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Transforming the Built Environment: Unlocking Value Across the Health Care Continuum


Health care providers suffer from a unique form of institutional irony: delivering institutionalized care in centralized, high-cost facilities impedes their ability to meet their communities’ expansive health and wellness needs. …

Fireside Chat: Why You Should Join the Customer Revolution


Join us in downtown Chicago on Thursday, November 14 at 5:30PM at MATTER. Michael Allen, CFO of OSF Healthcare, will interview David Johnson about critical concepts in Dave’s new book …

Mission-Critical Repurposing: Converting Aging Senior Living Properties to Affordable Housing


In 1908, the Jewish Home for the Aged of the Northwest opened in St. Paul, Minnesota, serving eight residents. As the facility deteriorated, the local Jewish community raised funds and …

Podcast: Win-Win Partnerships: Strategics and Sponsors Increasingly Team Up


John Soden, Managing Director at Cain Brothers, a division of KeyBanc Capital Markets Inc., and David Johnson talk about a new breed of innovative partnerships between strategic buyers and private …

House Calls – Cain Brothers Podcast


Welcome to House Calls, where we talk to investment bankers from Cain Brothers, a division of KeyBank Capital Markets Inc. These bankers are working in some of the most interesting …

Finding the Value for Healthcare Consumers in Outcomes-Based Contracting


When you buy something and it doesn’t work, you take it back to the store (or more likely send it back to Amazon via your local Kohl’s) for a refund. …

A Second Coming: Medical Education’s Desperate Need for Another Flexner Revolution


On June 26th, 2019, American Academic Health Systems announced its intention to cease all medical activities at Hahnemann University Hospital by September 6th, 2019. With roughly 17,000 annual admissions, Hahnemann …

How Consumer Demand Is Transforming Autism Care


Autism Spectrum Disorder (ASD) is the fastest growing, lifelong developmental disorder in the country. ASD affects 1 in 59 children, and boys are five times more likely than girls to …

What Revolutionary Healthcare Leaders Are Reading: The Top 5 4sight Health Commentaries Over the Past Six Months


4sight Health’s writers and authors have published 57 blog posts, commentaries, podcasts and videos on 4sighthealth.com from January through June of this year. The topics are as varied as the …

Platforming Health Care to Transform Care Delivery


NEJM Catalyst Article for September 19, 2019 David W. Johnson, MPP Amy Compton-Phillips, MD Hospitals used to be at the center of the health care universe. Today, new business models …

An American Inquiry: Why I Wrote The Customer Revolution in Healthcare


What convinced a former Peace Corps volunteer and healthcare investment banker like me that the U.S. healthcare system (the System) requires revolutionary overhaul? It really came down to just one …

Higher Practice Skill Mix May Not Be What the Doctor Ordered


“Practicing at the top of your license” and “upskilling your workforce”are two popular healthcare buzz phrases right now. As account-hungry consultants breathlessly will tell you, when medical professionals spend their …

The Truth About Genetics, Epigenetics and Chronic Disease


Chronic disease consumes 86% of the national health expenditure and kills 7 of 10 people. President Clinton and Obama both created initiatives to cure cancer through genetic research and therapies. …

How Commoditizing Colonoscopies Will Drive New Business


Colonoscopies are the American College of Gastroenterology’s preferred strategy to detect colon cancer. Ten million Americans annually undergo colonoscopies at a cost approximating $10 billion. Although colonoscopy prices vary, the …

Win-Win Partnerships: Strategics and Sponsors Increasingly Team Up


As US healthcare consolidation continues, innovative corporate buyers (strategics) and private equity investors (sponsors) are partnering to accomplish increasingly complex transactions. Such deals can create win-win arrangements that serve market …

4 Success Strategies of Interfacing Healthcare Companies


In post-reform healthcare, incumbent health systems must adapt or die from the force of  innovative new companies. Incumbents are vulnerable to value-based attacks. They are asset-heavy, revenue-centric and have ineffective …

Inconvenient Competition


When better customer service is a competitive threat, it really is time to rethink your business model.  That was my first thought when I read the results of a survey …

Who Will Rule Healthcare in 2030?


