is this: the need for health, rehabilitation, and fitness services is increasing rapidly and will continue to do for several decades. Those who expand capacity and value will be well rewarded. Those who don't will eventually be replaced. It is the way of the market. There is no place to hide. It is true for professionals, practices, and the profession. Evolve and adapt or go extinct.
Productivity is a measure of contribution, relevence, value, and vitality. Productivity is a matter of professional pride and possibility. Productivity means potential and prosperity. Productivity is a Game Changer!
Leading practices are Changing the Game today! They are doing so from the inside out while they have time. They are not blaming others and are not waiting for the inevitable. They are listening to the worries, needs, and preferences of the communities they serve. They are responding with new services provided in new ways with enhanced value to more people. And, they are being recognized and rewarded. They are sparking a revolution.
It was during the American Revolution that patriot Thomas Paine said, "Lead, follow, or get out of the way!" And so it is today with productivity in healthcare...
To be Continued...
All The Best!
Bob
© Copyright 2010 Performance Builders
Tuesday, February 2, 2010
Quotable - Truth Series
"Fear has silenced the voice of truth in your world, and this is the anguish with which you struggle." - Emmanuel/Pat Rodegast
Saturday, January 30, 2010
Game Changers - Productivity (Part 1 of 3)
The Western civilization’s enviable standard of living that we have come to take for granted is premised on improving productivity in the workplace – i.e. reliably doing more for less year after year, decade upon decade. In fact, US productivity has improved an average of 2.7% compounded annually over the last 50+ years. Productivity defines our standard of living and determines its sustainability.
Productivity is the fuel that drives prosperity. Productivity is a huge Game Changer. Prosperity follows productivity trends upward and downward! Prosperity erodes when productivity remains stagnant in an improving economy; and turns toxic in falling economic times.
Rising prosperity for rehabilitation professionals over the past half century has been leveraged largely by labor shortages, limited competition, relative affluence in matters of reimbursement, and limited financial accountability. But that is past tense.
Things began to change, first in the mid 60’s with the introduction of Medicare, and then again in the 90s with the introduction of managed care and its various derivatives. Both were Game Changers. Changing population demographics, particularly aging and obesity, along with technology costs, and administrative overhead drive the emerging national health cost crisis. It too promises to be a Game Changer.
With Medicare came increased documentation burdens that began to compete with patient care resources. Then came Intermediaries, fee schedules with ICD-9s, CPTs, RBRVUs, prospective payment with reimbursement literally by the minute, and rules – the rule of 8s, the Rule of one-on-one, and so on...
With Managed Care came more documentation demands, Gate-Keepers, preauthorization, provider networks and contracts, more fee schedules and various payment caps.
Together Medicare and Managed care have operated on the premise and claim of enhancing quality of care – who could possibly be against that? And to be fair, there have been benefits to the public. But also to be fair, operationally "quality of care" has primarily translated into rule based strategies that have helped assure third party payer profitability at the expense of provider productivity.
Such controls are not conducive to productivity or innovation; both of which are critically needed in the context of national health challenges inclusive of the expanding physical functional needs of the US population to remain healthy, independent, and avoid costly institutional care. Where would innovation, capacity, and culture be in emergency departments if they were operated and reimbursed like rehabilitation departments?
While those external factors have had their impact on productivity, there have also been critical internal factors at play – education and training, investment, management, infrastructure, and professional convenience. We will consider internal productivity matters and attitudes next post.
To be continued...
All The Best!
Bob
© Copyright 2010 Performance Builders
Productivity is the fuel that drives prosperity. Productivity is a huge Game Changer. Prosperity follows productivity trends upward and downward! Prosperity erodes when productivity remains stagnant in an improving economy; and turns toxic in falling economic times.
Rising prosperity for rehabilitation professionals over the past half century has been leveraged largely by labor shortages, limited competition, relative affluence in matters of reimbursement, and limited financial accountability. But that is past tense.
