On Purpose

West Virginia HFMAMay 19th, 2016

NASA Astronaut Paul Lockhart

Pilot STS-111, STS-113

Sippy CupKid

YesFunKidCarDogHimHer

Three Letter Words

NewAndButEgoJobHowWhy

Why.• The reason• The purpose• The

objective• The goal• The why.

Why?• Confusion• Conflict• Clarity• Justify

Why!• Alarm• Fear• Surprise

Renewed appreciation for the purpose of your organization

Impact of vocabulary on promoting you purpose

Understand how ideas spread

Stratification & organizational development

WhyAre We Here?

Start with WhySimon Sinek2009, Penguin Group

Resources & Citations:

Predictably IrrationalDan Ariely

2008 / 2009, Harper Collins

Resources & Citations:

Thing Explainer byRandall Munroe2015, Hought Mifflin Harcourt Publishing

Resources & Citations:

Mission Goal

GoalMission

Communicating Complexity

Thing Explainer

Using the 1000most common englishwords, explain supercomplicated stuff.

The US’s Laws of The Land (The Constitution)

In other words…

If it is a ten-minute speech it takes me all of two weeks to prepare it; if it is a half-hour speech it takes me a week; if I can talk as long as I want to it requires no preparation at all. I am ready now.- President Woodrow Wilson

“If I Had More Time, I Would Have Written a Shorter Letter.”- Mark Twain (maybe)

Why Try Simple Writer?

• It’s Free

• It’s Fun

• It’s good practice

Things to Avoid?

• Jargon

• Acronyms

• Codes

xkcd.com/simplewriter

• What big idea are you working on?

• Challenges in communicating the idea?

• Barriers to people “getting it”?

• Leading with What or How?

We need people to know what to say.

We need people toknow what to do.

We want people who are adaptable andself-managed.

We expect people tobe able to explain

“What it Is We Do Here”.

We need people to know what to say.

We need people toknow what to do.

We want people who are adaptable andself-managed.

We expect people tobe able to explain

“What it Is We Do Here”.

Ask the Audience

Less is the new more.

• How we engage patients?

• When will the old ways stop?

• Where should we focus?

• What’s next?

Who has time to innovate?

Top 4 Payer PrioritiesDecember 2015 – HealthLeaders Media

4. Reducing Administrative Expense ManualAutomagic, Reduce Human Errer

3. Enhancing Care CoordinationCombine and manage disease states,

influence patient behavior, shift-to-value

2. Better Use IT & Data73% Focused on Improving IT capabilities61% of executives cite real-time importance

1. Embrace New Business ModelsFFSACO, PCMH, Risk Share

Top 4 Payer PrioritiesDecember 2015 – HealthLeaders Media

4. Reducing Administrative Expense ManualAutomagic, Reduce Human Errer

3. Enhancing Care CoordinationCombine and manage disease states,

influence patient behavior, shift-to-value

2. Better Use IT & Data73% Focused on Improving IT capabilities61% of executives cite real-time importance

1. Embrace New Business ModelsFFSACO, PCMH, Risk Share

Areas of Rapid Change or Pressure in Healthcare

Diffusion of Ideas

McKesson Corporation Confidential & Proprietary20

Observability

Provides tangibleresults (ROI)

ComplexityDifficult to use or

understand?

Everett Rogers Synthesized in 1962 – originated with innovation infarming and agriculture.

Relative Advantage: better than the idea, program, or product it replaces

CompatibilityConsistent withthe values, experiences, andneeds of the adopters

TriabilityCan be tested or experimented with before a commitmentto adoptis made.

Adoption Curve

Everett Rogers, The Diffusion of Innovation, 1962Les Robinson, A summary of Diffusion of Innovations, 2009

Innovators - The first 2.5%

Passionate. Committed.Thought LeadersOut there already, looking for your.

First FollowersEngages as Partners

Bring great insight about the space, and much time to put to it.#nerd

Idealistic.Not your targetmarket.Myopic.

Early Adopters – The Next 13.5%

Peer NetworkMarketing Spreads Ideas. Conversations spread adoption.Find & Share the Advantage

Who ready?

Me.Manage Ego.

Risk TakersTrouble MakersBig ThinkersOpinion Makers

Quickly connect the innovation with their needs or goals.#winning

The Early Majority – The “First” 34%

Moderately progressive, get the idea but wait for clear proof points.

Solve my ProblemLimit cost, complexity.Happy with incremental Gains

Risk Averse.Convenience first.“That was easy.”

