More Thoughts on Segmenting Healthcare: Who’ll Serve the “High End” of the Market?

In a few previous blog posts I’ve written about market segmentation in US healthcare.  I’ve made the observation that healthcare delivery companies which once targeted geographies (we are a nation of “XYZ Regional Hospitals” after all) now target demographies.  Witness, for example, Walmart’s bold move into $40 primary care visits ( with a goal of being America’s largest provider of primary care“) and ...

Can “Agile Teams” Reform Healthcare Systems?

I recently had lunch with an experienced physician executive from a large academic medical center.  He told me that his organization was trying to migrate from fee-for-service to risk, and that management had appointed a bunch of large committees to oversee everything from a new cost accounting system to the development of multiple external partnerships.  

A (Lower Cost) Healthcare Industry to Deal With a (Higher Cost) Healthcare Industry

I was recently on the phone with a medical device company executive who was describing his company’s efforts to develop a non-invasive diagnostic device that could quantify the degree of cirrhosis in a patient with liver illness.  It’s technology that his firm sees as timely given the recent introduction of Solavdi and other Hepatitis C therapies: the device will be offered as a way ...

The Pendulum Swings Between Individualism vs. Collectivism in US Healthcare. What Does the Next Decade Hold?

Communities don’t think, don’t believe, don’t want, don’t have needs, don’t have interests and don’t make decisions. Only individuals have minds that generate desires and needs – and only individuals can make choices and decisions. Harry Browne- Libertarian Candidate for American President, 1996 and 2000 When I visit my European in-laws, some who work in ...

Humanizing the Healthcare Machine: On Not Getting Lost in the Warehouse

One summer afternoon, when I was eight or nine, I impulsively chose to ride my bike down a steep hill near my childhood home.   From the top of the hill my bike accelerated at a frightening rate and I remember for brief moments somehow being airborne before landing in a pile of bent metal and bloody asphalt.  My adventure ended with ...

A Few Thoughts on “Culture” in Healthcare

The big news in Boston healthcare last week was the announcement that Tufts and Boston University Medical Centers were calling off their proposed merger.  The Boston Globe wrote:  Although they did not specify why the deal fell apart, the hospitals were apparently unable to overcome differences in culture, mission, and strategies for the future, analysts ...

Why Value Generation Doesn’t Grow Your Risk-Bearing Medical Group: On Being Foiled by the Middleman

Imagine that you are an electronics manufacturer who has figured out how to build a superb stereo system at a far lower cost (20% less) than your competitors. Over time you’ve perfected the system, created a reputation for high quality and have a machine that sounds great.  Your manufacturing efficiencies position you to sell at ...

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