Things began to change, first in the mid 60’s with the introduction of Medicare, and then again in the 90s with the introduction of managed care and its various derivatives. Both were Game Changers. Changing population demographics, particularly aging and obesity, along with technology costs, and administrative overhead drive the emerging national health cost crisis. It too promises to be a Game Changer.
With Medicare came increased documentation burdens that began to compete with patient care resources. Then came Intermediaries, fee schedules with ICD-9s, CPTs, RBRVUs, prospective payment with reimbursement literally by the minute, and rules – the rule of 8s, the Rule of one-on-one, and so on...
With Managed Care came more documentation demands, Gate-Keepers, preauthorization, provider networks and contracts, more fee schedules and various payment caps.
From a productivity perspective such regulatory add-ons over time also resulted in the evolution of cumbersome and inefficient practice operations. The efficiency never got built in because systems were layered rather than integrated. The result was operational fragmentation, redundancy, and gaps which are now apparent in diminished productivity that goes unrecognized because "its always been that way" and staff accept it because, "that's just the way it is".
Like an old home that has been repeatedly remodeled over the years, evolved practices just don't flow right because they were designed for compliance not efficiency.
Efficiency is compromised in practices by communication systems, paper work and documentation, work processes and flow, facility layout, construction and traffic patterns, and so much more.
Productivity has also been compromised by the going and coming of staff over the years. Each introduced new layers of operational clutter by importing old compliance forms and processes they packed along from practices where they had previously worked - not because they were efficient but because they were familiar.
With layers, clutter, and variation comes inefficiency. Routine work that needs to be performed repeatedly should be performed consistently with optimal efficiency. The criteria for performing such work should be fast, cheap, and accurate where one size fits all.
Like an archeological dig, the excavation of a practice tells a story of evolution over time. And, practices like garages benefit from periodic reorganization. In practices the reorganization is less physical than it is operationally strategic. The result when done well can transform productivity.
Together Medicare and Managed care have operated on the premise and claim of enhancing quality of care – who could possibly be against that? And to be fair, there have been benefits to the public. But also to be fair, operationally "quality of care" has primarily translated into rule based strategies that have helped assure third party payer profitability at the expense of provider productivity.
Such controls are not conducive to productivity or innovation; both of which are critically needed in the context of national health challenges inclusive of the expanding physical functional needs of the US population to remain healthy, independent, and avoid costly institutional care. Where would innovation, capacity, and culture be in emergency departments if they were operated and reimbursed like rehabilitation departments?
While those external factors have had their impact on productivity, there have also been critical internal factors at play – education and training, investment, management, infrastructure, and professional convenience. We will consider internal productivity matters and attitudes next post.
To be continued...
All The Best!
Bob
© Copyright 2010 Performance Builders
Thursday, January 28, 2010
Monday, January 25, 2010
Game Changers - Restructuring (continued...)
Now, I’m not suggesting that “the sky is falling” but the imperative to re-imagine, re-structure, re-tool, and re-create health service practices should be obvious. The signs and symptoms are all around us.
Leading practices are pausing to take the time to carefully examine practice performance, to reassess purpose and priorities, to reconsider business models, to redesign operating systems. to streamline processes, to reinvent service offerings, to re-message marketing, to redistribute responsibility and accountability, to reinvigorate or replace staff, and to reap new rewards.
“To become something new we must first acquire all that we can no longer be.” – Kevin Kelly
Every practice begins with an entrepreneur’s vision and passion. Risks are taken and along hours are committed to make things work – there’s no excess baggage and focus is keen. But over time, entrepreneurs settle-in or move-on. Practice priorities shift from “make it work” to “keep it working”. There is a certain comfort, albeit a false comfort, in status-quo. Remaking a Practice requires a return to its entrepreneurial roots which may, or may not, have remained with the practice.
Restructuring for success begins with an entrepreneur’s vision and passion... something leading practices understand and something other practices will never quite get.
