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Leaders Innovate; Laggards Comply

Philip Betbeze, for HealthLeaders Media, March 15, 2013

Is your integration strategy more focused on avoiding penalties or are you focused more on embracing full collaboration? It's a question Paul Keckley, PhD, executive director of the Deloitte Center for Health Solutions, asks CEOs all the time.

You may not have ever heard the question phrased quite like this, and you may not think you know the answer yet. That's OK, but as the senior leader in charge of making healthcare work, (that is, operate with a margin), you'll probably know where you stand on that question by the time you finish reading this column.

"These two strategies are complementary, but very different," Keckley says.

You have no choice about integrating to avoid penalties—that is, reductions in revenues that will come from failing to avoid readmissions for the same malady within 30 days, for example, or from reimbursement penalties that will occur if you experience so-called "sentinel events," but the scope of your organization will be very different from those who fully embrace collaboration.

Neither answer is necessarily "correct" for everyone, but you have to be the decision maker on what's correct for your organization. There is a right or wrong answer there. Trouble is, given the unsettled state of healthcare right now, you may not know whether you've answered correctly according to your organization's circumstances until it's too late to change course.

"If it's just for penalties, you make more prominent the role of intensivists and discharge planners, and you're much more conscious of the frail elderly and managing them in an acute setting, simply to avoid being penalized for avoidable complications or readmissions or suboptimal functional status (in the case of implants)," says Keckley. "That level of coordinated care represents table stakes."

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