For the cover story, I used extensive conversations with three leaders of some of the most innovative health systems in the country about how they're hedging their bets on remaking how their systems do business. They're learning to live with the uncertainty, but they're far from paralyzed by it.
Though the strategic urgency doesn't end with figuring out your primary care strategy, much of preparing for a very different operating environment starts there, because that's what's being disrupted first, says Jesus Garza, interim CEO of Seton Healthcare Family in Austin, TX.
"The urgent care centers and the clinics inside Wal-Marts are less an issue for us and more for primary care physicians," he says.
But a leader has to look past the immediate effects of commoditizing much of the primary care space.
"We have to be mindful of the referral network because they have an established ecosystem, and that disruption begins to disrupt referral patterns," he says.
In that way, primary care can be seen as a precursor to further disruption, and Garza and his team are doing their best to prepare for the next dominoes that will be affected.
"If your primary care network refers to your specialty network, who then refers to the hospitals, and you change that dynamic, I don't know necessarily what the implications could be, but there will be impact," he says.
But Garza isn't waiting for a consultant study to tell him that those effects could potentially be dire for systems that ignore their referring physicians' pain.