It’s very likely that your practice is built on a foundation of management philosophies, business models, marketing strategies, clinical techniques, and operational systems that are at least three to four decades old. It’s prudent to ask if that foundation is sustainable for another decade or more.
This year, 2010, marks the beginning of a new decade. Is it time for you to wring out the old and ring in the new? Is it time for your Extreme Practice Makeover? Will your practice value rise with its relevance or fall with its failure?
It has been said that, “Every practice is perfectly designed to get the results it gets!” What is the design of your practice?
Today there is an opportunity for you to decide. Tomorrow the market may decide for you.
In my next post, we will consider game changing productivity.
All The Best!
Bob
© Copyright 2010 Performance Builders
Leading practices are pausing to take the time to carefully examine practice performance, to reassess purpose and priorities, to reconsider business models, to redesign operating systems. to streamline processes, to reinvent service offerings, to re-message marketing, to redistribute responsibility and accountability, to reinvigorate or replace staff, and to reap new rewards.
“To become something new we must first acquire all that we can no longer be.” – Kevin Kelly
Every practice begins with an entrepreneur’s vision and passion. Risks are taken and along hours are committed to make things work – there’s no excess baggage and focus is keen. But over time, entrepreneurs settle-in or move-on. Practice priorities shift from “make it work” to “keep it working”. There is a certain comfort, albeit a false comfort, in status-quo. Remaking a Practice requires a return to its entrepreneurial roots which may, or may not, have remained with the practice.
Restructuring for success begins with an entrepreneur’s vision and passion... something leading practices understand and something other practices will never quite get.
It’s very likely that your practice is built on a foundation of management philosophies, business models, marketing strategies, clinical techniques, and operational systems that are at least three to four decades old. It’s prudent to ask if that foundation is sustainable for another decade or more.
This year, 2010, marks the beginning of a new decade. Is it time for you to wring out the old and ring in the new? Is it time for your Extreme Practice Makeover? Will your practice value rise with its relevance or fall with its failure?
It has been said that, “Every practice is perfectly designed to get the results it gets!” What is the design of your practice?
Today there is an opportunity for you to decide. Tomorrow the market may decide for you.
In my next post, we will consider game changing productivity.
All The Best!
Bob
© Copyright 2010 Performance Builders
Saturday, January 23, 2010
Game Changers – Restructuring
Perhaps the ultimate Game Changer response to changing trends in the marketplace could be described as Extreme Practice Makeover (EPM). Market leaders have already begun.
Like the hit TV show Extreme Home Makeover, it’s “down with the old and up in the new.” It’s all about restructuring for success. While EPM occasionally involves physical facilities more often it’s about restructuring attitudes, performance standards, management controls, marketing strategies, service offerings and fees, clinical documentation, business contracts, staff compensation, and operational finance. It involves building profit into the practice rather than trying ever-harder to squeeze it out.
It’s a story that predictably begins with the gathering of help for a job too big to do alone and reliably ends with new possibilities and reward. ...”Welcome home”.
At least half of practices today are struggling against progressive financial erosion resulting from the relentless waves of increasing competition and costs amidst declining reimbursement – then there are matters of regulatory compliance, staff that expect and often deserve more, and operating systems that are part of the problem and not part of the solution. Many owners/managers privately acknowledge that, “work’s no fun anymore” and that they are, “at their wits end and need help”.
We all acknowledge the incredible rate of change that is happening in the world around us. But, we often don’t connect the dots to understand and anticipate what it likely means for our families, professions, and practices. We become comfortable and complacent inside the familiar walls and routines of our practices and fail to fully appreciate the implications and certainties that follow trends.
As in matters ranging from auto repair to obesity and global warming there are tendencies to delay, defer, and deny. With each passing day, practices and careers become either more obsolete or more relevant. It all depends on the decisions management makes and the actions it takes.
Consider a few technology changes over the past 25 years – Internet, laptop computers, Google, plasma TV, HDTV and now 3D TV, cell phones, airbags, GPS, CDs and DVDs, email and voice mail, digital cameras, ATMs, and space shuttles already being sent to museums rather than the moon. Then there is medical technology!
