Two Caveats

1. You are going to make A) some staff, B) some doctors, C) some managed care staff and D) some patients mad when you implement some of these Projects.

I am sorry. But providers have been doing many things wrong for a long time. You are not going to be able to start doing them right without conflict. No one will give you money with a grin.

B) and D) Fortunately, in almost every situation, whether it be with doctors or patients, the correct response will be, "The patient will have to phone his/her health plan about that." Providers, for bizarre reasons, have been assuming the customer service problems of the health plans for decades now. In point of fact, it is the health plans causing the problems, and you, the provider, can't fix that. You are powerless. These patients are going to be mad anyway, so you might as well have them yelling at the health plans. It is the only way to reform managed care.

It is extraordinary to what extent providers' problems grew because people in hospitals like to be nice. Therefore, they took over health plans' problems in order to help the patients. This effort is so pervasive in your firm that you never see it. It grew by bits and pieces, de-sensitizing you as it grew. "The last animal to discover water will be a fish." The whole time, your staff, whose intentions were pure, just wanted to help the patients. Doing health plans' customer service is now the Blob, eating you alive. But you actually cannot fix the health plans' problems. So you end up giving away money. That is the only way to make the patients happy again.

Get rid of the stress, free up staff time, and help undermine managed care by pointing angry people back to the real targets--the health plans. And resolve to ride out the temporary storm. It will pass.

B) and D) Of course, sometimes it is a doctor screwing things up. In which case, the response is, "The patient will have to phone her/his doctor about that." You can't solve the customer service problems of doctors, either. When angry patients talk to doctors, and when angry members talk to health plans, things improve. Health plans and doctors will never listen to you.

C) As for angry staff at managed care plans, good.

A) As for your own staff, if they can't get with the program, you will know whom you are better off without. These are the people who have been giving your money away all along.

The very staff who will implement these Projects, and benefit the most from them, will be the ones who will resist them. Be Machiavellian. If they really knew what to do, you would not need these Projects. I often think, as people emotionally resist change, "You were here when this place was going belly up. Because of these 'changes' you get to keep your job. Am I doing the right thing?"

2. Secondly, do not let your lawyers talk you out of these Projects. By all means, have everything you buy from me reviewed. The lawyers I have worked with typically had little business sense. They were automatically adverse to anything which had not been done before, as far as they knew. I have been arguing with lawyers my whole career. If your lawyers have real objections, make them quote you the laws or regulations. Then instruct (NOT ask) them to tell you how it can be done legally. No one seems to ask this of them. In my experience, this is when lawyers get all positive and helpful. You are telling them to do their job. They will start finding better ways to interpret the regs they just quoted you.

When I first had these Projects reviewed, the lawyers were stunned. By the time they were finished, all they said was, "Well, no one's ever done these things before. They are all surprising. But they are all legal and Compliant." Hah. They were sure they were going to get to quash me. Hah hah.

Further Consulting

Many of my Projects require you to hold firm, to stay the course, with patients, staff, doctors and payors. It is hard to do. One reason people work for hospitals is they like helping people. You must be unwavering.

If you wish, for a big fee, I will do conference calls with your staff and payors, or other parties, when needed, until they are confident in their ability to be steadfast.

Alternatively, but also for a big fee, your staff can blind cc me on emails with payors, doctors and such other parties. I will email your staff with strategies or what to say next, in order to hold the line.

This activity would require a separate contract.

The point of making the fee big is to entice you to hold the line on your own as fast as possible.

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