Thinking long in short-term America

Successful organizations think and work along their strategic vision. They set a future they’d like to see. Then they make and carry out plans to get there.

Part of the process is to act in light of the outside world. And in just the next three months, the world outside health care delivery and payment has these known tasks to do:

1. Fund Uncle Sam’s 2018 appropriations, as current money runs out Jan. 19.

2. Override or otherwise address a mandatory $25 billion Medicare cut and other reductions linked to the federal budget sequestration process.

3. Extend the Children’s Health Insurance Program beyond Jan. 19 and expired Medicare provisions like the therapy cap, and fund them.

4. Resolve the Affordable Care Act cost-sharing reduction (CSR) issue by either acting or deliberately not acting.  

5. Reauthorize expired Title 8 nurse workforce development programs needed to ensure safe and cost-effective care delivery tomorrow.

6. Explain that when the tax bill repealed the individual mandate, the repeal takes effect Jan. 1, 2019. That’s a year from now. Not right now.

7. Conduct primary elections in Texas and Illinois in March and in 11 more states by Memorial Day.

8. Move legislation stabilizing health coverage marketplaces unpinned by the individual mandate repeal.

9. Initiate Medicare hospital, ambulatory surgery, and physician and other health care professional payment rules through a regulatory process yielding published proposals in the Federal Register for comment in the spring and summer.

10. Issue Uncle Sam’s 2019 budget proposal.

This is just by April 1.

How can a long-facing organization function and lead effectively in such a short timeline driven environment?

First, stick to your chief mission. If you are on the right mission, no one can or will do that mission better than you. (Whether it’s the right mission is a topic for another day.)

Second, develop and revise your plans mindful of high rates of environmental change. Update your data-driven case. Frame your objectives in ways that appeal to both parties and to the variety of stakeholders necessary to push your issue over the line. Make and evaluate your plans with measurable waypoints you and your team can use for course evaluations and course corrections. In your enviroscanning, diligently separate the signal from the noise. Nurture your critical relationships.

Third, educate educate and educate some more. Educate your own constituencies using all of the platforms they use and demand. Educate policymakers using multiple points of contact in Washington and at home. Your value to them is how they count on you for curating wisdom, skills and insights they find important in light of the nature of temporary-extension America.

Rapid external change leads to two equally harmful temptations. One is to withdraw and hope things will slow down and favorably resolve. This is magical thinking. Second is to whipsaw the whole organization on the next headline. This is tail-chasing, no more productive for you than for a golden retriever.

To thrive in temporary-extension America, neither withdraw nor whipsaw. Stick to your mission.

Contact me here.