The current economy is a grim reminder for governments, companies, and individuals that the traveling companions of change are obsolescence and risk.
Futurists tell us that most jobs that will be performed 20 years from now have not yet been created and most have not even been imagined! Rohit Talwar, a London based futurist, suggests such jobs might include:
“Body Part Maker - Due to the huge advances being made in bio-tissues, robotics and plastics, the creation of body parts - from organs to limbs - will soon be possible, requiring body part makers, body part stores and body part repair shops.
Nano-Medic - Advances in nanotechnology offer the potential for a range of sub-atomic 'nanoscale' devices, inserts and procedures that could transform personal healthcare. A new range of nano-medicine specialists will be required to administer these treatments.
nano-medic,
Pharmer of Genetically Engineered Crops and Livestock - New-age farmers will raise crops and livestock that have been genetically engineered to improve yields and produce therapeutic proteins. Works in progress include a vaccine-carrying tomato and therapeutic milk from cows, sheep and goats.
Old Age Wellness Manager / Consultant Specialists - Drawing on a range of medical, pharmaceutical, prosthetic, psychiatric, natural and fitness solutions to help manage the various health and personal needs of the aging population. Memory Augmentation Surgeon - Surgeons that add extra memory to people who want to increase their memory capacity and to help those who have been over exposed to information in the course of their life and simply can no longer take on any more information - thus leading to sensory shutdown.”
Then of course there is the New Science Ethicist, Climate Change Reversal Specialist, Virtual Clutter Specialist, Waste Data Handler, and... Well, you get the picture.
As Dorothy said in the Wizard of Oz, “Toto, I've a feeling we're not in Kansas anymore.”
To be continued....
All The Best!
Bob
© Copyright 2010 Performance Builders
Like the hit TV show Extreme Home Makeover, it’s “down with the old and up in the new.” It’s all about restructuring for success. While EPM occasionally involves physical facilities more often it’s about restructuring attitudes, performance standards, management controls, marketing strategies, service offerings and fees, clinical documentation, business contracts, staff compensation, and operational finance. It involves building profit into the practice rather than trying ever-harder to squeeze it out.
It’s a story that predictably begins with the gathering of help for a job too big to do alone and reliably ends with new possibilities and reward. ...”Welcome home”.
At least half of practices today are struggling against progressive financial erosion resulting from the relentless waves of increasing competition and costs amidst declining reimbursement – then there are matters of regulatory compliance, staff that expect and often deserve more, and operating systems that are part of the problem and not part of the solution. Many owners/managers privately acknowledge that, “work’s no fun anymore” and that they are, “at their wits end and need help”.
We all acknowledge the incredible rate of change that is happening in the world around us. But, we often don’t connect the dots to understand and anticipate what it likely means for our families, professions, and practices. We become comfortable and complacent inside the familiar walls and routines of our practices and fail to fully appreciate the implications and certainties that follow trends.
As in matters ranging from auto repair to obesity and global warming there are tendencies to delay, defer, and deny. With each passing day, practices and careers become either more obsolete or more relevant. It all depends on the decisions management makes and the actions it takes.
Consider a few technology changes over the past 25 years – Internet, laptop computers, Google, plasma TV, HDTV and now 3D TV, cell phones, airbags, GPS, CDs and DVDs, email and voice mail, digital cameras, ATMs, and space shuttles already being sent to museums rather than the moon. Then there is medical technology!
The current economy is a grim reminder for governments, companies, and individuals that the traveling companions of change are obsolescence and risk.
Futurists tell us that most jobs that will be performed 20 years from now have not yet been created and most have not even been imagined! Rohit Talwar, a London based futurist, suggests such jobs might include:
“Body Part Maker - Due to the huge advances being made in bio-tissues, robotics and plastics, the creation of body parts - from organs to limbs - will soon be possible, requiring body part makers, body part stores and body part repair shops.