What will healthcare be like 10 years from now? Not a lot of healthcare executives toiling in our system have the luxury to think about that as they deal with …

There’s No O (outcomes) in ACO


Medicare accountable care organizations say they’re doing a lot to manage and coordinate the care of sick beneficiaries. But a new study says the ACOs don’t have much to show …

How to Use Social Determinants of Health to Fix Reimbursements


Healthcare providers can no longer ignore the Social Determinants of Health (SDH) in the exam room. Even John Snow considered community assessment factors to identify the source of the cholera …

3 Successful Telemedicine Companies Disrupting Healthcare


In August 2017, Hurricanes Harvey and Irma devastated the South and Southeast regions. Florida evacuated over 7 million people, 7.4 million people lost power and almost 60 hospitals throughout the …

VIDEO of Fireside Chat: Tom DeRosa, Welltower & David Johnson: Delivering Better Care, Outcomes & Health for Seniors


David Johnson interviewed Tom DeRosa, CEO of Welltower, for a packed audience at MATTER on June 19th. Tom considers Welltower a “platform for innovation on scale” in the realm of …

What Are Healthcare Executives Thinking? Burda on Healthcare


I write a lot about what healthcare organizations and companies do, and I make educated guesses on why they do what they do based on my experiences, industry knowledge and …

3 Essential Values Home Care Needs to Capture Greater Market Share


The home healthcare sector is dominated by “mom and pops” in a highly-fragmented and under-performing market. Fraud is rampant and customer care is inconsistent. The Department of Health and Human …

Regulatory Chess: Positioning for Competitive Advantage


To entrepreneurs, regulation is the enemy of innovation. That’s especially true in healthcare. Experts agree that healthcare is one of the most, if not the most regulated industry in the …

A GPS for Cardiac Arrest: In Life-or-Death Moments Clinical Apps Save Lives


Resuscitating Your Patients and Building Your Clinical Reputation The plane is in a nosedive. The sweating pilot is fighting to control the aircraft. A nervous co-pilot is furiously flipping through …

How to Improve Patient Satisfaction with Transparent Payment Systems


American healthcare patients are demanding more price transparency, affordable services and quality care. Why are they not receiving it? How can healthcare organizations listen to consumers and set themselves up …

Patients’ Growing Appetite for New Outpatient Care Models


If you believe in the adage “follow the money,” it would lead you to telemedicine. Analyzing billions of private health insurance claims, a new report said telemedicine is the fastest …

Why Healthcare is Spinning Its VBR Wheels


It’s like preparing and serving a seven-course meal that your biggest customer ordered only to have the entire menu change between the salad and the main course. That’s what it …

4 Data Principles Healthcare Companies Need to Advance Care Delivery


What if the healthcare industry could use data as efficiently as Amazon? What if physicians could know the habits of patients like Amazon knows consumers’ buying history? What is physicians …

Why Proponents Are Finding Innovative Health Plan Designs a Hard Sell


When your phone company or your cable provider offers you a new and innovative service plan, your immediate thought is that you’re going to end up paying more for less. …

The Big (Tech-Enabled) Shift: Turning Healthcare Consumers into Customers


Consumerism was the hot topic at this year’s HIMSS conference in Orlando and at the JP Morgan conference. Attendees debated whether 2019 will mark the year healthcare finally tips toward …

Digital Disillusionment: Are We There Yet?


There are signs that digital health—the promised cure for everything that’s wrong with healthcare—may be slipping into the trough of disillusionment.  You may want to check your heart rhythm on …

Everyone Knows What’s Going to Happen in Healthcare in 2019. Do You?


What’s going to happen in healthcare this year is anyone’s guess. Not really. What’s going to happen in healthcare this year is everyone’s guess. Like most of you, from mid-December …

Bundled-Pay Evaluation a Study in Hospital Market-Based Behavior


What would you cut out if you suddenly had to reduce your monthly household expenses by 5 percent, 10 percent, or even 25 percent? I’m sure that some of the …

Getting Precise about Precision Medicine: Balancing Hope, Potential and Cost


Definitions of precision medicine are anything but precise. For seriously ill patients and their families, precision medicine therapies provide a hope when all else has failed. They’re willing to risk …

