Accelerated and Deferred Strategic Maintenance

By Clive Riddle, October 22, 2009

As the Great Recession kicked in, two phenomena were documented in a number of studies: 1) accelerated utilization of services from employees and dependents with their existing health plan coverage, due to impending loss of coverage from layoffs or fear of potential loss; and 2) deferred maintenance with health care services by the uninsured, underinsured and those with broader coverage that sill involved material cost sharing.

Now impending national health care reform may be bringing about similar polar trends regarding strategic actions and resources deployed by all types of health care organizations: A) Accelerated steps taken by those organizations concerned that their applicable activities might be curtailed or inhibited post-reform; and B) Deferred activity by health care organizations that have adopted a “wait and see” philosophy until specifics of reform become tangible and apparent.

As opposed to consumer health care behavior derived from the Great Recession, which can by more readily quantified through survey and other research findings, such organizational behavior is evidenced only anecdotally.

But start networking with those involved in the business of health care, and it is difficult to escape a mounting sense of such anecdotes, particularly regarding deferred strategic maintenance. Now everyone loves a good reason to procrastinate, and “waiting until we see the specifics of what reform shakes out” has become a great reason de jour for executives to say no to requests for everything from planning meetings, conference attendance, capital purchases, programming changes, product development, and promotional campaigns.

Of course there are those who aren’t afraid of possibly spinning some wheels and take some risks in order to “hit the ground running.” But a combination of recession driven economic pressures that inhibit strategic initiatives, combined with the temptation to avoid the risks and unrewarded costs of spinning wheels, seem to motivate a growing number of health care organizations to defer their Strategic Maintenance for another day. So the question is, how soon is that Day going to be?