Nano-Medic - Advances in nanotechnology offer the potential for a range of sub-atomic 'nanoscale' devices, inserts and procedures that could transform personal healthcare. A new range of nano-medicine specialists will be required to administer these treatments.
nano-medic,
Pharmer of Genetically Engineered Crops and Livestock - New-age farmers will raise crops and livestock that have been genetically engineered to improve yields and produce therapeutic proteins. Works in progress include a vaccine-carrying tomato and therapeutic milk from cows, sheep and goats.
Old Age Wellness Manager / Consultant Specialists - Drawing on a range of medical, pharmaceutical, prosthetic, psychiatric, natural and fitness solutions to help manage the various health and personal needs of the aging population. Memory Augmentation Surgeon - Surgeons that add extra memory to people who want to increase their memory capacity and to help those who have been over exposed to information in the course of their life and simply can no longer take on any more information - thus leading to sensory shutdown.”
Then of course there is the New Science Ethicist, Climate Change Reversal Specialist, Virtual Clutter Specialist, Waste Data Handler, and... Well, you get the picture.
As Dorothy said in the Wizard of Oz, “Toto, I've a feeling we're not in Kansas anymore.”
To be continued....
All The Best!
Bob
© Copyright 2010 Performance Builders
Thursday, January 21, 2010
Quotable - Truth Series
"Knowledge is power, but too much knowledge can blind you to truth." - Alan Cohen
Sunday, January 17, 2010
Game Changers - Compensation
We've discussed certain Game Changers that are testing the economic foundations of traditional health services practice models. Change begets change. With change comes uncertainty and risk - but its where the reward is. Change is required of those who are committed to stay in the game and remain competitive.
Here's what I'm telling the leading practices that I'm working with...
The first responsibility of a leader is to define reality.
Here's what I'm telling the leading practices that I'm working with...
The first responsibility of a leader is to define reality.
Our emerging practice realities are economically driven... cost per unit of service needs to be improved, revenue sources need to expand and diversify, and risk needs to be shared. These are the same realities that have faced the automotive industry in recent years - enough said. Interestingly, a related reality is that most health services owners/managers come into the game with little economic training or passion.
In matters of economics it's aways a good discipline to begin with the big rocks. In the health services sector there is no bigger rock than compensation. Consider these realities...
1. Few practices establish adequately informed or disciplined compensation practices
2. Persistent labor shortages drive compensation packages steadily upward
3. Compensation progression is commonly tenure based rather than contribution driven
4. Staff have been conditioned to expect annual compensation adjustments - only upward
5. The value of escalating labor benefit expense goes under appreciated
6. A culture of "entitlement"has taken deep root in the industry
7. Salaried compensation models establish fixed rather than variable expense limiting management options
8. PT productivity is one of the lowest in the health services industry
9. Accountability for financial contribution and return on investment is weak
10. Practices are held hostage by fears of resignation and staff turnover
11. Financial compensation is framed by matters of experience and self-defined quality rather than financial contribution
12. Excessive labor costs threaten job security and even survival of many practices
The time for a well considered and systematic migration to variable compensation has arrived. Such a migration will produce winners and losers - both categories will be self defined. Are there risks in doing so? Certainly, but the status quo has its own risks. Is it easy to do so? No, but neither is keeping existing compensation models working!
Practices who successfully establish a sustainable variable compensation model with benchmarked performance will enjoy a decisive competitive advantage in the market as measured by clinical, operational and financial outcomes.
Professionals who step up and graduate to variable compensation will also improve their personal competitive advantage while enhancing earning capacity and earning job security. Variable compensation is all about accountability and risk sharing - its the future. Its a big rock that's worth moving.
Variable compensation based on financial contribution can be a huge Game Changer. Is everyone in that game? No, only the leaders...
The next Game Changers post will consider Start-ups, Start-overs, Turn-arounds, and Right Sizing.
All The Best!
Bob
(C) Copyright 2010