HHS Goes All In on Competition as the Way to Fix Healthcare Woes


Competition good. Regulation bad. That’s my caveman summary of HHS’ manifesto released on Dec. 3 on how to improve the quality and safety of patient care while simultaneously lowering healthcare …

Frontline Decisions in Real Time: What Health Systems Can Learn from the U.S. Military’s Defeat of Al Qaeda in Iraq


“The teams were operating independently—like workers in an efficient factory—while trying to keep pace with an interdependent environment. We all knew intuitively that intelligence gathered on AQI’s [Al Qaeda in …

Med Tech Bets on Value as Its Future Business Model


If you’re looking for a sign that we’re truly approaching a watershed moment in healthcare innovation, look no further than the people whose job is creating new medical technologies that …

Reader Response: Creating a “Freedom Platform” for Health Data


Dave, your article is nothing if not provocative and insightful.  What does it mean for health data to be truly free? At MultiScale, we have been thinking hard about health …

MARKET CORNER CONVERSATIONS: JIM HARDING, FOUNDER & CEO, MULTISCALE HEALTH NETWORKS


Jim Harding, Founder & CEO of MultiScale Health Networks, joins David Johnson for Episode 13 of Market Corner Conversations. Jim discusses how he applied his experience as a serial tech entrepreneur …

Man or Corporate Culture: Who Has More Power to Disrupt Healthcare?


We’re at a branch point in healthcare’s evolution. We’ll learn soon whether disruptive innovation is the product of individuals or organizations. When we find out, we’ll know the best path …

MARKET CORNER CONVERSATIONS: MUDIT GARG, FOUNDER & CEO, QVENTUS


Mudit Garg, Founder & CEO of Qventus, joins David Johnson for Episode 12 of Market Corner Conversations. Mudit shares how he views the challenges clinicians push through to provide care data …

No Time to Waste: Revolutionizing Healthcare Data Collection, Curation and Application


Healthcare data wants to be free, but it is oppressed. Entrenched oligarchs trap information within closed, centralized systems that prioritize revenue collection, misuse resources and tolerate medical error. Data gasps …

A CONCRETE DESCRIPTION OF THE CLOUD


In the simplest terms, cloud computing means storing data and software applications on the Internet, in secure files, then accessing that data and programs over the Internet rather than from physical …

Geeking-Up Healthcare: Consumer Giant Best Buy Makes a Big Move


Healthcare has experienced a parade of surprising megamergers and acquisitions during the last year. At first glance, Best Buy’s August acquisition of GreatCall may be the most startling. At a …

Belts and Suspenders: Major Healthcare Transactions Position Companies for Whatever Comes Next


During President Richard Nixon’s historic 1972 trip to China, the press asked China’s premier Zhou Enlai to comment on the French Revolution’s impact on world affairs. Zhou famously replied, “Too early to …

MARKET CORNER CONVERSATIONS: JAKE CRAMPTON, MEDSPEED


Jake Crampton, CEO of MedSpeed, joins David Johnson in Episode 8 of Market Corner Conversations. Crampton shares how MedSpeed facilitates “intra-company logistics.” MedSpeed’s customers transform their transportation networks from cost …

Market Corner Conversations: Jake Crampton, CEO, Medspeed


Jake Crampton, CEO of MedSpeed, joins David Johnson in Episode 8 of Market Corner Conversations. Crampton shares how MedSpeed facilitates “intra-company logistics.” MedSpeed’s customers transform their transportation networks from cost …

Market Corner Conversations: Dr. Rushika Fernandopulle, Co-Founder & CEO, Iora Health


Rushika Fernandopulle, M.D., Co-Founder & CEO of Iora Health, joins David Johnson in Episode 6 of Market Corner Conversations. Rushika shares how he decided that the incremental change model wasn’t working …

Goodbye “Dr. Know-It-All”: Medicine’s Liberating Knowledge Explosion


The digitization and globalization of medical information is overwhelming traditional medical practices. Physicians confront a continuous avalanche of medical discoveries on disease origins, symptoms and treatments. By 2020, medical knowledge …

Dr Know It All Icons

Scaling Relationship-Based Care: “Different Spokes (Care Models) for Different Folks”


In 1970, Marcus Welby, MD became ABC Television’s first show to top network television ratings. Dr. Welby was a cheerful family practice physician with a soothing bedside manner who was …