Drawn toBuzz.Spot a Fad.

The Late Majority – The “Next” 34%

We’ve Never Done it

that way!Risk HatingNew Idea ScoffingFear Mongers :-)

Conservative and set in

status quo.Identify

personal impact of the

change.

Adapt your approach.Cost focus

Laggards – The Last Mile… or 16%

Challenge you.Challenge your idea.Embrace & rise to the challenge.

Bring Data.Give level of control.Replacement of the loved.

Define irony:Laggards

help the next innovation.“How can I make them

move…”

Success ofother laggards.Similarities toknown.

Adoption Curve

Market Share %

100

75

50

25

0

High Low Low HighPropensity to Adopt Propensity to Resist

Evolution of an Idea

RefinementNuanceClaritySimple

Prior Authorization

PROPRIETARY AND CONFIDENTIAL. Copyright © 2014 McKesson Corporation and/or one of its subsidiaries.29

1/3

Up to 30 %Only 7%

U.S. Provider Cost of Payer Administration =78%

Payer Perspective of Knee Replacements not necessary

Hours per FTE per week registration staff can be onhold withpayers for Auth.

of Authorization transactions are

electronic

Of Denials result from Patient Access activities

Of physicians sayeliminating Preauthorization hassles is “very important”

$14Average provider

cost per manual Authorization

$31BHealth Affairs, May 14, 2009

CAQH, 2016

AMA Survey of Physicians, May 2010

CAQH, 2016

Arthritis & Rheumatology,

June 2014

8% Overlapin authorizationrequirements for 1300 procedures across 23 major health plans

McKesson Analysis, 2016

Pre-Authorization Opportunity

Does this line up with what you go through?

9

Traditional Authorization Workflow

The Authorization Problem

Source:  CAQH, 2016 

$14+Provider Cost:

Manual Authorization

7%Provider Adoption:

Electronic Authorization66¢Provider Cost:Manual Claim

94%Provider Adoption:Electronic Claims

History of the Fax Machine

Patented, 1843, Alexander BainFirst commercialized, 1865 Great Moments in 1843

1st Major Wagon Train on the Oregon Trail

Modern “Portland” Cement Invented

World’s First Christmas Card

Great Moments in 1843

1st Major Wagon Train on the Oregon Trail

Modern “Portland” Cement Invented

World’s First Christmas Card

Years Before:

13: President Woodrow Wilson, Born 1856

18: Liquid Soap, 1865

85: Penicillin, 1928

Years Before:

13: President Woodrow Wilson, Born 1856

18: Liquid Soap, 1865

85: Penicillin, 1928

Words Matter: “Electronic”

10%

Electronic Authorization

100

75

50

25

0

64%

Providers Sending Authorization Electronically

Health Plans Support for “Electronic”Authorization

Electronic = EDI, Portal

IVR

Reality Gap

Electronic = EDI

Evolving the Authorization Solution

Just payattention

to it.

Cut Problem In Half.

Can’ do anything,

until it does

everything

We’re not great, but we have

other priorities.

I Love My Fax.

Interactive

Best question you’ve ever been asked?

Think of a recent project…

• What worked went well project / team?

• What should be done over / differently?

• What surprises did handle during the project?

• Was the “Why” clearly undestood?

Boy Scouts EDGE Method

Explain

• First explain what you will be doing. Tell them the steps involved. Visual aids might be helpful for this step. Use questions to gauge their understanding.

Demonstrate

• Show them how to do the skill. Demonstrate the steps using the actual materials. Describe what you are doing.

Guide

• Let them practice the skill. Guide and coach them as they try to do it themselves. This step will take the most time.

Enable

• Enable them by letting them do the skill themselves without any intervention.

• Failure is an option. Safe failure is preferred.

Start With You

10 Leadership Development Goals

• Improve strategic thinking

• Build financial acumen

• Track your accomplishments

• Learn a new skill

• Develop your people

• Seek feedback

• Optimize time management (MAS – Mindless Accept Syndrome http://bit.ly/16masted)

• Enhance your people skills

• Hone executive presence

• Sharpen presentation skills

Darlene Price, 2016, WellSaid Executive Presentation & Communications

Top 5 Fears

1. Glossophobia – Public Speaking2. Necrophobia – Fear of Death

3. Arachnophobia – Fear of Spiders4. Achluphobia – Fear of Darkness

5. Acrophobia – Fear of Heights

Thank You

David Dykedavid.dyke@relayhealth.com