"I make the majority of my living giving speeches to hospital execs," Bauer says. "The most common comment I get after my speech is hospital C-suite people saying what they hated about it is that 'deep down inside, I know you're right,'" he says. "But courage to make the changes doesn't match the awareness."
For example, Bauer's main "pitch," strategically, is that CEOs need to quit thinking that horizontal integration will achieve anything that will move the system forward or alter its business model.
"Moving from two hospitals in a large community under the same ownership to 7 or 10, I think, is generally a waste of time," Bauer says. "I think we need vertical integration."
Vertical integration is much more difficult to organize and achieve, he says, but breaking down silos and remaking the organization into one that handles many more healthcare interactions than inpatient is the key to survival. That means adding talent and pieces of the businesses that make up the healthcare continuum.
But how many people are really doing that? It's a difficult idea to implement because to make such a leap, healthcare organizations probably have to run the risk of failing to increase the probability of doing something good, says Bauer. Horizontal integration may fail as well, but it's easier and results won't be known for quite some time. There's no going back if you horizontally integrate.