Steward Health Care System has pioneered the creation of accountable care networks nationwide through private funding sources. Steward was the first for-profit healthcare system to use private equity funding (Cerberus) to rescue, reimagine and reinvent a nonprofit health system (Caritas Christi). Steward subsequently became the first health system to use REIT financing (Medical Properties Trust) to fund aggressive expansion of their operating model to new markets.

Clay Christensen’s insights on disruption and innovation have shaped my perspective on health industry transformation and featured prominently in both of my books. In Part 1 of this series, I detailed his pathbreaking work on “Jobs to be Done (Jobs)” at Harvard Business School. By understanding what “jobs” customers “hire” products to do, innovative companies can design their products to get those jobs done.

I’ve been an admirer of Clay Christensen’s work since the late 1990s. Shortly after he published The Innovator’s Dilemma in 1997, Christensen headlined a Merrill Lynch global retreat for managing directors. During his keynote address, he presented and applied his theory of disruptive innovation. I was mesmerized.

Is Covid just a dress rehearsal? What have we learned about living with our biological and geopolitical adversaries?https://www.washingtonpost.com/health/2022/08/19/long-covid-brain-effects/

In Part 1 of “Separate and Unequal,” I took the Biden Administration to task for its proposed 2022 regulatory initiatives to advance health equity and improve maternal-health outcomes. These initiatives include five new reporting measures for hospitals and a new “birthing-friendly  hospital” designation. My complaint is that they add to hospitals’ regulatory burden without improving health access and service provision for people living in low-income communities.

As health systems report their earnings for the first quarter of 2022, the red ink is flowing in torrents. This is mostly due to financial losses on investment portfolios. More concerning, however, are hospitals’ substantial operating losses.

During a Fitch Ratings webinar on the mounting pressures confronting not-for-profit providers, Senior Director Kevin Halloran described health systems’ current financial performance as follows,

No matter how you look at it, the first quarter of 2022 will be one of the worst on record for most providers.

This is the third article in a four-part series on reimagining American medical education and ongoing clinician training. 

As part of its announcement of payment guidelines for FY 2023, the Centers for Medicare and Medicaid Services (CMS) launched six initiatives to advance health equity and improve maternal health outcomes within hospitals. These initiatives are central to the Biden Administration’s commitment to “improving care for people and communities who are disadvantaged and/or underserved by the healthcare system.”

My newest work on how the combination of Covid-19, Russia's invasion of the Ukraine, PRC engagement in the Caribbean, and transnational organized crime dynamics, are gravely stressing and transforming the Caribbean.

This piece is the third in a series of six columns in which David Johnson addresses five structural defects undermining nonprofit healthcare. He outlined all five defects in the first column of the series. Part two is here.