Platforming Healthcare (TM): Owning Hospitals Is So 2015


The news that Amazon, Berkshire Hathaway and JP Morgan Chase joined forces to create their own healthcare company rocked the industry. The ten largest health insurers and pharmacy businesses lost …

Is Tax-Exemption Necessary? Enlightened Health Systems Should Consider the Unthinkable


 In the mid-1800s, English philosopher and political economist John Stuart Mill developed “Utilitarianism,” a framework for making moral decisions. In Mill’s formulation, an action achieves optimal social utility when it …

5 Days that Shook the Healthcare World


In 1919, journalist John Reed published Ten Days that Shook the World, a first-hand account of the October 1917 Russian Revolution. During that dramatic 10-day period, Vladimir Lenin’s Bolsheviks took …

Capitalizing on Comprehensive Care: Cultivating a Medicare Advantage Mindset


This paper is Part 3 in our series on payment reform. After highlighting various efforts to reign in healthcare costs over the past 50 years in Part 1, Part 2 …

Market Corner Conversations: Rick Kimball, NFL & Medical Marijuana


In Episode 3 of Market Corner Conversations, Dave Johnson speaks with Rick Kimball about their commentary Mile High Potential: NFL Veterans Tackle America’s Opioid Crisis. The podcast digs into the social catastrophe …

Market Corner Conversations: Kurt Waltenbaugh, Carrott Health


In Episode 2 of Market Corner Conversations, Dave Johnson speaks with Kurt Waltenbaugh, the founder and CEO of Carrot Health, an exciting data analytics startup based in the Twin Cities. …

In the Eye of the Storm: When Outcomes Matter, Telemedicine Delivers


During the last week in August, Noah’s Ark found a new home in Houston. Unfortunately, it didn’t deliver medical supplies. Between August 25th and 29th, Hurricane Harvey dropped an almost …

Battling Cancer: Partnering to Make Headway Against Medicine’s Toughest Foe


Cancer has been humanity’s most persistent nemesis. Bone fragments and written records indicate that cancer afflicted people in ancient Rome, Greece and Egypt. Today, cancer is America’s second leading killer, …

Amazoning Pharmacy: Attacking “Indumbent” Business Practices


Sky-rocketing drug prices have captured the nation’s attention. President Trump echoes Senator Bernie Sanders when he asserts that drug companies are “getting away with murder.”[1] Republican and Democratic legislators alike assert …

Market Corner Conversations: Paul Walczak, NuVista


4sight Health’s inaugural episode with Paul Walczak, the CEO from NuVista, a remarkably innovative post-acute care company coordinating value-based delivery in southern Florida that achieves superior outcomes at very low costs. …

How Health Systems Get Technology, Innovation and the Patient Wrong 


The minute I walked into the new digs of the clinic, I knew it was very different and could get the gist of what they were trying to do. It …

40 Years in the Payment Reform Wilderness: DRGs to Nirvana


Introduction In an ideal state, a well-functioning healthcare delivery system should provide the right care at the right time and the right place, while being accountable for clinical and financial …

health insurance plans 

Darwinian Outsourcing: Big Pharma Adapts to Market Realities


by Kristin Carey and David W. Johnson Competitive markets drive innovations in business efficiency and strategy. Twenty-five years ago, Big Pharma companies did little outsourcing. Fortified by robust cash flows …

academic medicine partners 

Scaling Healthcare’s Mt. Everest: Peak Performers Engage Technology and Consumers


Climbing the highest mountains requires organization, preparation and strategy. Scaling Mt. Everest is a full-scale expedition. Large teams rely on a sophisticated infrastructure of supplies, equipment and support staff. A …

ZDogg Speaks: Rebooting Primary Care (The Unedited Version)


For the better part of a decade, I practiced inpatient hospital medicine at a large academic center (the name isn’t important, but it rhymes with Afghanistan…ford). I used to play …

Moving at the Speed of Medicine: Turbo-Charging Performance with Strategic Partnerships


Insourcing is a time-honored practice employed by market-dominant companies. Rather than contract with external experts, companies dedicate internal resources for specialized functions. While generally less efficient, insourcing enables companies to …

