The CFA Perspective

The Future Started Yesterday

Posted by Peter Rastello

6/26/12 4:24 AM

CFA staff has lately been reviewing an assortment of “thought leader” predictions about where healthcare is headed over the next ten or so years.  We have a number of ongoing projects that require our input and expertise about cardiovascular (CV) trends and, most importantly, their implications on everything from network strategy to facility design.  It can be a challenging task to sift through dozens of reports, articles, opinions and prognostications about the future and to reach cogent conclusions.  As Yogi Berra said, “Prediction is very hard, especially when it’s about the future.”


When functioning as CV business consultants (one of our hats in this field), our task is at times more difficult than those who deal with where the healthcare industry is going on a macro level.  We must predict where it is going on a micro level, specific to the CV enterprise.  That is our challenge – understanding trends, assumptions and key factors that will change the way healthcare is delivered from the perspective of the CV enterprise.  For every CV service line administrator who is reading this blog, here is one of our conclusions:  The future started yesterday!  You are already behind.  But don’t despair; you are not the only one, and you’re not alone in considering and developing successful strategies to address these critical issues.


Over the coming months and years, CFA will be devoting a lot of its present time to the future.  It is our goal to assist health systems, hospitals, physicians and others to understand the trends and assumptions that will shape the near-term future.  But most importantly, it is our belief that identifying likely changes is not the most important task of the prognosticator – it is identifying the implications of those changes to the CV enterprise that really matters.  Compounding this challenge is determining how one manages in the period of transition from where we are today to the world that is envisioned for the future with its conflicting incentives and disincentives.  The overarching trend – the evolution from a fee-for-service environment to a fee-for-value environment – demands new organizational structures, management skills, transparency, care delivery teams, etc.


For the CV administrator, we suggest that you begin to look at the potential implications of the future by developing possible future scenarios for your program.  You may wish to consider multiple scenarios – the likely future is always evolving, so differing strategies and tactics will likely be required over time.  In preparation, take each consensus-based trend or assumption from your scenario and ask yourself the following questions as a starting point:

  • If a specific trend materializes, what would I need to do to begin to prepare my service line?
  • Is the current culture of my organization conducive to making the required changes?  In particular, is it conducive to collaborative or team-based clinical decision making?
  • Are my physicians aligned with my hospital and program or otherwise engaged to be ready and willing to help?  Have physician leaders been identified and cultivated?
  • If my focus is now acute care, how do I provide services across the complete continuum of care?  What strategic alliances or other types of arrangements would I have to make and how?
  • What will the future care team look like?  What will be the role of each potential team member?  Are my employees’ goals and capabilities aligned with the enterprise?  Are there significant training, educational or motivational gaps.
  • What data and information will I need and how will I obtain it in a timely manner?  Will our electronic medical record be ready to provide comprehensive reporting needed going forward?
  • How is my service line prepared financially?  Do we know what resources will be needed in the future and how these resources will be obtained?


As I am sure you can tell, this set of questions is merely the starting point, but it should get you to begin to think about what the coming changes mean and how they will impact your enterprise.  CFA will have much more to say on this subject over the coming months.  Remember, the future started yesterday, so get going!


As always, CFA invites your comments, suggestions and questions.