I’ve written in the past about the need for specialist health care organizations (such as behavioral health organizations) to reposition themselves in an era of changing technology, science, and financing. There are many possible directions for repositioning – from primary care for individuals with chronic conditions; focused disease management programs for consumers with multiple chronic diseases and complex social support needs; and program to address unnecessary use of high-cost acute care interventions.

Now comes yet another study on the cost savings opportunities of prevention efforts in two areas – high blood pressure and diabetes. The study authors concluded that reducing the prevalence of diabetes and high blood pressure by five percent would save the nation about $9 billion a year in the short term. In addition, conditions related to those health problems would also be reduced, which would increase the savings to about $24.7 billion a year in the medium term.

The study was conducted using 2003-2005 data from the Medical Expenditure Panel Survey.   Study results were released on-line on November 18, and are scheduled to be published in the January print issue of the American Journal of Public Health.

This is data that can be the foundation for designing (and marketing) prevention programs.   For more on the evolving wellness and prevention market, check out these recent articles by our team:

• Market Opportunity in Prevention Programs: Reform Creates New Market Niche for Prevention (available to premium OPEN MINDS Circle members)
• New Science Changing The 'Perceived Value' of Prevention & Early Intervention  (available to all OPEN MINDS Circle members)
• Mental Illness & Addiction Prevention & Treatment Critical to U.S. Health Reform (available to premium OPEN MINDS Circle members)
• UnitedHealth Group Launches Diabetes Prevention & Control Alliance With Partners Walgreens & YMCA of the USA (available to premium OPEN MINDS Circle members)
• J&J to Grow New Wellness & Prevention Business as Part of Consumer Division (available to premium OPEN MINDS Circle members)

I read, with interest, a recent piece on the future of U.S. hospitals,  Service-line strategies for US hospitals, by the consultants of McKinsey & Company. The premise is quite simple – the full service hospital is going to have an increasingly difficult time competing. Their solution? "A commitment to clinical service lines as an organizing paradigm, much as many corporations organize themselves by business unit—is becoming a necessity. . . Specializing in a few service lines allows hospitals to build a critical mass of patients in select areas and to enjoy economies of skill and scale... "

This market focus on specialization – and the need to adopt service line management tools is not limited to hospitals. I see it as a key survival strategy for organizations in the behavioral health and social service niche playing field.

At our 2010 OPEN MINDS Strategic Planning Institute last month, I presented our recent analysis of our post-recession, post-health care reform model for specialists. In a nutshell, there are four likely delivery system market positions – two in facilities and two that are tech-enabled:

• Destination Specialty Services
• One-Stop Health Service Shopping
• Mobile, Home-Based, & Community Care Services
• E-Health & Remote Services

But, that is only part of the strategic positioning story. Within those delivery system market segments, the detail can only be answered by effective service line analysis and management. For your strategic planning – and then for your on-going market strategy implementation and operations management structure – service line management models are key to effective analysis and nimble management during this turbulent market environment. If your current planning isn’t grounded in an organizational view based on service lines, consider next year’s plan as a good place to start today.

I just read Gardiner Morse's great piece in Harvard Business Review, Ten Innovations That Will Transform Medicine. One of the ten – behavioral economics – reinforced my thinking that care management services for consumers with chronic physical health conditions is a great new market opportunity for behavioral health organizations. "If we all acted rationally, we'd eat right, floss, and take our pills as directed. But of course we can be pretty disobedient about doctors' orders, which not only is bad for our health but costs hundreds of billions of dollars a year. Behavioral economics tools — gentle prods that nudge us to behave in desired ways — may be more effective than any amount of browbeating by doctors... reminders, social pressure, default options, rewards, and other behavioral tricks can be used to improve compliance in stroke and diabetes patients... " I think that aggressive innovation organizations that are currently managing care (longitudinally) for consumers with a mental illness or addiction can be the ones to own the future chronic disease space (and, I think Alzheimer's disease, other dementias, diabetes, and strokes are great areas to start...)

P.S. The ten innovations that will transform medicine (according to Mr. Morse) are:

1. Checklists
2. Behavioral economics
3. Patient portals
4. Payment innovations
5. Evidence-based decisionmaking
6. Accountable care organizations
7. Virtual visits
8. Regenerative medicine
9. Surgical robots
10. Genetic medicine 

How far will consumerism extend in the health and human service space? A few weeks ago, I covered the new "eBay" of health care, On-Line Bidding For Professional Services Comes To Health Care. And now we have a new kind of ‘speed dating’ to link consumers and health professionals.

Doc Shop—a program Texas Health Resources launched in fall 2009 to connect patients with obstetrician-gynecologists—is like speed dating, the matchmaking process that lets singles meet a significant number of potential dates in a short period of time. The hospital's first event took place on September 24, 2009. Two others have been held since, and seven are scheduled for 2010. The program has been successful enough that the hospital is expanding it to include pediatricians, with longer-term plans to include other specialists. Those involved in planning the events believe the program is best suited for primary care physicians, where matching personalities for a long-term relationship can be particularly important.

Here’s how it works. About five or six physicians sit at tables while a dozen or so potential consumers rotate through. Every five minutes, organizers signal consumers to move on to the next doctor. There is no cost to consumers, and physicians do not get paid for their time. Participating physicians say the event is a welcome addition to other marketing efforts, such as magazine ads or information on their web sites.

An interesting addition to the marketing planning for health and human service professionals. The question – how would your clinical team fare in this ‘speed dating’ paradigm?