Mile High Potential: NFL Veterans Tackle America’s Opioid Crisis


Professional football has long since surpassed baseball as America’s most popular sport. The NFL’s Super Bowl is a national party. Super Bowls represent 19 of America’s 20 most-watched TV broadcasts. …

Behavioral Health Goes Local: The Emergence of Integrated, Community-Based Services


by Todd Rudsenske and David W. Johnson From addiction to depression to psychosis, mental illness exacts a growing toll on individuals, families, communities and health systems. We can measure its …

HealthCare.Gov’s Death-Defying 2013 Launch: Implications for Government-Led Payment Reform


Enrollment for purchasing health insurance on public health exchanges began November 1st. Headlines for this fourth enrollment period include: 22% average price increases; major health insurers dropping coverage; and single …

Medtech in the Fast Lane: Embracing Services, Solutions and Consumerism


by Rafe Hanahan and David W. Johnson Manufacturing built America. The iconic automotive industry epitomizes this organic relationship between industrial strength and economic growth. Since the early days of Ford …

medicine and health

What Would Einstein Do? Embedded Dilemmas in Disrupting Markets


Earlier this month, Ford CEO Mark Fields made two head-scratching announcements to advance transportation services in San Francisco. Ford acquired Chariot, a popular crowd-sourced shuttle-van service that uses algorithms to …

transforming american healthcare

Rethinking Cyber-Security: A New Paradigm for Democratizing Data Exchange


Liberated data connects people, informs decision-making, stimulates innovation, streamlines production, creates wealth and advances humanity.  The upward trajectory of human accomplishment arises from ever-more sophisticated data exchange supporting ever-more complex …

capital formation design

Necessity Turbo-Charges Productivity at Cleveland Clinic Florida


Coming into 2015, Ozzie Delgado confronted a thorny problem. Cleveland Clinic Florida was experiencing expansive demand for surgical services. Occupancy was already at 92% and there would be no capacity …

transforming american healthcare

FTC Chasing the Wrong Healthcare Villain in Chicago


Last December the Federal Trade Commission sued to block the proposed merger between Advocate Health Care and NorthShore University Health System. The combined company’s annual revenues would exceed $7 billion. …

Market vs. Medicine Book Launch: You Are Invited


After more than a year of research, writing, editing, re-writing, and re-editing, Market vs. Medicine: America’s Fight for Better, Affordable Healthcare is being printed and will be available on May …

market vs medicine

Two Runners, Two Countries, Two Emergencies: You Decide


For over a decade I’ve plodded up and down the Chicago lakefront with the same group of idiotic runners. Through wind, sun, snow and rain we babble about anything that …

Misdirected Fury: The Boston Globe “Spotlights” Concurrent Surgeries


Market Corner Commentary for March 2, 2016: Misdirected Fury: The Boston Globe “Spotlights” Concurrent Surgeries At Sunday night’s 88th Academy Awards, Spotlight won the Oscar for best picture. The movie chronicles …

Big Data’s Ups and Downs: The Good, The Scary and The Creepy


Market Corner Commentary for February 10, 2016-Big Data’s Ups and Downs: The Good, The Scary and The Creepy Big data analytics are essential for understanding consumer preferences. Collecting, measuring and …

Pursuing What Works: Genetics, Epigenetics and Chronic Disease


Market Corner Commentary for February 3, 2016-Pursuing What Works: Genetics, Epigenetics and Chronic Disease Genetics-based therapies represent the pinnacle of medical science. Billions of dollars have poured into research to …

chronic disease management

U.S. Healthcare in 2016: Enjoy the Sideshow; Watch the Main Event


Market Corner Commentary for January 27, 2016- U.S. Healthcare in 2016: Enjoy the Sideshow; Watch the Main Event For the sixty-second time, the U.S. House of Representatives passed legislation repealing Obamacare …

Exchange Matters: UnitedHealth Takes a Stand or Does It?


