North by Northeast
Health systems tend to fall into one of four organizational realities based on their relative strengths in strategy and execution.
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Best of kin: How we relate determines how well we can run
Most integrated health systems are still plagued by the reality of business lines working "alone, together" in one of two configurations.
Stacking aspirations or solving problems
Healthcare leaders rarely lack ambition. Strategic plans across the industry are filled with bold aspirations, frequently highlighting digital transformation, AI-enabled workflows, new care models, population health strategies, and consumer-focused access.
Where growth meets risk
Designing health system structures that align specialty growth with population health performance
Change of address
Shifting accountability for growth
outcomes, and where the total cost of care performance lives
It's time to blink slower
Design strategy has evolved from useful and usable to the maximization of time through the reduction of friction. As AI accelerates, we must rethink the design of our frictionless approach to organizational change. Leaders must design space for curiosity and acceptance as a prerequisite for change.
Designing problem-solving frameworks
Winning at the wrong game: a call to change for health system leaders
As an industry, hospitals and doctors are winning at the wrong game. The system largely performs as it is incentivized to perform. It pays far more reliably for downstream intervention than upstream prevention and produces world-class medical care after people are sick.
You can’t price a new network with an old operating model
Why aggressive premium reduction requires redesigning how care actually flows
Performance improvement plus portfolio repositioning
Primary care without permission
For decades, primary care has been the gatekeeper of American medicine. Now, it is at an inflection point.
When the market doesn’t reward health
Faster, smarter, simpler
Too often, we optimize what isn’t actually broken or spend years fixing symptoms instead of reframing the real problem. The hardest problems in healthcare often persist not because they’re unsolvable but because we’re looking at them the wrong way.
VBC capital efficiency
In an environment where financial margins are tight, labor is constrained, and value-based expectations are rising, capital efficiency defines an organization’s ability to stay competitive. It is about achieving the greatest measurable impact with the least investment, in the shortest time.