The picture below is of my son “working” with the fence piece we were moving last summer. It takes a lot of work to move some fence, more than I’d realized.

• It’s difficult, if not impossible, to carry a chunk of fencing by yourself. It’s not that heavy, but it’s cumbersome and awkward. In addition to carrying the fence from wherever you had it to wherever it’s going, you have to keep picking up and putting down the fence to measure the depth of the hole and line up the sides.
• The post hole has to be about a foot deeper than you think. Even when the post-hole digger seems to be all the way in the hole, the fence probably won’t be level yet. Keep digging.

Leveling a fence is also a multiple-person job. Fences are wobbly, and it’s hard to get a stable reading on a wobbly thing.

What’s this have to do with healthcare? Well, it’s all about collaboration. According to recent healthcare trends, working together to coordinate care seems to be primarily via the forced collaboration born from mergers and acquisitions. At least that’s the claim reported in this article by the New York Times. If you ask the FTC, the answer seems to be that, even if that is the best way to collaborate, it’s not an option.

This article focuses on the merger/acquisition trends, and certainly, we’re noticing that more and more. But healthcare organizations are under a lot of pressure from a lot of different places, all impacting how hospitals and physician groups do their business. It’s easy to make bold statements; the challenges are real and continue to challenge the industry. For example:

• EHRs are expensive, and methods for interoperability across different vendors continue to be inconsistent.
• The Affordable Care Act emphasizes care coordination, but anyone who’s worked through the details of ACO setup knows that’s an uphill climb, in time and in resources.
• The increasing reliance on high-tech diagnostic tools means small shops need some sort of alliance with the big dogs.
• Mergers, acquisitions, and other strategic partnerships require a lot of work and money; the resulting collaboration (and, yes, bargaining power) doesn’t come for free.

At Prominence, we’ve worked with organizations seeking collaboration both as part of strategic partnership without changes to the business entities and as part of a merger or acquisition. And we know that there are challenges to success with any complex path you take. At the end of the day, regardless of the pros and cons inherent in working together, our goal is always to improve care and outcomes for patients.

We’re interested in looking more deeply at the challenges and the outcomes of acquisitions and mergers, as well as the ways organizations have overcome their challenges with collaboration, so we’ll revisit this topic in future posts.