Market Corner Commentary for January 20, 2016 During an investor call in November, the nation’s largest health insurance company (UnitedHealth Group) delivered a body blow to the Affordable Care Act’s …

Rational Lending: Demystifying Medical Student Loan Debt


Market Corner Commentary—Demystifying Medical Student Loan Debt, for December 16, 2015 Winston Churchill famously observed that “Russia was a riddle wrapped in mystery inside an enigma.” Churchill’s language provides an …

Medical Student Loan Debt

Fujifilm’s “Moment”: Disruption, Adaptation and Health System Transformation


Almost every healthcare “transformation” discussion includes Kodak’s cautionary tale – how the once iconic company fails to embrace digital imaging, capsizes and drowns. The story’s moral is to embrace disruption, …

transformation

November Indigestion: The Idiocy and Promise of Benefit Selection


Market Corner Commentary for December 2, 2016- November Indigestion: The Idiocy and Promise of Benefit Selection David Johnson and Nathan Bays Dave’s wife Terri Brady is a Senior Leadership Coach at …

benefit

Righteous Analytics: Right Data. Right Time. Right Way


Market Corner Commentary for November 4, 2015- Righteous Analytics: Right Data. Right Time. Right Way Technology is on the cusp of channeling diagnosis and treatment toward best outcomes at lowest costs. …

data

“Amazoning” Healthcare’s High Prices


“Amazoning” Healthcare’s High Prices A recent Kaiser Health News article reports that prices for basic women’s health services vary dramatically within and across markets. The cost for mammograms in Dallas …

prices

Rebels with a Cause: Venture Companies Attack Healthcare


Market Corner Commentary for September 2, 2015-Rebels with a Cause: Venture Companies Attack Healthcare There is a meaningful shift occurring in healthcare private equity and venture investing.  The “smart money” …

King for a Day: Winning Strategies in Post-Reform Healthcare


Market Corner Commentary for August 12, 2015 -King for a Day: Winning Strategies in Post-Reform Healthcare-(#Quality Outcomes) Great leaders ask great questions. Banner Health’s CEO recently wrote and asked me, …

Medicare at Fifty: More Yesterdays than Tomorrows?


Market Corner Commentary: August 5, 2015-Medicare at Fifty: More Yesterdays than Tomorrows? A version of this commentary appeared in Huron Healthcare’s “Perspectives” on July 30th With Harry Truman watching, Lyndon …

Crossing the Technology Chasm: Tele-ICUs Save Lives and Money


Crossing the Technology Chasm: Tele-ICUs Save Lives and Money The Leapfrog Group’s[1] fact sheet on ICU Physician Staffing estimates that preventable ICU deaths exceed 54,000 each year. This figure excludes …

healthcare in usa 

Uber Up! Customer Interfacing Discovers Healthcare


Market Corner Commentary: July 15, 2015-Uber Up!  Customer Interfacing Discovers Healthcare A version of this commentary first appeared in “Academy 360” on July 9, 2015 More “suits” flock to downtown …

No One is an Island: Meaningful Second Opinions


Market Corner Commentary: July 1, 2015-No One is an Island: Meaningful Second Opinions A good friend (let’s call him John Donne) in his mid-fifties recently wrote describing his treatment for …

Welcome Back, Kotter! Leading Health System Change


#Leading Change-Market Corner Commentary: June 24, 2015-Welcome Back, Kotter!  Leading Health System Change A version of this commentary first appeared in “Academy 360” on June 11th In the popular 1970s …

Chasing Colonoscopies: It’s the Customer, Stupid!


Market Corner Commentary: June 17, 2015-Chasing Colonoscopies: It’s the Customer, Stupid! Who knew a routine colonoscopy could illuminate the wild world of healthcare consumerism? Before getting to my story, let’s …

Deep Web Rising: Healthcare’s Looming Cyber Threat


A version of this commentary first appeared April 30th in “Academy 360”-Deep Web Rising: Healthcare’s Looming Cyber Threat Healthcare is a “target-rich” environment for cyber criminals. Cyber attacks on health …

Exploiting Perverse Incentives: Kentucky Basketball and Prime Healthcare


  Hoping to become college basketball’s first undefeated champion in almost forty years, the Kentucky Wildcats captured the nation’s attention as they qualified for this year’s “Final Four” tournament in …

payer and regulatory policy 

When Healthcare is a “Lemon”: Asymmetric Information and Market Failure


When Healthcare is a “Lemon”: Asymmetric Information and Market Failure In 1970 George Akerlof published “The Market for “Lemons”: Quality Uncertainty and the Market Mechanism in The Quarterly Journal of …